Elizabeth Nightingale, Neuro Services Lead at Chiltern Music Therapy
In 2020, the immediate impacts of COVID-19 required us to move our Neuro Music Therapy services online. In order for us to continue supporting children and young people with ABI effectively, we collaborated even more closely with our clients and their families to identify a myriad of digital solutions that could supplement our therapy work together. Adaptations initially brought about by necessity have offered us rich learning opportunities and the digital legacy from this time has permanently evolved the way we support those with a brain injury. As we move into Action for Brain Injury week, there is one particular area of neuro music therapy we want to highlight for the benefits it can bring to children and young people following ABI and that is music technology.
Music is the ‘key’
Music is a unique tool to use in neurorehabilitation because developments in neuroimaging have evidenced that music stimulates more parts of the brain simultaneously than anything else. Because of the unique way in which our brains process music, we can actually use it to help rewire the brain and build new neural networks around areas damaged by disease or injury. If we want to give children and young people with ABI the best possible opportunity to respond and engage in rehabilitation, music is key.
Neurologic Music Therapy
Neuro Music Therapy uses music to support children and young people with ABI with non-musical goals in 3 key areas: communication, movement, and cognition & learning skills. It is based on 20 standardised clinical training techniques which can involve active engagement in vocal, instrumental and music-based exercises targeting different parts of the brain.
At Chiltern, we’ve been pioneering the use of music technology in clinical practice for the last 10 years but the pandemic really accelerated it’s adoption across our team as well as with our clients too. Many of the children & young people we support in Neuro Music Therapy did not have access to instruments at home, so virtual instruments became a crucial part of our toolkit in online therapy sessions as well as the creative use of AAC devices (including switches). We built on our existing database of apps that identified what clinical areas could be supported – such as finger dexterity for writing, or social skills for peer relationships – and made suitable recommendations for families to download and use at home both during sessions, or as part of their personalised Home Programmes. Many of our families found this invaluable as they could make use of music technology independently and at times that suited them – when considering issues like fatigue management, these digital resources really could serve as a meaningful solution when provided in balance with direct session support. In those instances where families did not have their own iPad, we gifted these pre-loaded with relevant apps as part of a fundraising initiative we launched in March 2020 – a Public Appeal that formed part of our iPod Pharmacy scheme. Perhaps most importantly though, the huge advantage of music technology is accessibility and the opportunities it can open up for shared musical experiences.
One of our Neuro Music Therapy clients is a 14-year-old girl named Max* who has been using the iPad app GarageBand to support her to develop her executive function skills following her brain injury. GarageBand is a track-writing app and whilst it can be used to support emotional expression and identity, it can simultaneously be a great way to work on skills including choice-making, organisation and planning, problem-solving, and reasoning and comprehension. As part of Max’s Home Programme, she has been creating tracks in-between sessions as an engaging way to develop and practice the important cognitive skills she needs every day for activities like going to the shops or the steps involved in making her favourite snack.
Another of our clients is an 8-year-old boy named Jack. Jack is non-verbal since his brain injury and has very limited independent movement. In our Neuro Music Therapy sessions we have
been using apps such as EchoString to support him to engage in accessible shared musical experiences with his family. The first time he was introduced to this virtual harp, he smiled as his sister supported him to touch the screen. To further support his understanding of cause and effect we connected the iPad to a vibrating speaker to offer him a multisensory and vibrotactile experience. He enjoys taking turns with his sister and having the speaker on his tummy.
Here are the links to the above apps:
Music technology offers up an accessible world of creative expression for children and young people following brain injury but it can also be used alongside Neuro Music Therapy to support targeted rehabilitation in essential functional areas for skills they need every day. Chiltern’s Music Tech Lead, Irene Lo Coco summarises it this way:Coda
“The use of music technology provides a contemporary approach to creating music in music therapy. The field of applied music tech is so rich and diverse as much is fast changing, with constant development and new technologies becoming available every day. There is a huge offer of technology that supports and facilitates the clinical work that we do in music therapy, for all the levels of ability and stages of rehabilitation. At Chiltern Music Therapy we are constantly assessing and evaluating new tech tools to use in clinical work for enhanced therapeutic outcomes”.