Music Therapy at Central Wisconsin Center for the Developmentally Disabled

By Laurie Farnan

Central Wisconsin Center for the Developmentally Disabled (CWC) is a residential developmental facility that provides a home and learning environment for individuals diagnosed with mental retardation (MR) and complex developmental disabilities (DD). CWC is licensed as an Intermediate Care Facility for the Mentally Retarded (ICF/MR). Long-term care and treatment are currently provided to 350 individuals with profound and severe MR. Approximately 200 people per year receive short-term care of an average stay of 14 days to provide specialized medical care and rehabilitation. Recently, an intensive short-term (28 day) assessment program was added. On the 105-acre campus are nine living units in which dedicated teams of health care professionals provide round the clock (24/7/365) care and treatment for the residents. CWC is a partner in Wisconsin's integrated system of comprehensive services for citizens with DD and their families. As a contemporary leader, CWC offers a wide array of innovative, specialized, habilitative, educational, health, and support services in a variety of settings. Excellence and respect are emphasized by dedicated, compassionate, and highly trained staff who promote self-determination and human development to assist residents with DD to improve the quality of their lives. The Center is operated by the State of Wisconsin Department of Health and Family Services and has been serving individuals with severe developmental disabilities since 1959. Music Therapy has been offered at CWC since 1975. Currently there are three full time Music Therapists on the staff, Laurie Farnan MMT, WMRT, MT-BC, Jane Meyer, RMT, WMTR, and Michelle Schumacher, MSE, RMT, WMTR. Clinical training internships in Music Therapy have been offered since 1980.

What began as a Title I Grant in 1975 to hire a music therapist, has grown into an internationally recognized music therapy program and clinical training site. The second music therapist was hired in the fall of 1982, while the third position was filled in the fall of 1983.

The letter granting approval to become a clinical training site is dated December 14, 1979 and is signed by Margaret Sears, then Executive Director of NAMT and Marcia Wunderlich then Chairperson of the Clinical Training Committee. The first interns arrived in July of 1980. To date, 94 interns have completed the internship phase of their undergraduate and sometimes, graduate academic programs. Interns have come from 32 of the approved undergraduate programs in music therapy in the United States. Over the last several years, Central Wisconsin Center has seen an increase in international interns including students from Japan, Korea, Malaysia, and Singapore. Interns leave Central Wisconsin Center with a well-rounded knowledge of individuals with profound mental retardation and complex developmental disabilities. In addition, the internship program offers interns the opportunity to serve as a transdisciplinary team member and work with a wide variety of other staff including teachers and therapists. Developing a good foundation of functional music skills and techniques in composition are also particular areas of training focus.

Publication of materials, articles, columns, and books has been an important area of work for the MT program at Central Center. Articles have been published in the Journal of Practical Approaches to Developmental Handicap (Canada), Music K-8, Mental Retardation, Music Therapy Perspectives, as well as in newsletters of CWC, the State of Wisconsin Department of Health and Family Services, and Very Special Arts Wisconsin.Contributions were made to the following books: Clinical Techniques for the Orthopedically Handicapped (1982), Models of Music Therapy Interventions in School Settings (1996), Helping Adults with Mental Retardation Grieve a Death Loss (1998), and Music Therapy Supervision (2001). The two books and tapes titled Music is for Everyone and Everyone Can Move were published by Hal Leonard Publications (1988).

Starting in 1976, there have been over 25 state, regional, national and international presentations given for the International Association for the Scientific Study of Mental Deficiency, Council for Exceptional Children, Music Therapy, Music Technology, Occupational Therapy, Therapeutic Recreation, Very Special Arts - Wisconsin, and the Wisconsin Park and Recreation conferences. Topics of presentations have included: the Transdisciplinary Model of Service Delivery, Clinical Applications of Tone Bars, Methods and Techniques for Composition in a Clinical Setting, Constructing Adapted Instruments, Sensory Stimulation and Integration Techniques, Infection Control and Immunization, Assistive Technology, Music for Students with Special Needs, and Supervision Practices.

CWC Music Therapists have also shown a commitment of service to the music therapy associations on the state, regional, and national levels having served in the following capacities: Great Lakes Regional President, Great Lakes Regional Vice President, Great Lakes Regional Secretary, president of the state association (2); regional membership chair, state representative (3), representative to the NAMT Clinical Training Committee, NAMT Continuing Education Chair, Assembly of Delegates (2), Unification Commission on Education and Clinical Training, NAMT Executive Board, and AMTA Financial Advisory Board.

Awards received by CWC Music Therapists have included two Great Lakes Region Service Awards (1994, 1996), the State of Wisconsin Department of Health and Family Services, Exceptional Performance Award (1997), an AMTA Presidential Citation (2000), and an Award of Excellence from the CWC Administrative Quality Team (2001).
 

