[Lydia Westle]

In my work at Children’s Hospital of Philadelphia, I work with an incredibly diverse group of patients / families – ranging from people who are local to the hospital, as well as families who come from all over the world to get treatment. Therefore, I always ask patients and families about music that is most meaningful to them and follow their lead with learning/ incorporating into sessions in a way that feels authentic / respectful – whether it is a song of kin / song in another language. In particular, many of my families, especially on the PICU / Cardiac ICU, often gain comfort from their faith. It is not uncommon for me to be asked to incorporate spiritual / religious requests in 1:1 sessions, such as lullabies in Hebrew or Christian workshop songs / hymns, especially “Jesus Love Me,” as well as songs that might typically be thought of as an adult song, such as “Oceans” by Hillsong. Whether it is a religious / spiritual adult song, or just a non-children’s songs that helps a caregiver to feel connected to their child that might have been played in utero, I will often adapt the meter / repeat the chorus in a way that helps the song to be developmentally appropriate, while often still aiming to foster opportunities for bonding and intimacy.

[Lydia Westle]

I have been working with an infant awaiting a heart transplant who has had an extended hospital stay. It’s interesting to think about how she initially appeared to be functioning at the level of “awareness” when I first met her in a group several months ago, during which she participated receptively through listening, gazed at me when I sang / played guitar and focused her attention towards the music experience. In recent months in both group and 1:1 sessions, she has become much more interactive / playful and currently seems to be functioning primarily in the developmental stage of “trust”, with elements that seem to be progressing towards fitting in “independence”, though not all of them. In our work together, she reaches to strike the guitar with her hand, brings a shaker towards her mouth to explore orally (rather than shaking) and is incredibly vocal, – primarily through high-pitched “squealing” vocalizations that have a descending melodic contour. I’ve recently started vocally improvising in a call-and-response manner / mirroring her vocalizations, during which she smiles, laughs and continues to present as incredibly animated.

[Lydia Westle]

Awareness
1. To look or not look (looks towards source of sound)
2. To reach towards the music (reaches, turns body towards it, etc)
3. To turn attention towards music or turn away

Trust
1. To turn attention towards music or turn away
2. To chose how to explore instruments: hands (tactile) or mouth (orally)
3. The duration of instrument play

Independence
1. Babbles with melodic inflection & uses varied vowels and consonants when vocalizing
2. Uses hands to strike drumhead or tambourine
3. Transfers instrument from one hand to another

Control
1. Dance spontaneously to the music
2. Pounds and bangs instrument (ex: drum) loudly, often rapidly with fast internal rhythm / tempo
3. Imitates learned movement

Responsibility
1. Maintains a steady beat & can imitate simple rhythmic patterns
2. Recognizes and reproduces “loud” and “soft”
3. Can listen to play of others

[Lydia Westle]

Hi Amy! It’s so nice to meet you! That’s awesome! I had initially started as a voice performance major for one semester (at Towson), then switched over to music therapy at Temple for the remaining of my undergrad / grad, but have many MT friends who did their initial degree in voice performance too! That’s so great that you are back where you interned! I was just reading over your post and we cover many of the same units. It’s always so wonderful to meet people who do such similar work! 🙂

[Lydia Westle]

I apologize that I wrote a really long post on the other comment / didn’t realize the questions were in two separate posts. While I elaborated upon some of this in my other post, i think the most valuable take-a-way was the ways in which these concrete developmental milestones of different age groupings can serve as a base to inform the music experience. In particular, I found it helpful to see the ages / milestones so separate, as it is not uncommon in my work environment to facilitate groups with children of very varied age ranges. While I have always found this to be a challenge, I felt validated when I reviewed just how different and specific, as well as special, the different age groupings are. I think I can use this as evidence / as a basic foundational knowledge when advocating for how to enhance groups / the ages invited to them.

[Lydia Westle]

Hello,

I’ve enjoyed reading all of the above reflections so far and very much agree with the sentiments shared. Courtney, I particularly agreed with what you shared regarding the importance of balancing working on skills within one’s developmental level with music that is appropriate for one’s chronological age. In my work in a children’s hospital, I come across this situation often and aim to help educate other staff (and caregivers) regarding these considerations.

Similar to what others shared, I found the review of the checklists / developmental milestones helpful as a foundational knowledge. In my current work, I have strived and will continue to strive to incorporate these considerations as I help young children and caregivers experience greater meaning with each other, and with the world, through music. In my work primarily on a Pediatric Intensive Care Unit and Cardiac Unit, I work with many infants and toddlers who are hospitalized for extensive periods of time – sometimes over a year or two, depending on the situation – and often times can not leave their room or can only leave for very minimal periods of time, if at all. Due to the nature of long-term hospitalizations and the fact that often times patients are understandably not always able to have a consistent caregiver presence at bedside, my patients are typically significantly behind in meeting their developmental milestones. Therefore, is not uncommon for me to co-treat with Physical Therapy / Occupational Therapy to help support these goals further. In particular, I found the review of these checklists very helpful, as sometimes it’s easy for me to forget exactly what is “typical,” as what I am seeing at work is so far from that.

Daniel, I really appreciate what you shared regarding the ways in which you strive to help the people you work with experience joy and meaning. I think about this often and especially when working with children facing potentially life-limiting illnesses, I think about ways in which I can help my patients / families experience moments of beauty together as often as possible. In the setting in which I work, there are often many barriers to bonding (extensive medical equipment, levels of sedation, lack of “normal” environment, caregivers navigating trauma / anxiety) and so much of my work often centers around quality of life and helping caregivers to feel empowered with what they CAN do for their baby – especially with music. When I was reading over the developmental considerations and thinking about my work with a diverse group of patients / families, I thought about the ways in which I often aim to help caregivers modify songs of personal significance or create an original song for their child – whether it’s a song listened to while baby was in utero, cultural/ religious/ spiritual song, song of kin, or an original lullaby that reflects a caregiver’s love and hopes for their child. The information from this week was so helpful, as it can continue to help inform my thought process with repertoire choices, as well as the ways in which I use music / design music experiences to not only foster connection, but also help with a child’s psychosocial development.

[Lydia Westle]

Hi Olivia! That’s so exciting! Where will you be working? It’s always great to meet other MTs who work in this setting!

[Lydia Westle]

Hi everyone! My name is Lydia and I live in Philadelphia, PA. I went to Temple University for both my undergrad and graduate degrees in music therapy (voice concentration) and have been practicing as a MT-BC for just about 13 years. For the initial 6 years of my career, I worked with adults in an inpatient psychiatric setting and have been working at a pediatric children’s hospital for just about 7 years, which I absolutely love. Although I work on many different units of the hospital, I primarily work on a Cardiac Unit / Cardiac ICU, a Pediatric Intensive Care Unit and a Surgery Trauma unit, with a focus and passion for pediatric palliative care / end-of-life work. In addition to working with patients / families individually in their rooms, I also facilitate several infant-caregiver (and sometimes infant / toddler/caregiver) music therapy groups throughout the hospital.</p>
<p>I am always looking to grow / enhance my skillset and was so excited when I learned about this course, as one of my friends had taken it and loved it! In particular, I am hoping to gain new ideas and repertoire to support bonding, work towards development milestones and to enhance quality of life through meaningful music interactions between patients / caregivers, especially during my groups. I feel very grateful to have this opportunity and am looking forward to this course! I am also excited to meet and network with other music therapists! :)</p>
<p>Looking forwards towards the next ten weeks!<br />
Lydia

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