TME Tuesday: New Songs All Around Me
Yesterday, my intern sang three new songs with our clients. One of the things that I require of my interns is writing at least 25 original songs for use in TMEs with our clients. These songs don't have to be great at all, but they do have to be written because that skill is something that comes in handy when you have an unusual goal or topic to share with a particular client.
I had a conversation with a former intern who is now working with older adults. During the conversation, #31 shared that how music was used with older adults is different from how music was used in my program. There is more of a focus on repertoire with older adults. With my students, there is more of a focus on the use of music to teach specific things, so there is more impetus to compose. I had never really thought about that before - it is easy to get caught up in your own population when you do not have much of an opportunity to see what music therapy is when other therapists engage. I have not worked in memory care or assisted living for 19 years, so it has been a while since I had even a toe in how music works with people other than my own population.
Anyway...
I enjoyed the new songs that intern #33 shared with clients yesterday. It was a breath of fresh air to have a new opening and several new TME songs to learn. I am excited about adding these melodies and TMEs to my own repertoire, but I am also wanting more of this type of musical exploration for myself - specifically, composing music again.
I talk to others about this all the time. I have all sorts of tricks and strategies on how to break out of a creative rut and get composing again. I think I may need to head to my YouTube channel where I have recently uploaded all sorts of music therapy information and presentations for public use. It is time to get back into composing music again - just to keep myself engaged.
One of the things that I do when faced with this type of creative hole is to go deeper into something that we all love and that probably led us into this profession to begin with - music.
It is time to get going with my own musicking. I will have one group and an individual session to lead today. Intern #33 will lead three groups and an individual session as well. Intern #34 will be in training, so there will be a bit of time to make music just for myself today. I may take the keyboard and some of my music books to just sit down and play music.
If you are still reading, thank you. Here is a TME that uses repeated words and Orff instruments to help me get back into rhythm and a composing frame of mind. Thanks for reading!!
Purpose:
Assessment of attention to visual cue – duration of attention, ability to focus attention to subtle cue, ability to ignore competing stimuli;
Musical concepts – ostinati, repetitive patterns, improvisation, melodic percussion instruments;
Creativity – improvisation opportunities;
Impulse control through nonverbal musical signals – e.g., start cues, stop cues, dynamic cues, meter cues;
Impulse control through verbal signals – e.g., start cues, stop cues, dynamic cues, and meter cues;
Fine motor control – palmar grasp for mallet use; instrument assembly task;
Pattern recognition – instrument assembly according to predetermined pattern;
Letter recognition – instrument assembly according to predetermined pattern;
Social interaction – group music making, improvisation, eye contact with others for musical cues;
Group awareness – moving from one instrument to the next in the pattern, waiting for peers to move, fixing instruments so next player can play without interruption
Rationale: Clients with developmental and psychiatric disorders are often unable to entrain to an external stimulus. This inability to entrain may stem from sensory difficulties in the auditory domain, motor coordination deficits, and/or issues with comprehension of abstract musical concepts.
Source: Original idea. © 1/6/2010 by Mary Jane Landaker, MME, MT-BC
Materials: Orff instrument for each participant (for children with auditory sensitivities, watch for signs/symptoms of auditory distress such as hands on ears, increase in wandering, increase in aggressive or self-injurious behaviors, etc.; appropriate mallets for each participant; (optional) visual chart for aiding with instrument assembly; visual aids of sandwich parts (bread, meat, cheese, mayo, etc.)
Environment: Clients sitting in semicircle on floor or in chairs to facilitate instrument play. Beat keeper (therapist or member of group with excellent tempo recognition skills) sitting directly across from the bass xylophone players to aid in visual attention.
Song/Chant/Words: Not necessary for TME – optional chant/song words included below
Make a sound sandwich; Build it from the bottom,
Make a sound sandwich, hear the sound.
Procedure: R = Reinforcement opportunities; C = Redirection/Cue opportunities; A = Assessment
1. Invite client to choose xylophone from storage cabinet. Encourage independence through providing prompt and waiting to see if client follows prompt. R – Provide specific reinforcement if client moves independently to cabinet with only one prompt (Say, “Name, way to follow directions!). C – if client does not start to move on own, provide verbal prompt again and pair with gestural prompt (e.g., sign or pointing towards storage cabinet). If client still does not respond, move to client and assist client physically in moving to cabinet (e.g., touch prompts, proximity, leading client to cabinet)
2. Provide reminders to client (as needed) about difference between xylophones and metallophones (wooden bars versus metal bars); provide physical assistance to manipulate instruments without damage.
3. While client is moving xylophone to playing area, provide movement cues to arrange the environment appropriately. If possible, arrange client before he/she starts next step in procedure.
4. Instruct client to remove all bars from the xylophone box.
5. Direct client attention to xylophone diagram to assist in placing bars in correct location on xylophone box. R – provide specific reinforcement if client assembles instrument with only one prompt (Say, “Name, you’re putting it together by yourself!). C – if client does not start on own, provide verbal prompt again and pair with gestural prompt (e.g., demonstrate assembly). If client still does not respond, move to client and assist client physically in assembling the instrument (e.g., touch prompts, proximity, pointing to visual aid)
6. After instrument is assembled, allow client to play independently until cued to stop.
7. Provide cue (conducting cut-off) with verbal countdown to focus attention on therapist and encourage client success.
8. Ask client how to make a sandwich. R – acknowledge and reinforce all answers that are relevant to the discussion about sandwiches – may take time to get desired answer relating to bread as the most important part of a sandwich (without bread, the food is not technically a sandwich!).
9. Explain that client and therapist will be making a sound sandwich using the instruments. (Be prepared for lots of confused looks and expressions of confusion about this concept.)
10. Start client playing the bass xylophone on steady, repetitive pattern – for beginners, the note pattern does not matter. Focus on the steady, entrained pattern as the most important element of the experience. C – incorporate a “beat keeper” to provide visual cue for playing with steady beat. This increases success for client during difficult task.
11. Continue with steady repetitive pattern from bass xylophone player. A – watch bass xylophone players to determine if they are able to maintain attention to beat keeper (indicated by playing when the beat keeper pats his/her legs), if they are able to use mallets appropriately, if they become distracted by other performances, and other elements of attention during the experience.
12. Once bass xylophone players have established steady beat for short period of time, cue other players to improvise. C – point or use baton to cue client to play instrument. A – watch players to see if they can recognize a nonverbal cue to play, if they are able to entrain their improvisation to the beat of the bass xylophone players, and if they are able to use mallets appropriately.
13. Provide clients with verbal countdown before indicating cut-off. R – verbally recognize all players who stopped at the cut-off. Reinforce all other desired behaviors either verbally or nonverbally.
14. Ask client to move to the instrument located next to his/her current position.
15. Repeat steps 10-14 until client has finished turns on all of the instruments or starts to indicate saturation with the TME (e.g., increase in wiggling, decrease in attention to task, difficulty attending to visual cues, other behaviors as appropriate).
Adaptations:
1. Use therapist as beat keeper and ask all clients to entrain movements to visual cue of patting legs.
2. Use file folders to notate specific ostinati for use during the session
3. Use visual aids to illustrate the concept of a sandwich – ask clients to make the sandwich with the pictures, then choose instruments to correspond to each part of the sandwich.
4. Decrease complexity by limiting number of bars on instruments. Use pentatonic or two-tone setups to increase musical structure and decrease opportunity for dissonance.
Extensions:
1. Increase complexity through decreasing improvisation – assign an ostinato to each classification of instruments – all clients have to remain within the beat structure.
2. Use different instruments to illustrate layers of music – drums, guitars, keyboards, etc.
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