The Magic of Music:
Children with Hearing
Loss
Christine Barton, MM, MT-BC
June 28, 2014
Music Experience
Today is Saturday, it’s time for
music
Today is Saturday all day long
Today is Saturday, it’s time for
music
So, won’t you sing along?
Christine Barton 2014
2
How did you get here…
or… where did your
journey start?
Christine Barton 2014
3
For me, it began here…
C. Barton © 2014
4
Then here…
C. Barton © 2014
5
And here…
C. Barton © 2014
6
Then here…
C. Barton © 2014
7
Finally here!
C. Barton © 2014
8
Agenda
•Introduce music therapy profession
•Introduce selected current research on
deafness and co-existing conditions
• Highlight key issues in music perception
in children who are deaf or hard of hearing
•Provide music experiences and resources
to support communication in children with
hearing loss and co-existing conditions
Christine Barton 2014
9
Music Therapy Defined
The clinical and evidence-based use of
music interventions to accomplish
individualized goals within a
therapeutic relationship by a
credentialed professional who has
completed a music therapy
program.
-American Music Therapy
Association, 2005
Christine Barton 2014
10
MT-BC Credential
Music Therapist-Board Certified
• Earn a Bachelor, Equivalency,
or Master’s in MT from an
accredited university
• Complete a six month
internship at accredited site
• Pass the Certification Board
Exam for Music Therapy
• Earn CEUs or retake exam on
5 year cycle
Christine Barton 2014
11
Why Music Therapy?
• Takes advantage of the child’s innate musical
abilities
• Current meta-analysis reveals music therapy to be
effective in developing communication,
interpersonal, personal responsibility and play
skills (Kern & Humpal, 2013)
• May involve families in shared music-making
experiences which can be carried over in the
home
• Can target gross and fine motor skill development
through playing instruments or creatively moving
to music
• The structure and sensory input inherent in music
help to establish response and role expectations,
positive interactions and organization (AMTA,
www.musictherapy.org)
My Current MT Practice
• 200+ children/week
– D/HH
– ASD
– Dev. Preschool
– Elementary Life Skills
– Montessori (PTT)
– Private Practice
Christine Barton 2014
13
My Current MT Practice
• Dual Diagnosis:
– ASD/HL (5)
– Down Syndrome/HL (2)
– Mitochondrial Disorder/HL (1)
– Bronchio-oto-renal/ASD/HL (1)
– Intellectual Impairments/HL (3)
– Medically Fragile/HL (1)
Christine Barton 2014
14
CDC Prevalence of HL
2014
http://www.cdc.gov/ncbddd/hearingloss/facts.html
• 1 to 3 children per 1000 are
born with a hearing loss
• 9 out of 10 deaf children are
born to hearing parents
Christine Barton 2014
15
Music/Language
Similarities
• Share terminology
– Pitch, timbre, timing, intensity
• Both have melodic contour
• Similar strategies used when
listening to music or language
• Early exposure is critical for
acquisition of both
• Both follow a time-ordered
sequence of skills or milestones
Christine Barton 2014
16
Children learn their native
language by hearing it, then
speaking it, and finally reading
and writing it. Music learning
follows the same sequence.
Christine Barton 2014
17
Music/Language
Differences
• Music encompasses a greater
spectral range
• Music can exist without language
• Language can be altered in music
without changing the music itself
• Spoken language surrounds most
children whereas music may not
Christine Barton 2014
18
Music and Hearing Loss
•HA and CI children perceive rhythm nearly
as well as their hearing peers (Gfeller,
2000)
•CI users less accurate than hearing peers
in song recognition (Stordahl, 2002)
•Pitch perception and production more of a
challenge
•For some, music may not be as enjoyable,
but for others it is very motivating and
desirable
Christine Barton 2014
19
Music and Hearing Loss
A handful of studies have shown that
music training for individuals with
hearing loss can have positive
effects in cognitive, linguistic,
memory, and music perception
domains.
(Abdi, Kahlessi, Khorsandi, & Gholami, 2001; Galvin,
Fu, & Nogaki, 2007; Peterson, Mortenson, Gjedde,
& Vuust, 2009; Yuba, Itoh, & Kaga, 2007).
Christine Barton 2014
20
Deafness and Comorbid
Conditions
Gallaudet Research Institute (2009-2010)
• 40% of D/HH children have
comorbid conditions
• 1 in 59 D/HH children receive
services for ASD
• More children (35.4%)with profound
loss have the dual diagnosis
• Result: deaf children receive ASD
diagnosis later than hearing peers
(Vernon and Rhodes, 2009)
Christine Barton 2014
21
Deafness and ASD
Rosenhall et al., 1999
• 1-6% of children who are
deaf also have ASD
• 1.6% unilateral
• 7.9% mild to moderate
• 3.5% profound
Christine Barton 2014
22
CDC Prevalence of ASD
2014
http://www.cdc.gov/ncbddd/autism/data.html
• 1 in 68 (eight year old) US
children identified with ASD
• Increase of 30% from 2008
• Boys 5 times more likely than
girls
• Most not diagnosed until after 4
Christine Barton 2014
23
Music and Autism
Leo Kanner, 1943
• At the age of 1 year "he could
hum and sing many tunes
accurately.“
• About 2 1/2 years, he began to
sing. He sang about twenty or
thirty songs, including a little
French lullaby.
