The Out of Sync Child: Vestibular System

During internship for a few weeks of symposium I read the book The Out Of Sync Child. This book was very informative and gave me a better idea of how the clients I am working with process the world. The Out Of Sync Child has a chapter on each of our senses and how those can be affected for those with Sensory Processing Disorder. Sensory Processing Disorder is the inability to use information received through the sense in order to function in daily life. The five main areas included are tactile, vestibular, proprioception, vision, and auditory. This book has so much information in it so for this post I am going to focus on Vestibular.

First, when we are using the vestibular we have the ability to tell where our body is in space specifically by sending sensory messages from the neck, eyes, and body to Central Nervous System to generate muscle tone to move smoothly.

The functions of the vestibular include:

  • Balance and where the body is directionally
  • Awareness of dizziness
  • Awareness of other peoples movements
  • Keeping us from falling (which is a learned skill)

Clients either have overresponsivity or underresponsivity to the vestibular senses. They can also be vestibular seeking. Knowing the difference and observing this behavior can make all the difference during a session. When a client is overresponsive they don’t like fast movement so they like to stay stationary, and they don’t enjoy spinning and even sometimes driving in a car. When a client is underresponsive they don’t notice movement and they frequently fall. When a client is vestibular seeking they love movement, like jumping, spinning, swinging, climbing, and they need to move to stay focused.

Some typical problems for clients with vestibular dysfunction include:

  • Being uncoordinated/bad posture
  • Visual problems (looking from the board to their desk)
  • Difficulty interpreting language
  • No awareness of falling
  • Bilateral coordination is slow
  • Hard time riding a moving bike

You can find The Out of Sync Child at:

Emily Kent

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Improvisation

There are many techniques a music therapist can use when working with clients. This week I have learned about the importance of improvisation especially when working with clients who have autism or who are nonverbal. One study called The Effects of Improvisational Music Therapy on Joint Attention Behaviors in Autistic Children: A Randomized Controlled Study shows the benefits of improvisation with this population. They found that music therapy led to longer lengths of eye contact and turn taking. Techniques such as matching were used to fit with the participants style, dynamic and tempo, which led to more connections between the therapist and child. This study also found that the improvisation aspect helped the children work through their rigidity and inflexibility, which often children with autism struggle with.

Improvisational music therapy could be a whole course because there are so many techniques and methods to learn. Below I have defined a few improvisational techniques that I find useful and have used with clients before:

 

Mirroring: imitating or copying the client musically and meeting them exactly where they are.

 

Reflecting/Matching: following the client’s mood musically, and playing the style, tempo, dynamics, and complexity of the music the same.

 

Grounding: creating a beat or melody that anchors the client’s music. This could be holding strong octaves, playing a steady pulse on the drum, or playing a simple ostinato.

 

Dialoguing: communicating through musical play. This could be similar to a conversation where you may interject, take turns, or play at the same time.

 

All of these techniques allow the therapist to begin to connect with the client, and can be very effective if the client is having a hard time engaging with you. In some cases the client might begin to notice you are playing with them, and this can help to guide the therapeutic experience for the rest of the session.

 

Emily Kent

 

Resource

Kim, J., Wigram, T., & Gold, C. (2008). The Effects of Improvisational Music Therapy on Joint Attention Behaviors in Autistic Children: A Randomized Controlled Study. Journal of Autism and Developmental Disorders, 38(9), 1758-1766.

The Importance of Self Care and Helpful Resources

It is important for everyone, not just therapists, to evaluate their personal well-being. This can be difficult when your job (or internship) is focused on the success of others especially when it seems there is always a huge list of things to do. I was reminded this week that I need to take some time for myself, even if that means changing my to do list around for that week. In any situation where you are working with others, if you yourself are not taken care of, how do you expect to help guide others in a successful way? I think every so often it is important to be mindful of what you need physically, psychologically, emotionally, spiritually, in relationships, and in the workplace. Taking a few minutes to write down my needs in each area has been helpful. Below I have attached a simple form to help you write a Self Care Plan from REACHOUT.com. When I did this alongside my coworkers I was able to see the areas I am lacking in, and also heared ideas of how to improve them from other coworkers. If you are doing this on your own, to get some ideas check out the link below where you can find the self care plan and other resources.

