The Magic of Music: Children with Hearing Loss Christine Barton, MM, MT-BC June 28, 2014.

The Magic of Music: Children with Hearing

Loss

Christine Barton, MM, MT-BC

June 28, 2014

Music Experience

Today is Saturday, it’s time for music

Today is Saturday all day long

Today is Saturday, it’s time for music

So, won’t you sing along?

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How did you get here…

or… where did your journey start?

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For me, it began here…

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Then here…

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And here…

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Then here…

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Finally here!

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Agenda• Introduce music therapy profession

• Introduce selected current research on deafness and co-existing conditions

• Highlight key issues in music perception in children who are deaf or hard of hearing

• Provide music experiences and resources to support communication in children with hearing loss and co-existing conditions

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Music Therapy Defined

The clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed a music therapy program.

-American Music Therapy Association, 2005

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MT-BC CredentialMusic Therapist-Board Certified

• Earn a Bachelor, Equivalency, or Master’s in MT from an accredited university

• Complete a six month internship at accredited site

• Pass the Certification Board Exam for Music Therapy

• Earn CEUs or retake exam on 5 year cycle

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Why Music Therapy?• Takes advantage of the child’s innate musical

abilities• Current meta-analysis reveals music therapy to be

effective in developing communication, interpersonal, personal responsibility and play skills (Kern & Humpal, 2013)

• May involve families in shared music-making experiences which can be carried over in the home

• Can target gross and fine motor skill development through playing instruments or creatively moving to music

• The structure and sensory input inherent in music help to establish response and role expectations, positive interactions and organization (AMTA, www.musictherapy.org)

My Current MT Practice

• 200+ children/week– D/HH – ASD– Dev. Preschool– Elementary Life Skills– Montessori (PTT)– Private Practice

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My Current MT Practice

• Dual Diagnosis:– ASD/HL (5)– Down Syndrome/HL (2)– Mitochondrial Disorder/HL (1)– Bronchio-oto-renal/ASD/HL (1)– Intellectual Impairments/HL (3)– Medically Fragile/HL (1)

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CDC Prevalence of HL 2014

http://www.cdc.gov/ncbddd/hearingloss/facts.html

• 1 to 3 children per 1000 are born with a hearing loss

• 9 out of 10 deaf children are born to hearing parents

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Music/Language Similarities

• Share terminology– Pitch, timbre, timing, intensity

• Both have melodic contour• Similar strategies used when

listening to music or language• Early exposure is critical for

acquisition of both• Both follow a time-ordered

sequence of skills or milestones

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Children learn their native language by hearing it, then speaking it, and finally reading and writing it. Music learning follows the same sequence.

Music/Language Differences

• Music encompasses a greater spectral range

• Music can exist without language• Language can be altered in music

without changing the music itself• Spoken language surrounds most

children whereas music may not

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Music and Hearing Loss

• HA and CI children perceive rhythm nearly as well as their hearing peers (Gfeller, 2000)

• CI users less accurate than hearing peers in song recognition (Stordahl, 2002)

• Pitch perception and production more of a challenge

• For some, music may not be as enjoyable, but for others it is very motivating and desirable

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Music and Hearing Loss

A handful of studies have shown that music training for individuals with hearing loss can have positive effects in cognitive, linguistic, memory, and music perception domains.

(Abdi, Kahlessi, Khorsandi, & Gholami, 2001; Galvin, Fu, & Nogaki, 2007; Peterson, Mortenson, Gjedde, & Vuust, 2009; Yuba, Itoh, & Kaga, 2007).

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Deafness and Comorbid Conditions

Gallaudet Research Institute (2009-2010)

• 40% of D/HH children have comorbid conditions

• 1 in 59 D/HH children receive services for ASD

• More children (35.4%)with profound loss have the dual diagnosis

• Result: deaf children receive ASD diagnosis later than hearing peers (Vernon and Rhodes, 2009)

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Deafness and ASDRosenhall et al., 1999

• 1-6% of children who are deaf also have ASD

• 1.6% unilateral • 7.9% mild to moderate • 3.5% profound

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CDC Prevalence of ASD 2014

http://www.cdc.gov/ncbddd/autism/data.html

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• 1 in 68 (eight year old) US children identified with ASD

• Increase of 30% from 2008• Boys 5 times more likely than

girls• Most not diagnosed until after 4

Music and AutismLeo Kanner, 1943

• At the age of 1 year "he could

hum and sing many tunes accurately.“

• About 2 1/2 years, he began to sing. He sang about twenty or thirty songs, including a little French lullaby.

