Helen Shoemark

The influence of music on aEEG activity in neurologically healthy newborns ≥32 weeks’ gestational age

Aim:  Music is increasingly being used in neonatal intensive care units to aid neurodevelopmental care. The aim of this pilot study was to examine the possible effects of music on quiet sleep (QS) in neurologically healthy newborns.

Constructing optimal experience for the hospitalized newborn through neuro-based music therapy.

Music-based intervention for hospitalized newborn infants has traditionally been based in a biomedical model, with physiological stability as the prime objective. More recent applications are grounded in other theories, including attachment, trauma and neurological models in which infant, parent and the dyadic interaction may be viewed as a dynamic system bound by the common context of the neonatal intensive care unit (NICU). The immature state of the preterm infant’s auditory processing system requires a careful and individualized approach for the introduction of purposeful auditory experience intended to support development. The infant’s experience of an unpredictable auditory environment is further compromised by a potential lack of meaningful auditory stimulation. Parents often feel disconnected from their own capacities to nurture their infant with potentially life-long implications for the infant’s neurobehavioral and psychological well-being. This perspectives paper will outline some neurological considerations for auditory processing in the premature infant to frame a premise for music-based interventions. A hypothetical clinical case will illustrate the application of music by a music therapist with an infant and family in NICU.

How musical engagement promotes well-being in education contexts: The case of a young man with profound and multiple disabilities

Students with profound intellectual disabilities disorders (IDDs) have the right to participate in educational opportunities that recognize their unique resources and needs, as do all children. Because of their specific communication challenges, positive relationships with attentive communication partners are critical for success. In fact, the power of positive relationships in schools is recognized to be connected to student well-being more broadly. This article examines the case of one young man with profound IDD and his relationship with his music therapist using a duo-ethnographic informed paradigmatic case study. Video analysis based on multi-voice perspectives is used to generate hermeneutic phenomenological findings to closely examine the relationship between a young man with profound IDD and a music therapist. The voices of four allied health researchers were also gathered to inform the authors’ construction of an informed commentary on the phenomenon. The results suggest that the essence lay in a combination of attentive, responsive and creative being with the other person over time. Four principles of musical engagement were identified in the video footage as critical to the meaningful relationships through music: the music therapist listens; the music therapist takes responsibility for structure; spontaneous initiation is sought from the young person; and the relationship is built over time. These concepts are contextualized within a discussion of student well-being that is underpinned by positive relationships and leads to students achieving their full potential within diverse school contexts.

Music therapy for early cognitive rehabilitation post-childhood TBI: An intrinsic mixed methods case study

Abstract Objective: The primary aim of this case study was to explore the behavioural changes of a paediatric patient in post-traumatic amnesia (PTA) during a music therapy session. A secondary objective was to measure the effect of the music therapy intervention on agitation. Method: Video data from pre, during and post-music therapy sessions were collected and analysed using video micro-analysis and the Agitated Behaviour Scale. Results: The participant displayed four discrete categories of behaviours: Neutral, Acceptance, Recruitment and Rejection. Further analysis revealed brief but consistent and repeated periods of awareness and responsiveness to the live singing of familiar songs, which were classified as Islands of Awareness. Song offered an Environment of Potential to maximise these periods of emerging consciousness. The quantitative data analysis yielded inconclusive results in determining if music therapy was effective in reducing agitation during and immediately post the music therapy sessions. Conclusion: The process of micro-analysis illuminated four discrete participant behaviours not apparent in the immediate clinical setting. The results of this case suggest that the use of familiar song as a music therapy intervention may harness early patient responsiveness to foster cognitive rehabilitation in the early acute phase post-TBI.

Characterising the ambient sound environment for infants in intensive care wards

The purpose of this study is to characterise ambient sound levels of paediatric and neonatal intensive care units in an old and new hospital according to current standards.

Music Therapy for the Pediatric Patient Experiencing Agitation During Posttraumatic Amnesia: Constructing a Foundation From Theory

Posttraumatic amnesia can be a clinically difficult phase to manage in the pediatric patient emerging from coma following severe traumatic brain injury (TBI), as agitation is a common presentation during this stage of recovery. Familiar song is offered, as a music therapy intervention, to reduce agitation for the pediatric patient; however, there is a paucity of evidence to support this. The purpose of this article is to combine interrelated knowledge from the fields of pediatric TBI recovery, music therapy, music neuropsychology, and mother–infant musicality to construct a theoretical foundation for the use of familiar song with this population.

Empowering Parents in Singing to Hospitalized Infants: The Role of the Music Therapist

Introduction: While we understand the potential benefits of mothers and fathers singing to their infants in the Neonatal Intensive Care Unit (NICU), the process is not simple. The challenges can be personal, contextual, and temporal. Singing is not a natural action for everyone. With rapidly increasing individualized music listening technology and decreasing opportunities for active music making in many countries, people have less experience and awareness of their own musicality. This can hinder their capacity to use music as part of nurturing their infant. Additionally, across their time in the NICU, parents can feel concerned about singing in a “public” place.

The fundamental interaction of singing

This edition of the Nordic Journal of Music Therapy provides articles for two contrasting and eminently useful aspects of music therapy research with preterm infants. Friederike Haslbeck provides two articles to champion the lived experience of creative music therapy (CMT) for the preterm infant in the Neonatal Intensive Care Unit (NICU), while Garunkstiene and her team refine the application of live and recorded music for preterm infants. The studies epitomise the contrasting conceptualisation of music as an interpersonal process, and music as a stimulus. In both cases, the researchers have used pre-existingmodels of music therapy for inspiration and protocol delineation. This provides the reader with an advantage in comprehending how the intervention protocol looks and sounds. For the Garunkstiene study, we learn that the often-cited Arnon et al. (2006) study protocol is largely replicated, but with valuable refinements. They specify the age group at 28–32 weeks postmenstrual age, which discriminates a definite developmental phase rather than classifying all preterm infants as one group. Based on newborn preference for unaccompanied singing (Ilari & Sundara, 2009), they make a judicious choice to use unaccompanied singing as a simpler stimulus than voice and instrument combined. The explanation of the rationale for these selections enables the reader to confirm the rationale for these very immature participants. Haslbeck builds on the precise application of CMT with patients in coma, and her own broad base of experience in the perinatal NICU. The shared underpinning on breath clearly implies that this is a meticulous process, which she has fully explored across both of these articles arising from her elegant PhD study. The researchers have all selected research methods which exemplify rather than try to eliminate the complexity of the experience. Garunkstiene tests the effectiveness of recorded and live singing using traditional quantitative methods, but specifically a within subject design to acknowledge the unique capacities of each infant. Haslbeck celebrates the lived experience of infant, parent and therapist by using richly triangulated data to produce new categorisations of infant vitality, therapist responsiveness and tightly interpreted relationships. Nordic Journal of Music Therapy, 2014 Vol. 23, No. 1, 2–4, http://dx.doi.org/10.1080/08098131.2014.876178