Christine Barton 2014
24
Music and Autism
Heaton, P. (2005)
Journal of Autism and Developmental
Disorders, Vol. 35, No. 6, December 2005
Experimental investigations have
highlighted exceptional pitch
discrimination and memory in
individuals with ASD.
Christine Barton 2014
25
Music and Autism
Ehlers, S., & Gillberg, C. (1993).
Journal of Child Psychology
and Psychiatry, 34, 1327–1350.
Absolute Pitch (AP) in ASD
individuals was at least 20
times the prevalence of the
general population
Christine Barton 2014
26
Music and Autism
Brenton JN, Devries SP, Barton C, Minnich H, Sokol
DK. (2008)
Pediatric Neurology 2008;39:137-138.
Absolute pitch is thought to be
attributable to a single gene, transmitted
in an autosomal-dominant fashion. The
association of absolute pitch with autism
raises the speculation that this talent
could be linked to a genetically distinct
subset of children with autism. Further,
the identification of absolute pitch in even
young children with autism may lead to a
lifelong skill. Christine Barton 2014
27
Music and Autism
Whipple, J. (2004)
Journal of Music Therapy, Vol
41(2), 2004, 90-106.
Meta-analysis revealed:
All music intervention, regardless of
purpose or implementation, has
been effective for children and
adolescents with autism.
Christine Barton 2014
28
Music Experience for
Benjamin
• Improvisational in nature,
incorporating his utterances,
name or familiar phrases
• Drums, guitar in open tuning or
pre-tuned xylophones
Christine Barton 2014
29
Music Experience for
Yeahsen
It rained on Yeahsen and
Yeahsen got wet
Pitter patter, pitter patter, pitter,
patter, pat
Use other names of family members,
neighbors, classmates, baseball team,
animals, food
Christine Barton 2014
30
Music experience for
William
• Sing the Lings, syllables with
xylophone or drum
accompaniment
Christine Barton 2014
31
Music Experience for
Nathan
• Write a Music Experience Book
• Write a song
Christine Barton 2014
32
Assessment Tools
• SJI Music Assessment Rubrick,
Barton, 2008
• Auditory Learning Guide,
Developed for First YEARS by
Beth Walker
• FLAQ Parent Survey
• Gordon PMMA
Christine Barton 2014
33
Strategies
• Utilize the team with the family at
the core
• Enlist and coach parents to help
generalize targeted goals across
multiple settings
• Provide structure/routine
– Visual schedule/class rules
• Provide music
experiences/instruments that
require no formal training
Christine Barton 2014
34
Strategies
• Simple directions (use fingers as
mnemonics)
• Get attention first (“show me you
are thinking about me”)
• Appeal to all the senses
• Repetition
• Choices and alternatives
• Tell them what they can do
• Do not ask rhetorical questions!
Christine Barton 2014
35
Considerations/Observations
• Each child is unique
• Hearing loss is usually addressed first
• Intervention/placement is chosen based
upon the most current need
• Spoken language (and even reading) can
occur after 5!
• Hearing devices make a positive
difference in the quality of life for
individuals and families
• Music offers the potential to create
relationships and provide life long
enjoyment
Christine Barton 2014
36
Resources
• The Listening Room (Advanced Bionics)
– www.hearingjourney.com
• Perspectives on Deafness and Autism
Webinar Series
– http://www.audiologyonline.com/ce/adv
ancedbionics/events/details/23774/deafnesswith-autism-music-therapy
Christine Barton 2014
37
Resources
• Gallaudette Clerc Center
– http://www.gallaudet.edu/clerc_center.html
• More Than Meets the Eye: An Introduction to
Autism Spectrum Disorders
– http://www.gallaudet.edu/clerc_center/webinars
/more_than_meets_the_eye_an_introduction_t
o_autism_spectrum_disorders.html
• Managing Behavior by Managing the Classroom:
Making Learning Accessible for Deaf and Hard of
Hearing Students with Autism Spectrum Disorder
– http://www.gallaudet.edu/clerc_center/webinars
/sharing_autism_research_on_deaf_or_hard_o
f_hearing_students.html
Christine Barton 2014
38
Resources
• Autism Research Institute
– http://www.autism.com/services_visualhearing
• American Society for Deaf Children:
http://www.deafchildren.org/deaf-autismamerica
• Autism Speaks: www.autismspeaks.org
Christine Barton 2014
39
Resources
• West Music
– www.westmusic.com
• American Music Therapy Association
– www.musictherapy.org
• Guidelines for MT Practice in Developmental Care
- Chapter 9: Children with Hearing Loss (Barton,
2013) Barcelona Publishers
http://www.barcelonapublishers.com/index.php?ro
ute=product/product&product_id=269&type=epub
Christine Barton 2014
40
For More Information …
Central Canal Creative
Arts Therapies
Chris Barton, MM, MT-BC,
Director,
Music Therapy
Services/Consulting
www.christinebarton.net
Phone: 317-475-9914
E-mail:
cgbarton@sbcglobal.net
Christine Barton 2014
41