The Siblings in Music: routines

So, the analysis of the need for routine in my brother and sister clients this week has been a total theme. It is a well-known fact that children and other individuals with ASDs do better when there is a predictable routine for them to follow, or when things are consistent, repetitive or there is sameness. The reason for this seems to be an anxiety related to trying new things, an inability to process new sensations, new ideas or new experiences in a way that feels 'safe' to an autistic system. I think that has been the general consensus among professionals too, maybe there is something I could cite here, but I wanted to talk more about the music than I did about autism (I tend to get on tangents when I start talking about autism and my theories!)

So, both of the siblings have a tendency to create their own routines. They will continuously play instruments a certain way, and only that way. It's interesting because it is entirely their own creation. The repetition clearly comforts them (more so her than him), and the fact that they know this, and create this environment of repetitive sound/motion and routine, shows that they clearly know what they desire and what they need to feel comfortable. As her aide put it 'she knows exactly what she wants, but she just can't tell us'. I think that's a great insight. She absolutely does know what she wants, and her rigidity in thinking about what she wants is probably the first place I'd like to start in targeting her anxiety. 

I would ideally like her to develop a completely new way of playing (if it becomes a routine eventually, that is actually okay with me, as long we we work together to create it). Basically, this is the same thing as anyone writing a song and then practicing it over and over or finding a favorite song and listening to it over and over. Widely accepted right?

repetition happens in art quite often. And what is music but repetition of rhythms, melodies, sounds etc.?

So, I'm thinking, there has to be a way to make that work for them!

So, I'm going to try to keep working with them with a specific schedule. I want to encourage them to play the same instruments in music each time and to learn that they CAN create new routines that make musical sense and can also be comforting for them. I know that statement specifically may not express how they will understand what I want to teach them, but they will show me with their actions, like always!

Garage Band Part I

Use of Garage Band Program to create Auditory Integration Exercise

Garage band can be used for all kinds of activities in Music Therapy, and it comes standard on all Macintosh computers produced after a certain year, I'm not sure which but the point is, its free with your Mac!*

The most basic use for garage band is as a means of generating rhythms or melodies to use as jumping off points for improvisation activities with clients. There are many loops that come with garage band, including various percussion patterns, lots of different instruments, melodies on piano, guitar, and synthesized 'beats'. These can be great simply to move to in music therapy, and the loops can continue infinitely without variation, so they can be great for use with clients who like familiar or repetitive music. Some of them are also pretty complex. I have used bass lines accompanied with techno beats from garage band in auditory integration exercises, one that I designed for one of 'the siblings' I work with (the older brother), and he excelled with this. I have yet to explore the technique further, but basically it goes like this:

1.  choose a simple bass pattern from the loops included in Garage Band. Loops can be copied directly into a track on Garage Band and can be set to repeat for an infinite number of measures. Decide on a length for your exercise and fill the entire track length with your chosen bass line.

2. Choose additional rhythmic or melodic loops (or record your own) and gradually introduce the layers of sound into your composition. For example: play JUST the bass line for 32 measures, then add a shaker rhythm, fade it in or not. Allow the bass and shaker to play for another 12 bars or so Then, add a more complex rhythm included with the shaker and bass line, this is where I used a 'dance' beat, but obviously you can add anything you'd like! It helps to increase the complexity gradually so that the bass gets more and more difficult to distinguish, but is still audible!

3. Play the track (or just the bass line loop at first to introduce it) for student and imitate rhythm on a hand drum or other percussion instrument. (this can also be expanded if the student is more advanced and can include imitation of melodic contour in addition to the rhythm, but we just used my djembe and copied what we heard!)

2. Play the bass pattern along with the loop/recording for a minute or more, allow the student to imitate the bass line without therapist support (musically) and encourage this. 

3. (here's where garage band comes in because it is so easy to layer composition with the program!) As the track plays through, the student will have to continue to hear the bass part which will require increased ability to meld all the sounds that are being processed and pick out the most 'important' sound (the bass line). Training the brain to be able to distinguish between sounds that must be heard and focused on versus those that may be largely disregarded is an important aspect of auditory integration. 

