[Megan Calabro]

Hi, everyone

Five words/terms that I feel describe SM2 – playful, joyous, exploration, “quiet energy”, and welcoming. Five sentences that I may share with a parent are: “It’s totally fine for baby to explore the instruments/guitar/etc! No worries!” “Feel free to sit with your baby in your lap so that he/she can check out what’s happening!” “I invite you to help model clapping for your baby – here’s a great way to do that.” “It’s ok for him/her to be watching the other people in the group, and check out what’s going on. Look at how much he/she is taking in!” “At this stage of development, it’s wonderful to help your baby to organize him or herself. One great way to do that is to help make sure that your baby is able to feel his/her feet firmly on the ground when we’re standing, jumping, etc, in the music. Here’s s great way that you can help!”

Session format: I would start with some quieter, yet playful music as people are coming in. Gathering song – Good Morning To You into Hello, Hello! Bonding song – Come Sit With Me. Song About Me – All Of This Is Me. Instrument Song – In My Little Hand. Movement Song – Marching With My Baby. Transition/Bonding Song – perhaps something familiar to parents such as Twinkle Twinkle, or Hush Little Baby. Goodbye – It’s Time To Go into Thank You for Singing Today.

[Megan Calabro]

Erika – I’m glad to hear that there is potential!! I’m still hoping that MT someday will magically be recognized as part of EI. I’m hoping to connect with the NJ chapter of the infant mental health association, so there may be some opportunities to educate. Who knows?!

Beth – I’m unable to get to nationals as it falls around my son’s birthday, so thank you for offering to share some of what you’re putting together! I’d love to hear more about it after conference. Cheers!

[Megan Calabro]

Thank you, everyone, for your positive feedback! This is definitely an interesting topic to discuss simply because of where MT is currently at, and the various directions it can go in. It’s been wonderful to read everyone’s comments, and to hear about your thoughts about MT from a wellness perspective. I really liked a lot of the ideas that were shared for wellness/community groups! I’m still waiting to hear if the grant funding for my position was renewed (oddly enough, I was supposed to find out a couple of months ago), but my battle plan, if the funding does not go through, is to start a private practice focusing on both wellness and early childhood. Have a good week, all!

[Megan Calabro]

Please forgive any typos on my part!! (Just noticed one). My 7 year old is not a good sleeper, and here past few days have been pretty rough. But, hey… Sleeps pretty overrated, right?!

[Megan Calabro]

I think the five words I would use to describe SM 1 would be: calm, inviting, gentle, joyful, and welcoming.

The five sentences I might put out for parents may include: “Welcome! It’s wonderful that you’re here today.” “I invite you to really take this time to simply be, and enjoy being with your baby.” “I invite and encourage you to sing with and to your baby – yours is the voice they love more than anything.” “It’s completely fine if your baby is quiet – they’re taking it all in.” “Your baby is loving this time with you – notice how he/she is watching you, listening to you, (etc).”

I might try the following format for a group: Embedded music for exploration and setting the space; Gathering/Hello song; Holding/Bonding song (possibly an All About Me); small movement or play song; simple instrument or body percussion song; “winding down” song – possibly using a story book; Transition/Goodbye song.

[Megan Calabro]

Love, love, love this age group!! In my personal life, I had so much enjoyment with my two kiddos when they were this age. It was wonderful to sit and sing, cuddle, and play with them, and just see the glow that would come across their faces. It’s just beautiful to behold. =)

In my clinical work, I spend quite a significant amount of time with babies in this age group. I will admit that a lot of my time is spent doing one of two things – either trying to promote rest, or providing procedural support during blood work, IV starts, Lp’s, etc… I do have one story from earlier today, when I was able to spend some time with a little one who is requiring a decent amount of respiratory support. One challenge that many of the kiddos experience, who are in similar situations, is withdrawal from the various mess they’re being given during their admission. And it all throws their sleep/wake cycles off pretty nicely. Well, I was called to come see this one particular little one because, “they’re awake and pretty feisty.” In other words, the baby was agitated, possibly overwhelmed by life in general, and really struggling to regulate. I love taking that quiet, gentle, rocking approach, which was exactly what we started with. I usually use guitar and voice, and spend a depending on the situation, will also incorporate a lot of breaths and/or gentle sighs. This little one responded so positively to that, and their posture really began to relax. The tension around the baby’s mouth lessened, and the baby stopped furrowing. When I was speaking with the nurse afterwards, I did find out that the baby is having many more “awake” times, which is great, but it also means really keying into what the baby is sharing with me with regards to what their overall tolerance level is, and teasing out what is what. Good stuff!

[Megan Calabro]

Erika – thank you for your response! I’m glad that you’ve had positive responses with your SM families. (Btw – one family that I referred to you has told me how much they LOVE what they are doing with you) I think my one fear, which is probably somewhat irrational, is that I’m going to start doing some demo groups at our child development center as part of the NICU follow up clinic, and then hopefully get some good solid groups going. And I’m somewhat nervous that it’s not necessarily going to be supported because it’s (a) something completely different from anything that has been offered thus far, and (b) something that’s totally not ABA. Hopefully, the value will prove itself.

