Using the language of music to speak to children with autism

by Ellen Chase/The Star-Ledger

A 12-year-old boy with autism is profoundly deaf. The music therapist instructs him to rest his chin atop the body of a cello, his face inclined toward the instrument's neck. As the therapist guides him in moving the bow across the strings, the vibrations travel up his jawbone to the inner ear, and the boy "hears" music for the first time.

A 4-year-old boy with autism does not use speech to communicate. He points at objects to express his needs. His music therapist ends all the sessions by singing "Happy Trails," directing the nonverbal children to pantomime riding a horse. They make "clucking" sounds with their tongues to imitate the sound of the horse's hooves. Soon, the boy starts making the sound to "request" the song. The teachers and aides point out that this is the first time he has used a speech sound to express a need.

Months later, the boy is saying, "One, two, three" and "ball game" to request another favorite song.

Not a bad day at the office for a New Jersey musician, and the accomplished artists like him who have achieved something that conventional therapists strive to do: open the eyes and ears and minds of children who have closed out their world.

"For people with autism, the world is a chaotic place, full of overwhelming levels of sensory input," says John Foley, who has been working as a music therapist for more than a decade at schools and programs throughout North Jersey. "Music has form we all recognize, even if we don't think in those terms; music makes sense. In the early days of defining autism, heightened response to music was considered for the list of possible symptoms."

Scientists may be skeptical, but ask music therapists and parents whose children are receiving their services, and you'll hear plenty of anecdotal evidence to support the healing power of music.

"There's no doubt in my mind that it's made a difference," says Michele Phalon, whose, son, Michael, 4, receives music therapy from "Mr. John," as Foley is called by parents and students at the Peter Cooper School in Ringwood. "Mr. John is a such a wonderful teacher and has a great way with the kids. I wish I could say how, exactly, but I just know that music is an avenue to get their little brains going."

Foley himself admits, "We know music therapy works with people on the autism spectrum, even if we don't always know why or how."

There are several theories about why people with autism are particularly responsive to music. One suggests that it complements their cognitive tendencies: namely, an inclination toward creating patterns. Music is structured and reassuring, with anticipated progressions and a certain predictability.

Just over a year ago, a session titled "The Autism Agenda" at the conference of the Silver Springs, Md.-based American Music Therapy Association emphasized the need for further research and for the practice to be more evidence-based. But there can be special challenges in assessing the benefits of music therapy for children with autism because they often are receiving other services at the same time. Some experts also have suggested that using randomized controlled trials to conduct research is difficult because autism is a spectrum disorder and individual behavior varies so greatly.

In New Jersey, where autism is diagnosed in one out of every 94 children -- compared with one in 150 nationally -- parents are often desperate for an effective intervention. "Determining the efficacy of many therapies is a major issue," says Madeleine Goldfarb, the director of Outreach and Education at the Autism Center at UMDNJ-New Jersey Medical School in Newark. "Parents aren't going to wait around for the evidence."

When it comes to music therapy, many of them insist they already have it.

"The proof is in what you see and the changes in your child," says Chelsea Celentano, whose son, Santino, 5, attends Peter Cooper School. "It's hard to argue with physical progress. There're naysayers out there in everything. But you see the difference."

And how would she describe the difference in Santino, who was nonverbal until 19 months of age and was diagnosed with autism at 27 months?

"Amazing," she says. "Part of his disability is the anxiety he feels in new situations. Now, he participates independently. He had a sensitivity to certain songs -- like 'Happy Birthday' -- and would cry. That has never happened in music therapy with Mr. John. He dances now. And he talks up a storm."

On Thursdays, the talk is likely to revolve around his activities for the following day. "And he's so excited because 'on Fridays, it's Mr. John!'" Celentano says, echoing her son's enthusiasm.

Celentano, who commutes 45 minutes from the family's home in Lyndhurst to Ringwood for the overall services at Peter Cooper, said she was considering enrolling Santino in a weekend music therapy program and was pleasantly surprised to learn of one at the YM-YWHA of Wayne -- where, coincidentally, Foley is the therapist.

