MUSIC 2MT3 Lecture Notes - Lecture 5: Stevie Wonder, Music Therapy, Pain Management
18 Jun 2018
School
Department
Course
Professor
Neurologic Music Therapy
Midterm one week from today
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NMT = one of the music approaches
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Neurologic Conditions
Guest speaker looks at common symptoms to construct interventions
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She mostly looks at these neurological symptoms: weak muscles, loss of coordination,
pain management, altered cognition, altered speech patterns
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Music
“Music is a world within itself, it is a language we all understand” – Stevie Wonder
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Diff components: pitch, timbre
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MT uses elements of pitch to drive intervention
Dynamics = to get client engaged
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Rhythm = 97% of the world’s population really attunes to (ex. She made the
class clap at the same time) We grasp so easily to
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Music can name the unnameable
When we can’t find words, we can express ourselves through music
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The brain that engages
Structure of our brain changes when we engage in music – whether listening,
singing, playing instrument – something in our brain is moving
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Diagram: Music – The Brain
A simplified diagram of what happens when we engage in music
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10 major areas of our brain across both hemispheres are being changed
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Aspects of rhythm, melody, pitch, words are being stored
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When we remember songs, we store that in a diff area than where we store our vocab
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Ex. When someone has stroke (lose speech), they can still sing…because speech and
music is stored in diff brain areas
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Neurologic Music Therapy
Neuroscience approach to music therapy -
We address 3 diff domains: speeh & language, sensory motor skills and cognition -
We look at functional perception of all properties of music to change/retain brain and
behaviour function
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There’s 20 techniques/interventions -
Looking at sensorimotor training, rhythmic fuges provide fluidity of the movement
(like moving our arms, walking, moving fingers…..rhythm is at the heart of the
intervention)
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Looking at speech and language (rhythm is also there. PLUS a melodic layer). Music
therapists is tapping/holding the patient’s arm providing rhythm and also singing at
the same time.
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At cognition – we look at attention, memory and psychosocial side like self-
expression, emotional need, emo support. Psychosocial aspects allows you to
understand client. But it’s also good to address functional needs (like client is so
distressed they can’t move their arms?)
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Music: Another Diagram
20 NMT Techniques
Techniques to highlight TIMP, rhythmic auditory stimulation (RAS), melodic intonation
therapy (MiT) and therapeutic singing (TS) and associative mood and memory training
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For MIT, it was not originally a NMT technique, it’s a speech & language therapy
technique
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Don’t have to memorize all 20 NMT techniques -
Just know there are more than 3 techniques -
Training to become an NMT is only 4 days – OT, PT, psychiatrist can do the course -
TIMP
Therapeutic Instrumental Music Performance -
Rhythm is the driving force for the intervention-
Vid: this is a man in LTC for a while, with Parkinson’s, only working with him for a year
but he worked with an NMT program for 2 years. Took on a psychosocial approach in
LTC
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Addressed emotional needs at the beginning of treatment-
Works with physiotherapy team 2-3x a week -
Guest speaker combined physiotherapy exercise and TIMP -
Working on ROM, flexibility -
Video: older male hitting an instrument (good rhythm) while somebody played a
ukulele? Very steady beat despite Parkinson’s
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RAS
Rhythmic auditory stimulation -
Used for gait training, heel-to-toe movement, balance when standing -
Going from hard wood to carpet is difficult-
Pt only walks when physiotherapist is with him-
Posture was dependent on the walker -
Video: older male walking with physiotherapist using a walker, stepping to the beat of
the ukelele’s chords
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If music consistency is a factor from session to session? This depends on the pt and
whether if it is oversimulating for them or not
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Some patients only use a metronome -
Neurologic Music therapists draw from other assessments – if we look at velocity,
stride length….there’s already formulas that physiotherapists use
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NMTs just keep comparing, that’s how they know it works -
With RAS, you’re only working on walking. TIMP = you’re doing movement -
Speech & Language Skills
Therapeutic singing encapsulates everything you do in the speech & language rehab -
We also look at non-verbal communication and oral motor skills -
Video: older male singing with musical therapist on guitar. To pronounce words -
Hold the client’s hand – accesses other neurological pathways, when let go à it
provides structure and motivation
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Video of therapeutic singing:
7 year old boy and Asian MT •
Helped to control breath •
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Cognition
In NMT, is divided into 2 areas: cognitive rehab (functional side of how our mind
works, memory,) Psychosocial (how we are processing our emotions, opportunity for
self-expression)
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The psychosocial intervention are very much like a psychodynamic approach -
The only difference is there’s pre=opposing? Testing-
WE use diff assessment tools to measure if the music is helping with the goal -
Video: Henry (has dementia) his caregiver explains he’s very withdrawn but when
listening to music, he is alive; his reaction with ipod/music – he becomes animated.
He was asked specific questions. Questions that probe memory response – who’s your
favourite artist? What’s your favourite song?
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When working with people with dementia, they may be so advanced into their
disease that they may not answer that question
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The intervention must be implemented early to elicit a response (oh my favourite
artist is….. )
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Controversy of ipod project: What if music triggers behaviour? Or a memory that they
didn’t want to re-live? Good to have a family member present b/c we are unsure of
client’s response
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Lecture 5
Thursday, May 17, 2018
11:07 AM
Document Summary
Guest speaker looks at common symptoms to construct interventions. She mostly looks at these neurological symptoms: weak muscles, loss of coordination, pain management, altered cognition, altered speech patterns. Music is a world within itself, it is a language we all understand stevie wonder. Mt uses elements of pitch to drive intervention. Rhythm = 97% of the world"s population really attunes to (ex. She made the class clap at the same time) we grasp so easily to. When we can"t find words, we can express ourselves through music. Structure of our brain changes when we engage in music whether listening, singing, playing instrument something in our brain is moving. A simplified diagram of what happens when we engage in music. 10 major areas of our brain across both hemispheres are being changed. Aspects of rhythm, melody, pitch, words are being stored. When we remember songs, we store that in a diff area than where we store our vocab.