Beth – thank you! I actually had printed out a copy of the AMTA document earlier this year. It’s a helpful resource for sure.

=)

[Megan Calabro]

Erika – no problem, and be my guest! =)

[Megan Calabro]

Just in case I didn’t fully answer the question.., I think MT can function naturally within a wellness model. There are a good number of people who are looking at preventative care, which is something that MT can support. One clear example of that is stress management. MT is unique in the fact that it’s not one specific thing for stress management. This can be achieved in so many ways from actively creating music, to creating art in response to music, to engaging in guided imagery. One particular intervention I did with our eating disorders population was to critically evaluate how we each use music within our lives on a daily basis. I then challenged them to create four different playlists based on the following themes: (1) a chill-out playlist that may include songs/selections specifically geared for relaxation; (2) a “feel good” playlist that may include songs/selections that promoted a “happy go lucky” feel; (3) a “pump up” playlist, which is pretty self explanatory; and (4) an “emotional release” playlist that may include songs that allow us to cry or be angry, but then intentionally shift towards acceptance. Exercises such as these, or as another example, those that support mindfulness, can be extremely beneficial and effective as part of a wellness model. And again, MT’s have a unique advantage in that they can be more clinical when needed, and more loose when needed as well. Happy day, all!

[Megan Calabro]

Hi, all. I found this to be a pretty thought provoking discussion and question. One of the things I’ve personally always struggled with is the question, “well, is it, or is it not music therapy?” Perhaps it’s because of my experiences of being within a medical facility, but I feel like I have a tendency to get caught up in the “clinical” mindset, which I think comes from a need to “justify” the why of MT. But, that’s also an understandable mindset when there is a drive to essentially prove the efficacy of what we’re doing (ie all of those observable and measurable outcomes). So, thinking about MT from a community standpoint is almost (but not quite) foreign to me. That all being said, though, there is also a push in the medical world to look at things from a wellness perspective, which I think MT can fit into pretty naturally.

With regards specifically to early childhood development and this particular model, I think it makes a good deal of sense to look at it from a community and wellness perspective. When you consider the rising instances of things such as prematurity or low birth weight that can negatively impact development, and when you consider how parenting styles are changing due to societal and economic challenges, it goes without saying that we’re going to meet more and more families who are struggling in one way or another. So, why not have programs available that can help foster and support healthy development both for the child and for the family regardless of where the family is coming from? Yes, there are several other early childhood music programs out there, but I think MT has a unique advantage with regards to the fact that it can be clinical, within a community/wellness model, when need be. MT’s can appropriately identify red flags, provide support and direction, and can also really support what is happening between the parent and child. MT’s can also recognize and appreciate that it may not be developmentally appropriate for a child to sit still or do A, B, and C, the way it may be expected in another early childhood music program. And while other programs may have an end goal of having children/families actively making music, two other primary goals of MT are to ultimately strengthen the relationships that exist within the family, and then to use those relationships to support a child’s ability to develop to his/her fullest potential. Just food for thought on this one… As I’ve shared, I also went through the training for DIRFloortime, and I think this quote from Stanley Greenspan nicely sums up my thoughts: “All children have within them the potential to be great kids. It’s our job to create a great world where this potential can flourish.”

[Megan Calabro]

Beth, Meredith, and Erika – weird, random question for you all… I happen to live in a smaller town, that happens to have Music Together centers in I think every neighboring town (so about 4, and all literally within a 15 minute radius). I also have another MT with a booming private practice (one who strongly promotes ABA informed MT) who’s located 15 minutes away as well… Have any of you ever had challenges with really advocating for SM in similar set ups? I’m mainly asking because music together had actually developed a clinical license (music together within therapy), and there’s just a lot of marketing that’s going around there. The other MT also has a very strong presence in the ASD world, and really advocates for ABA/MT. Just curious more than anything…

[Megan Calabro]

Hi, all. Here in NJ, we also have a higher number of families with children on the autism spectrum. However, from my experience in and around my own area, there is such a heavy emphasis placed on “only ABA”, which is a huge struggle for me. (Erika – I know you’re relatively close in proximity, and would love to hear your input!!). There is another MT who lives nearby, and has a booming private practice, but she also heavily emphasisizes her incorporation of ABA into her MT sessions, which again is a struggle. While I can understand the need for a behavioral approach at times, I also firmly believe that it needs to be within the context of a developmental approach. Personally, I see such a need for a developmental approach, and I also see a need for parents to have opportunities to engage with their child differently. Actually, all things considered, I see a need for parents to engage with their child period! There are so many families who don’t engage during therapy sessions, because it’s discouraged in the ABA world, and it makes such a tremendous difference when parents engage. Additionally, I’ve also had several parents at work ask me about how to include MT on their child’s IEP, or somehow incorporate it into EI. But, like Gina, the schools won’t hire MTs to provide MT, or really acknowledge MT as something that can be included as part of EI. While much of that is strictly red tape, it’s pretty frustrating. It’s also frustrating to hear how so many parents are paying enormous out of pocket fees for additional services for their child. Finally, I see a need for parent education. Parents need to know that it’s ok to be playful, and have opportunities where they can explore that with their child. And thinking about my own experiences as a parent of a child with ADHD, sensory needs, and an auditory processing disorder, I can appreciate the need to provide educational opportunities where parents can learn how to creatively support their child as they grow and develop.

