This article is written as a response to and reflections on Orff Music Therapy - An Overview by Melanie Voight, Ph.D. The author will present a short review of early intervention and music therapy service delivery in the United States as well as a brief overview of how music therapy is used with young children in her setting. Comparisons of methodology will be noted.
As a music therapist who works with young children in an educational setting, I was very interested in the explanation of Dr. Voight's work that utilizes the technique known as Orff Music Therapy. I am employed by a public agency that provides services for individuals with or at risk for developmental disabilities and mental retardation. In our early childhood division, our staff work with families and children 1) ages birth to age three who have at least one area of risk (programs are developed for each on the Individualized Family Service Plan [IFSP]) and 2) ages three to five who have at least two areas of identified need (programs are developed for each on the Individualized Education Program [IEP]).
In the United States, free and appropriate educational services have been mandated for individuals with mental retardation and/or developmental disabilities since 1975. Public Law 105-17 (known as IDEA-1997) is a reauthorization of the original federal legislation that provides these services.
While music therapy is not specifically listed under the law as a required related service, many children do receive music therapy when assessment has indicated they can benefit from it. The American Music Therapy Association (AMTA) continues to lobby for music therapy to be specifically named in the law.
For detailed descriptions of music therapy in the school setting, legal issues, and proactive support efforts, the reader is referred to the book Models of Music Therapy Interventions in School Settings, edited by Brian Wilson (2002, The American Music Therapy Association, Inc.).
Keeping this background information in mind, I would like to direct attention to how I deliver services to those children who have music therapy listed as part of their IFSP or IEP and how this model compares to the Orff Music Therapy method.
In the Early Childhood Division's school settings, children are seen once weekly for one half hour sessions in a group setting. Services are delivered in inclusion (children with and without disabilities in the same class), integrated (one class of typically developing children brought together with one class of children with specific needs just for "specials", i.e. physical education and/or music therapy), reverse mainstream (majority of children with special needs and a few children with no disabilities), or in specialized classes for children with severe or specialized specific needs that follow a pre-determined protocol. Music therapy programs for parents/caregivers and their children also are part of the caseload of the music therapists. A few children receive individual music therapy, but this is a rare exception. Time constraints and large caseloads drastically hinder this type of service delivery.
Goals for children are based on educational needs and all children receive services based on an interdisciplinary team model. The team is comprised of the classroom instructor or early intervention specialist, instructor assistant, music therapist, adapted physical education specialist and the speech/language pathologist, occupational therapist, and/or physical therapist depending on the particular needs of the child. Input from parents/caregivers is always solicited and welcomed.
Music therapists in this setting rarely have goals that are purely music therapy oriented. Rather, they use music to improve or enhance collaborative goals that have been developed by the team and families. Thus, in the group music therapy sessions, musical activities are designed to meet the needs of not only several children, but of several goals of each child. This requires knowledge of each child's goals and needs, general child development, various disabilities and how they present as well as on-going assessment techniques and effective strategies (both musical and educational).
In many ways, our educational setting for young children with disabilities is similar to that of Germany's social pediatrics settings. Our team approach and realization that our children need much more than institutional care and medicine seems to have much in common with the concepts set forth by Theodor Hellbrügge, as explained by Dr. Voigt.
No discussion about music therapy and early intervention in the United States would be complete without a description of the theoretical foundations upon which many of our service delivery systems are based. Since the late 1980s, the National Association for the Education of Young Children (NAEYC) has been a leader among organizations that follow, research, develop and disseminate information on and for young children. They published Developmentally Appropriate Practice (D.A.P.) in Early Childhood Programs Serving Children From Birth Through Age 8 (Bredekamp, 1987), and have recently updated their policy to include serving children with special needs and added emphasis to the role of the family. These D.A.P. guidelines stress that best practices for working with young children include:
These developmentally appropriate practices guide the work of the music therapy staff. However, additional philosophical underpinnings also are evident. The importance of play and the classifications regarding developmental stages of play, as set forth by many theorists such as Erikson, Freud, Bruner, Ellis, Piaget, Smilansky and Parten, theorists such as Vygotsky who describe how we can scaffold this development of play, as well as proponents of methods for specialized interventions such as Linder and Greenspan guide our work. Furthermore, general standards for delivering music to young children have been developed by MENC, the national association for music education and these play a part in how we conduct sessions. I am choosing not to review each of these philosophies herein; however, readers who wish to learn more may find interesting reading in the following publications:
Entire edition: Hallquist, M. (Ed.) (2001). Music Therapy in Early Childhood. Early Childhood Connections: Journal of Music- and Movement- Based Learning, Vol. 7, No. 2. [E-mail contact: ecconnect@aol.com]
Entire edition: Hallquist, M. (Ed.) (1997). Children at Play. Early Childhood Connections: Journal of Music- and Movement- Based Learning, Vol. 3, No. 3. [E-mail contact: ecconnect@aol.com]
Humpal, M. (2002). Music Therapy for Learners in an Early Childhood Community Interagency Setting. In B. Wilson (Ed.) Models of Music Therapy Interventions in School Settings. Silver Spring, MD: American Music Therapy Assn.
