I have been working with a client who whose parents called me to inform me of his needs: he was unable to concentrate well or make any close friends or belong to any groups despite a friendly disposition. When the boy came to see me, I could tell he was a very friendly, outgoing, happy boy. However, although he spoke in complete sentences, I had difficulty understanding him because his speech was so rapid and unclear. At his first session, he came in and began to explore my instruments. He enjoyed making music with me and stayed connected to the rhythm, but was totally unable to synchronize with the beat. He did enjoy the music making, but he would play, then wander, then play, then chat, then play briefly and wander some more. It was difficult for him to play for very long consecutively, but he continued to go back to it. His mom told me he had been taking clarinet lessons for 2 years privately, but had learned nothing. Mom said they had continued the clarinet because he enjoyed being part of the band in school. He was not coordinated enough to impair his overall ability to be in public school unassisted, but not at all coordinated enough to be good at sports. Ironically, the instruments that he gravitated to most were the drums and the trumpet.
Although synchronizing his playing with the beat did not seem to be within his capabilities at the time, playing with the rhythm seemed to attract and sustain his attention. As our sessions continued, and he played more, he also complained about being tired and would talk for longer periods before resuming his playing. His mom told me he does that kind of thing often to get out of work. I remember thinking as I watched him attend to the beat but fail to synchronize his playing to it, that no wonder he could not learn the clarinet. If he could not synchronize to the beat, how was he going to learn fingerings, breathing patterns, reading music, or any of the other techniques involved with a wind instrument? So I decided to work on 3 areas: synchronizing to the beat in his playing, playing for longer periods (to increase his endurance), and increasing his attention to be able to do this. Although he was very attentive to what I was doing, he did not yet have the ability to repeat something I had played, or change his playing with intention to do so, nor could he adapt to any changes I had made when playing. He physically could not coordinate or hear these efforts. Despite the fact that his attention was attracted to the rhythm and he gravitated towards the drums, his drum playing was related to the beat but was chaotic at the same time, as if he was drowning. Fortunately, at this time, he gave up on instruments with many choices, like the piano. He gravitated to instruments that had fewer options and that he was more easily able to manipulate.
This week, approximately 6 months later, I was impressed by what I saw, and so I pulled out his records to see where he began. I tried to explain to my husband – the more science and math-minded person out of the two of us – why what this boy was doing was so significant. He kept asking me, “But how did you affect change in his brain?” This is how I attempted to explain it: I saw this week that not only was N playing for 4 consecutive minutes at a time, but doing that several times throughout the session. Not only that, but he did so with few and shorter breaks. His playing was also completely synchronized to the beat, sometimes using both hands and feet on the drumset. Earlier on in the sessions, N used to like to continue giving a big drum finale to the piece, as we ended. He would hear me play the end and then react by developing a great big drum cadence that went on and on and on. It seemed as though when he heard the end, his reaction was somewhat delayed. However, the fact that he thought he heard this and comprehended (like getting encouraged by knowing the right answer in school), he would continue to repeat the process, feeling encouraged and proud. In addition, he previously would request popular songs which I would then play so that I was able to support and carry him when he would lose the beat on his own. I would then continually be aiding him in finding it. This particular day, as we turned up the radio recording and both played along, he did not need my assistance to hear and stay with the beat. Not only that, but when I watched him, he was really, really listening and attending with focus. N was hearing, in the recorded song, where the drums dropped out and began again: he was hearing cadences and varying his playing to match them. At this point, my husband kept asking, “Yes, but how did this effect his brain, how did you help him?”
Because I knew N briefly when he was little, I knew how delayed he was early on in life and development. He was currently in the proper grade, but was getting lots of help. N had been diagnosed with Lyme Disease, which took a while to finally diagnose and then treat. He was a smart guy, and caught up on many things developmentally; but he had also missed some important. He had undeveloped pockets that were in-between more developed pockets. I explained to my husband that attending is difficult when there are undeveloped pockets. I made a couple of attempts at this using my guitar tuner as an illustration. I said, “See how you are able to tell when the string is in tune? It all lines up. Now, if you have pockets here and there” – then I began to turn the guitar peg back and forth – “it is difficult to find that middle line, the thing you are supposed to focus on. So when N sees 3 + 4, even though he can probably add those two numbers easily, when he looks, maybe he sees an 8 instead of a 3 at times, and at times when he sees 3, maybe he sees ‘h’ instead of 4, so he starts to chat and redirect my attention because this is so hard to see and he can’t do what I am asking him to do.” My husbands reply was, “Okay, but what did you do?” I told him that when he can’t coordinate his playing to synchronize to the beat, but he can feel the pull of the rhythm, that is him seeing 8 and ‘h.’ The more I isolate the 3 and 4, by limiting the music to what he can do, the easier it gets for his brain to just do it: to see 3 and 4 more often instead of blinking, changing forms. Now, he has something he can hold onto. So when he plays without that help, to the predestined beat, he can see 3 and 4 and he can perceive and what he needs to. The more he is able to do this, the more perceptive his brain becomes, and he is able to hear other things surrounding the beat, cadences, dynamics, and chord progressions. Or, the easier he can see 3 and 4 and write down 7, the easier it is to get bigger numbers, because he can now perceive and understand what is in front of him. The more success he has at this (like the elongated drumming at the end of the song), the more practice he employs because he is interested and motivated. The more he practices this, the longer he attends and the more successful he gets. His development continues to capture more and more subtlety as he builds one thing on top of the other. But in order to do this, I had to start with what already interests him, and play it with him at his level on his time, so that he will not get stressed out, but instead will have fun and continue the process. This made sense to my husband. I said that I was guessing that when I mentioned to his mom that we could help things get easier for him if we could work on him synchronizing to the beat, she probably wondered where my tie-dye shirt and sandals were. Since her occupation was in the medical field, I sent her some research to support my premise. I had only begun looking for him to synchronize with the beat and play and attend longer, but when I pulled out his assessment, I was happy to see we were accomplishing the four areas I initially noted as most immediate goals:
1) Increase the duration of participation in any musical intervention
2) Develop the ability to jointly hear, anticipate and end the musical play with the therapist
3) Increase the ability to hear and anticipate recurring musical responses as cued by the therapist
4) Develop the ability to musically change focus or follow subtle change as led by another.
I hope at this point it is easy to see, as he fills in these pockets with success, how he will be able to catch up with his peers socially by being able to perceive and control his body and interpret what is happening and how he can respond more appropriately. I would love to hear from my readers on this. Is it making sense to you?
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