[Samantha M Lawrence]

My caseload for children is fully virtual. Some of my families are those who are isolated due to their children being medically fragile. These families are often looking for any therapeutic service they can to help their kiddos from regressing during this time. I agree with Celia, as a whole there is a lot of adjusting for the kiddos who are re-emerging after lockdown. For my community, lockdown is certainly less strict, but it’s not over. They need resources to help keep their children stimulated, maintaining social skills as best they can, and to provide engagement.

As for meeting the needs of my clients and community, I do my best to make the most of virtual. When I did in-person home visits, I often was just with the child. However, when I’m virtual I find that I really get to know everyone in the home. I am able to structure my sessions to involve adult participation and make it into an experience for everyone present and not just the kiddo.

[Samantha M Lawrence]

This question really got me thinking about what qualities are inherent to music therapists and our value, what do we “bring to the table” as compared to other early childhood professionals.

One thing that really stands out to me is inclusivity. Not just for differing ages and abilities, but also for people who are just overwhelmed or uncertain. The mindset of “every stays, everyone plays” is not unique to music therapy necessarily, but it is evident in music because everyone is able to find a role. By being in music, you are participating. Everyone here in this experience, in this moment, together. This lends opportunities for bonding in a safe space of playfulness and creativity.

Music therapists also work so fully with a child. We are trained to observe so many developmental milestones. We see children reaching, or not reaching, age-specific speech, fine and gross motor skills, and emotional developments, and we can communicate these things to parents. For most of the clients I work with, they already have a diagnosis and parents are aware of where their children may have developmental delays. However, what is so important for them is to see where their child is thriving! This is something we are able to do in music. I love when I am able to highlight the achievements I am seeing.

[Samantha M Lawrence]

Singing: A lot of the kiddos I work with are non-verbal or minimally verbal. For some, they are unable to produce sound due to trachs. For my clients who are able to make vocalizations, I often encourage them through the use of songs with repeated simple pitches and syllables. With my clients who are more verbal, I often use fill-in-the-blank song structure to encourage them to verbalize words at the end of phrases.

Playing: My instrument selection is limited to whatever instruments my clients have in their homes. A lot of my kiddos do have instruments. For my clients, instrument play is often an opportunity for choice-making and self-expression. It is also a way that we work on stamina and fine motor skills.

Moving: I have a few younger clients who love to just move freely to the music. With my younger preschool kiddos, I tend to allow them to get up and dance and let the teachers ask them to sit if they feel the need. I’m just getting to know these classrooms, and especially being virtual, I’m trying to respect teachers’ rules and ways of keeping order! However I try to structure my sessions in a way that they have a specific time to dance with both a song that prompts 1 step directions as well as a dance where my kids can move however they like in the space.

Listening: Listening has become so much more of a central part of my work. I often can only see the faces of my clients. So especially for my clients who are non-verbal, watching for small cues in the facial affect of pleasure/displeasure or a spark when they hear a familiar and favorite song has become so important.

Since starting this course, I have been trying to observe the little things that occur in the music to help me better locate the development levels so I can make more developmentally appropriate music experiences for them.

[Samantha M Lawrence]

I’ve really started observing “listening” more as my work is mostly virtual. I definitely didn’t think about those more subtle actions in response to hearing and listening to music nearly as much when I was only in person.

[Samantha M Lawrence]

Singing:
– Awareness: Make pitched vocalizations
– Trust: Make purposeful pitched vocalizations
– Independence: Imitate short vocalizations
– Control: Match specific pitches
– Responsibility: Sing familiar songs with melodic/rhythmic contour

Playing:
– Awareness: Reach, touch, and explore source of sound
– Trust: Play/strike an instrument to own rhythm
– Independence: Bang two objects together
– Control: Use familiar instruments functionally
– Responsibility: Maintain internal beat when not playing

Moving:
– Awareness: Calm to rhythmic rocking
– Trust: Move body to own rhythm
– Independence: Move body rhythmically to music
– Control: Isolate body parts to move rhythmically
– Responsibility: Learn simple social dances

Listening:
– Awareness: Attention/enjoyment of consonance, inattention/displeasure of dissonance
– Trust: Vocalize during the silence of music
– Independence: Attend to favored music even with distractions
– Control: Tolerate singing/playing along with peers/others
– Responsibility: Listen to the music of others!

