[Lydia Westle]

5 Words: Gentle, Cuddling, Joyful, Bonding, Swaying (Not using words from the slide, the words “tender,” “snuggly”, “special”, “connection” “fun” came to mind as well.

5 Sentences: In sprouting melodies 1, a Board Certified Music Therapist will demonstrate ways that you can use music to help support your child’s development, as well as to bond and connect with your child in a meaningful way. At this young age, your child is just starting to take in the world around them. You may notice the ways in which your child might turn their head as they hear your voice singing to them, as your voice is a safe and familiar voice, even if you not consider yourself to be a singer. You may also notice how they look attentively as they hear the gentle sound of a maraca or the swooshing of a baby ocean drum. While very young infants will initially participate receptively through listening as they adjust to stimuli, gradually, children will begin to explore playing instruments and engage in more interactive movement experiences as time progresses.

Session Plan:

Gathering / Hello Song – Good Morning Song, Followed by Hello Song

Bonding / Lapride Songs – Tickle Song, Row Row Row Your Boat / Wiggly Jiggly Car

Instrument Play – In My Little Hand

Movement Song – Adapted lyrics to “Wheels On The Bus” Tune (We are swaying in music today, music today, music today, we are swaying in music today, swaying in music today) – then would shift lyrics to “we are dancing music today” ; would encourage caregivers to rock their babies from side to side, and gradually shift to standing up to holding babies / “dancing” with them gently, if appropriate

Cool Down Song – Would improvise a snuggle song for a tender moment to end (Ex: “We are snuggling in music today, snuggling in music in such a special way) – tune of initial part of initial ABCS, then repeat it

Transition Song – Goodbye song

[Lydia Westle]

In my experience facilitating music therapy groups with this age level, I have found that children tend to be very curious and attentive (and sensitive) to the world / stimuli around them. Oftentimes, as soon as I start to sing, babies are gazing towards my guitar and / or the sound of their caregiver’s voice singing to them. In the medical setting, as I’ve mentioned a bit in some of my other posts, I find that caregivers often feel very overwhelmed with the many barriers they face in regards to bonding – whether it be not being able to hold their baby, extensive medical equipment and / or the many factors out of their control. For this reason, I’ve found that meaningful moments of connection during music therapy can feel particularly special, as it may be one of the only moments or experiences within the hospital that has allowed for these intimate moments, as well as moments of joy, in a way that hasn’t felt medical. Even in situations where a caregiver hasn’t been able to hold their baby, I’ve found that intentionally striving to give caregivers a role to have with their child in the music experience can help support those normalized moments for connectedness, as well as opportunities for empowerment with how caregivers can help their child to feel loved. For example, inviting a caregiver to stand at cribside and hold their baby’s hand may feel very intimidating in a setting such as a Pediatric Intensive Care Unit. However, I’ve found that music therapy can really help invite caregivers into a space in a non-threatening way that feels tender and humanizing, such as swaying hands in a rocking fashion in the rhythm to the music or helping a child to explore a shaker for the first time. Caregivers have shared with me the ways in which having these meaningful moments to bond with their child has not only helped support their child’s development, but have also really helped an experience to feel less traumatic.

[Lydia Westle]

I think the role of music therapy in community-based settings has great potential to support opportunities for connectedness and to foster an environment where caregivers feel supported with resources. While I do not have children myself yet, I think caregivers, especially new parents, can often feel very isolated and overwhelmed with how to best support their child. I think that music therapy can foster these bonding opportunities organically and serve as a resource to help caregivers feel empowered with how they can best support their child’s development at home. As emphasized in the videos, I think that music therapy also supports opportunities for caregivers to socialize with other caregivers, just as much as it provide meaningful moments for children to connect with other children. In a world where there is often a lot of societal pressure / comparison to “be the best parent,” I think music therapy can minimize some of these dynamics by providing a humanizing experience that allows opportunities for meaningful connection naturally.

[Lydia Westle]

Yes, I very much agree! It’s always really special to witness and experience!

[Lydia Westle]

Thanks so much! It really is quite special and I still am kind of “in aw” of the strength and resilience we get to see daily! Prior to working in peds, I had worked in adult inpatient psych for 6 years, so it was definitely an adjustment of feeling confident / comfortable with how I could support during those moments. However, I continue to learn every day!

