A Child’s Musical Journey
By Laurence Marie, Harp Therapy Journal, Summer 2010
I have now been working primarily with Special Need Children for 6 years as a Therapeutic Harp Practitioner. These children have various conditions: Cerebral Palsy, Down Syndrome, Erchern-Wolf Syndrome, Williams Syndrome, Angelman’s Syndrome to name a few and Autism. Consistently more than half of the children I see are autistic, which is why I decided to do this article on my experience with autism. Because of the numbers I keep informed about the condition: special TV programs, articles, books by professionals and also books written by autistic people, a major eye opener for my approach.
The word autism comes from the Greek autos, meaning self, so by extension autism means withdrawn, self-absorbed. Dr Kaner was the first to establish a diagnosis in 1943. Autism or ASD (Autism Spectrum Disorder) affects language development, social development, emotional development and behaviour. The level of disability varies from severe (non-verbal, self-injurious, mental retardation) to high functioning autism or Asperger’s Syndrome (very intelligent, good language development but lacking social skills).
There has been a tremendous increase in the incidence of autism in the last few decades. In 1980 it was 1/10 000, nowadays, it is 1/100 and it is four times more common among boys. In classic autism, symptoms are present at birth. In regressive autism, children are diagnosed between 18 and 36 months of age. There seems to be a variety of factors that causes autism: vaccines, environment, processed foods, allergies as well as hereditary factors. (Interestingly enough, autism is very rare in the Amish community*. It is also very rare in Africa**except among the elite families).
The most common treatment is ABA (Applied Behavioural Analysis). As its name implies, it is a behavioural therapy offered to preschoolers for up to 40 hours a week. Other similar therapies include: IRD (Relationship Developmental Intervention), DIR (Developmental Individual differences Relationship based), and SACCADE, a relatively new therapy from Quebec, Canada. Other therapies considered by some families: Medication, Naturopathy, Homeopathy, special diets and music therapy.
Working with children who are not bedridden or wheelchair bound, bedside harp was not appropriate. Even though they have special needs, they also have energy, are curious and just playing for them was not going to be enough and therefore I needed to modify the approach taught to us in the IHTP program. William Jackson, the Music Therapist my class of 2000 had the privilege to have, was an inspiration but there again not enough information so I had to come up with ideas. Having had four children of my own helped some, having taught in an alternative school long ago where most of the children attended because they did not fit in the system for one reason or another helped also, and so did my experience as a youth group facilitator. I had learned from those experiences that each child has "special needs" and it is up to the adult involved to figure out ways so that each child can learn, can deal with an emotional issue, can sort out a problem, etc.
The children I work with presently are more challenged, that is true, but they are still individuals so I still need to get to know them as individuals, and devise musical activities for each of them depending on their very special needs so that music can transform them, heal them. I do use the harp; it is very much part of the sessions and all the children love it. The harp seems to be a magnet, they are attracted to it and run towards it as soon as they come in the room. But I also use small percussive instruments for variety, rhythm, communication, dexterity. We also sing, make up songs, which encourage the children to communicate verbally, increases their vocabulary and we also improvise. I might create a song around sounds a child has difficulty with. We also dance and move to music for the development of gross motor skills, coordination and pleasure. We tell stories incorporating the harp and other instruments. In my part of the country, we have a Francophone community and an Anglophone one: my children come from both so that means double the work! The sessions vary from half-hour to one-hour, depending on different factors (age being the obvious one) once a week. Sessions run from mid-September to mid-June, also in the summer but on a more flexible schedule. The sessions are framed by a ‘hello song’ and a "goodbye song'. The 'hello song' is followed by a 'sound massage," which consists of rolled chords accompanying a song that uses all 7 notes of the scale, then various activities start. Before the "goodbye song," some children like to lie down on a blanket while I play for them. Once the child has developed a solid relationship with me through the music, which can take anywhere from a few weeks to a few months depending on their personal circumstance, he/she takes part in a monthly group session while still coming for individual weekly sessions.
Parents sometimes pull their children out too quickly, not realizing miracles do not happen overnight or because of financial reasons or because the goal they had for their child has been achieved.
I should also say that I am registered with the Department of Social Development, a government agency, and it pays for some of the children based on various criteria. Another government program, Respite Care gives some financial assistance to some families. It doesn’t cover my fees entirely so a portion of my work is volunteered which is fine with me. Families who do not have access to these programs pay me directly and I issue them with a receipt for income tax return purposes.
Generally, I find the younger the autistic child is the easier it is to reach them and get results. With older children, it takes much longer to get results and those are not so miraculous. Those children have been in their "bubble" as I call it for so long it is harder to reach and touch them and bring them out. Even though I don’t just use the harp, I do follow the therapeutic music philosophy. I always watch for "what is willing to meet me", so sometimes what I thought was a great idea has to be abandoned because the child does not respond or other times the child gives me some signal, a cue and I go with it.
For ease of telling my experience with autistic children, I have chosen a child’s story in particular. But all stories are similar in the way they develop even if the activities and the journey are different (which they are). The goal is to get them in a place where they can express themselves verbally, emotionally and can interact with their peers and the adults in their lives.
