James E. Riley, MM, MT-BC

“Hello, hello! I see you there in the green shirt, the green shirt, won’t you please tell us your name?” A child looks down to check before opening her eyes wide and pointing to her own shirt. The Music Therapist – Board Certified (MT-BC) responds, “That’s you! Welcome! Everyone say hi to Sarah!” Several shy children whisper their greetings and make brief eye contact. A father helps his toddler wave. An older child turns to shake Sarah’s hand and pronounces, “Hello!!! I’m Gaawry!!!” The MT-BC smiles, then challenges everyone to repeat the shirt’s color “green” before giving each child their own turn.

Next, the group sings, “Music sweet music, all children love music! We work real hard and have great fun, we know it’s therapeutic!” Every Tuesday morning and afternoon on the Johns Hopkins All Children’s Hospital’s outpatient Speech-Language Pathology (SLP) floor, children with speech and communication delays achieve non-musical benefits through music therapy groups. These fun and innovative clinical services are funded by donations to Music Sweet Music, Inc. “Great singing! Let’s practice that big word, ‘therapeutic.’ Stick your tongue out a little and try it again. Yes! Timmy, that was great a “th” sound when you sang the word ‘therapeutic’!”

Before singing our ABCs or drumming today’s activities, before sharing instruments or labeling our emotions, we’ve already shown off our social skills, articulated several target sounds, demonstrated new confidence, and engaged successfully in a clinical environment. We have connected on an individual basis through music; the children are motivated to engage in SLP interventions without realizing how hard they’re working.

Whereas the children love the music, their families value the therapy. Music therapy is the clinical application of music, evidence-based interventions, and a unique therapeutic relationship in order to accomplish non-musical objectives.

Gary’s SLP goals include improved articulation and fluency, but we’re also working on executive functioning. His attention span is limited so it’s important to use patient preferred music, engaging activities, visual aides, transition songs, and verbal reminders. We adapt many familiar songs so that we practice key words, such as, “The ants go marching three by three, hurrah! Good three! Hurrah!” Gary’s academic focus is piqued by melody, and his need for social attention provided when he adheres to the expectations of this carefully constructed therapeutic environment. Gary is one of few children who joins group without family usually present, but once when his grandfather observed, Gary memorized all the words for a new song, waiting patiently while raising his hand before speaking out of turn, and proudly modeled how to pronounce therapeutic, fifth, and thank you. Grandfather’s smile was wide, and his love for his grandchild was bright.

Sarah seems to understand more than she can communicate. She was able to express herself through music instruments, and responded well to upbeat songs with characters and repetitive melodies. After several weeks of engaging in music play, onomatopoeia of percussive strikes, and listening to objects being labelled, Sarah saw a drum and pointed, “Boom!” Her vocabulary is now expanding to include, “Boom drum!”, Cookie Monster’s “Om nom nom nom!” to indicate something she likes, “up” and “down” for a favorite movement song, and “love-ou!” when she gives Mom a warm hug.

Timmy speaks English as a second language, but he’s also socially inhibited. When he first joined music therapy, his face was tucked tightly into his father’s chest. Age appropriate songs were fun enough to catch a brief moment of eye contact, but they also served to calm the other group members down. Then, it was the drums that achieved first eye contact. Timmy had a glimmer in his eyes, then turned away when he saw others looking. I met his height and offered him choice of percussion, and he selected the biggest djembe. Soon, he was playing alongside his peers, and next, he was even listening to directions about how to play the music. Before long, he was given the opportunity to lead the group, and he audibly verbalized, “Go!!!!”     Stop!  Go!!!!  Loud!!!!” Through a therapeutic relationship that allows children to feel secure, respected, and confident, we can now sing silly songs, make animal noises, drum our emotions, share something about ourselves, and more. Timmy’s answers are usually single word responses, but he is engaging, communicating, and growing.

Gary, Sarah, Timmy, and their expanding community of music group friends know the hello routine, they know how to follow directions with each week’s new interventions, they are comforted by transition songs, they actually look forward to the clean-up song, and after the hour quickly flies by they sing: “Goodbye friends, goodbye friends! Goodbye friends, I’ll see you another time!” Even the youngest, most inhibited child often shares a warm “Bye!” after spending time in Music Sweet Music’s SLP groups at the Johns Hopkins All Children’s Hospital.