I should mention that this is in no way a means of completely developing auditory integration skills in a student who struggles significantly with sounds/auditory processing. This should only be practiced by trained professionals and is not an attempt to diagnose or treat any specific condition. It is an exercise that may increase auditory integration skills in music.

 If you have a student who has a very hard time distinguishing sounds within a musical context then it might make sense to include 'non-musical' sounds in the recording. Something I haven't explored yet admittedly, but I like the possibilities!

4. The auditory integration happens when the student is able to process all the sounds 'appropriately' and pick the bass line out and continue to copy it (which, if this is done with a hand drum or other tactile instrument, will also require motor coordination and provide tactile stimulation/vestibular feedback, the possibilities are pretty endless really, but you have to know your student and what he/she can handle safely) while the other musical or non-musical auditory stimuli are present. This activity can be made more challenging by including a changing bass line that the student will have to continue to listen for and imitate throughout the track.

5. The student I work with has been very successful with this activity. It may be his ability to center in on the bass sound and process that as 'foreground sound' versus the additional music playing, and this is an important aspect of auditory integration! I also was informed by his mother that he did receive Auditory Integration Therapy when he was younger, and that he was discovered to have hyper-acusis.

Well, since that turned out to be pretty lengthy, I guess I will make another entry about using the other features in garage band. There is more to come.

Please share any and all ideas!

*( I would recommend Macintosh computers to all music therapists looking to significantly integrate technology into their music therapy practices, I started using Macs in college at Berklee, and they are the preferred operating systems for most modern musicians/music technologists/film score writers etc.)

Holiday Music, Vacation + A.J in music

Hopefully I will have some time to put significant research into this blog during the week I have off.

I am officially on vacation as of yesterday at 2 p.m. (!!!)

Here is a tune I jammed out to with two clients yesterday, really got them moving, lots of fun!
All I want for Christmas is You!

I had a day of really great sessions with the kids yesterday. A girl I see twice a week (we will call her A.J.) in the mornings has been REALLY progressing in her ability to (seemingly) understand and follow directions. It's exciting for both her aide and I. She is also vocalizing a lot in music, and I was recently informed that these vocalizations are different than the types of sounds she makes during non-musical activities.

 Her repetition of similar sounds apparently varies from her attempts to articulate melded sounds outside of music, suggesting that she is 'trying to sing' (as her aide commented). I think she is singing for sure! I would love to try recording with her if she will allow it, she has an extremely short attention span and her sessions must progress quickly from one activity to the next to keep her engaged. She also seems to have a lot of energy in music and basically never stops moving. I think next session I will set up a garage band track and see if she is at all interested in hearing her own voice played back to her. I imagine it is something I will have to introduce gradually, and as simply as possible, but I think the implications could be spectacular. Hearing her voice recorded and played back to her could potentially be motivating for her and we can encourage these singing type vocalizations, which are often recognized as the precursor to developing language in clients with communication delays.

(her delays are quite significant, seeing that she is in middle school at this point and working on basic communication methods, but her behaviors have been difficult for many to manage in the past so it was hard to develop effective communication strategies with her I think)


Anyway, just wanted to note the vacation beginning and introduce A.J. who I will probably refer to more in later posts.

'The Siblings In Music' - wednesday routine and help from Donna Williams

yesterday was a much better day for both me and the kids, all around. It's necessary to have 'tough days' so that you can recognize the days that go very well!

I had the youngest sister in a morning session yesterday, and she did not touch the keyboard once! I think her aide and her have been working on this, and you could see the battle going on inside her, wanting to go to the keyboard, but forcing herself to resist. She is really quite intelligent, as if anyone would have assume otherwise!

I am currently reading 'Nobody, Nowhere' by Donna Williams. It is a FABULOUS read and I recommend it to any and all who know anyone with autism or are interested in learning about this or if you just want to read an incredible story of human perseverance! Anyway, the book has really given me an insight into the minds of my students, I think that the girl I see on mondays and wednesdays is likely a lot like Donna, and after reading most of this book I feel as though I have a totally new understanding of the autistic 'avoidance' that I observe often in her. I also have a new appreciation for the power of metallic, clean and simple musical sounds, as well as classical piano.