MENC (1995). Prekindergarten Music Education Standards [brochure]. Reston, VA: MENC.
The Journal of Music Therapy and Music Therapy Perspectives, the two journals of the American Music Therapy Association, as well as Music Therapy, the journal of the former American Association for Music Therapy have published several articles that address using music therapy with young children. The American Music Therapy Association has an Early Childhood Network that meets at each national conference and posts an annual newsletter on the AMTA website (http://www.musictherapy.org). This group generated information that resulted in the publication of the Music Therapy and Young Children Fact Sheet. This fact sheet may be found under "Events and News" on the AMTA website. All of the above publications examine how music is used with young children to address a variety of nonmusical goals (e.g. in communication, academic, motor, emotional, social, sensory and play areas).
The music (and how the therapist uses it) addresses these goals through various aspects of singing (or using the voice), playing (with instruments or props such as scarves or other objects that aid in expression - similar to the Orff Music Therapy instrumentarium), moving and listening. Though he or she often presents the music experiences to a group, the music therapist is guided by the responses of the children.
Spontaneous play and responses are an important part of the session. Children are encouraged to explore and investigate in a type of improvisation. They are presented with a wide variety of ways to play with sound and respond to sound. The abilities of all children are considered and adaptations for instruments, augmentative ways to use the voice, and alternate ways to move are always present so that all children can be successful in experiencing and making music.
In these ways, our approach to music therapy with young children invites comparison to Orff Music Therapy. Our terminology differs, but our overall intent is quite similar. Coming from an educational approach, we meet the child at the level where he or she is functioning and then expand on the responses of children and structure our musical activities to help them respond by using more difficult skills.we "bump them up" to a higher level of play.
In my chapter of the previously mentioned book edited by Wilson, I note that Linder's (1990) Transdisciplinary Play-based Assessment: A functional Approach for Working with Young Children suggests that the following six skills are necessary for facilitating play-based instruction. I added musical examples to demonstrate how these can be accomplished in a music therapy setting:
This "bumping up" step is crucial and is often overlooked by those who do not fully understand the techniques used in D.A.P. If the child's level of play is not showing progress, this is a clue that "bumping up" may be needed.
The results of the interactions and progress in music should correlate to those seen by the interdisciplinary team in other environments. When the music therapy approach is play-based and child-directed in nature, there is a purpose, structure and intent built into the planning and implementation of the session. It is not just play for the sake of play. The children are playing but the music therapist has enabled the play by adhering to the above guidelines and responding to the needs of the child.
(Humpal in Wilson (Ed.), 2002; p. 406)
Thus we employ our version of responsive interaction and provocation.
The above examples lend themselves to delivering music therapy services to individuals or small groups. It is much more difficult to follow these strategies precisely when working with larger groups and/or those made up of children with a wide range of abilities and diverse goals. Such is the reality that faces music therapists who work in many early childhood settings in the United States. Guided large group experiences often are more therapist-directed, focusing on themes, literacy units or activities that directly relate to what is taking place in the children's classroom setting. In fact, many early childhood settings do not have music therapists on staff or may hire a music therapist to act solely as a consultant to classroom staff. Through written literature, seminars, and other public relations vehicles, music therapists in the United States are working to educate the public to the benefits of music therapy in the early intervention setting.
It is always interesting to learn how others are delivering music therapy services. I am struck by how our methodologies have developed in somewhat parallel paths even though we are geographically so very many miles apart.
Thank you for the opportunity to learn about Orff Music Therapy and to reflect upon the similarities of our philosophies.
Like other music therapy students who responded to this article, I was also excited and enlightened by Voight’s introduction to Orff music therapy. In her article, Voight gives a wonderful synopsis of the history, principles, and uses of Orff music therapy, as well as two clinical examples that illustrate the effectiveness of this type of music therapy in working with developmentally delayed and disabled young children. As a music educator and aspiring music therapist interested in working with developmentally delayed young children, Orff music therapy is a method I would like to study more as it seems to be a way to combine the skills I already have as a music educator with the skills I will gain in my training as a music therapist.
