(From the Spring 2013 issue of Everything Matters: In Patient Care)
Jennifer A. Yurkovich, MT-BC, NICU MT, Music Therapist, Family and Volunteer Services
As you walk through the halls of Nationwide Children’s, you may hear the sounds of medical equipment, alarms and pagers – but you may also hear singing, a guitar, shakers and joy. Music therapy has been part of the inpatient treatment teams at Nationwide Children’s since 2003 but the first collegiate training programs in music therapy were created in the 1940s.
Music therapy is a research-based clinical field which uses music interventions and music’s therapeutic relationship to promote health and to help patients reach individualized goals. At Nationwide Children’s, music therapy interventions are implemented to address pain management, self-expression, developmental skills, memory building, coping with hospitalization, academic skills and leisure skill development.
Why music? The unique properties of music allow for positive change resulting from a non-invasive intervention. Music and its contributing qualities including rhythm, pitch, timbre, lyric content, dynamic, tempo and texture are processed in 23 areas of the brain and across both hemispheres. This results in music being an activating stimulus throughout development as well as in the face of neurologic decline or devastation. Even in a medically sedated state, research has shown music therapy intervention is successful in decreasing pain and lowering heart rate as the familiar musical stimulus is still perceived. Similarly, infants from birth are responsive to musical qualities including pitch and melodic contour and quickly develop expectation related to repetitive and structured musical experiences. This is why music is effective in transitioning infants to organized behavior states, allowing for more efficient neurologic development and learning.
Music therapy services are offered throughout inpatient units at Nationwide Children’s. Due to limited staffing, services are prioritized for patients who are most likely to suffer psychosocial impact due to hospitalization, including patients experiencing frequent and lengthy hospitalizations, chronic illness or developmental decline. The Music Therapy Program has expanded in recent months with the addition of a part-time position serving the Hematology/Oncology Unit, a grant-funded research position contributing services to the on-site Neonatal Intensive Care Units (NICU), and the development of an accredited music therapy clinical internship position.
As we celebrate these additions, we also look to the future of music therapy at Nationwide Children’s. Parents of children on the autism spectrum have expressed interest in music therapy services in outpatient clinics as a supportive behavioral therapy. Music therapy may also benefit patients and families receiving hospice and palliative care services. Research supporting the use of music therapy with these populations is vast. We hope to be able to provide these services throughout Nationwide Children's in coming years.
The Music Therapy Program also hopes to extend to the off-site NICUs, focusing on the use of Multimodal Stimulation and the Pacifier Activated Lullaby (PAL). Multimodal stimulation is a protocol backed by more than 20 years of research combining auditory, tactile and vestibular stimulation which has resulted in shortened hospitalizations and increased tolerance of the environment for premature infants. Parent training in multimodal stimulation has shown to increase parent visitation time in the NICU, empowers parents to interact with their infant appropriately and promotes bonding. The PAL is a device approved by the Food and Drug Administration, which encourages the development of feeding skills in premature infants through contingent music presentation. Studies show that premature infants learn to produce a non-nutritive suck response more quickly when using the PAL device than with other methods.
Consults to music therapy services can be placed within the Epic system. As music is a natural component of childhood, family and culture, no musical expertise is necessary for a patient to benefit from music therapy services. The music therapists at Nationwide Children’s look forward to working with the patients and families you refer!