[Lydia Westle]

It sounds like you have so many valuable things to offer your community and the new moms / caregivers in it! They are so lucky to have you! I really agree with what you wrote regarding Meredith’s sentiments about believing in the value of what we do. It can be so hard to put ourselves out there, but so worth it! You got this! 🙂

[Lydia Westle]

Agreeing with all of the sentiments above, music therapy can provide opportunities for bonding, connection and developmentally appropriate stimulation, especially for young families. In a time of so many transitions and adjustments that can often times feel overwhelming, music therapists can help provide opportunities for empowerment, structure and routine, while also helping families to experience meaningful moments together.

[Lydia Westle]

Elmira,

Thank you so much for sharing! Many of the concepts you shared are also applicable to my work setting of a pediatric medical hospital and I appreciate how you broke then down in such a detailed way!

When I think about the families I work with at CHOP (Children’s Hospital of Philadelphia) especially on my primary units of Pediatric Intensive Care Unit, Cardiac Unit and Surgery / Trauma Unit, many of them are facing some of the most difficult moments of their lives and experiencing significant psychosocial trauma. My caregivers are often making so many sacrifices with the hopes of finding their child treatment – whether that’s being far away from their homes, putting jobs on hold, being away from other family members / other children to stay with their hospitalized (if possible, though not always the case), or navigating “caregiver guilt” in NOT being able to remain at the hospital due to many other responsibilities at home. Many caregivers feel very overwhelmed with the amount of medical equipment on their child, overwhelmed with not having answers and overwhelmed with the many unknowns, overwhelmed with a new diagnosis / injury OR a chronic illness and understandably worried as they navigate potentially life-limiting or terminal illnesses. Oftentimes these moments can feel incredibly isolating for families, although I tend to think of CHOP as a community and often find that these similar feelings and experiences are shared amongst almost of the families I work with, even if the exact specifics of the medical circumstance varies. In this way, I find that the needs of families and the needs of my community are intertwined – as I see them both connected, with a lot of overlap.

Similar to the sentiments that Elmira shared, music can help families experience beauty and meaningful moments, even simultaneously, as they navigate some of the most challenging, and sometimes devastating, experiences of their lives. To this day, I still find it incredibly humbling, as well as an honor, to be able to witness families connecting with their child through music, especially in times when they felt so disconnected in some many ways – whether it’s creating a personalized lullaby for their child, helping their child to explore an instrument or even holding their child’s hand while listening receptively to a meaningful song. Especially in circumstances where families are living in the hospital for extended stays (even over a year), music can help to humanize the experience, help caregivers feel empowered with what they can do for their child and help patients / families to create special memories. Additionally, many of the patients I work with are experiencing all of their milestones within the hospital (birthdays, holidays, etc) – and music can help add moments of normalcy, as well as support opportunities for legacy building, throughout a family’s journey. My hope is always that music can help provide moments of comfort and foster opportunities for inner- resilience, even in some of the most trying moments.

[Lydia Westle]

Singing:

Awareness – coos on a pitch
Trust – Typically vocalizes in a descending melodic contour
Independence – Uses varied vowels and consonants when vocalizing
Control – Sings intervals of 2nd, minor and major 3rd, 4ths, and 5ths
Responsibility – Uses dynamics in singing (Ex: Shout vs. whisper)

Playing Instruments:
Awareness – N/A
Trust – Brings shaker to mouth
Independence – Grasps or shakes maraca
Control – Bangs on instruments
Responsibility – Is able to maintain playing in a steady beat

Move:
Awareness – moves head towards source of sound & reaches towards music source
Trust – Movements are rhythmic, but not synchronized
Independence – Starts to match intensity in movements to intensity of the music
Control – Dances spontaneously to music
Responsibility – Uses musical movements in sequence

Listen
Awareness – Prefers higher pitches & familiar vocal timbre
Trust – Focuses inwardly in response to sedative / lullaby style singing ; outwardly to play-songs
Independence – Enjoys crescendo & musical surprises of glissando, silence
Control – Recognizes & associates favorite songs
Responsibility – Listens to others play

