By Mark Finch, Susan LeMessurier Quinn, & Ellen Waterman
Adaptive Use Musical Instrument (AUMI) is a digital instrument that facilitates independent music making for people with diverse ranges of mobility. Employing the camera tracking capabilities available on most digital devices, users with even very little voluntary mobility are able to create and perform music by controlling a visual cursor within adaptable parameters to trigger sounds. Instead of requiring players to conform to an instrument, AUMI’s flexibility enables it to adapt to divergent artistic impulses and individual bodies. Building on previous studies that examined AUMI in an educational setting (Oliveros et al. 2011) this article presents three case studies that explore AUMI’s use in a community music therapy context. In addition to assessing the instrument’s effectiveness in achieving specific music therapy goals, ethnographic research methods illuminated various socio-cultural implications of integrating digital instruments into a music therapy setting that challenge conventional notions of youth culture, independence, and collaboration. We conclude with a discussion of the notions of adaptability and universal design as they apply not only to AUMI’s functionality in the music therapy sessions, but also in view of the instrument's ongoing development.
Keywords: adaptive design, digital instruments, youth culture, improvisation, universal design
In recent decades, efforts have been made to design tools and spaces that are not only accessible, but also adaptable to people with a wide range of abilities and body types. In music therapy contexts, this movement has inspired the production of adjustable devices and attachments such as specialized stands that enable individuals to utilize instruments in unconventional performance positions. The focus on adaptability has also encompassed the design of digital technologies and software. Magee and Burland (2008), for example, described the wide variety of electronic music technologies (EMT) commonly used in clinical music therapy in the UK, including the distance-to-MIDI device Soundbeam® and the sensor-based Midicreator (p. 125). EMTs have been used in music therapy contexts as a way to increase the accessibility of music making for those with disabilities (p. 125). Research has found that technologies that enable free, unassisted movement, such as virtual instruments triggered by sensors, can minimize the frustrations that come with trying to operate traditional, non-adaptable musical instruments while increasing the player’s sense of independence and freedom (Knox et al., 2005).
Within a practice that is largely acoustic in nature, such technologies can pose challenges to music therapists that do not have specialized instrumental training. As digital technologies become more accessible and more prevalent in the lives of young music therapy participants, however, they are becoming increasingly drawn into music therapy practice. Misje (2013) explored four settings where technology was used in music therapy sessions, acknowledging that there continue to be on-going discussions among music therapists regarding the effective implementation and appropriate uses of technology in music therapy practice. He recommends that music therapists should continue to learn about the growth of technology in society in order to understand its role in the lives of our music therapy clients (p. 54).
In the spirit of Misje’s call to action, this article explores the implementation of a digital musical instrument called AUMI (Adaptive Use Musical Instrument) into a traditional community music therapy setting in Canada. Here, “traditional” refers to individual and group sessions within a community centre where, previously, only acoustic instruments and vocalization had been used for music making. Combining methodologies from ethnomusicology and music therapy, we examine the effects of this adaptive technology on the music therapy experiences of children and youth. Stige and Aarø (2012) addressed the importance of “technology enabling people to decontextualize and recontextualize music, giving a high degree of flexibility in musical meaning-making” (p. 123). We consider this to be the case with AUMI, since instead of requiring players to conform to an instrument, its flexibility enables it to adapt to divergent artistic whims and individual bodies—even those with minimal movement capacity—and in the process, challenges conventional notions of independence, creativity, and collaboration.
AUMI takes advantage of the video tracking capability available on most contemporary computers. When the computer and camera are placed in front of the user, his or her image appears on the screen providing a visual field of reference for operating the instrument. A coloured cursor, in the form of a round dot, can be placed on any part of the image to further help the user track his or her movements. When the user moves in front of the computer screen, the cursor “sticks” to the body and follows the movements, triggering sounds as determined by the software’s settings and parameters. The version discussed here (AUMI 2.0) is available in four modes: keyboard, split screen, quarter screen, and a relative movement percussion mode, which is geared toward free motion. (AUMI has since been significantly updated, as we’ll discuss below.) The user, then, might place the cursor on his or her nose and, moving their head to guide the cursor across a visual line on the screen, trigger sounds from a bank of samples (see Figure 1). Like a conventional synthesizer, the available sounds range from musical instruments to humourous effects (e.g., dog barking, helicopters, bubbles). Users can also upload custom audio samples.
