Part 3: Eliciting Speech

Back to my mantra: watch the child. Let the child direct and the therapist/parent/teacher support. Even if they child is not giving sound, one can support movement or even breathing with sound. Repeated sound, as I had spoken about in the previous blog (https://backmountainmusictherapy.com/2012/12/where-to-start-control-of-oral-movements/), sometimes gives structure to a child’s irrelevant, chaotic, seemingly impulsive behavior. Structure is a pathway to purpose. When we speak of music as being a sensory experience (concerning the autistic population), I think most people’s first thought is “hearing.” I personally find that most of my autistic individuals initially connect with the sound, but learn and make sense from the vibrations of sound. This may initially sound far-fetched. However, we forget that their brains receive and make sense of information differently than our own. We need to stop evaluating from a neuro-typical standpoint. For example, just compare a neuro-typical three-year-old classroom with a four-year-old classroom after Christmas. The three-year-old class, still neurologically more immature than the four-year-old class, is still enjoying musical experiences, mainly from the excitement and the sensory experience including elements of rhythm, dynamics, vibration, and the visuals involved. A four-year-old classroom at this time is generally getting ready to learn academics. Colors, letters, numbers, and words are getting their attention. The four-year-old class is maturing in the minds and bodies for kindergarten. The less mature mind is doing less conscious thinking and more sensing.

The flow of a steady rhythm has a pull. If a child feels, sees, and hears something that repetitively reflects what they are doing, they become more aware of their own bodies or actions. When you supply that reflective rhythmic structure, you are facilitating awareness and organization, giving predictability and establishing trust on their terms. However, you are pulling their brains towards a more functional structure. Often with nonverbal children, there are areas of development that precede speech which need organization and structure. This requires patience and persistence. Let’s face it. Waiting three year for a child to learn to blow into a recorder to get sound (https://backmountainmusictherapy.com/2012/12/where-to-start-control-of-oral-movements/) does bring about doubts. However, when the child is eager to continue to work, how can you give up on that? Watch the changes and check the development. Is some other area developing at the moment? Then you are on the right track.

Watchful, steady, repetitive, mirroring, topped off with patience and persistence is what elicits speech. Here is a brief example. I once saw a nonverbal three-year-old boy who was labeled with autism. In the early intervention classroom, after circle time the children were to choose their work, sit down, and do it. This little boy liked to clap his hands all the time. If  unattended after circle time, he would wander over to the mirror and giggle while watching himself clap. At this time, he did not really interact with the other children.

When he came to Music Therapy, we used the clapping in our sessions. I had pictures of his classmates in which he had great interest. We transferred the clapping into tapping out their names. Who knew that this little boy was interested to know his classmates? But there were no means of communicating with him. His tapping and guttural vocalizations eventually turned into one-word sentences. He worked up to two-word sentences. In time, in between speaking and tapping, he would go to my snare drum. Although his fine motor skills were very poor and his arm movements somewhat rigid, he enjoyed hitting the snare drum. He was doing what he enjoyed in a safe, encouraging, predictable environment. Sometimes he would take the sticks and rapidly yet evenly use alternating hands in a perfect brisk rhythm to the music. This always surprised me because nothing else he did with his body was done with such smooth preciseness and control. He didn’t do this for very long, but then he would go back to working on speaking and vocalizing. precise, controlled motor movements alternated with speech. He moved on from early intervention to public school. He recently is returning to private Music Therapy sessions; we shall see where it goes from there. Watchful, steady, repetitive, reflective mirroring topped with patience and persistence is what elicits speech.

Antoinette Morrison MT-BC  Back Mountain Music Therapy