S. was 3 1/2 years old when he first came to me. This was in July 05. He had been diagnosed at age 3. He was verbal but with echolalia and often his language was off, out of context, not connected to what I had said, did or played; he spoke in the 3rd person and talked more to himself rather than to me. He did not respond when I talked to him. He was in his "bubble." He was very hyper and could not concentrate at all. There was no eye contact, no physical contact. He would get over-stimulated very easily so I had to introduce the small percussive instruments, one at a time. He did not like loud sounds either, he would cover his ears. He mixed what, why, when, who, which. He could not tell his mother if he was hungry, thirsty, cold, hot and never showed emotions of any kind. But he was enchanted by the harp and liked playing glissandi, was excited by the sounds. By the end of the first session I managed to get him to throw a ball (with a bell inside) back at me just the once but I figured, that was communication!
The second time he came to see me, he marched right in. Played with the harp, the ball, took my cues: rolling, throwing, catching, and kicking the ball. He looked at me through the strings and tried to say my name! By August his attention span has definitely improved and he enjoyed us playing the harp together. He had a good sense of rhythm and could reproduce patterns very easily. By the end of September he responded well to cues, made eye contact on a regular basis, tried to learn songs, had a sweet voice and sang in tune. He initiated activities, gave me cues for a change, offered me his cheek for me to kiss! The very last session of September 05, as he entered the Conservatory he saw me and yelled, "here she is" and run to me, took my hand and said, "lets go in here," (meaning the music room). When he left that day he told his mum my name was Laurence and he said it better than a lot of adults!! S. was obviously relating to me by then… only 3 months had gone by since he had started. By November he participated in storytelling with the harp.
All of the activities we did were musical, a lot with the harp, making stories where the strings would come alive: hungry teddies, big dancing bears, small birds chirping, all geared to get him to express himself verbally better, to show his emotions. We also sang and danced, made up songs. I also used the resonator bars, one at a time then 2 or 3. S. played them and I harmonized on the harp and S. was aware of what I was doing and was watching me. We played the drum; he imitated various rhythm combinations. By mid December he did not speak through the various characters of our stories anymore but addressed me directly. He also let me give him a goodbye hug.
In February 06, 7 months after starting Harp Therapy, he joined the group lesson, once a month with other children but still came for the weekly sessions. At first he is not so sure because he had to share me and because he is not used to being with other children "that’s MY Laurence!". But he learned to share the instruments, understood taking turns, pointed out when it is so and so’s turn, thanked a child for giving him an instrument and sings with them. The other kids are somewhat older, one is non-verbal, the other has CP and even though he is now verbal, it is still difficult to understand him so S. finds it a little disconcerting.
After the summer break, individual and group sessions resume for S. The group sessions are more satisfying this time: he is with two other autistic kids around the same age and at the same level of development. They will have a great time together, becoming close friends not just during the group but also outside of therapy. The 3 mothers have become friends and get together with the children during the week. During that Fall 06, S. notices the Instruments of the Orchestra poster on the wall. He keeps going to it and eventually asks me what they are. So I am thinking, does that still fall under Harp Therapy? The immediate answer is NO but then I hear "What is willing to meet me?" I decide the answer to be YES instead!! so I asked him would he like to learn their name? he does. Within 3 weeks (3 sessions) S. knows the names of all the instruments and then he wants to know how they sound!! So I make a CD compilation and the following week we start listening as we look at the picture of each instrument…well it only took another 3 weeks (3 sessions) for him to master that feat! He is 4 ½ years old! So to carry on this trend I decide to bring Benjamin Britten’s Young Person’s Guide to the Orchestra CD. We listen to each instrument and then to the final Fugue when all instruments play together. His face was priceless, he was so taken by it, his eyes and ears were wide open…the music finally stopped and S. is silent for a few seconds, still wide eyed as if in a trance then turns to me and says, "Laurence, I WANT to give you a hug!" And that little guy puts his arms around me and squeezed me so hard and so long, I had tears in my eyes…it doesn’t get any better than that! What a gift! From here on S. was able to express his wants and needs, his feelings. He was able to transfer his newly found ability to connect to his friends in the group, to his mum and dad and other family members. Mid-June 2007, S. said goodbye for the summer. His mum was pretty elated by her son’s progress. She felt that he would be able to not only integrate kindergarten in the fall but function well.
In September, S. came back as planned but I did not recognize him! He had regressed! I just did not understand so I asked his mother for an explanation. During the summer the parents had separated and as planned S. had started Kindergarten 2 weeks prior and both these events had set him back. I was devastated, after all the work I had done and the progress S. had made. But this was not about me. I figured if I had been able to bring him out of his autism once, I should be able to do it again…and indeed after a few weeks, S. was back on track and we had a marvellous year together. It was to be our last. S. entered grade one in the Fall 2008. I recently had news from his mum that he is doing well. During that last year with me, he was able to transfer what he had learned in the monthly group sessions to the playground and the classroom. He could actually approach another child and asked if he would play with him!
I have been on this journey many times with different children enough to give me the confidence to know that I can help autistic children. The journey might vary: different music, different songs, different dances, stories but the intention is the same, the love is the same. What is willing to meet me sooner or later lets a beautiful child emerge from his "bubble".
In conclusion I shall quote S.’s mother: "Music with Laurence has allowed S. to just be — to live fully in the moment. He has grown in confidence and self-esteem, has become more focused and aware of his surroundings. Music has become for S. a tool to make meaningful connections with one adult as well as with his peers. S. has learned to express love and affection. Harp Therapy has made real my hopes for my son to be the loving and affectionate person that I knew he always was."
I would like to thank Christina Tourin from the IHTP program and Sarajane Williams from the VAHT program for all they have given me. Their gifts have allowed me to bring some light in people’s lives.