The Improvement of Non-Verbal Communication Skills of Five Females with Profound and Multiple Disabilities Using Song-Choices in Music Therapy

Supplementary Files

Summary of Communication Development Stages Before Speech (Cited from Triple C: Checklist of Communication Competencies, Bloomberg & West 1999)
Descriptive Analysis of the Intervention Session 1 for Participant 1


Adults with profound and multiple disabilities
Preference and choice
Song-preference assessment
Intentional communication

How to Cite

Lee, J.- young, & McFerran, K. (2012). The Improvement of Non-Verbal Communication Skills of Five Females with Profound and Multiple Disabilities Using Song-Choices in Music Therapy. Voices: A World Forum for Music Therapy, 12(3).


Facilitating the expression of preferences and choices of non-verbal adults who have profound and multiple disabilities is important yet challenging. The present research project aimed to examine whether consistent opportunities for expressing song-choices within music therapy resulted in an improvement in communication abilities of five females with profound and multiple disabilities. A multiple case study design was used. Each participant attended weekly thirty-minute sessions comprising three song-preference assessment sessions followed by ten song-choice intervention sessions. Affective responses to songs in the song-preference assessment were analyzed to identify each participant’s preferred songs. Four song-choice opportunities consisting of a pair of preferred and less-preferred songs were offered during the intervention sessions, and intentional choice-making behaviors were facilitated. The descriptive video-analysis of the sessions shows that the participants were able to indicate consistent preferences for songs, make intentional choices of songs, and improve communication skills throughout the ten intervention sessions. Two participants developed clear choice-making skills, such as selecting a preferred song-card from two options and alternating eye-gaze between a song-card and the researcher. The other three participants demonstrated idiosyncratic but clear intentional behaviors using body movements, facial expressions, and vocalizations to indicate choices of preferred songs. Inter-rater reliability was calculated. These results suggest that some adults with profound and multiple disabilities are capable of improving non-verbal communication skills when appropriate interventions and strategies are provided and also highlight the potential of music therapy to promote communication development of these individuals.

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