As the little boy continues the game of “I want blue truck,” and rolls the truck as the therapist puts both parts to a tune, the little boy quickens the process to see if the therapist will continue to follow him and giggles. “She is still playing with me!” He has initiated an activity in order to receive a predicted response and is having fun. However, the game, if not watched carefully, could turn into a repetitive cycle that continues into self-absorption. The therapist recalled how the boy acquired his language in Music Therapy. As the boy grabbed a new car, the therapist would say, “**Boy’s name** has a blue car.” As the boy repeated this sequence a couple times, the therapist would leave out the color of the car and the boy would fill it in. Over time, the therapist began to leave out more and more words from that phrase which the boy began to fill in, little by little. The therapist noticed, however, that after he had accumulated approximately all the language that was age-appropriate, the boy began some repetitive movie-quoting. It appeared that when this began, his play became stunted and cyclical. The therapist also noticed that the boy was using very skeletal language outside the session. He was only able to ask for some immediate needs or wants. He was not using all the language he demonstrated in Music Therapy in regular everyday life. He was also tantrumming occasionally when he was not getting his point across. The therapist realized she had to look at things closer now. Now, what she did musically was more important than ever. She would have to pay attention more closely. As the boy picked up the car and dropped it, the therapist sang, “Where did the yellow car go?” repetitively. As he bent down to pick up the car, the therapist played an oscillating octave in the bass as she sang, “Its r-i-g-h-t,” and as he picked it up, he said, “It is right here.” Finally, progress was slowly being made into more subtle, less visual areas. Although this little guy loved his animated movies, he also loved the animated accompaniment, the predictability, and the suspense in the music that followed his actions. The therapist used the elements of music, specific harmony in her chords, dynamics, and tempo to follow his lead and to build to the next action. The boy was so engrossed in his activity that the music was accompanying, that he subconsciously began to pick up on the musical transitions to the next action. In his therapy sessions, the therapist was able to use the animation in her music and his specific interests to further attain his attention. The predictability of the animated music that followed his actions, accompanied by the song and its words that were tailored to his interests and abilities, allowed the therapist to get closer to his pace. The elongation of speech sounds through the singing helped him to process these sounds that were paired with his interests. After fully processing, he could not only understand, but predict, reproduce, and use the words functionally. However, up until now, reproduced language was limited mostly to nouns, visible adjectives (yellow car), and a few directional verbs that were relevant to the current play. As the therapist concentrated more on the relating part of the music, the suspenseful invitations, the rising lead-ins, etc., she was able to keep his attention as he was picking up on the process’s auditory cues. Now she would have to leave more space for him to respond. She would have to eliminate more non-musical items from the session. He was beginning to notice and process the finer subtleties of communication. The evidence of this was the use of the abstract word “here.” Also, in between the car play, the boy began to initiate more music-making with the therapist. As the boy hit a drum randomly, the therapist synchronized her playing to his random drum hits, putting musical phrases in between his drum beating. As his interest, strength, and coordination in ability to beat the drum grew, so did the length of his playing. Over time, his random drum beats were turning into responsive musical phrase-playing with the therapist. He knew, could hear, and comprehend, where the phrases began and ended. When the therapist played the effective chords, he would look at her with a great big smile and giggle slightly as he slowly raised his hand higher before playing the final phrase note with her, using all his might. A game-like musical conversation was beginning. The therapist built-in this musical suspense with him. He followed the timing in order to end with her.
His beginning awkward motor skills used to hold the drumsticks was upside-down, poking the drum to play it. He had, over time, developed a proper palmer grasp and was holding the drumstick the more effective way. His ability to process and hear the structure, and more importantly, consciously participate in it also developed over time along with this motor skill. This was all developed relationally. No one showed the boy how or what to do, nor asked him to repeat or point. This was all done through spontaneous interactive play. This little boy was allowed, like any neurotypical child, to develop his skills through play. As the therapist catered to his individual interests, sensory characteristics, and time schedule, she facilitated his play in a relatable, yet untangible, structure through the music that could not only be felt, but also could encourage the auditory processing needed. His parents began to report their surprise when he randomly spoke occasional very appropriate complete thoughts. Also, they noticed the ease with which he was handling newer situations. The ability to not only comprehend more of what was going on around him, but also to respond to it appropriately relaxed the little boy’s fears and brought many smiles at home.
Antoinette Morrison MT-BC