A Child in Time and Health

Music therapists often speak of working with the ‘whole’ child, and of music therapy addressing the multiple needs of children with disabilities, disorders or ‘in crisis’. Since many music therapists work in settings that think of childhood within the developmental framework, and of pathology as distinct from health, how do practitioners fit their experience of the ‘whole’ with the developmental, educational or medical images of the child? In reporting our work to other professionals, how is this ‘wholeness' portrayed – and conveyed? This paper1 explores ‘childhood’ and ‘pathology’ from various perspectives without aligning itself with any one at the expense of another. Rather, it offers various convergences to help conceptualise and describe the whole child in music therapy. Although the notion of the ‘whole’ applies not only to children but to all persons in music therapy, this paper focuses on childhood, which is especially susceptible to being viewed as a ‘developmental’ stage in life.

Analysing change in music therapy interactions of children with communication difficulties

Music therapy has been found to improve communicative behaviours and joint attention in children with autism, but it is unclear what in the music therapy sessions drives those changes. We developed an annotation protocol and tools to accumulate large datasets of music therapy, for analysis of interaction dynamics. Analysis of video recordings of improvisational music therapy sessions focused on simple, unambiguous individual and shared behaviours: movement and facing behaviours, rhythmic activity and musical structures and the relationships between them. To test the feasibility of the protocol, early and late sessions of five client-therapist pairs were annotated and analysed to track changes in behaviours. To assess the reliability and validity of the protocol, inter-rater reliability of the annotation tiers was calculated, and the therapists provided feedback about the relevance of the analyses and results. This small-scale study suggests that there are both similarities and differences in the profiles of client-therapist sessions. For example, all therapists faced the clients most of the time, while the clients did not face back so often. Conversely, only two pairs had an increase in regular pulse from early to late sessions. More broadly, similarity across pairs at a general level is complemented by variation in the details. This perhaps goes some way to reconciling client- and context-specificity on one hand and generalizability on the other. Behavioural characteristics seem to influence each other. For instance, shared rhythmic pulse alternated with mutual facing and the occurrence of shared pulse was found to relate to the musical structure. These observations point towards a framework for looking at change in music therapy that focuses on networks of variables or broader categories. The results suggest that even when starting with simple behaviours, we can trace aspects of interaction and change in music therapy, which are seen as relevant by therapists.