An important design principle of AUMI is that the instrument be adaptable to users with extremely limited voluntary mobility. By adjusting a series of parameters, AUMI can track even micro bodily movements such as breathing and eye movement. Using the “guide size” parameter, for instance, a tracking box around the image can be expanded or contracted in order to calibrate AUMI’s responsiveness. A narrow box in the keyboard mode allows users with a limited range of motion to play an entire scale using very little movement. Alternatively, for someone who has active, more wide-ranging, and perhaps uncontrolled movements, a larger tracking box reduces the sensitivity to motion, thus enhancing control. Similarly, in relative movement percussion mode, users can adjust the “sensitivity” to require more or less movement to trigger a sound. 
AUMI has been utilized extensively to enable individuals with varying physical disabilities to participate in recreational and structured music making sessions. The following research report examines the use of AUMI in a community music therapy context, where users carry out predetermined routines structured around specific therapy goals such as socialization, communication, engagement, and relaxed physical movement. After describing the development of AUMI and some of the theoretical perspectives that inform our research, we discuss our fieldwork involving both group and one-on-one music therapy sessions at Easter Seals Newfoundland and Labrador.  Drawing on ethnographic participant observation, we then consider in turn the therapeutic and sociocultural implications of bringing AUMI into a community music therapy context. We conclude with a discussion of the notions of adaptability and universal design as they apply not only to AUMI’s functionality in music therapy sessions, but also in view of the instrument’s ongoing development.
AUMI was born in 2007 through conversations between renowned musician Pauline Oliveros and her friend Leaf Miller, an occupational therapist and drummer who works at Abilities First public school in Poughkeepsie, New York. Miller runs an improvisational drum circle at the school and wondered how she could involve the many students who are unable to hold or manipulate percussion instruments in collective improvisation. Another important factor was that the instrument be affordable, since public schools have extremely limited financial resources. Popular EMT’s such as Soundbeam can cost thousands of dollars to purchase. Oliveros, working through Rensselaer Polytechnic Institute (RPI) and the Deep Listening Institute (DLI) , obtained a grant to develop an adaptive instrument prototype drawing on the technical expertise of her colleagues Curtis Bahn and Don Millard. The first version of the software was built by Zane Van Dusen, then an undergraduate student at RPI, using Max/MSP/Jitter software and was further developed by Zevin Polsen. The idea was to create a non-invasive interface that would not be dependent on specialized equipment and expensive software. In this way, AUMI is distinct from other accessible instrument technologies that require switches or an infrared sensor mechanism to activate sounds. The AUMI software is available as a free download and the only hardware required is an ordinary computer (Macintosh or PC) with a camera.  AUMI is distinct from forerunners such as movement-to-music (M2M) and Virtual Music Instrument (VMI)®, which also use camera-tracking technology, but are geared toward music pedagogy. While these technologies guide users through a series of lessons and a predetermined repertoire, AUMI is designed to encourage independent music making and improvisation (Oliveros et al., 2011, p. 174).
From the beginning, developing AUMI has been a collective and interdisciplinary endeavour. Oliveros also happened to be a researcher in an international research project called Improvisation, Community and Social Practice (ICASP), based at the University of Guelph in Canada (2007-2013) and involving over 50 researchers from around the world. A number of ICASP researchers, including Ellen Waterman, became excited about the possibilities of AUMI as a way of both fostering individual creativity and extending improvising communities across different bodies. “One of the guiding principles of AUMI’s use and development, then, is that anyone, even those with profound physical and cognitive impairments, can produce music and be part of a community in doing so” (Oliveros et al., 2011, p.173). Currently, an AUMI Consortium conducts research and development at six universities in Canada and the United States.  Contexts for AUMI research include music therapy, education, recreation, and performance for mixed ability ensembles but in all cases improvisation is central.
Keith Sawyer (2007) argued that musical improvisation offers educational, cognitive, and creative benefits to children because it emphasizes deep conceptual understanding, integrated knowledge, adaptive expertise, and collaborative skills. AUMI researchers see a strong connection between Sawyer’s valuation of improvisation and the concept of music as a human right because improvisation is by its very nature adaptable to everyone. In this sense, AUMI addresses some of the concerns brought up in the field of disability studies, which observes how disability is socially constructed as a “deviance needing correction and grants authoritative voice to the medical professional rather than the disabled subject” (Lubet, 2004, p.133). Positing an “ethnomusicology of disability,” Alex Lubet (2004) highlighted how music cultures can also “construct disability and negotiate […] impairment” (p. 134) in ways that exclude differently-abled musicians. Focusing on Western classical music, for instance, he noted the wide breadth of exclusions based on a variety of perceived “abnormalities” from sight impairment to left-handedness. Lubet examined cases in which musicians with sight impairments are discouraged from participating by their peers and mentors (e.g., conductors), and by musical conventions (e.g., emphasis on sight-reading and following a conductor) (p. 134–135). Musical instruments can require a high degree of conformity such that left-handed children are often urged to adapt to right-handed instrumental practice. By contrast, AUMI is adaptable to a wide array of body types and abilities, and is designed to foster improvisation, a practice that privileges musicians’ creative agency over “correct” interpretation of a musical work.
