SCHAFER AUTISM REPORT "Healing Autism:

No Finer a Cause on the Planet"

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August 30, 2002 CALENDAR LISTING: EVENTS@doitnow.com

TREATMENT

* Music Therapy Heals Young and Old

* Music Therapy and Autism In the Special Education Setting

CARE

* Speaker Provides Insight On Disorders Like ADHD

* The Challenges of Moving With an Autistic Child

* A Ministry For The Developmentally Disabled

TREATMENT

Music Therapy Heals Young and Old

[From the ABCNews.com website.]

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Just about everybody can recall a song that has made them giddy with happiness or brought back painful memories of someone who broke their heart. Now, researchers are exploring the power of music to make you healthy as well.

From the very young to the very old, science is uncovering roles for music in everything from releasing tension and improving mood to helping brain damaged stroke patients regain their ability to walk.

"Music is typically seen as benign," says Dr. O.J. Sahler, professor of pediatrics, psychiatry, medical humanities and oncology at the University of Rochester Medical Center in New York. "People take it for granted as opposed to thinking about how rhythm and melody can be used to induce states that would be useful."

And researchers are getting closer to understanding how music — whether played, sung or simply listened to — works its magic. Over the past decade, major strides have been made in figuring out the neurological basis for its beneficial effects, helping music therapy and its practitioners make the move into the mainstream.

"We are really at a crossroads where certain forms of music therapy will really break through and become widely accepted and practiced because you have the science to back it up," explains Michael Thaut, professor of graduate music therapy and neuroscience and director of the Center for Biomedical Research in Music at Colorado State University in Fort Collins.

Music as Therapist

Because music is so strongly linked to emotions, some music therapists use it as a tool for processing moods. Using what is known as "isomoodic" therapy, a therapist and a patient will decide on a piece of music that the patient wants to hear that fits with their current mood, and then gradually work towards more positive selections.

"Let's say you are feeling very angry about something so you may want to start out with music that is very expressive of that anger," explains Sahler. "Over the course of 45 minutes, you work into something which is much more calming and soothing to the point where you relax."

During the course of such sessions, music can help people address issues, like what made them so angry in the first place. Other music therapists allow patients to pen lyrics to songs and use that as a vehicle of self-expression.

Because of music's ability to evoke feelings that may be difficult to verbalize, its use as a therapeutic vehicle for emotions makes a lot of sense to some researchers.

"[Music] allows something to unfold and be released and expressed that can really help [people] begin their healing process," says Dr. Steven Johnson, medical director for the Paracelsus Foxhollow Clinic in Louisville, Ky.

The potentially calming and stress relieving benefits of music have also been explored for improving behavioral problems related to obsessive compulsive disorder, autism and attention deficit disorder.

But you don't necessarily need a therapist to evoke music's soothing powers. Its healing potential is something that anyone can easily tap into, with no harmful side effects. "It's a superb self-help remedy. You almost can't give yourself too much of it," says Sahler who adds that what one person finds edgy or soothing is pretty subjective: One man's punk is another man's Handel.

Beyond Psychology

The benefits of music can also transcend the psychological to the management of symptoms like pain and nausea during invasive procedures like bone marrow transplantation.

"What we're looking at is symptom management," says Sahler who recalls one of the earliest known uses of music during a medical procedure was reported by a surgeon in the early 20th century. "And we have shown some startling changes in terms of how people are feeling so that they are improving tremendously."

The changes cited by Sahler may reduce or eliminate the need for medications otherwise used to manage these symptoms, she adds. And they have been measured physiologically. Sahler's research with bone marrow transplant recipients has found that those who received music therapy during the transplantation process showed signs of immune system recovery as much as two days faster than those who did not.

While the physiologic mechanisms behind this healing are not yet understood, significant strides have been made in uncovering how music affects the brain.

"The brain that engages in music is changed by engaging in music," says Thaut who explains why listening to music can potentially impact health. "The basic skeleton for music is rhythm and rhythm is one of the most important elements of music that influences how the brain organizes time."

The effect of rhythm on timing in the brain can be used to help Parkinson's patients and stroke patients retrain their ability to walk in time with musical rhythm. This rhythm can also be used to improve speech articulation and fluency disorders. Additionally, music may also have applications in improving learning and memory for people with diseases like Alzheimer's.

With so many possible applications, the future of music therapy appears promising and may be limited only by the inability to research all potential avenues. "There are loads of applications that we just haven't given ourselves the opportunity to explore," says Sahler.