[Megan Calabro]

Kristina – best wishes!!

I was really inspired by this weeks training and the questions that were posed. I had the opportunity to run into a parent today at work that I had first met several years ago, and this parents shared with me why they felt MT was so beneficial. In their words, “you have such a unique skill set, and such unique experience.” I had to pause when they said that, because I know that I for one do not necessarily acknowledge that in myself. I one that I have unique training in comparison to many of my colleagues, but by being in a medical setting, I’m so used to seeing a child “only while in the music” (usually as procedural support), and I don’t necessarily have an opportunity to see them “outside of the music” (for example, when they are just with the child life specialist or another individual) and therefore truly see the difference that MT can make.

Bearing all of this in mind, I think it’s important to acknowledge what this parent said to me. MT’s have a very unique vantage point, and can truly provide opportunities for children and parents to intentionally be together in a creative, playful atmosphere that truly supports the overall development of the child and family. When I’m introducing MT to the families I work with at the hospital, I almost always say, “it’s so easy to get caught up in who you have to talk to, what you have to do, and families so often just need an opportunity to simply be family.” MT allows this to happen naturally, and supports that in very unique ways. I feel like this is particularly true when I meet first-time parents, adolescent parents, or single parents. But, I also can see where parents may feel threatened or anxious when the word “therapy” is used. Definitely something to continue to bear in mind when considering how MT can work within the community.

[Megan Calabro]

Hi, everyone. I have noticed that I tend to stick more towards singing/listening/playing, and not as much towards movement, unless I’m working with a child where there is a concern about motor delays. Then again, I’m working in an inpatient pediatric setting, and incorporating opportunities for movement can be challenging just from a logistics stand point. I also tend to work with a lot of kiddos who are in the awareness and trust stages of development, so a lot of what I do musically is geared towards self-regulation. I was able to work with a little one over the course of the past few weeks who was definitely growing into the independence stage, and it was really cool to see where they were at, and just have fun doing musical play together. I can’t say that I have made changes per say, but I have been able to more clearly identify (at least to me, if no one else) where the child wa at developmentally, and how to better tweak the little things (such as timbre or pitch) to elicit a positive response.

[Megan Calabro]

Ok! Giving this a good try… I’ve been under a decent amount of stress this week, so I apologize if I sound a little flustered with everything. Hope this all makes sense!!

Singing:
Awareness – child first becomes aware of their auditory world. The child will localize to the sound source, and may vocalize in response to sound/singing.
Trust – the child may purposefully make pitched vocalizations, or may change their own pitch, in response to what is happening in their world.
Independence – the child engages in tonal babbling, and may use word approximations when singing.
Control – the child may begin to sing tonal phrases approximating the melodic contour of a song.
Responsibility – the child may begin to sing songs with more tonal and rhythmic accuracy, following the contour and structure of the song.

Playing Instruments:
Awareness – the child will localize to the sound source, and may begin to alter movements in response to what is happening within their musical world.
Trust – the child may purposefully explore instruments, to figure out “what is this thing”, and begin to play based upon their own internal rhythm.
Independence – the child may purposefully explore instruments to figure out “what can I do with this thing?”. The child may also begin to transfer from one hand to another.
Control – the child may begin to use the instruments functionally, and utilize a pincher grasp.
Responsibility – the child may purposefully utilize both hands to play a particular instrument, and alternate hands. The child may also demonstrate and ability to organize their musical responses when playing.

Listening:
Awareness – the child will localize to sound, and demonstrate the ability to differentiate sounds / pitches / timbres. The child may also demonstrate a preference for a particular vocal timbre.
Trust – the child may vocalize in response to a trusted and familiar voice, and may indicate awareness of changes in response to changes within the music (and emotional content of the music).
Independence – the child may begin to seek out the source of sound, and attend to preferred sounds / voices.
Control – the child may take an active interest in the music / sounds of others, and signal this by stopping what they are doing.
Responsibility – the child may begin to take an active interest in how they are able to make music with others, and how those pieces fit together.

Moving:
Awareness – the child will demonstrate rhythmic sucking responses, and will demonstrate reflexive movement patterns.
Trust – the child may move their body parts with their own internal rhythm. From what I understand, the movements are primarily bilateral, as opposed to single sided.
Independence – the child may demonstrate rhythmic movements, particularly to the macro-best. The child may also after their rhythmic patterns in response to the music.
Control – the child may begin to alternate their feet while stamping (when seated!), and may begin to combine two movements into a pattern.
Responsibility – the child may begin to sequence movement patterns, and imitate the movement patterns of others.

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