Another idea to help you stay mindful of self-care is to put a sticky note on your mirror in the bathroom or in a place that you will see it every day as a reminder of what you want to do each day to feel balanced. This can help you to just take a second to take a few deep breaths or remind you to make time to exercise, eat well, or maybe even just talk with a friend or family member on the phone. Another way to be mindful and take some time to relax can be done through listening to relaxation tracks from YouTube, or using an app like Headspace. This can even be beneficial for your clients as well, so below I am sharing a video, The Headspace app/website and a few scripts that you can use for relaxation.

Self Care plan and Further Information:

Self care plan

https://schools.au.reachout.com/articles/developing-a-self-care-plan

Relaxation Track: https://www.youtube.com/watch?v=86HUcX8ZtAk

Headspace (Check this awesome website out): https://www.headspace.com/

Scripts for Relaxation: https://hubpages.com/health/Progressive-Muscle-Relaxation-Script

https://hubpages.com/health/Guided-Imagery-Forest-Script

 

Happy Mindfulness,

Emily Kent

 

Everyone Can Move

Movement is an essential part of life. We are constantly moving our bodies, and for those where actions of daily living may be more difficult it is still essential for them to move as well. These two books below (Everyone Can Move and Music is For Everyone by Laurie Farnan and Faith Johnson) give a great overview of why movement is so important to our well-being and show how as a therapist we can use music to help facilitate beneficial movements. From these books I have learned the importance of movement, and as an intern, have utilized these skills in sessions with my clients. For example, I often will incorporate music and movement following the opening song because of its ability to the grab the attention of my clients because it quickly helps them engage in the session. Movement is also a great way to re-engage your clients near the end of the session, especially when they are tired (e.g. late afternoon or evening sessions). These books also helped me to think about how I am positioning a client when I am working with them, and to consider what instruments I am giving to each client because that will affect their ability to be successful and to stay engaged.

Everyone Can Move- Short Summary of Important Sections

It is important to continue to work on the use of motor movements even if there are impairments because it helps the client use their senses. Music motivates people to move, and causes a physiological effect on the body. Music stimulates the nervous system and can cause large muscle groups or small muscle groups to move. Movement at the beginning of a music therapy session can be beneficial because it grabs the client’s attention and focus, and warm’s up the central nervous system so they are primed for later activities. Even if a client is not ambulatory, they can still move. These are called non-locomotor movements. Moving as a group is also important because it not only helps with moving the body but it also works on social skills. It is important to remember that movement is also beneficial when it is creative or expressive. This means that even if it is something copied and repeated it is still a form of self-expression. Ways to help facilitate this type of movement would be by first modeling a movement and using these movements throughout activities and then giving opportunities to move freely during an activity.

Music is for Everyone- Short Summary of Important Sections

Everyone can participate in music as it is motivating and inviting because of music’s components. Music affects the auditory senses as well as the physical senses because of vibrations. Music stimulates the entire brain and is first processed below the level of awareness and then at awareness level, which is why it affects many areas like attention, memory, language, social skills, and voluntary movement. People respond to music in four different ways, moving, playing, singing, and listening. Body posture is also important when working with people with disabilities because if they aren’t supported in the right places they will have a hard time participating in the activities. Fine motor skills can be worked on through playing an instrument because it is motivating and it effectively improves these skills. For example playing the triangle or castanet works on pincer and tripod grasp. It is also important to remember how much effort it takes to play an instrument and you may need to re-evaluate if the client it having a hard time playing the instrument. Remember that rhythm will bring the group together and the words will direct the group.

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Where you can purchase this book:

http://www.westmusic.com/p/everyone-can-move-book-804107

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Where you can purchase this book:

https://www.amazon.com/Music-Everyone-Laurie-Farnan-Johnson/dp/0931205212

Citation:

Farnan, L., & Johnson, F. (1988). Everyone can move. New Berlin, WI: Jenson.

Farnan, L., & Johnson, F. (1988). Everyone can move. New Berlin, WI: Jenson

 

Emily Kent