[Lydia Westle]

I found this week’s information about singing, playing instruments, moving and listening to be very helpful. Currently, in the infant/ caregiver & infant/toddler/caregiver groups that I facilitate at my hospital, I often incorporate many of the 4 different categories – although not necessarily all within the same group, depending on how patients are responding or depending on the nature of the unit. I often times rely on a lot on my voice, frequently accompanied on guitar and while I often have groups with instrument exploration opportunities, it is not uncommon for me to have groups that tend to be more receptive / listening based, especially for patients who have had chronic illness / long hospitalizations and easily over-stimulated. For a while, I was doing a group for babies with trach’s / vents who had never left their rooms and I found that for the first time or two attending it, I often times did not incorporate instruments until they were a bit more comfortable / demonstrating they could tolerate the level of stimulation in being a new environment, with other people. In these types of circumstances, I might just gently sing with guitar, will invite caregivers to join me in singing if they’re comfortable and encourage movement in ways that might be very subtle – such as rocking their baby gently to the rhythm of the music. As I watched the videos this week / reviewed the materials, I felt empowered to be a bit more intentional with considering using JUST voice, not necessarily with guitar, as I tend to sing acapella more in individual sessions than I do in groups.

In times when I’m working with babies who are more interactive / a bit less medically fragile (perhaps circumstances with less medical equipment / less levels o sedation) or toddlers, I’ve found movement and instrument exploration to be a really beautiful way to foster bonding opportunities; whether it’s bouncing on a caregiver’s lap, rowing to “row row row your boat” or exploring a baby rain stick for the first time with a caregiver.

Since starting this course and after reviewing this week’s materials, I’m finding myself to be more cognizant of noticing very subtle differences. I have also found myself to be more intentional to make sure I’m aligning with reccommendations for the different developmental phases. I also felt validated to be reminded that it is okay for children just to listen and to remind caregivers of that, as sometimes I’ve noticed that they come to a music group anticipating their child will play an instrument and seem a bit disappointed if their child isn’t engaging in an interactive way just yet. I think I could be more intentional in setting up that standard ahead of time / reminding caregivers of this.

[Lydia Westle]

You are very kind! It’s definitely a challenge at times, but I love the opportunity to constantly learn and grow. 🙂

[Lydia Westle]

Hi Camryn,

I really relate with what you shared, as I’m also definitely very challenged with adapting many songs that typically are not considered “children’s songs.” More often than not, the songs I’m incorporating, especially in 1:1 sessions, are caregiver preferences or songs that were sung to them as a child. Although, I very much echo you that the challenge has been an enjoyable one!

[Lydia Westle]

Update: I was actually able to use the Tickle song today with an infant awaiting a heart transplant and her grandmother. It worked really well, was easy for grandmom to replicate and patient smiled / laughed in response.

[Lydia Westle]

I had also meant to include that another behavior I’ve noticed that seems to fall under “independence” is that she recently just started clapping – not totally spontaneously, more in response to having it modeled to her. However, her parents were both really excited to see this new milestone, as it was a big one! We’ve now been incorporating clapping into songs, and at the end some songs as well.

[Lydia Westle]

I facilitate a bi-weekly group for infants with Ventricular Assist Devices (VADs) awaiting heart transplants / their caregivers and I was excited to try some of these songs in group last week! Unfortunately, the group needed to be cancelled due to patients needing to be on isolation precautions as an infection prevention. While I sadly haven’t had an appropriate patient on my caseload to individually try these songs yet, I practiced them at home and could easily envision being able to incorporate these into my work soon. In particular, I think that many of the caregivers I work with would feel very empowered in learning “The Tickle Song’, as it is repetitive, easy to sing, and builds upon natural interactions that happen in play. As I was watching all of the videos, I was thinking about many of my patients who are not necessarily as “active” or able to be mobile / exploratory due to amount of medical equipment / level of sedation. However, I do think this one in particular would help caregivers in having special, “normal” moments of bonding with their child and I look forward to utilizing it soon! I also feel that the song about the car would be quite well-received by many of my patients (as well as easily adaptable), for very similar situations to the case example described in regards to concerns with bonding.

[Author]

Posts