I have taught general music (kindergarten-eighth grade), Kindermusik classes (0-3 year olds), and Musical Movement classes (2-4 year olds) and am currently studying to be a music therapist. Although I have not gone through the three levels of Orff training, I have been exposed to the Orff method through my undergraduate studies in music education and at music education conferences. I incorporate many of the Orff principles into my teaching, regardless of the age I am working with, especially the use of movement, speech, and sound. After reading this article, I would like to study much more about this model of music therapy and intend on becoming trained in the Orff-Schulwerk method or Orff music therapy.
The three aspects of Orff music therapy that resonated with me the most in Voight’s article were the importance of “musiké”, “improvisation as play,” and the role of the parents in an Orff music therapy session. The Orff-Schulwerk method uses “elements of speech, rhythm, movement, dance, and song” (Davis et al, 2008) in teaching concepts to children. This holistic approach to learning is even more important when working with developmentally delayed children to help awaken all of their senses and to help improve physical and cognitive delays. I always found that my students learned best when I incorporated as many different sensory experiences as I could when teaching a concept. For example, when teaching about meter, students would move to different meters, count rhythms in different meters, and play instruments in different meters. This allowed them to feel, see, and understand this musical concept. Incorporating speech, movement, and rhythm into a music therapy session will help the developmentally delayed child successfully meet their goals of the therapy session.
When talking about improvisation, Voight emphasizes the importance of play in Orff music therapy. Marcia Humpal wrote about theorists such as Vygotsky, Piaget, Smilansky, and Erikson and their work around the importance of play in a child’s development, as well as the different stages and types of play in her response to Voight’s article. It is so important that Orff music therapy recognizes the importance of play and uses this as the way to interact with the child in a music therapy session. Play is how a child naturally learns about, discovers, and interacts with the world around them (Olfman, 2003). Therefore, it is imperative that we use this in working with children with developmental problems to help them attain the clinical goals for them. By allowing the child to play with music and explore sounds we are allowing them to exercise their creativity and to learn skills in a natural way. In addition, a music therapy session that is playful will keep the young child engaged in what they are doing.
Voight also discusses the active role of the parent in an Orff music therapy session. Like social pediatrics in Germany, early intervention services in the United States offers therapeutic services to developmentally delayed children under three years of age. The parents are a key part of the early intervention service. As Voight wrote, the music therapy session can offer a nervous, stressed, or intimidated parent of a developmentally delayed child the tools to play and make music with their child in a developmentally appropriate way. In this way, the parent becomes an integral role in the therapy of the child. This can help empower the parent who may feel inadequate or unsure of how to care for a developmentally delayed or disabled child.
If a parent is able to incorporate the activities done in a music therapy session throughout the week or time in between sessions, I would also expect that that the therapy would be more effective and faster results may be seen. In teaching Kindermusik classes, which incorporates at-home materials including a recording of the music we use in class, I have seen a marked difference in the children that frequently listen to the CD and do some of the in-class activities at home and those that do not spend as much time with the material outside of class. My students who listen to our music throughout the week are often more active in singing and participating in the activities in class because they are more familiar with them. Therefore, in working with young children in particular, it is important to never underestimate the role the parent can play in music therapy.
Regardless of what method or model of music therapy is being used with a young child with developmental delays, some of the principles and ideas of Orff music therapy can be incorporated into the music therapy sessions, such as the use of movement, play, and inclusion of parents. I look forward to studying and learning more about Orff music therapy and how I can incorporate it into my work with future clients.
For others interested in learning more about Orff music therapy, The Orff Music Therapy: Active Furthering of the Development of the Child (Orff, 1974) and Alike and Different: The Clinical and Educational Uses of Orff-Schulwerk (Bitcon, 2000) are two additional resources I found on the method that were not mentioned in Voight’s article or the responses to it.
References
Davis, W.B., Gfeller, K.E. & Thaut, M.H. (ed.), (2008). An Introduction to Music Therapy: Theory and Practice, Third Edition. Silver Spring, MD: the American Music Therapy Association.
Olfman, Sharna. (2003). All Work and No Play…How Educational Reforms Are Harming Our Preschoolers. Westport, CT: Praeger.
As an undergraduate music therapy student, I was introduced to the Orff-Schulwerk approach during a methods class for music education and music therapy students. The case studies and examples that were presented often involved typically developing children in general music classes. I was interested in utilizing this approach, but wondered how I would do so with the students that I worked with, many of whom had developmental delays. When thinking about how to implement this with my students, I could not help but return to the term "Orffestra". When speaking with fellow music therapists, this is often how they refer to the Orff-Schulwerk approach. Utilizing the term "Orffestra" implies the traditional Orff-Schulwerk configuration of instruments; xylophones, glockenspiels, etc. As a student, I continued to wonder how I could implement this with students who may not be able to partake in traditional group music-making experiences. I questioned whether or not it really be considered the Orff-Schulwerk approach if I adapted the approach to meet the children's needs?
