Breaking Out of a Mental Jail

Music Therapists Paul Nordoff and Clive Robbins. Photo: Nordoff Robbins

Breaking Out of a Mental Jail

Joe Paxton explores how the basic processes of music can help people with autism communicate through improvisatory music therapy.

Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship.’ — AMTA 2011

Music Therapy can be used to help people who have physical or mental conditions such as dementia, behavioural difficulties, depression and autism. It strengthens communicative functions, working on the basis that all humans have an innate response to music.

Autism is a life long developmental disability that affects how a person communicates with, and relates to other people. It also affects how they make sense of the world around them.’ — The Autistic Society, 2012

Although the term autism — first coined by Dr Leo Kanner in 1943 in his book The Nervous Child — has only been used in the last seventy years, it is by no means a new condition. There are even many theories that link the disorder to Beethoven and Mozart. Autism is a spectrum disorder (ASD), meaning that there are different types of autism that come with varying degrees of symptoms. Although some types of autism develop as people age, such as Rett’s Syndrome, all types of autism are genetic; that is the person is born with the developmental disability. Symptoms of autism differ greatly across the spectrum and each type of autism has its own traits.

Autistic people struggle to some degree with social interaction, social communication and social imagination. Mild ASD people for example may struggle to understand facial expressions and sarcasm, finding conversation very confusing, while people with Severe ASD may have no functioning verbal skills or understanding. It is also quite common for autistic people to be either hypo-sensitive or hyper-sensitive. This means that everything can seem overly loud and bright (hyper-sensitive) or quiet and dull (hypo-sensitive). This can lead to extra difficulties in communication: in both of these cases, it can be difficult to separate background noise from the sound of the person speaking to them.

Research into therapies for autistic people has increased greatly in the last twenty years. These therapies are aimed at two main areas: as a soothing and calming exercise providing the autistic person with physical or mental relief, and as a tool for enhancing communication skills; both verbal and non-verbal. The most common therapy used by autistic people is speech and language therapy, which uses a wide range of skills, often involving a speech therapist working very closely with a child.

Music therapy has a history that can be traced back to the use of music as a sedative in late nineteenth-century hospitals, but since its formalisation as a recognised discipline in the 1950s and 60s there has been much research into music therapy for a wide range of physical and mental disabilities, from depression to stroke recovery. In the case of autism, music therapy is used both as a sensory relaxation tool and a tool for teaching communication skills. Music — like language — consists of a complex set of symbols with governing rules, and entail a great deal of emotive representation. It can be used in therapy as a medium aiding communication as it is a simpler process through which language can be developed.

Music therapy for autism allows the autistic person to practise social interaction, communication and imagination: the three main areas of communication affected by autism. Improvisation in music therapy classes allows the patient to experiment with imagination, by creating patterns for the therapist to follow. In call and response situations both social interaction and communication can be exercised to differing degrees as determined by the therapist.

The best way to demonstrate how music therapy is used with autistic people is to consider case studies, such as that of the non-verbal girl in Juliette Alvin’s book Music Therapy for the Autistic Child. When arriving for music therapy, this child was completely shutting out the outside world and hardly communicated with anyone in any form. Attempts to interest her in using instruments were met with complete rejection. However, the girl slowly came round to joining in with the therapist on a medium-sized drum and as her therapy progressed, became more confident, playing it louder and beginning to respond to different rhythms and dynamics. The dynamic and rhythms that the therapist and child each used reflected some low level of meaning in communication. Although she never learned to speak, music therapy here gave her the ability to express herself in a musical medium.

Another example of this type of communication, though this time with improvised vocal sounds, is the video by the Nordorff and Robbins Research Institute in London.This video shows the patient Jack, who has severe learning difficulties and autism, communicating with the sounds ‘hiya’, ‘aye’ and even ‘ba doo ba doo’. Increases in speed and changes in levels of dynamic are met in response by Jack’s singing and he even displays improvised dancing to some of the more exciting sections of the conversation or song. It is clear that there is an improvisatory conversation going on here such as Alvin described with her patient.

Improvisation is an extremely important factor in these modes of therapy. It means that the process of communication is not daunting to the patient, as there is no need to think of words. It also allows patients that can or may one day be able to use verbal language to practice the skills of taking turns in conversation. By responding to the therapist in this way, it is clear to see that Jack is able to drive the song to some extent toward the music that he wants to hears and the music that he wants to engage in to be able to express himself.

Music has an amazing ability to work as a therapy for enhancing and transforming lives of people with autism. The simplified nature of language in music can be a medium for expression of emotion, which can lead to development to more complex verbal communication. Music therapy has the ability to release autistic people from a mental jail where confusing emotions are impossible to express. People’s innate responsiveness to music has developed into a medicinal art which with further research could further the lives of hundreds of people who suffer from autism.

Published on 22 August 2012

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