Music Therapy and Sensory Processing
This is part two in a blog series on Sensory Processing Disorder. Part One explains a little bit about what it is and how it works. Part Three will give some online and community resources.
It's been a busy few months here at Aim High Music Therapy, but we're back to talking about Sensory Processing Disorder-- specifically ways that it can be addressed with Music Therapy. I want to mention that a lot of this is coming from the work of Lilieth Grand, an incredible music therapist based in Oregon who might be one of the top experts in using music therapy to address Auditory Processing Disorder.
SPD (Sensory processing disorder) is most frequently treated with occupational therapy. And for sensory issues related to the tactile or vestibular senses, that makes sense. Occupational therapists have toolkits that include rope swings and brushes and other items that can work with all the senses. In such a case, music therapy would work best to support occupational therapy-- for example, supporting work on tactile defensiveness by playing instruments (such as a cabasa) that create a lot of tactile stimulation when played.
However, there is one area of sensory processing which music therapy is uniquely suited to treating: auditory processing.
Auditory Processing Disorder is closely related to Sensory Processing Disorder (and has a lot of overlap). It's also complex enough that it deserves it's own blog series, which I might do in the future. Making sense of what we hear is a complicated process with a lot of parts (such as discrimination, memory, and sequencing). Music is ideal for improving each of these components in the brain. For the present, however, we're going to focus on auditory defensiveness or sound sensitivity.
Sound sensitivity can be its own disorder (sometimes called hyperacusis), or it can be part of the symptoms of SPD. (It can also be a symptom of a concussion, a migraine, PTSD, depression, or multiple sclerosis. Most individuals with William's syndrome have this as well.) It's described as having a heightened sensitivity to sounds that others consider normal. For example, a television at a comfortable volume to others would be painfully loud to the person who has this. Generally the sensitivities become more severe with stress and anxiety.
For a long time, the conventional wisdom for how to treat sound sensitivity has been to avoid sound-- to stay in quiet areas, to wear noise cancelling headphones or use ear plugs. These can be effective in the short term (which is why you frequently see individuals with autism wearing headphones all the time).
The problem is that, in the long term, this can actually make the symptoms worse.
I had it explained to me this way; in your eye, your pupil dilates to adjust to the amount of light in your environment. It opens wider when there's less light, and narrows when there's more light. If you are in a dark room and someone suddenly turns on the light, it's painful-- because your eye is adjusted to the level of light in the dark.
Your ears don't have "pupils" but there is a similar sort of mechanism going on in the brain. When your sound environment is very loud, your brain learns to "turn down the volume" a little so that you can adapt to that noise level. When your environment is very soft, your brain more or less "turns the volume up". If you've ever heard an environment described as being so quiet you could hear a pin drop, that's because your brain has adjusted to the quieter environment to an extent that very small sounds stand out.
One theory of hyperacusis is that people who have it have their brains set for a quiet environment-- so like dark adjusted eyes are hurt by a sudden bright light, quiet-adjusted brains are hurt by a sudden loud sound.
Current treatments involve having the person with hyperacusis wear an earphone that constantly plays white noise. This is, to be blunt, torture-- sound sensitivity usually includes a sensitivity to white noise. But the idea is that by creating a constant background noise, you can retrain the brain to a louder sound environment-- like giving your eyes a chance to adjust in low light before turning the bright lights on.
Music therapy can also be used to treat hyperacusis in a more pleasant way. Because music is generally more pleasant than white noise to listen to, it can be a nicer way to adjust the sound environment. And as we discussed in the previous blog post, having a sense of control over the sound is a powerful way of making it more bearable. One example I've seen is to put a bunch of egg shakers inside an upside-down frame drum, then bounce them up and down. The sound it makes is pretty awful-- but give a kid with sound sensitivity control over when the sound starts and stops, and it soon becomes a fun game. That's because this process is happening in the brain, not in the ears-- so changing the way that the brain perceives the sound changes the experience of the sound.
I can speak to this process myself; as I've mentioned a few times before, I have sensory processing disorder and sound sensitivity is one of the ways that manifests for me. I have an uncomfortably long list of experiences where it was a problem, too: for example, when I was in high school a lot of teeagers started using "mosquito ringtones" on their phones. It's a tone high pitched enough that most adults have lost the ability to hear it, so the teenagers could hear their phones ring without the teachers noticing. Except I kind of ruined it because everytime one of them rang in class I screamed and clapped my hands over my ears. This did not help me make friends.
Since I attended a training by Lilieth Grand on Auditory Processing and Music Therapy three years ago, I've been challenging myself to deal with my sound sensitivities by exposing myself to loud sounds instead of avoiding them-- to go to concerts without wearing earplugs, for example, or make myself stay in a noisy room for a little longer than I think I can. Notice that this is a gradual process, not a sink or swim-- pushing yourself to do a little more each time. And it's going to look different for individuals who are nonverbal and can't always communicate clearly what their sound experience is. But it has been making a huge difference in my ability to tolerate loud sounds.
We'll wrap up there for now, but my next post will have some sensory processing disorder resources. In the meantime-- Happy Thanksgiving! If you're reading this from outside the US-- happy Thursday! We'll see you again soon.
(And if you have sound sensitivities or your child does, please don't think I'm telling you not to use sound cancelling headphones if that helps you survive noisy holiday gatherings. I just mean that it's more of a short term strategy than a long term solution. But whatever you do, relax-- having a disability can make holidays challenging experiences sometimes, but find out what works for you and don't worry too much about whether your holiday is "perfect" or "normal". You're probably doing a better job than you think you are.)