THE ROLE OF A MUSIC THERAPIST IN A REHABILITATION TEAM IN THE HEALTH PROMOTION OF CHILDREN WITH CEREBRAL PALSY

Jautrė Ramutė Šinkūnienė

Abstract


Cerebral palsy in children is an early impairment of the central nervous system that affects various areas of a child’s functioning – movement, speech, communication, cognitive functions, attention, behaviour, and emotions (Rosenbaum et al., 2007). Lack of independence poses a high risk of causing a child psychological and social difficulties, limits opportunities to participate in daily life, and makes the child dependent on others; these factors reduce a child’s self-confidence and their desire to act in a social space (Whittingham, Bodimeade, Lloyd, & Boyd, 2014). This article concerns global experiences of the application of music therapy in neurology, and presents the situation in Lithuania (Abramavičiūtė & Aleksienė, 2011). The concept of neurological music therapy is disclosed on the basis of theoretical research methods, and an overview of the range of options for the application of music therapy in rehabilitating children with CP is provided (Alves-Pinto & Turova, 2016; Rolvsjord, 2010; Thaut & Hoemberg, 2014).
The therapeutic effects of music are increasingly being recognized in the field of rehabilitation medicine. More music therapists are being employed in physical medicine and rehabilitation centres, with the goal of using music therapy services to assist in the physical recovery and maintenance of the health of children with cerebral palsy. Music therapy and rehabilitation medicine are starting to find a common niche in working together with clients who have various neurological, orthopaedic, and paediatric conditions (Stanley & Ramsey, 2001). The therapeutic application of music in rehabilitation contributes to the quality of life of individuals with disabilities. Combined goals include improving strength, range of motion, balance, communication, and cognition (Nip, Arias, Morita, & Richardson, 2017; Rolvsjord, 2010). Continued research and efforts in clinical practice will build on the information already available to further define the possible applications of music therapy in rehabilitation, its outcome, and its benefits. Occupational therapists can use the therapeutic medium of music, and the services of the discipline of music therapy, in assisting clients to maximize their functional independence in their daily occupational roles.
The research object of this paper is music therapy methods, focused on the individual special needs of children with CP. The aim of this article is to reveal the role of a music therapist in a team of rehabilitation specialists in the health maintenance of children with cerebral palsy. This will involve three tasks: 1) to review the results of music therapy research in children with CP, revealing the applied methods for the development of movement, emotion, and communication skills; 2) to present the assessment of specialists regarding children with CP (their strengths, weaknesses, achievements, and goals) from those working in the rehabilitation team – namely the speech therapist/special pedagogue, occupational therapist, and physiotherapist; and 3) to analyse the possibilities of the individual effects of music therapy on children with CP in order to achieve positive changes in psychosocial status. The research question asks: Which methods can a music therapist contribute to the rehabilitation programme of children with CP as an equal member of the team?
The sample of this study was three children with cerebral palsy attending X social care day centre. Children were selected by convenient selection (all children attended the same institution) to analyse homogeneous cases according to CP diagnosis during music therapy sessions. The research ethics were ensured in a number of ways. Firstly, the participation of the day centre specialists in the interview survey was voluntary. In accordance with the principles of ethics, the researcher presented the topic of the work, the objectives of the research, and confirmed the anonymity of the received information and its use only for the purposes of the work. The parents of the study participants (children) were introduced to the objectives of the study and confirmed their consent in writing, as well as approving the use of the recordings of the MT sessions for scientific purposes. Finally, the children’s names were changed to preserve anonymity. The study possesses some limitations – primarily the fact that, due to the complexity of the disabilities of children with cerebral palsy and the nature of supportive rehabilitation, trends in therapeutic effects could not be confirmed over eight individual MT sessions. Music therapy should be an individual, long-term, and systematic process, as consolidating new abilities in a child with CP requires the consistency and continuity of activities.
The research methods utilized include: theoretical analysis of scientific literature and research in rehabilitation and music therapy; structured interview with rehabilitation specialists – physiotherapist, occupational therapist, and speech therapist; and empirical research – an analysis of three cases identifying physical, emotional, and communication changes in the process of music therapy. Analysis of the video recordings of individual sessions of music therapy revealed positive changes in children with CP in the following areas of development: movement skills, emotions, and communication.
The findings of the empirical research revealed that therapeutically created space – by properly choosing musical instruments – strengthened the child’s movement control, the musical environment increased motivation, and rhythmic music playing allowed the child to adjust the sequence of their movements and their range. Music was an alternative means of communication, helping to develop the child’s communication skills, social interaction, and the creation of a new communication experience for the child. The individualized selection of music therapy methods provided an opportunity to delve into the child’s emotional state, develop their self-awareness, strengthen self-confidence, reduce anxiety levels, and model appropriate behaviour.

Keywords


music therapy, rehabilitation team, health promotion, children with cerebral palsy.

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DOI: https://doi.org/10.13165/SD-21-19-1-04

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