"Mr. John works a special kind of magic," says Vicki Woodruff, whose son, Kyle, 5, has been in the program since the age of 3. "Kyle doesn't like me to sing. He always puts his hands in front of his ears when I do -- but he absolutely loves his time with Mr. John."

Woodruff was floored the first time Kyle came home humming a tune. "It was a miracle," she said. "Now, he knows different kinds of instruments because he has hands-on experience with them in class. He knows what they're called. He'll see them in stores and talks about them. Perhaps the best part is the carry-over effect.

"I love this therapy," Woodruff says, "because it's social, it's academic and it's structured. Mr. John teaches them a lot and they have to pay attention."

But while parents whose children are benefiting from music therapy sing its praises, many New Jerseyans still may have difficulty finding it, and many others may not even know it exists.

"It's not as widespread here as you might think," says Brian Abrams, president of the mid-Atlantic region of the American Music Therapy Association and an associate professor at Montclair State University's John J. Cali School of Music.

"New Jersey probably has about 150 certified music therapists -- as opposed to a couple of hundred more in New York and about 4,000 nationwide," he says. "But it is a rapidly expanding field."

As the undergraduate coordinator of the school's music therapy studies program -- the oldest program in the country and the only one in New Jersey that trains music therapists -- he ought to know. And although he agrees that there is a need for the therapy to be more research-based, Abrams says there already is "some compelling evidence backed by case studies" to support what so many parents of children with autism have learned: that music helps their children focus; that it relieves anxiety and frustration; that it decreases agitation; that it improves their cognitive function and their ability to master language; that when they are in a musical environment, they are better able to interact with their peers.

Abrams' colleague, Karen Goodman, a music therapist who is also a professor at the Montclair State program, isn't buying the idea that more research is needed. "The research is significant enough to make the case," she says. "I think what we really need is more music therapy."

Goodman, a senior clinician at Montclair State's music therapy clinic who has been treating children and adolescents on the autism spectrum since 1978, has taken a step toward that end with her recently published book, "Music Therapy Groupwork for Special Needs Children: The Evolving Process." But if music therapy is evolving, she suggests, its goal remains constant.

She illustrates this point with an anecdote about one of her longtime patients. "This girl was the daughter of a Broadway performer, and she could sing an entire musical score but couldn't say 'hello,'" Goodman says. "The idea is to tap someone's musical ability in order for them to communicate -- not to be a freak. We want these kids to be able to 'make their own music' in the form of dialogue ... to be able to have a conversation."

Parents turn to music therapy in order to improve their children's everyday function, and what could be more basic to human function than communication?

"Imitation is probably the most basic form of communication," Foley says, "so I use songs that demonstrate a desired response and leave an opening. For nonverbal students, I might play two or three percussion instruments in a certain sequence and leave space for an 'answer.' We can take this up a level by varying the sequence."

These activities also help develop motor skills, Foley notes.

"I wrote a song in the 'doo-wop' style to help integrate children who can sing words with those who are limited to vocalizing syllables," he says. "In the time I've been using the activity, I've seen children who began by vocalizing 'ah-mm' and 'ooh-wah' move up to singing words.

"Obviously, most of the credit goes to the teachers and speech therapists, but I believe the music therapy plays a part."

Foley wanted to record some of the songs so the students and teachers could become familiar with the material. So he took some friends into a studio and recorded a dozen songs that he released on CD. They found themselves getting air play on NPR and college stations as the Radar Rangers -- "named after my microwave oven," Foley says.

Foley, 57, and a resident of West Milford Township, has done many concerts in New Jersey to promote the material, the most recent of which has been aired regularly on PKRG-TV (Park Ridge, Cablevision Channel 77, Verizon Channel 22). It is a distant relative to the genres he had mastered in the past: He has fronted rock (and rockabilly) bands for 40 years, and is still a regular sideman for folk legend Oscar Brand.

The Radar Rangers are now working on their third CD and giving concerts with a focus on integrating special-needs children with the general audience.

And he expects the music will continue to help children with autism learn to connect with others.

"It may be difficult to explain or to quantify," he says, "but it's not difficult to see."

Source: http://www.nj.com/entertainment/arts..._music_to.html

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