AUMI is not the only recent attempt to bring non-invasive digital technology and free improvisation together in a music therapy context. Lem, and Paine (2011) experimented with a dynamic sonification program within the framework of Creative Music Therapy (an improvisation-based practice). Their programming environment uses algorithms triggered, like AUMI, via video capture with an emphasis placed on tracking the velocity, amplitude, and direction of bodily movement. The team of music therapist and programmers worked directly with five adult participants with disabilities. Coding was done on the spot in reaction to participants’ responses to the software. In this way, they sought to bring the participants directly into the development phase of the interface as active agents in experimental research.
Similarly, our research is collaborative, drawing on the knowledge and observations of Susan LeMessurier Quinn a music therapist, ethnomusicologists Ellen Waterman and Mark Finch, music therapy participants and their guardians, as well as a number of volunteers associated with Easter Seals. Our research project treated the participants (including two children and one teenager as well as their guardians) as active agents within the research team: their experience of AUMI provided invaluable information about both its strengths and its limitations. However, our focus was also on creating a useful and positive community music therapy experience for the participants, keeping in mind each participant’s specific music therapy goals and being highly sensitive to their energy level and comfort throughout each session. The music therapist on our team focused on goal setting with participants and program delivery with AUMI, while the ethnomusicologists engaged in a participant observation methodology that mandated their active engagement in the activities of the community. In short, instead of the laboratory research setting employed by Lem and Paine (2011), our research was conducted in the ordinary setting of the community music therapy program at Easter Seals.
This interdisciplinary research, then, contributes to the growing field of medical ethnomusicology by offering an ethnographic perspective of how adaptable digital technologies like AUMI can be incorporated into individual and group music therapy sessions. Interestingly, this study lends nuance to the view that music therapy primarily takes a “Western biomedical” approach to healthcare, the body, and illness by relying on therapy goals that privilege the “proper functioning of the physical body” (Koen et al., 2008, p. 7). The music therapy sessions conducted during this research did involve therapy goals assessed within a music therapy context and informed by a broader health and healing network. Within this context, however, AUMI’s adaptability introduced flexibility in attaining particular goals by recognizing and accommodating various body types and functionality. In this way, improvisation extends to the therapy routine as the instrument’s parameters and modes are altered in the moment to accommodate both the user’s therapy goals and creative ambitions. Furthermore, moving beyond Western biomedical concerns, AUMI—and music therapy in general—fits into holistic approaches to healthcare that integrate research and knowledge from various fields (e.g., medicine, humanities, social sciences, psychology, etc.) and from which medical ethnomusicology emerged (Ibid., 3-4). By enabling users to exercise their creative agency within one-on-one and group community music therapy settings, AUMI helps create meaningful social opportunities for individuals who are often marginalized through their “disability.”  Improvising with AUMI, for instance, users are able to develop a sense of “world-making” and “imprinting” themselves upon a socio-musical moment (DeNora, 2000, p.15).
Fieldwork for this research took place over the course of 6 months during weekly music therapy sessions at Husky Energy Easter Seals House in St. John’s, Newfoundland. Easter Seals is a community organization with a general focus on group programs and camps for individuals with varying physical abilities. The music therapy program at Easter Seals is in line with the principles outlined by Curtis and Vaillancourt (2012) in their Children’s Right to Music Project. They described the importance of making music accessible to children with physical disabilities, which they linked to the United Nations Conventions on the Rights of Children and on the Rights of People with Disabilities. They argued that families, educators, and music therapists all have a role in the successful participation of children in musical activities through to adulthood. Easter Seals offers individual and group music therapy sessions to children, teens, and young adults ages 0-21 years. Group sessions are divided according to age (i.e., 2-4, 5-8, 9-13, and teen/young adult). Younger groups incorporate developmental goals, with the use of song and improvisation as the main interventions. Meanwhile, the teen/young adult groups focus on peer engagement through instrumental improvisation, songwriting, and arrangement of popular songs. Group music therapy sessions aim to enhance social engagement, benefit physical movement, increase communication with peers, and provide opportunities to share musical abilities with the wider community. Individual music therapy sessions are offered to those requiring assistance in group integration, engagement, focus, and increasing sound tolerance.
