Today’s post is about the use of music therapy with maladaptive behaviors (i.e. aggression, short attention span, won’t follow directions, difficulty coping, etc). Depending on diagnoses, approaches might vary a bit, but you will read a few tips/suggestions regarding this population.
Sample Goals/Objectives:
- Request/Terminate an Activity: Lots of times, a child can become frustrated (which can lead to aggressive behaviors) when they can’t communicate 1)what they want or 2)when they want something different. We may see the most aggressive issues when a child is non-verbal, so requesting through pictures, the use of an iPad, or speaking device can provide them a ‘voice’. For the client who can use their words, it is important to model key phrases (generally through song!), when they are ready for something different. A sample objective is: By December 2013, (child’s name) will expand his language skills in asking for a preferred item/activity or terminating item/activity by using appropriate phrases, given one model by therapist, 80% of opportunities, across (#) consecutive sessions, as measured by data collection.
- Following Directions: Seems simple, right? Well, for some it is, and for others it is not. During assessment, probe the child’s ability to follow simple 1-step, 2-step, etc. directions. The child may not be able to follow multiple-step directions, and perhaps this is where they are becoming frustrated. Make it simple, make it meaningful and useful in their life. Make mom and dad happy by getting the basics down! A sample objective is: By December 2013, (child’s name) will demonstrate the ability to follow basic one-step directives*, given one prompt by therapist, 80% of opportunities, across (#) consecutive sessions, as measured by data collection. *Targeted directives: stop, sit down, come here, wait, clean up.
- Role Play ‘Calm Body’: When a child does become agitated, or you sense that they are becoming increasingly aroused, it is important to teach them how to calm their body. I use a lot of role play in my sessions, as well as visuals. One of my favorite resources is the Tuned into Learning books. For these types of children, I generally use the “Body Check” song, “The Expression on My Face” song, and “Tall Trees” song to target self-regulation. Here is a sample objective: By December 2013, (child’s name) will demonstrate the ability to role play 1) quiet voice, 2) calm body/deep breathing, 3) eye contact, and 4) sitting up straight/show me ready, during the “Body Check” song, given visual cues, 80% of opportunities, across (#) consecutive sessions, as measured by data collection.
Tips for working with a child with difficult behaviors*:
- Set a schedule: Give the child a sense of what is coming. They will work towards a goal/break better when they know what they have to accomplish first (ie. First you will complete the ‘Feelings Song’, then an ‘Action Song,’ and then you will get a break). A visual schedule (even if the child is cognitively high) may help in reinforcing your expectations and can assist in the child’s awareness of their schedule.
- Set a timer: For children who struggle with staying on-task, completing tasks, or just from short attention, timers are a great tool. Set the child up for success the first several sessions. When the child hears the duck go ‘quack quack’ that means they get a break. Praise them for completing their task! Once you have built rapport and the child knows what to expect, start the timer over if they get up from the task or show maladaptive behaviors during the task. Bummer!
- Keep a calm tone: Remember that you are working with a child. This child may have come from a family who argues, yells, hits, etc. and perhaps they have picked up on those behaviors. Your tone should be even, calm, and positive. If the child starts to become agitated, use an intervention to bring them down.
- Make expectations clear and attainable: Be consistent. If working with a three-year-old, take into consideration a ‘typical’ attention span. Work towards that. Remember to praise when the child has reached a goal (whether completing an intervention for one whole minute without spitting(!) or reading an entire book without ripping the pages), and say why you are proud of them (I’m so proud of you for reading that entire book with such gentle hands!).
- Communicate with Parents/Teachers/Team: Hopefully a child with aggressive or maladaptive behaviors is working with a behavioral therapist, and/or a licensed psychologist. It is important to be working on their goals in your music therapy sessions. Don’t write completely new goals – work on the same – progress will be quicker and parents and child will be happier. Express to the family what is working, what isn’t, and give them tips and tools for success at home.
I hope these sample objectives and tips might help you in your treatment sessions. Feel free to comment below with your ideas, research, and thoughts! Thanks for reading!
*These tips are my own and are what have worked for me with my clients. I use a behavioral approach to music therapy. All clients are different and may require different approaches.