[Samantha M Lawrence]

I don’t have any clients for whom these songs would be appropriate. But, I grabbed my baby (scarf) and tried them out! I really was so interested in the way that A Car on My Knee was used to integrate not only the client and his mother, but also the whole group. I’m thinking back on a group of 6 young elementary school aged kids who all had ASD. Some days it was a real challenge to get any sense of group cohesion, especially when a kiddo was fixated on their transitional object of the day (often a small toy). The spontaneity of this song and the way that it could transition to be about any object a child was stuck on is so perfect for this type of group.

[Samantha M Lawrence]

It’s wonderful you’ve been able to work with the same client for so long!

[Samantha M Lawrence]

I’ve been working with one kiddo for about a year and she’s moved from the control stage into the responsibility stage. She’s really found her singing voice, just becoming more melodic as she sings, compared to just speaking me the words on a pitch. She’s able to slow down her internal rhythm, and will match me in singing. When we sang together before, she was always racing ahead. Now she is able to LISTEN and match the tempo I have set.

[Samantha M Lawrence]

I love when clients teach me their music! It’s so meaningful.

[Samantha M Lawrence]

I, too, work with a huge span of clients aging from pre-school to older adults in nursing homes. I work remotely from the capital region of New York and in-person in Vermont. For my Vermont clients, who are mostly white older adults, we really dig into some folk songs – Peter Seeger; Peter, Paul, and Mary; Bob Dylan; Joni Mitchell. As for my kiddos, I don’t have a lot of information about their ethnicities and any traditional cultural music. I have in the past had Spanish-speaking clients who enjoyed some Spanish songs. I certainly see kids from different backgrounds now, but for I’m sure many reasons it hasn’t come up in sessions. Either because some are groups, many I haven’t ever met in person as I’m virtual, or maybe they haven’t felt comfortable bringing it up to me. This was a wonderful reflection of whether or not I could be more inclusive in my practice.

As for the music I use with my kiddos, it’s a big range. Pop songs, old traditional kids songs, newer kids songs, songs I’ve made up, and lots of adapted books!

[Samantha M Lawrence]

Awareness: Choice-making through looking, turning away, or reaching; often quiet while listening to the music; may cry when music ends because they want more

Trust: Choice-making through turning towards or away and instrument exploration; match or approximate pitch; rhythmic moving to internal beat – not necessarily the beat of the music

Independence: Increased instrument maneuvering – passing an instrument from hand to hand, shaking a maraca; imitating movements and intensity; anticipation of surprises and changes in the music

Control: Creation of more intervals; imitation of words before pitch (a switch from previous levels); dancing – purposeful movement & enjoyment of imitation of dance moves

Responsibility: Maintains steady beat; can sing in major and minor; can use rests within music

[Samantha M Lawrence]

I agree with Celia, it’s so much about relationships. With the little ones I work so hard to create a space of trust and safety. I also really try to show them that this is their time! I let them lead the way, be creative, and push the boundaries and learn what they can and cannot do in music therapy. I think some of what I bring is patience, flexibility, and consistency!

[Samantha M Lawrence]

I envy your ease with being “silly,” I sometimes find it so hard to do!

[Samantha M Lawrence]

This EXACTLY! I’ve had a lot of experience taking clients and classrooms for other MTs and it’s so hard to remind myself (and honestly, sometimes the clients & classrooms) that I’m not them and I don’t have to do everything they did they way they did it!

[Samantha M Lawrence]

Yes! I so agree with your point about what this all looks like in music therapy. In all the developmental coursework I did, none of it was taught by a music therapist. It’s so nice to have a MT specific overview!

[Author]

Posts