Yesterdays session involved a lot of positive communication from her, I'm not going to call it a breakthrough, because this work is often one step forward two steps back, but I am going to archive it in my own mind as a successful session.

Based on her interest in the keyboard 'demo' I downloaded a bunch of classical piano pieces, all of which included various sections during which the paino melody is multilayered and very fast, but also very predictable in terms of the chord progressions. My thought was that this music might seem to 'wash over' the listener, particularly the client (sibling 2). I also noted that she seemed to enjoy the 'tinkling' of the higher notes on the keyboard, particularly when these sounds are multilayered. It makes sense really, that the more intense the sound, if she enjoys it, the more comfort or pleasure it can provide her.

 So, I played some of this paino music for her, after our usual structured greeting song and our dance to 'The Wiggles' (which she was able to request appropriately, both the artist and a specific song, which is excellent progress for her), and used the potential comfort this music provided her, as a jumping off point for interaction. We played numerous instruments and she participated, willing to play instruments I chose for her as well as some she chose on her own! She continues to love the triangle and the chimes, but yesterday she also played maracas and interacted with both myself and her aide with these instruments. I feel that positive sessions like this will help her to further view music therapy as a 'safe space' to express herself. I will keep the classical piano coming and maybe reintroduce the keyboard and see if she can eventually do a call and response activity on that instrument. I would say that is a pretty long-term goal given her obsessions/compulsions related to the keyboard, but I think she can get there!

a 'classic' look I recognize in a lot of my clients with autism, this is Donna Williams at around age 5 or 6 I think...

I plan to write a more detailed review of 'Nobody, Nowhere' at some point. I think there are a lot of absolutely brilliant quotes there, but I need to go through it again with a more critical eye, right now I'm just doing my first read-through, taking in Donna's story and absorbing what I can at first read.

                                                           D. Williams with guitar at a young age



To read about Donna's  book, or order a copy go Here
(you can get it for less than a dollar, plus the shipping, but still a great deal!)

Donna is also a HUGE advocate of music and its power...more on this in another post
but have a look Here  at her band, Donna and the Aspinauts

'The Siblings In Music' - welcome to rough days

Yesterday was a rough day for a lot of my kiddos. I am convinced it was the energy, the alignment of the planets (retrograde mercury, mars and pluto), and maybe the fact that it was a rainy cloudy monday.
Regardless, it was one of my toughest days of practice to date. Obviously this was no one's fault. Especially not my clients! In fact more than anything it was me, feeling a little 'off' myself, worrying about whether I could have at least ONE good session to make up for the seemingly uncharacteristic fits and breakdowns that seemed to be in order, but how unfair is that? I really really (possibly desperately!) need to not take the vibe of one session to another, and even more so if it is negative.

Ok, so I'm writing this because I need to look at yesterday as a learning experience. Yes, clients will have tough days, and I will have my 'off' days too. The key is to keep going, to learn from the rocky spots (and I already have assessed what went wrong in some of the cases yesterday)

I work with a brother and sister, both of whom I see individually, with autism, and both of them had issues with rigidity, or ocd, perseverations, you can call it what you'd like, yesterday. They were both fixated on electronic keyboards and seemed to be developing an obsession with operating the keyboard in specific ways. Both of them got upset when these keyboard operating routines were disturbed, and both of them seemed to have trouble pulling themselves out of these obsessions. The anxiety that they felt at not being able to perform their obsessive rituals (I use these terms because one of the aides mentioned that a clients behavior with the keyboard was becoming 'an o.c.d. thing') really set the tone of each of their sessions, and this was where I made my biggest mistake. I needed to bring them out of this anxiety in an effective therapeutic way, redirect the attention of the session AWAY from the objects of obsession, with something novel, engaging, and calming.

ok, so what do I do if this happens again? It most likely will. Tomorrow I will be seeing one of those same clients again and would like to more effectively engage her. She responds wonderfully to pre-recorded music that is familiar to her, as well as physical interaction, dancing/moving/shaking/playing to music.

