Cerebral Palsy, Part Two: Music Therapy and Cerebral Palsy
This is the second of a three part series on Cerebral Palsy. You can find the previous post, describing what cerebral palsy is, here. Today's post is about how music therapy can be used to help individuals who have cerebral palsy. Section three will be talking about some community resources in the Salt Lake Area and online for individuals with CP and their families.
March 25th is National Cerebral Palsy Awareness Day! You can celebrate/show support by wearing green, and/or educating yourself and others about Cerebral Palsy.
I'm actually writing this post in between sessions of a music therapy conference in Denver, Colorado. Conferences are an important resource for music therapists; we are required to get a certain number of recertification credits every five year period-- and regardless of that, it's important for keeping up on current training and research. I've been having a great time (and I'm excited to get to my posts on Autism and share some of what I've been learning about neuroscience and autism here), and I even had an amazing music therapist from Arizona offer to write a guest post for this blog. (More details on that when we've had a chance to write a few emails.)
Moving on to this month's topic-- let's talk music therapy and cerebral palsy.
As a clinician, my first real introduction working with cerebral palsy was at Hartvigsen School. That's a special education school in Taylorsville, Utah, where I completed my internship. One of the classes I ran there was a high school class for medically fragile students, several of whom had cerebral palsy (in addition to intellectual disabilities) --and that was one of my favorite groups to work with. Those kids had an incredible sense of humor. Since then I've worked with a teenager who has cerebral palsy and has an IQ off the charts. (Which comes with it's own unique considerations, but that's a blog post for another day.) One of the amazing things about music therapy is that it can help individuals of all abilities; whether there are other disorders present or not, whether the symptoms are mild or severe.
So the next question is-- help with what? A lot of things, so I'll break it down a bit.
"Motor skills" is another word for any skills that have to do with moving your body. There are gross motor skills (involving bigger movements-- walking, waving your arms) and fine motor skills (involving smaller movements-- holding a pencil, turning a page). Because Cerebral Palsy affects the part of the brain that controls muscle movements, this is one of the biggest areas of need for individuals who have cerebral palsy.
With gross motor skills, music can help set a foundation for organized movement. This is because when you hear music, it actually stimulates the parts of the brain related to movement-- that's why most people can't help tapping their toes or nodding their heads to the beat of a song. Some music therapists use a technique called Rhythmic Auditory Stimulation (or RAS) to help individuals who struggle with walking. (This could be due to cerebral palsy or many other causes) It involves a music therapist providing live music with a steady beat-- at the speed at which the person is trying to walk. This makes it easier for the person to walk at a steady rhythm because the music helps to organize their movements. RAS is done in collaboration with a physical therapist--that's always cool because two therapists from different disciplines who work together well can accomplish so much more than either of the two could have on their own.
Not everyone who has cerebral palsy can walk, but similar interventions can be used to support stretching and moving other parts of the body. Playing a drum held in different positions can help improve range of motion, for example. And while there is the very real neuroscience component, adding music to gross motor exercises just makes them more fun. How many people find it easier to work out if they can listen to music while they do it?
As for fine motor skills, one of the best ways to target that in music therapy is playing instruments.
For someone who has more severe cerebral palsy, that could mean working on holding a maraca or a drumstick in order to improve grasping and holding. For someone who has more fine motor control, learning how to play more complicated instruments (a guitar or a piano, for example) is very effective. Especially with a music therapist who can adapt the music to the individual needs of the client. There are also adaptive tools, such as specialized drumsticks and guitar picks, which help accommodate various levels of ability.
It's easy to forget, but we use an incredible number of muscles every time we speak. For this reason, many individuals who have cerebral palsy can struggle to speak (and eat and swallow). Music therapy can be used to support speech therapy in helping these individuals to communicate, whether that's through using some sort of ACC (alternative communication device), using sign language, or actually using the voice. Not to mention the fact that music can be used for self expression by people of all ability levels.
Like with walking and other gross motor movements, providing a steady beat can help people organize the movement of muscles needed for speech. Singing can be used to develop better control of breath, pitch, and volume, as well as the ability to articulate words clearly.
To give you a more visual example-- the video below is of a music therapy session (not by me, a different music therapist, and this was filmed several years ago) where a therapist is working with a young boy who has cerebral palsy and some other disorders. The music therapist is using music to help him practice functional ASL and other communication skills.
Although most individuals who have cerebral palsy have normal intelligence, many do have some sort of intellectual disability in addition to cerebral palsy. Music therapy is excellent for developing cognitive and academic skills because music serves as a memory aid in learning. If you ever tried to memorize something by setting it to music (from the names of the states to just the letters of the alphabet), then you've experienced this for yourself. Music therapy can be an excellent opportunity to practice cognitive skills such as counting, identifying objects, matching colors, and using new words. This is one reason why several school districts in the area employ music therapists to work with their students in special education; listening to music engages more of the brain than speech alone, so music can make things easier to learn.
As we talk about other populations who benefit from music therapy, you'll see some overlap; everything I've just talked about can be used to address the symptoms of a variety of disorders. There are other challenges that individuals who have cerebral palsy deal with that can benefit from music therapy-- pain management, for example, or practicing social skills-- but I wanted to focus on the three most common target areas for this overview.
If you have any questions about other uses of music therapy, or about the above information, don't hesitate to ask a question in the comments or to shoot me an email! If you live in the Salt Lake Valley and are interested in finding out if music therapy can help you or someone you care about, please feel free to call and set up a free consultation. If you don't live here in Utah, you can do a search for certified music therapists who live in your area on the American Music Therapy Association website, here.
And that's it for today! There will be one more post on cerebral palsy coming up. In the meantime, Happy Cerebral Palsy Awareness month! And I'll see you again soon!