In her article, Melanie Voigt (2003) discusses the evolution of Orff Music Therapy, based largely upon the principles and foundations of the Orff-Schulwerk method. In reviewing the article, I felt as if I had found the missing link between the Orff-Schulwerk method and its implementation into the field of music therapy with children with developmental delays.
The majority of the clientele that I currently work with have a diagnosis on the Autism Spectrum Disorder (ASD). That said, early intervention is the key to their success. Voigt (2003) points out some key proponents of Orff Music Therapy support and the belief that therapy should begin at a young age. There is great emphasis put on the family involvement with the child's therapy within this approach. I also believe that this is a crucial component to a child's success or failure to succeed not only in music therapy, but in all therapies. Open and honest communication is crucial as we are all members of the child's treatment team and must work together in order for success to be attained.
As a member of a school-based treatment team, I work on a consistent basis with occupational therapists, social workers, speech therapists, teachers, and physical therapists in order to create goals specific to each child's current functioning level. We have found that in order for success to be attained at school, the parent must be able to carry the techniques over to their home setting as well. Voigt (2003) includes the example of Mark, and how his parents were a crucial part of his treatment team as evidenced by them using the Orff Music Therapy techniques in their home. All of this information was then included on the Individualized Education Plan (IEP). In Mark's case, the more complex the child's problems were, the greater the need for specialized services.
Voigt (2003) further states that Orff Music Therapy is based upon the humanistic approach to therapy and that the children should be able to actively participate. When first beginning my professional career as a music therapist I utilized the behavioral approach to therapy. This was particularly evident in my work with children with ASD. I began to question, though, how I could help the child change his or her behavior and help move him or her from "Point A" to "Point B" during their sessions. It is when I began to allow myself to step out of my comfort zone and explore the therapeutic environment more in depth that I began to see changes in my students. As I have grown professionally, I now practice much more within the humanistic approach. When I allow myself to improvise and think "in the moment" in order to meet children where they are, they respond with a greater level of focus and attention. This is a primary focus of Orff Music Therapy as Voigt (2003) further states in the article. She makes note of Gertrude Orff's use of the Iso-Principle and its importance during music therapy sessions. I absolutely agree with the use of the Iso-Principle and I have seen the benefits of its use during sessions with my students.
Reading this article has been an eye opening experience for me. I believe that I am implementing more aspects of Orff Music Therapy into my sessions than I did in the past. This article has been an inspiration to me in that I have finally gotten a clear sense of how the Orff-Schulwerk approach has been adapted to fit into a music therapy approach called Orff Music Therapy. I now know that I am able to adapt the traditional "Orffestra" in order to meet my student's functioning levels and that it is still part of Orff Music Therapy. In addition, the Iso-Principle is a very important aspect of the therapeutic process, one in which I will continue to utilize and implement into my daily work with children with a diagnosis on Autism Spectrum.Disorder.
I have been interested in Orff Music Therapy since I was a freshman Music Therapy major in college, and I would readily recommend this article to all of the freshmen at my school. The descriptions of the history of Orff and the basic theoretical foundations of Orff were quite detailed and informative. The points that piqued my interest the most was how the different methods of Orff Music Therapy were used in the two clinical examples: "Petra" and "Mark."
The clinical example about Mark really helped to reinforce the importance of parents participating in a session with their child who has a developmental disability. I did not know that parental involvement was a crucial element of Orff Music Therapy with this population. Voigt points out that Mark's parents primarily interacted with him to maintain his bodily care. I'm curious to know how many other parents maintain this level of interaction with their children with severe disabilities. Mark's progress, no matter how small, was a success. In this clinical example, it became obvious to me that the more progress that Mark made, the more his parents became comfortable interacting with him musically.
The clinical example with Petra, a non-verbal girl, was one of my favorites because it shows how any object can be integrated into Orff Music Therapy. What really impacted me was the session using the marble and the flutes. I don't think that the activity would have been as successful or responsive with Petra had the Music Therapist not established an great rapport with the girl. It is obvious to me that she felt as if she could communicate in any and all ways with the therapist, given the success of the bead activity during her first block of music therapy. I observed that many students don't understand Orff Music Therapy completely, and limit themselves to large tone blocks, xylophones, and glockenspiels. The role of Orff in my practicum clinicals has morphed over the years from xylophones and mallets to finger puppets, shakers, and even toy animals.
