Theory-guided Therapeutic Function of Music to facilitate emotion regulation development in preschool-aged children

Emotion regulation (ER) is an umbrella term to describe interactive, goal-dependent explicit, and implicit processes that are intended to help an individual manage and shift an emotional experience. The primary window for appropriate ER development occurs during the infant, toddler, and preschool years. Atypical ER development is considered a risk factor for mental health problems and has been implicated as a primary mechanism underlying childhood pathologies. Current treatments are predominantly verbal- and behavioral-based and lack the opportunity to practice in-the-moment management of emotionally charged situations. There is also an absence of caregiver–child interaction in these treatment strategies. Based on behavioral and neural support for music as a therapeutic mechanism, the incorporation of intentional music experiences, facilitated by a music therapist, may be one way to address these limitations. Musical Contour Regulation Facilitation (MCRF) is an interactive therapist-child music-based intervention for ER development practice in preschoolers. The MCRF intervention uses the deliberate contour and temporal structure of a music therapy session to mirror the changing flow of the caregiver–child interaction through the alternation of high arousal and low arousal music experiences. The purpose of this paper is to describe the Therapeutic Function of Music (TFM), a theory-based description of the structural characteristics for a music-based stimulus to musically facilitate developmentally appropriate high arousal and low arousal in-the-moment ER experiences. The TFM analysis is based on a review of the music theory, music neuroscience, and music development literature and provides a preliminary model of the structural characteristics of the music as a core component of the MCRF intervention

Construct optimal experience for the hospitalized newborn through neuro-based music therapy

Music-based intervention for hospitalized newborn infants has traditionally been based in a biomedical model, with physiological stability as the prime objective. More recent applications are grounded in other theories, including attachment, trauma and neurological models in which infant, parent and the dyadic interaction may be viewed as a dynamic system bound by the common context of the neonatal intensive care unit (NICU). The immature state of the preterm infant’s auditory processing system requires a careful and individualized approach for the introduction of purposeful auditory experience intended to support development. The infant’s experience of an unpredictable auditory environment is further compromised by a potential lack of meaningful auditory stimulation. Parents often feel disconnected from their own capacities to nurture their infant with potentially life-long implications for the infant’s neurobehavioral and psychological well-being. This perspectives paper will outline some neurological considerations for auditory processing in the premature infant to frame a premise for music-based interventions. A hypothetical clinical case will illustrate the application of music by a music therapist with an infant and family in NICU

Reporting quality of music intervention research in healthcare: A systematic review

INTRODUCTION: Concomitant with the growth of music intervention research, are concerns about inadequate intervention reporting and inconsistent terminology, which limits validity, replicability, and clinical application of findings. OBJECTIVE: Examine reporting quality of music intervention research, in chronic and acute medical settings, using the Checklist for Reporting Music-based Interventions. In addition, describe patient populations and primary outcomes, intervention content and corresponding interventionist qualifications, and terminology. METHODS: Searching MEDLINE, PubMed, CINAHL, HealthSTAR, and PsycINFO we identified articles meeting inclusion/exclusion criteria for a five-year period (2010-2015) and extracted relevant data. Coded material included reporting quality across seven areas (theory, content, delivery schedule, interventionist qualifications, treatment fidelity, setting, unit of delivery), author/journal information, patient population/outcomes, and terminology. RESULTS: Of 860 articles, 187 met review criteria (128 experimental; 59 quasi-experimental), with 121 publishing journals, and authors from 31 countries. Overall reporting quality was poor with <50% providing information for four of the seven checklist components (theory, interventionist qualifications, treatment fidelity, setting). Intervention content reporting was also poor with <50% providing information about the music used, decibel levels/volume controls, or materials. Credentialed music therapists and registered nurses delivered most interventions, with clear differences in content and delivery. Terminology was varied and inconsistent. CONCLUSIONS: Problems with reporting quality impedes meaningful interpretation and cross-study comparisons. Inconsistent and misapplied terminology also create barriers to interprofessional communication and translation of findings to patient care. Improved reporting quality and creation of shared language will advance scientific rigor and clinical relevance of music intervention research

They did what? A Systematic Review of Music Intervention Reporting in Healthcare Research

poster abstractAbstract Background/Purpose: Both public interest in and publication of music intervention studies are increasing, with more than 1,000 articles published in healthcare journals over the last twenty years. Concomitant with this growth are concerns about inadequate intervention descriptions and inconsistent terminology in published research which limits cross-study comparisons, interdisciplinary communication, and integration of findings into practice. Purposes of this systematic review were to summarize and describe music intervention reporting in published research for patients with chronic or acute medical conditions including intervention content, outcomes of interest, interventionist qualifications, and terminology used to label and describe interventions. Theoretical/Conceptual Framework: Our review is based on published Reporting Guidelines for Musicbased Interventions which specifies 7 areas of reporting: theory, content, delivery schedule, interventionist, treatment fidelity, setting, and unit of delivery. Method: We identified experimental music intervention studies for patients with chronic/acute medical conditions, published 2010 - 2014, using MEDLINE, PubMed, CINAHL, and PsycINFO databases. Our initial search identified 620 articles, with 133 retained based on specific inclusion/exclusion criteria. Five nurse/music therapy student dyads reviewed full articles and abstracted data for analysis. Faculty mentors conducted interrater reliability checks and resolved data extraction discrepancies through discussion/consensus. This interdisciplinary approach provided a rich context for exploring how intervention descriptions/terminology may be interpreted and understood differently based on background and discipline-specific training. Results: Data are summarized based on Reporting Guidelines for Music-based interventions. Areas poorly reported: 1) intervention theory (i.e., mechanisms of action), 2) references for sound recordings/musical arrangements, 3) decibel level/sound controls, 4) interventionist qualifications and training. Two hundred music terms were cited (84 terms defined; 116 terms not defined), and often misapplied. Conclusions: Improved reporting will allow better cross-study comparisons, replication, and translation to practice. Additionally, standardization of music intervention terminology will improve interdisciplinary communication, delineation of music interventions across disciplines, and implementation

A Survey of Neonatal Nurses Perspectives on Voice Use and Auditory Needs with Premature Infants in the NICU

Background: Exposure to the voice and language during the critical period of auditory development associated with the third trimester is thought to be an essential building block for language. Differences in the auditory experience associated with early life in the NICU may increase the risk of language delays for premature infants. NICU nurses are fundamental in the care of premature infants; how they use their voices may be important in understanding auditory experiences in the NICU. This study examined voice use behaviors of NICU nurses in the United States and their current knowledge of early auditory development. Method: An opt-in, online questionnaire. Results: Nurses reported using their voice more as the age of infants approached term gestation and speaking to infants was the most common type of voice use. Both infant and nurse factors influenced reported voice use decisions in the NICU. Nurses did not believe the NICU auditory environment to be sufficient to meet early auditory needs of premature infants but did believe that premature infants are exposed to adequate voice sounds. Conclusions: A gap in knowledge regarding the importance of early exposure to voice sounds may be a barrier to nurses using their voices to support early auditory development