Neurologic Music Therapy (NMT) …Demystified: MACT

Musical Attention Control Training: MACT

What is MACT?

Musical Attention Control Training, or MACT, is the use of music experiences and/or musical elements to practice a specific type of attention.

To really understand MACT, we’re going to take a closer look at the “A” in that acronym, for attention.

 Attention is the selective awareness of or selective responsiveness to the sensory environment around you. The ability to choose where you focus your attention is the first step in the learning process, and we all differ in our abilities to control our attention. The good news: we can develop attention control skills like building blocks through structured practice! We can conceptualize the types of attention as a pyramid, starting with focused attention as the base:

 

 

What does MACT look like in a music therapy session?

Music therapists tailor MACT exercises to suit their clients’ interests and clinical needs. As a result, MACT can look very different from session to session or client to client. MACT exercises may entail the use of many different music-based therapeutic music experiences.

For example, music therapists may facilitate sustained instrument-playing incorporating preferred and (the ever tricky) non-preferred instruments. Alternatively, a sustained attention exercise may call for the client and therapist to play instruments while the client adjusts their playing style (e.g. fast vs. slow, loud vs. soft, high vs. low, etc.) in response to musical cues (ideally without verbal prompts) from the therapist. A music therapist may target selective attention by introducing extraneous sound “distractors” to a music experience and challenge the client not to respond to (e.g. turn head to look at) the distractors.

Alternating attention exercises may require a client to shift their attention between two tasks, like tracking visual notation (e.g. sheet music) and playing an instrument simultaneously. At the end of the day, MACT could refer to a wide range of active or receptive music experiences, as long as they are designed to practice one or more types of attention, and utilize music as a delivery medium.

How music makes it work:

Active and receptive music experiences share powerful patterns of brain activation in the bilateral frontal lobes, brainstem, and attention systems in the cerebral cortex. This overlap ensures that the attention skills practiced with music will translate to other contexts, like school or vocational skills. Furthermore, music experiences like instrument-playing, singing, or improvising are often intrinsically motivating, allowing music therapists to get our “foot in the door” to engage with clients and bolster attention skills. Finally, music, as an organized auditory stimulus, brings timing, grouping, and temporal organization so that attention can be sustained and strengthened over time.

 

Thanks for reading!

~Esther

Cognition

Eleven percent of children in the United States have been diagnosed with ADHD and 1 in 88 children have been identified with having autism.  People who have these diagnoses exhibit trouble with cognition, specifically with attention and inhibitory control.  So why use music therapy to help with attention?

• Rhythm creates a temporal structure for neurons to fire
• Rhythm creates an organized time frame, helps with learning and perception
• Rhythm can create the right amount of predictability
• Pleasant music increases blood flow to the basal ganglia and prefrontal cortex and decreases blood flow to the flight or fight response area in the amygdala

Below is an example of an ABA therapist working on joint attention with a child with autism.  Music therapists use similar techniques, but using musical instruments and songs.

Here is an example of a music therapist working on joint attention with a child.  You can also see how well the child’s attention is sustained while playing an instrument.  Playing an instrument is a great way for someone to practice and develop sustaining attention to a task as well as other types of attention and cognitive skills.

Mary Jane

Word of the Week: DIVERSITY

Music therapy is very diverse in its clinical applications.  During my internship at the Music Therapy Center of California I have worked in individual and group settings.  The individuals and groups also have a variety of diagnoses such as Autism, Down syndrome, Cerebral Palsy, Apraxia, Dysarthria, Alzheimer’s/Dementia, Stroke, and Traumatic Brain Injury.  The diverse client load lends itself to diverse approaches of using music to meet non-musical goals.

During internship I have focused on learning and applying neurologic music therapy.  Neurologic music therapy is evidence-based and focuses on using techniques that can be generalized into life situations.  Instead of seeing music therapy as black and

 white, neurologic music therapy allows for an addition of various “colors” or techniques to accomplish goals such as attention.  Within the goal for attention there are five different NMT techniques that breakdown what type of attention is being worked on: focused, selective, divided, alternating, and sustained.

– Hilary White