I guess one of my options could be to create a movement song for her, with interesting sounds, engaging rhythm/melody etc. The problem with that is, she often does not respond too positively to new and unfamiliar songs, but we have to start somewhere right? So I guess the risk lies in getting her to listen and engage, and then later come to 'like' and 'enjoy'. The interaction has to come first, and in order for her to be able to process something new, her system has to be anxiety free (at least mostly!). So, regulation is first, then the introduction of a new and personalized activity...
I'm also debating how to use the keyboard in a positive way, should I totally eliminate/discourage it? Should I continue to allow her to act out the compulsions and continue to interrupt them so that through the exposure she can learn? How do you tackle compulsions in autistic individuals?

Sometimes when I think about these 'off' days that my clients have, I imagine that the music is simply too much for them. Their anxiety levels are higher than they usually are, they're systems are not processing in a way that is functional for them, and in order for them to process music, they really need to have their auditory processing system in decent working order, I can't expect it to be like this every day!

Well, holy introduction batman!
Where I was originally going with this was wanting to illustrate the use of sounds, and non-conventional 'music' to help kiddos through these difficult sensory dis-regulation periods. I am going to try to develop a process by which anxiety ridden clients can reintroduce 'music' to their systems, bit by bit, throughout the course of a session. The session needs to have structure and predictability, particularly for these clients, and because of how I've developed sessions with my clients up to this point, there is not so much of that.

okay so, a few things I'm going to try:

posters or other visual aides to show a session's SCHEDULE/structure



Digitally developing songs/sounds personalized for clients based on knowledge of sounds they appear to enjoy and seek out

Allow for client contribution, clear instruction and room for lots of success and validation


I think I'm going to make a sub-section within my blog to document my sessions with these two fabulous siblings and their unique needs. We'll call it, 'the siblings in music' - hence today's title.

to follow this section of my blog, search for entries beginning with 'the siblings in music'

Frequency studies

WikiPedia Def of Audio Frequency

 the above contains a good amount of info regarding frequencies, what the 'typical' human can hear (is hyperacusis considered an augmentation of this standard or does it simply mean that an individual hears sounds in a more detailed way rather than hearing MORE sounds?) The best part of this is the standardized charts indicating the frequencies of certain familiar sounds...
the implications of amplitude, I imagine, are where things could get complicated, because I have no doubt that the amplitude of sounds greatly influences the reactions/processing of individuals with APD's, but is amplitude harder to measure? Maybe I just need to put more effort into this!

Anyway, I should clarify; my interest in this research stems from a suggestion that it may be possible that auditory integration/auditory processing 'deficits' may be measured based on an individual's response to various frequencies/amplitudes. I wonder if that's been studied..

I'm off to gather related studies..

More on this later.

p.s. anyone who checked out that wikipedia link..I played the C10 and my poor puppy startled like you wouldn't believe!
..not to mention my ears are ringing pretty significantly, I wouldn't recommend listening to it!

tUnE yArDs

This is an artist I believe to be on the forefront of alternative music- melding sounds from everyday life with sounds that are more 'musical' (obvisouly she isn't the FIRST to do this but just a favorite of mine)

tuNe yArDs- Fiya
(free download courtesy of ME!)

(you may recognise this particular song from a recent verizon wireless/blackberry commercial)

Her myspace page
More about tUnE yArDs

There are implications here for auditory integration training, for example, a child cannot tolerate the sound of a vacuum cleaner and often throws a fit when similar sounds occur also;

add this sound to a song and make it musical, continue to use this sound in music making WITH the child, allow the child to have control over the use of this sound by allowing him/her to add a sample of this sound to music, gradually introduce this sound with music (starting very small and keeping the use safe and the increase of use VERY gradual, also, be trained in responding to outbursts related to the processing issues related to this sound) This is a technique I only have speculative ideas about, but I think it could be a great auditory integration tool. Music is already the primary tool used in Auditory Integration Training


Also, tell me the above image doesn't scream quirky/possibly autistic creativity! (I mean this in an unbelievably positive way)