Annie, age 10, sits with two other children in an after-school music class and beats on the drum, answers questions, participates in group singing games and strums an autoharp. Extraordinary?
Annie's mother, Mary Callanan of Kensington, thinks so. A few years ago Annie was completely nonverbal and unable to relate to people. She also displayed autistic tendencies and other behavioral disorders.
"In addition to helping her become more verbal," says Callanan, "the music therapy program has given her greater confidence to try new things. She's more interested in the world around her, and makes more of an effort to relate to people."
Music, for Annie, has been a link with life.
And for others, claim music therapists. Increasingly familiar as a stress-reduction device in hospital labor and delivery rooms, music therapy is also being used to reach out to emotionally disturbed and mentally retarded children and adults, the gifted and talented, stroke victims, chronic pain sufferers and the dying. Multiple-handicapped children and the elderly constitute two of the largest groups.
Ruthlee F. Adler, music therapist at Christ Church Child Center in Potomac, explains: "While autistic and handicapped children may ignore or be indifferent to various kinds of stimulation, they do respond to music. We can use it as a learning tool to teach basic skills -- numbers, vocabulary, colors, shapes."
Also, says Adler, "music provides opportunities to practice gross motor skills -- clapping and marching -- and fine motor skills needed to play even a simple instrument.
"Music is calming, all-encompassing, and nonthreatening. It helps these children to relax and focus their attention."
The same is true at the Hebrew Home in Rockville, where music therapist Louise Lynch conducts regular music sessions for elderly residents. Twice a week she works with patients with Alzheimer's disease, who range in age from 59 to 92.
"Some have lost all ability to talk or recognize family members," says Lynch, "but they still respond to music. Some will sing the words of familiar songs, a few will dance, and nearly all will at least tap a foot to the rhythm. Music provides a way of reaching them when little else can."
Adler and Lynch are two of approximately 40 registered music therapists in the Washington area, and 2,000 in the country. Although the healing qualities of music have long been recognized, music therapy as a profession began only after World War II, with the treatment of vets who came home with psychological problems, says Edward Norwood, executive director of the National Association for Music Therapy in the District. NAMT was founded in 1950 and a sister organization, the American Association for Music Therapy (AAMT), in 1969. Today 75 universities and colleges across the country offer programs in music therapy, including Catholic University and Howard University.
JoDelle Waller, director of music therapy at Catholic University , defines music therapy as a tool for teaching nonmusical skills. "Music is frequency," says Waller. "It affects mind and body. Every human responds to rhythm and sound. It provides us a way of reaching people and teaching nonmusical responses, whether it be socialization, academic goals or emotional expression."
"We have very specific therapeutic goals in mind when we use music," says Lynch. "If, along the way, a patient enjoys himself, or learns to play an instrument, that's great, but it's a byproduct of the process, not the goal."
Ava Dowdy, music therapist with the Fairfax County school system, concurs. "Music accomplishment is not important," says Dowdy. "Only the process is important." Dowdy works with 180 mentally retarded or multiple-handicapped children, aged 5 to 21, at the Kilmer Center in Vienna. "We set goals for each child. They may relate to communication skills, motor skills or socialization skills. We find that music motivates and holds the interest of these students so that we can teach the skills they need."
Guided imagery -- combining relaxation, music and vocal narrative -- is one technique used by Eileen Borris, a registered music therapist in Baltimore with a PhD in psychology. Patients are encouraged to describe the images and emotions produced by the music, and to discuss them later with the therapist.
Borris describes how this approach helped a 10-year-old leukemia patient face his own death:
"The child had been withdrawn and depressed. Then one day his mother brought him a present. It was a snail in a box of sand. He was fascinated by this and I followed up on it by asking him to imagine warmth, a beach. At the same time I played some classical music.
"This child then imagined the most beautiful creation scene, and after that, his own funeral. Afterward he told his mother, 'You don't have to cry for me anymore.' From this point on this child seemed at peace with himself. He became more independent and even allowed his mother to go back to work. He died three weeks later.
"Here is a clear case," claims Borris, "of how music became the instrument which allowed a person to open up and deal with feelings."
Allison Shipe, 24, of Warrenton, has used guided imagery in music, in combination with intensive physical therapy, to reduce pain after back surgery on two ruptured discs. "I was desperate, willing to try anything that would help to alleviate my pain," Shipe admits, "or perhaps I would not have been as receptive to this idea." Under the direction of music therapist Carolyn Sonnen, then at Mount Vernon Hospital in Alexandria, Shipe began to learn how to use the imagery and relaxation techniques. The result: a lessened dependency on medication.
"Music provides a creative outlet," says music therapist Lisa Turpin, who works with mentally ill adults at St. Elizabeths Hospital. "Through music," she says, "we can help them to get in touch with their feelings, improve their levels of functioning and work on social interaction skills. We use a team approach, working with other therapists on the same goals and objectives for each individual patient."
With emotionally disturbed adolescents at St. Elizabeths, Jackie Portis will sometimes use music to generate discussion. She selects a theme and plays familiar music to illustrate it. The group then analyzes the message, discusses it and relates personal experiences. "Music increases their ability to concentrate," says Portis, "so that they can respond appropriately. It also helps to build a trusting relationship with the therapist."
With younger children Portis uses structured music games as a means to build skills. A major goal with these children is to teach them self-control.
Researchers in other parts of the country are involved in studying the effectiveness of using guided imagery in music in fighting cancer. Others are describing and even photographing the effect of different pitches and frequencies on subatomic particles in an effort to understand why music affects us on so many levels.
"There are a number of ways in which music can be used to assist patient recovery," says Dr. John N. Aseff, assistant medical director of the National Rehabilitation Hospital, which is scheduled to open in November in Washington. "Still, music as a therapeutic tool is probably underappreciated by the medical community. The problem is that very little, if any, of the therapeutic effects of music have been quantified, or scientifically measured."
Ara Rachal, director of music therapy at Howard University, agrees. "We are still doing research to verify and support what music therapy does, but it's hard to do. Music is so subjective; it's very hard to measure behavioral change in any one person brought about by music. Perhaps because it is so hard to measure, there is a very slow acceptance by the medical community. Many doctors don't understand what music therapy does or how to use it."
Louise Lynch believes we've seen only the tip of the iceberg when it comes to using music for therapeutic purposes. Lynch's 20-year-old son recently sustained severe head injuries in an automobile accident that left him in a coma for 7 1/2 weeks. Doctors at the Baltimore Shock Trauma Center warned Lynch that it was highly probable he would be impaired if he survived at all.
Lynch proceeded to enlist the cooperation of the medical and nursing staff. During each nursing shift anti-stress music was played to her son, along with tapes Lynch made herself describing events they had shared. Lynch is convinced that the music not only stimulated his brain, but helped to keep his blood pressure and other vital signs and agitation under control. Today her son has completely recovered from his injuries and has sustained no perceptible brain damage. Except for the music, he received standard treatment for a patient with such injuries.
According to neurotrauma clinical nurse supervisor Connie Walleck, "the type of stimulation used by Louise Lynch for her son is good in that people in a coma can hear and process information. It probably can help but to what degree we cannot say."
A graduate student at the center currently is studying the effect on music on intracranial pressure. "We don't know the answer yet," says Walleck, "but there is enough interest in finding whether music can have a positive effect on recovery that it is being looked at seriously by researchers here and in other areas."