So feel good about cranking up that cheesy pop song on the radio and singing out at the top of your lungs. If it makes you happy, it may be making you healthy.

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* * *

Music Therapy and Autism In the Special Education Setting Defining Music Therapy

Due to its unique characteristics when compared with spoken language or the visual modality, music is an effective tool to mediate change in non-musical functioning for certain individuals. Research supports parallels between speech/singing, rhythm/motor behavior, memory for song/memory for academic material, and overall ability of preferred music to enhance mood, attention, and behavior to optimize the student's ability to learn and interact. Music therapists receive specialized training to address these areas by completing a baccalaureate or advanced degree program in music therapy in addition to national board certification.

Within a music therapy session, a targeted task relating to an IEP goal (e.g., counting to 10, learning prepositions, following a 2-step direction, taking turns, or describing an object) is presented through song or rhythmic cueing. The focus of sessions is first to provide the student with an assist through musical cueing followed by fading of music to aid in transfer to the non-music setting.

Link Between Autism and Music

Research documents that students with autism often exhibit a high level of preference for the music modality and show little deficit in processing musical components although they may have processing difficulties in non-musical areas. Many individuals with autism demonstrate a highly accurate memory for song lyrics, increased initiation of singing compared with speaking, and significant increases in attention, motivation, and emotional engagement during music activities.

Music Therapy as a Related Service

Before referring a student for an evaluation, the IEP team first considers whether the student has demonstrated enhanced responses to music and is also in need of supplemental assistance due to insufficient progress or severity of needs. If this is the case, a direct evaluation is then conducted to determine if the student's performance is significantly improved on IEP-related tasks when musical cueing is used. Because music therapy is an "overlap" service, it is not considered necessary if the student can achieve similar levels of success through services already being offered. If the student does qualify, services are provided by a credentialed music therapist on a direct or consult basis.

For additional questions or criteria sheet for school evaluations, please contact Michelle Lazar, MT-BC, Director of Coast Music Therapy and Consulting at (858) 453-5211

Rationale For Music Therapy Interventions Cognitive / Academic

Songs act as a "mnemonic" device to aid in memory of new or difficult academic concepts by organizing information into smaller chunks making it easier to encode and retain. Musical presentation also provides an optimal learning environment for those students who are highly attentive to music activities but are often distractible with other modalities. Educational research supports that our ability to learn and later use new concepts and information is best when we are motivated and the material presented is meaningful to us.

Communication / Social Interaction

Because singing and speech share many similarities, yet are accessed differently by the brain, music strategies can be used as a rehabilitative approach to functional communication. Language skills such as asking and answering questions, maintaining a conversation, and using new vocabulary are embedded in song lyrics that the student is encouraged to sing during sessions followed by fading of music to spoken language.

In small groups, musical instruments and interactive songs are presented to address turn-taking, cooperative interaction, and other social skills including learning and role playing "social stories." Individualized tapes are often made for additional home practice of skills.

Motor Abilities

Research is highly conclusive in supporting rhythm as an external timekeeper for movement. Due to the nature of educational motor goals (e.g., handwriting, cutting, using playground equipment, etc.), music therapy is most often recommended as a direct intervention for students with severe orthopedic impairments, or basic goals such as imitating movement. In these cases, musical instruments are used with song cueing to target various grasps, improve coordination, and increase duration of participation. For higher functioning students, the music therapist can offer consult to the adapted physical education provider, occupational therapist, or physical therapist if needed.

Behavior / Sensory Concerns

These areas are frequently addressed through consult if it is shown that music is one of the key motivators for a particular student. Activities are designed to use music as a reward, contingency, transition aid, or to calm the student.

For additional questions or criteria sheet for school evaluations, please contact Michelle Lazar, MT-BC, Director of Coast Music Therapy and Consulting at (858) 453-5211 Coast Music Therapy: Revised 3/01

References

Music Therapy: Autism and Related Topics

General

Alvin, J. (1968): Music Therapy for the Autistic Child. Oxford: Oxford University Press.

Alvin, J. & Warwick, A. (1991): Music Therapy for the Autistic Child (2nd ed.): Oxford: Oxford University Press.

Applebaum, E.,Egel, A.;Koegel, R.; and Imhoff, B. (1979): Measuring musical abilities of autistic children. Journal of Autism and Developmental Disorders, 9(3), 279-285.

Bettison, S. (1996): The long-term effects of auditory training on children with autism. Journal of Autism and Developmental Disorders 26(3), 361-374.

Brown, S. (1994): Autism and music therapy-is change possible, and why music? Journal of British Music Therapy, 8(1), 15-25.