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Music and Autism

Heaton, P. (2005)Journal of Autism and Developmental

Disorders, Vol. 35, No. 6, December 2005

Experimental investigations have highlighted exceptional pitch discrimination and memory in

individuals with ASD.

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Music and Autism

Ehlers, S., & Gillberg, C. (1993). Journal of Child Psychology

and Psychiatry, 34, 1327–1350.

Absolute Pitch (AP) in ASD individuals was at least 20 times the prevalence of the

general population

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Music and AutismBrenton JN, Devries SP, Barton C, Minnich H, Sokol

DK. (2008)Pediatric Neurology 2008;39:137-138.

Absolute pitch is thought to be attributable to a single gene, transmitted in an autosomal-dominant fashion. The association of absolute pitch with autism raises the speculation that this talent could be linked to a genetically distinct subset of children with autism. Further, the identification of absolute pitch in even young children with autism may lead to a lifelong skill. Christine Barton 2014 27

Music and Autism

Whipple, J. (2004)Journal of Music Therapy, Vol 41(2),

2004, 90-106.

Meta-analysis revealed:

All music intervention, regardless of purpose or implementation, has been effective for children and adolescents with autism.

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Music Experience for Benjamin

• Improvisational in nature, incorporating his utterances, name or familiar phrases

• Drums, guitar in open tuning or pre-tuned xylophones

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Music Experience for Yeahsen

It rained on Yeahsen and Yeahsen got wet

Pitter patter, pitter patter, pitter, patter, pat

Use other names of family members, neighbors, classmates, baseball team, animals, food

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Music experience for William

• Sing the Lings, syllables with xylophone or drum accompaniment

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Music Experience for Nathan

• Write a Music Experience Book• Write a song

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Assessment Tools

• SJI Music Assessment Rubrick, Barton, 2008

• Auditory Learning Guide, Developed for First YEARS by Beth Walker

• FLAQ Parent Survey• Gordon PMMA

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Strategies• Utilize the team with the family at

the core• Enlist and coach parents to help

generalize targeted goals across multiple settings

• Provide structure/routine– Visual schedule/class rules

• Provide music experiences/instruments that require no formal training

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Strategies

• Simple directions (use fingers as mnemonics)

• Get attention first (“show me you are thinking about me”)

• Appeal to all the senses• Repetition• Choices and alternatives• Tell them what they can do• Do not ask rhetorical questions!

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Considerations/Observations

• Each child is unique• Hearing loss is usually addressed first• Intervention/placement is chosen based

upon the most current need • Spoken language (and even reading) can

occur after 5!• Hearing devices make a positive

difference in the quality of life for individuals and families

• Music offers the potential to create relationships and provide life long enjoyment

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Resources• The Listening Room (Advanced Bionics)

– www.hearingjourney.com• Perspectives on Deafness and Autism

Webinar Series– http://

www.audiologyonline.com/ce/advanced-bionics/events/details/23774/deafness-with-autism-music-therapy

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Resources• Gallaudette Clerc Center

– http://www.gallaudet.edu/clerc_center.html• More Than Meets the Eye: An Introduction to

Autism Spectrum Disorders– http://www.gallaudet.edu/clerc_center/webinars

/more_than_meets_the_eye_an_introduction_to_autism_spectrum_disorders.html

• Managing Behavior by Managing the Classroom: Making Learning Accessible for Deaf and Hard of Hearing Students with Autism Spectrum Disorder– http://www.gallaudet.edu/clerc_center/webinars

/sharing_autism_research_on_deaf_or_hard_of_hearing_students.html

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Resources

• Autism Research Institute– http://www.autism.com/services_visualhearing

• American Society for Deaf Children: http://www.deafchildren.org/deaf-autism-america

• Autism Speaks: www.autismspeaks.org

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Resources

• West Music– www.westmusic.com

• American Music Therapy Association– www.musictherapy.org

• Guidelines for MT Practice in Developmental Care - Chapter 9: Children with Hearing Loss (Barton, 2013) Barcelona Publishers http://www.barcelonapublishers.com/index.php?route=product/product&product_id=269&type=epub

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For More Information …

Central Canal Creative Arts

TherapiesChris Barton, MM, MT-BC,

Director, Music Therapy

Services/Consultingwww.christinebarton.net

Phone: 317-475-9914E-mail:

[email protected]

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