Voigt quotes Hellbrugge: "...medicine alone could not meet the needs of the children whose developmental problems were very complex". I firmly agree with that quote, and I wish that this insight could be transfered to children with other disabilities such as ADHD, EBD, and other mental problems. Many children and adults receive their medication without any therapy to help them cope with their condition.
Hellbrugge presented what I believe is a complete list of professionals who should be involved therapy and recovery. He writes that pediatricians, psychologists, physiotherapists, occupational therapists, Montessori-therapists, educators, social workers, and pediatric nurses are important to diagnosis and treatment. I feel that the entire spectrum of professionals was covered in his description, and I found it hard to think of a profession or discipline which was ignored. I even learned a new word-- Montessori, which I will research at a later date.
My interest in music therapy at the begining of 2001 was quite intuitive. I just felt myself that it could be important and interesting for me. By that time I had already had a musical education and studied medical psychology for more than 3 years. That's why such a field as music therapy sounded great for me. Moreover, there is a collaborative project between the Department of Social Padagogy and Psychology of Zaporizhyazhya State University (Ukraine) and Department of Music Therapy of the University of Applied Sciences Magdeburg-Stendal (Germany).
In spite of the fact that I didn't participate in this project from the very beginning, immediately after familiarization with it, I set my mind on understanding and learning more about what music therapy is and how I can participate in this project more actively.
In 2001 I became an inspired participant of the project and got an opportunity to learn more about music therapy and so to achieve my goal. The feeling that my scope and outlook in the field of music therapy is getting rapidly wider and broader was absolutely great.
In the framework of the collaborative project, I have been involved in 2003 in a student study program in Magdeburg in the field of music therapy. Studying in Germany, I'm trying to collect as much information as I can about different kinds of musical psychotherapeutic approaches. In Germany there are a lot of kinds of music therapy and students learn and practice most of them here.
As for me, I'm interested in children's music psychotherapy and how to work musically with handicapted and mentally retarded children. As I have during my study in Germany not only a theoretical chapter, I have had an opportunity to make my practice in one of the most largest centers for children in Germany, Kinderzentrum München in Munich. There I saw how to treat and to develop children's possibilities for life in the framework of one kind of music therapy - Orff Music Therapy. My 3-weeks practice there was financed by the Orff Music Therapy Society. During my practice I had an opportunity not only to observe the process of psychotherapy but also to take an active part as a co-therapist in a music therapy setting. I have had a real experience in working musically with children who have special needs. Such kind of music therapy as Orff-Music Therapy is needed for Ukrainian children who have dysfunctions on the neurological or physical level. It will be very important to provide the knowledge that I have gotten here in Germany in developing the process of music therapy in Ukraine.
I plan not to stop my investigation of the music therapy field after coming back home. I still want to know more about music therapy works. Music for me is my everyday life. And now when I know that music can help others to become healthy, I cannot work without using it.
It was during my work as a public school music teacher that I became introduced and interested in the Orff -Schulwerk process, and consequently completed the 3 levels of certification courses offered here in the United States. I was under the excellent tutelage of Judy Body, Arvida Steen, and Jane Frazee during my training courses. I have always felt my decision to become a music therapist was in large part based on my training and experience as an "Orff teacher." I learned many techniques that enabled all the children in my classroom to have a successful experience in moving, speaking, creating, and performing music. I use many of these same tools in the music therapy session, and it is actually hard to separate sometimes what I do as something I learned as a music therapist, as opposed to what I learned as a teacher using the Orff philosophy.
I. Session Planning
The greeting chant format is based on rondo form that is used so often in the Orff-Schulwerk. Students speak, and/or play a chant that either refers to their general well-being, or to current events. Structure is maintained throughout the activity by alternating the saying/playing of the chant with each individual response.
Using the pentatonic, blues, modal skills as a basis for improvisation on both piano, resonator bells, and Orff instruments is an important form of melodic communication in the therapy setting.
Phyllis Weikart basic music and movement approach is used with the preschool classes in developing beat awareness and leading to walking, skipping, galloping, etc. to music. The same approach is used in building skills to increase psychomotor functioning in children with disabilities.
II. Building on Successes
In both the Orff-Schulwerk process and the Music Therapy Process, goals and objectives are reached in a systematic, sequential process through building on previous skills learned. Objectives are updated in a way that continues the use of the learned skill and generalizing that skill to other settings, or to the next desired step.
III. No Child Left Behind
A current focus in the education setting is to believe and work toward the idea that all children can learn important skills necessary for functioning in society. That philosophy has always been present in the Orff-Schulwerk classrooms, and a similar belief by music therapists in that we can encourage growth and improvement in our assigned individuals.