Bryan, A. (1989): Autistic group case study. Journal of British Music Therapy, 3(1), 16-21.

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CARE

Speaker Provides Insight On Disorders Like ADHD

Sheryl K. Pruitt, a nationally recognized expert on neurological disorders like attention deficit hyperactivity disorder, said one-third of all children diagnosed with ADHD are still at home at age 30.

She said only 5 percent of those with ADHD graduate from college.

“As much as we love our children, we would like some time on earth without an ADHD child at home,” Pruitt said Tuesday before an audience of 150 parents, many of whom have children with neurological disorders. “This is your incentive to listen tonight."

Pruitt, who lives in Atlanta, co-authored “Teaching the Tiger,” a handbook for people involved in the education of students with neurological disorders, including ADHD, Tourette’s syndrome and obsessive-compulsive disorder.

She has two grown sons with neurological disorders. She conducts seminars to help parents and educators handle children with behavioral problems caused by neurological disorders.

Children with neurological disorders typically function at two-thirds of their chronological age, meaning a 12-year-old will act like an 8-year-old when their frontal lobe shuts down.

Pruitt said parents need to learn how to recognize when a “storm” or “meltdown” is coming and then teach their children survival skills, such as how to gracefully exit a room to cool off.

She taught one of her sons to ask to go to the bathroom when he feels a storm brewing within. She said he uses the escape technique today. She said confronting a child during a storm will make the matter worse.

Pruitt also told parents to change their approach until they find something that works. She advised to test a strategy for days, not months. “Don’t be patient with things that aren’t working,” she said.

People attending the seminar were hungry for the advice.

Renee McGuire of Appleton, a therapist who works with children with autism, found Pruitt’s seminar informative, particularly for parents with verbal children.

“Some things I’ve heard before and some things I haven’t,” McGuire said. “I think she has a keen insight because she is a parent as well as an educator.

You always get an extreme opposite from both ends of the issue. Having her be both is real helpful."

Tina Swinford of New London, who has four children with ADHD and bipolar disorder, related to many of Pruitt’s stories and examples.

“I think Sheryl has helped develop ways to communicate and to trust your instincts (as a parent),” she said.

Pruitt’s seminar was sponsored by Neenah parents Eric and Gail Hjortness, who have two children with Tourette’s syndrome, and the Wisconsin Family Assistance Center for Education, Training and Support Inc. (WI-FACETS).

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The Challenges of Moving With an Autistic Child

Q. Yesterday my landlord told me that he is selling my house, and I can't afford to rent in this area anymore. How can I make the move to a new home and a new neighborhood easier for my son -- and for me? He is almost 4 and fairly resilient, but he is also autistic and needs a lot of security.

I don't know how he will handle the changes. He has always lived in this neighborhood, he knows everybody, and his dad lives only a block away.

His father and I think I should move to another county, where services are better for children with special needs. Although our son's great abilities are making us question his diagnosis, we know he needs more speech therapy, occupational therapy and other services.

We have hired an educational consultant to find the right public or private school for him, which will decide where I move. My ex-husband might sell his home and move, too, to stay close to him. It takes a team to parent our son because his needs are so great.

I've even thought about living with my husband again, because our resources are stretched so thin, and because I enjoy being with him and being together as a family sometimes -- odd as that sounds -- but we couldn't go to our own homes when we got tense the way we do now.

In reality, I guess my husband and I are having problems separating from each other but I don't think we could make our marriage work. We couldn't do it before, even with a lot of counseling, but should we continue to live near each other? It works now, but would it cause trouble one day?

A. If children had their way, their parents would live with them in the same house, forever and ever, and if they should divorce, they would live close enough to see them every day.

Children of divorce seldom get their way, so it's especially nice to see how hard you and your ex-husband are trying to accommodate your little boy.

This is in his best interest and yours.

A child with autism, Asperger's syndrome or pervasive developmental delays has many needs, and it's exhausting for one person to fill them all. If you and your ex continue to live near each other, you can still share much of the tending and the trips to doctors and therapists. Since you get along pretty well, however -- you called him your ex-husband only once -- you might ask him to move in with you, but only if you both promise to save time for yourselves. The more attention parents give to their special-needs child, the less they can give to their own mental health or to their relationship -- a situation that may have caused your divorce in the first place.

Whether your ex moves in, moves nearby or stays put, you still have to help your son adjust to the move. Talk to him about the great adventure ahead and wear your happiest face. Take pictures of the new house, too, so he will know what to expect, and of the old house, so he can look at his album later, and do most of your planning and packing when he's asleep or at his dad's.

