A unique child: Music therapy - Scaling up

A research project carried out at Coram is demonstrating the extent to which music therapy can assist vulnerable children in developing their confidence, self-esteem and social interaction skills.The project was led by Tiffany Drake, who has been developing music therapy at Coram since 2002.

She says, 'While there has been a lot of research carried out around music therapy, no standardised tools exist. For this project I drew on tools from other studies to develop new tools specifically for this study, and I hope that in the future these may be used by other music therapists. At Coram, the challenge was evaluating the impact of music therapy across a range of ages and needs.'

Tiffany hopes that her findings will raise awareness about music therapy and how it can support children. She feels that currently there is often a misconception that it is about musical skills and attainment, rather than about emotional well-being.

'It would be good to see music therapy becoming an integral part of early intervention,' she says. 'We are seeing increasing numbers of practitioners undertake some training in the basic principles of music therapy, to give them an understanding of how to use music on an interactive level.'

Methodology

Twelve children, aged 20 months to nine years and referred to the Coram music therapy service, participated in an investigation to assess the impact of music therapy on their emotional, communication, interaction and concentration skills. Each child had between ten and 20 individual or parent-and-child music therapy sessions.

Video analysis

Video extracts from the beginning, middle and end of each child's music therapy were analysed by an interdisciplinary panel of observers. Five video rating scales were designed specifically for the investigation to measure changes in the children's responses across a range of modes of interaction.

The rating scales were: voice; interaction and communication; play, imitation and control; musical relationship; concentration. Each of these was rated on a scale of -2 to 2 under the headings:

- Avoidant (-2)
- Emergent (-1)
- Equitable (0)
- Testing (1)
- Dominant (2)

Interviews

Pre- and post-therapy interviews were conducted with parents and those who referred the child for music therapy to assess the child's development, strengths and needs, and the generalisation of the impact of music therapy to other settings (such as home and nursery).

Questionnaires

In order to assess the impact on the multi-agency team, questionnaires were distributed to staff before the music therapy service was fully established and again near the completion of the research.

Research results

Video rating scales showed that 75 per cent of the children made positive progress in three or more of the five scales.

Feedback from the questionnaires highlighted that the children were able to communicate their feelings better through actions, implying an increased capacity for self-expressions. Negotiation and tolerance skills improved for many children. At least a third, according to parents and carers, were 'able to wait when asked' and 'generally did what asked to do', suggesting improved negotiation and tolerance skills. Concentration improved for a quarter of the participants.

Implications of the research for childcare services

The positive findings of the research suggest that this model of music therapy might be successfully replicated in similar multi-agency settings, such as children's centres, where the integration of a therapist into the team could benefit staff and parents as well as children.

They suggest that positive outcomes for children could be maximised by:

- Embedding music therapy provision within a multi-agency team

- Approaching children's needs in a wider context by engaging with related professionals and the family

- Directly involving parents in the child's therapy, where appropriate

- Locating such specialist services in non-stigmatising, community based settings to maximise the potential for engaging vulnerable families

- Adopting a flexible approach so the needs of vulnerable children and families are addressed in the most appropriate and timely manner.

FURTHER INFORMATION

- A summary of the research can be downloaded at www.coram.org.uk

- British Society of Music Therapists: www.bsmt.org.