Pattern Sensory Enhancement, or PSE, is a Neurologic Music Therapy (NMT) technique developed by Michael Thaut. This technique’s purpose is to elicit movement with musical cues through all elements of music (i.e. tempo, rhythm, dynamics, etc.). Those cues fall under three primary categories, spatial, temporal and force, and has a step by step procedure to follow. When done correctly, PSE can be very effective in not only engaging but driving movement and prompting full range of motion and functional motor movement.
Spatial cues are broken down into pitch, dynamics, sound duration and harmony. All of these elements indicate how the body should be moving in space in one capacity or another. If a music therapist wants to facilitate an arm swing up and down, they could use a legato scale crescendoing as the scale ascends to elicit the upward momentum of the arm and a decrescendo as the scale descends down on the release of the movement. Gravity naturally assists this lowering or downward motion of the arm meaning emphasizing the movement with rising dynamics and a connected melodic line are less of a necessity as the laws of physics state that what goes up must come down.
Temporal cues encompass tempo, meter, rhythmic pattern, and form. Matching the desired motion to these cues is important for the clarity and facilitation of the movement. For example, if a therapist’s objective is to maintain or improve lower body gross motor function in the legs, and therefore is facilitating leg lifts, using a duple meter march will depict the movement within the music. Duple meter because the natural cadence for walking goes 1. 2., 1.2. (i.e. leg goes up/down, up/down). An example of an appropriate song might be “When the Saints go Marching in”. It is in a duple meter and the downbeat is very strong and easy to pic out. The corresponding lyrics are convenient, although not necessary.
Force cues are musical elements like dynamics, harmony, and tempo. Although these elements are used as spatial and temporal cues, they can also be used to indicate where the “work” or exertion is in the movement (i.e. in the leg lift example above, lifting the leg requires more exertion to work against gravity). In other words these help to cue the points at which the muscles are either exerting or releasing energy. A dissonant chord, such as a diminished C, might be used at the moment a client needs to hold a position of tension. The chord resolving to C major would indicate the release or relaxation of the muscles.
To effectively implement PSE, it is important for the music therapist to follow these 4 steps.
- Demonstrate the movement with your client and set a tempo on a metronome that matches their natural cadence (i.e. If you will be marching, introduce it verbally but also demonstrate what the movement should look like.)
- Following the metronome, give your clients rhythmic verbal cues. (i.e. Give your verbal cues in the corresponding meter. If you have a metronome that allows for tapping in the beat, do so.)
- I.E. up and down, out and in
- Continue the verbal cues while gently bringing music in.
- Fade out the verbal prompts and let the music facilitate the movement.
- Optional: add a song, but never compromise the beat!
*Source by Tara Harwell