You also want to take good care of his medical records, dividing them by subject and putting them in a notebook so you can keep track of his treatments and his progress. Loose papers are easily lost in a move.

Also, make an effort to attend the Defeat Autism Now Conference in San Diego Oct. 26-27, sponsored by the Autism Research Institute. It would burden your close budget but it should be worth it. More than 1,000 pediatricians, therapists and parents of autistic children attend ARI's fine semiannual conferences -- one of the few medical meetings where presenters and parents treat each other as equals. Here doctors, biologists and chemists report on their latest research on autism, Asperger's and developmental delays and on the treatments that help at least some children, such as a casein-free, gluten-free diet; digestive enzymes; amino acids; chelation; secretin; and old-fashioned cod liver oil.

To learn about them, read "Unraveling the Mystery of Autism and Pervasive Developmental Disorder" by Karyn Seroussi (Broadway, $12.95) and send $18 to ARI at 4182 Adams Ave., San Diego, Calif. 92116, to subscribe to its quarterly newsletter. It's highly informative and cites the latest studies, pro and con.

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A Ministry For The Developmentally Disabled

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As the sun and fun of summer begins winding down, First Lutheran Church of Detroit Lakes is busy getting ready for the launch of a new ministry project focused on area teens and adults with developmental disabilities.

"God's Faithful Followers" will hold its first weekly session on Sunday, Sept. 15, from 9:35 to 10:45 a.m., and continue on each succeeding Sunday from September through May.

This program, which will run during First Lutheran's Sunday school hour, is not limited to congregation members.

"You don't have to be a member (of First Lutheran) to come to this program," says RoxAnn Lindquist, director of special needs ministry at First Lutheran. "It's an opportunity for anyone (with developmental disabilities) ... to develop a sense of community and bring Jesus into their life."

First Lutheran began planning to implement the program last spring, after Lindquist had heard a "Focus on the Family" broadcast about autism awareness. The show spotlighted a special needs ministry program that had been established at New Life Church in Colorado Springs, Colo.

Lindquist listened to the broadcast with particular interest: her 14-year-old daughter, Ellen, is autistic. Inspired by what she heard, Lindquist approached Pastor David Peterson about the possibility of establishing a similar program at First Lutheran.

"Our church has talked about opening its doors to all people for quite a few years," she said. "I went to Pastor Dave and asked him, 'Can we do this?'

"He liked the idea," Lindquist continued, noting that both Peterson and Pastor Wade Dutton have been "very supportive" of her efforts to get the program up and running.

But Lindquist is particularly grateful to Beth Kraiss, the director of that other special needs ministry program in Colorado Springs. Kraiss has mentored her through the process of setting up the "God's Faithful Followers" program.

"She's been a great inspiration," Lindquist said of Kraiss. "I went out there (to Colorado Springs) in July, and she took me into her home and heart ... she said, 'I will guide you through this.'"

The "God's Faithful Followers" program will include Bible lessons, Christian music, crafts and refreshments. Eventually, Lindquist said, she would like to expand the program to include evening social events on a once-a-month basis - events like pizza parties, bowling, games or nights at the movies.

Besides Kraiss, Lindquist said her other inspiration has been her daughter, Ellen.

"Living with Ellen has been a learning experience ... I'm learning about the world through her eyes," she said. "Ellen has taught me so much about life and people, and how to communicate God's love through the heart, not just the intellect."

In fact, Lindquist believes that by opening its doors and hearts to people with developmental disabilities, the congregation of First Lutheran Church will also be getting a great deal in return.

"This program is not only about what we can give them, but what they can give us," she said. "Just by being, they live out God's grace on a daily basis."

Through her daughter, Lindquist has learned that faith "doesn't have to be that complicated."

"She (Ellen) just gets it ... that it's all about God's love for us," she said. "She really believes in her heart that she's a child of God."

First Lutheran Church office and ministries coordinator Cindy Bruflodt, whom Lindquist calls "my right arm," said that she has been amazed by how many people have come forward and said, "I want to be a part of this (program)."

Bruflodt has been busy putting together brochures, lining up contacts and resources, and getting the classroom ready - but she doesn't mind the work.

"I think this is a very valuable ministry for our community," she said. "What I think the people in our congregation will realize, in a very short time, is that they will be the receivers of a special gift."

"There's a lot of excitement building," Lindquist added.

For more information about "God's Faithful Followers," contact First Lutheran Church by phone, at (218) 847-5656, or e-mail at: flc@firstlutheranchurch.com.

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