Music Therapy Case Sharing – supporting non-verbal participants

Music therapy is a professional practice that uses music as a clinical tool, supported by evidence-based research. Music therapists purposefully apply music to actively support participants’ health, functionality, and well-being. Through the interactive relationship between therapist and participant, music therapists employ a diverse range of methods. Unlike general music education or entertainment, music therapy focuses on improving health, functional abilities, and overall well-being.

Regardless of a participant’s musical ability, culture, or background, Registered Music Therapists (RMTs) strategically use music to achieve various functional goals, such as communication skills, social interaction, cognitive abilities, physical movement, or self-regulation. Music therapy can be conducted through one-on-one individual sessions or group therapy. In this issue, I will share how music therapy supports the functional goals of a participant with severe disabilities.

[Supporting Nonverbal Participants in Music Therapy]

Xuan Xuan (pseudonym) is a teenage with Level 3 Autism Spectrum Disorder who is nonverbal. She is unable to care for herself independently and falls into the category of severe disability. Xuan Xuan has been participating in music therapy for eight years, and over this time, music therapy has played a crucial role in improving her quality of life and achieving meaningful functional goals.

In music therapy, the therapist connects with her using nonverbal methods, such as improvisation. Through elements like rhythm, melody, and dynamics, the therapist guides and encourages nonverbal responses, fostering interaction. During sessions, Xuan Xuan often jumps excitedly. Sometimes, the therapist improvises on the piano, matching her jumping rhythm with harmonies. Upon hearing the music, Xuan Xuan is immediately drawn in—she rushes to the piano, takes the therapist’s hand, and laughs with excitement. Although this interaction does not involve spoken language, it is a clear and effective form of communication.

Music therapy also collaborates with Xuan Xuan’s other therapists, such as speech therapists, by incorporating music—her strongest motivator—to support communication training with augmentative and alternative communication (AAC) tools. During sessions, Xuan Xuan uses AAC devices to give instructions and "sing" her favorite songs. For instance, the therapist uses her favorite Disney song, Let It Go, as a prompt. Xuan Xuan listens to the therapist play and sing while using hand-eye coordination to select "Go" on her AAC device in sync with the song. Being able to actively engage with music she loves directly and positively reinforces her ability to use this communication tool and maintain focus.

Additionally, music therapy provides Xuan Xuan with opportunities to express herself and make choices. In song choice activities, she selects a song using picture cards, and the therapist immediately sings or plays it, strengthening her ability to make choices. At times, she also selects commands such as "fast/slow" or "loud/soft," and the therapist adjusts the music accordingly. This process not only enhances her decision-making skills but also improves her understanding of abstract concepts like tempo.

Beyond communication, music therapy supports Xuan Xuan’s physical health and emotional regulation. She suffers from severe eczema, which often causes discomfort and distress. Individuals with autism may struggle to express their needs effectively, and the lack of verbal communication can make it difficult for others to understand them, leading to frustration. When Xuan Xuan feels agitated, the therapist guides her to choose a favorite song, which often helps her calm down and even smile.

For Xuan Xuan, music therapy is the only medium through which she can form meaningful connections with others while effectively working toward her functional goals.

(This article was written originally in Chinese for online magazine Sameway Issue 723, It is translated to English with aid of ChatGPT)