CWC Music Therapy Department Mission Statement

The mission of the CWC Music Therapy Department is to provide professional program planning and implement goal, oriented, quality music therapy services specifically designed to develop and enhance functional life skills for individuals with developmental disabilities. Recognizing that individuals are diverse in their abilities and needs there a number of different types of groups and therapeutic approaches are utilized to best suit each participant.

Music Therapy Groups at Central Center

Sensory Stimulation and Processing

Music based sensory programs are designed in conjunction with Occupational Therapy. OT principles of vestibular stimulation are paired with rhythmic and auditory stimulation in prescribed protocols for activities. Tactile desensitization techniques are used with fabrics and the physical vibration of low tones (62 Hz - 110 Hz). Range of motion activities are also included. The guiding principles of the group can be found in sensory integration literature. The pairing of rhythmic stimuli with specific movements is utilized to provide multisensorial stimulation and to develop improved sensory processing and integration. (Sit/Spin and Sing & Swing).

Early Intervention

The young child at CWC experiences music through innovative, rhythmic and melodic experiences. Creating musically rich environments for the students is essential and includes the use of interactive children's songs, multisensorial percussion instruments, children's music from various cultures, and props to encourage movement, peer interaction, and vocalization. Children are encouraged to listen, experiment, and improvise with a variety of instruments, materials, and equipment. Each student's motoric and cognitive objectives are implemented in the music therapy setting.

Instrument Play and Object Manipulation

Instruments are selected for use in sessions based upon the specific hand or grasp pattern necessary to produce a sound. The purpose of instrument play is to provide opportunities to develop improved functional hand use. Open hand pattern instruments such as tambourines, hand drums, and cabasa afuches are used. Other instruments such as maracas, bells, adapted mallets, and sticks are used to elicit cylindrical grasp patterns. Residents are encouraged or assisted to reach into containers to select instruments and encouraged or assisted to release the instrument or object back into the container when finished. Turn taking, socialization, peer interactions, and group ensemble play are also emphasized in this type of group.

Computer Music

As with other techniques used in Music Therapy, the goal of treatment is to empower and enable the client to have greater positive control over themselves and their environment. Through the combination of computer software and electronic musical instruments music therapists utilize current technology to enable the residents of Central Center to work on goal areas of communication; expression of preferences; visual, auditory, and tactile stimulation; functional hand use; peer interaction; sensory development; positive experiences with technology and enjoyment. The use of technology allows residents to practice using adaptive communication devices. Software programs currently used include FracTunes and Band in a Box.

Proactive/Prosocial Cooperation and Interaction

Individual Behavior Treatment Programs are closely adhered to in these groups. Reinforcement of prosocial behaviors such as cooperation and on task participation is provided. These groups are kept small with a maximum of four participants. Rhythm provides the impulse to act and to act together in cooperation in these groups. Tasks of instrument play are kept brief and structured. Strengths and needs of each resident determine the session design. Residents participating chose instruments and may assist in distributing, or collecting materials and instruments. Interactions are closely monitored and structured. All staff use a proactive approach.

Music and Speech Therapy

The group focus is to increase active participation by utilizing a variety of verbal and nonverbal communication systems. Music is the stimulus that provides the means of expression. The immediate reinforcement of creating live music, making choices and expression of individual preferences has made this a unique transdisciplinary program approach. Projects are selected each semester and the group selects destinations in the Madison area. These outings combine a music element (stores, concerts, making purchases etc with community exposure employing various communication systems.

Music Therapy in Cardinal School

Music Therapists and Interns provide developmental music experiences commensurate with age and ability levels in the classroom. These groups reinforce both the Individual Education Program objectives and the Individual Program Plan for each student. Concepts from the Wisconsin School Music Education Curriculum are also integrated.

Music Therapy with Adults

Adult groups are held in conjunction with other disciplines that include OT, recreation therapy, adult education, case managers (QMRP), and speech therapy. Individual Program Plan (IPP) goals and objectives are used to develop individual program goals for each person. Functional life skills are worked on through the handling and playing of hand-held instruments and objects. Verbal cues are provided in the lyrics of activity songs. Sessions follow a standardized format designed to provide for the diverse needs of individual me
 

CWC Music Therapy Department Statistics

• Number of session held per week: 75 (depending on the number of interns)

• Length of sessions: 30, 45, or 60 minute sessions

• Number of participants per week in active treatment in MT groups: 250

• Number of participants in leisure groups per week : 50

• Average number of participants per group: 4-5

• Number of interns per training period: 3

• Other Center Wide activities provided by Music Therapy staff: Music for Special Events, Memorial Services, Family Picnic, Drum Circles, Volunteer Events.