Developmental Disabilities involve deficits in the areas of self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and economic sufficiency. Adaptive behavior deficits may also exist in the areas of perceptual, sensorimotor, and socialization.
In PL94-142 (Education for all Handicapped Children Act) Congress stated “the use of the arts as a teaching tool for the handicapped has long been recognized as a viable, effective way not only of teaching special skills, but also of reaching youngsters who had otherwise been unteachable “(Implementation, 1977, p. 42488). Music, having the strongest research base of all the arts to document its effectiveness, can be used as a discriminative stimulus, a reinforcer, a structure or activity to provide a desired learning experience, or a cue to facilitate learning of social, academic, and perceptual/motor skills.
As with other populations, the first step to providing music therapy to people with developmental disabilities is to conduct a thorough assessment of their capabilities. This is most effective after a specific target behavior has been identified and defined and the therapist has had a chance to build rapport with the client. The four areas in which music therapy can make a unique contribution are most often addressed in the assessment results. These are perceptual, sensorimotor, social, and communication.
Programming may then begin starting with the Music Therapy Plan. This may involve constructing a response hierarchy in which prerequisite skills are specified and then built upon. An objective hierarchy, whether it is chronological, developmental, or increasingly complex in nature, provides a way of evaluating progress on a continual basis. Next, music therapy strategies are determined. These strategies include but are not limited to using music as a behavioral consequence, as a behavioral antecedent, teaching music to teach other skills, and music in insight therapy. Implementation follows, where the music therapist conducts either individual or group sessions. Music Therapy sessions may take place in a habilitation center, residence for the developmentally disabled, training center, school, or private residence.
An example of a group music therapy session can be seen below, with at least one activity/goal in each skill area.
- Music Therapist will play the guitar as he/she sings the “Hello Song” to the members of the group. Each person in the group will look toward the therapist as he or she sings in front of them. (Auditory/Visual Perceptual Skill Area; Goal: Increased awareness of environment; Objective: Auditory location of objects)
- Music Therapist will offer everyone three choices of rhythm instruments. The therapist will give the instructions “Show me the ________”. (Communication Skill Area; Goal: Receptive labeling; Objective: Label musical instruments) After each person points to the correct instrument during his/her turn, he/she will be asked to choose and take an instrument to play. (Sensorimotor Skills Area; Goal: Arm extension; Objective: Reaching for and playing instruments)
- When the music therapist gives the instructions “Play your ___________”, everyone will play their instruments for the duration of 2 phrases. (Social Skills Area; Goal: Develop appropriate play skills and increase interaction with environment; Objective: Parallel Play)
- When the music therapist gives the instructions “Pass your instruments to the person to your right”, everyone will give their instrument to the person on their right and take the instrument from the person on their left. (Social Skills Area; Goal: Improve peer interaction skills; Objective: Make contact with another person for a need) Repeat 3 and 4 until everyone has had an opportunity to play all of the instruments.
- Music therapist will pick up the instruments and then play the guitar while he/she sings the “Good-bye Song” for the group.
Note: More prompting is needed beyond verbal instructions with some clients. Also, certain adaptations to the instruments and equipment are necessary to ensure success of all participants. Everyone in a group will have their own unique challenges and strengths which must be taken into consideration when planning each session. The group session outlined above is purely hypothetical.