Easter Seals’ music therapy programming is informed by the practices of community music therapy where weekly accessible music therapy enables participants to feel confident in their music making within the music therapy context and beyond the music therapy room. Many families who join the music therapy program are looking for a community-based experience where their child can grow in a relationship-focused and skills-based program outside of a traditional rehabilitation setting, facilitated by persons with the knowledge of their needs and goals. As one mother stated following a one-on-one AUMI session in which her son improvised with Susan, it’s "kind of nice to be able to sit and watch him do something [on his own] and participate ... that rarely happens in our lives" (Interview, September 21, 2013). The program also offers regular performance opportunities for participants. David Stewart made reference to music therapy group members sharing their experiences with staff and visitors at a community centre, leading to a musical presentation for members’ families (Pavlicevic & Andsell 2004, p. 294). Judging by their attendance and enthusiasm, families at Easter Seals also seem to appreciate an environment where their child can play an instrument and share their music successfully during an end-of-year performance.
Participation in the research project was offered to individuals who were currently registered in the group program. The research was undertaken after an ethics review by the Interdisciplinary Committee for Ethics in Human Research at Memorial University of Newfoundland, and with the consent of Easter Seals. In the months leading up to the primary research period, music therapist Susan LeMessurier Quinn and ethnomusicologist Ellen Waterman met with an interdisciplinary collection of members from the broader AUMI research team, including Oliveros, Miller, and technical assistant Jaclyn Heyen, who suggested ways to incorporate AUMI into the Easter Seals music therapy sessions. Based on these meetings, Susan, who facilitated the Easter Seals music therapy program between 2008 and 2013, consulted with individuals and their guardians to assess who might benefit from using AUMI.
The selection was based on previous responses to music therapy, the potential benefit for increased participation and independent response from individuals with limited motor movement, and those who required assistance to play an instrument. From this process, three individuals—two children and one young adult—were selected to participate in the research, which took place over the course of 10 individual and 10 group sessions for each participant. All three participants had a diagnosis of cerebral palsy and required the use of wheelchairs.
While Alan and Jacob  the two children involved in our research, exhibited typical age-appropriate responses to music therapy ranging from excitement and joy to frustration, boredom, and tiredness, they varied greatly in their ranges of mobility. Alan (age 5)  used facial expressions, such as eye contact and smiling, and vocalizations to communicate. He demonstrated effort to move his head from side to side and reach towards an object with his left hand. Alan was also non-verbal and had a very small range of motion. Most of the physical goals during his one-on-one sessions were focused on strengthening neck and head control and enhancing movement of his left arm. Jacob (age 5) verbalized some words in sessions, smiled in response to the AUMI sounds, and demonstrated effort to control his upper body movements while using AUMI. He exhibited a broad range of energetic, often uncontrolled movement. Whereas Alan’s therapy sessions aimed to maximize movement, Jacob’s sessions were geared toward increasing muscular control by concentrating on his core strength and posture. During one-on-one sessions, AUMI was adapted to each child’s movement patterns and used to target particular areas of the body. With Alan, for instance, AUMI’s cursor was placed on the image of his left hand and the software’s interface set to keyboard mode. The guide size parameter was adjusted to balance accessibility and challenge during an improvisation or song, so that Alan could make small but focused movements to trigger sounds by using his hand to move the cursor within a visual field. Jacob, in contrast, often used AUMI’s relative movement percussion mode, which enables free movements to trigger percussion sounds with no determined field and no visual cursor. This mode complemented his large-scale movements, and by putting the sensitivity parameter on a low setting, encouraged focused, intentional motions that exercised his trunk muscles. Because AUMI is adaptable to body type, range of motion, and personal preference, each child was able to participate in improvised music making sessions one-on-one with Susan, as well as with other children in a group setting.
The third participant in our research, Sam, was 19 years of age and demonstrated mature relationships with his family and peers, a great sense of humour, and well-developed cultural tastes. Sam participated in a music therapy group with five peers ranging in age from 16-21. This group incorporated the interests and skills of all participants, such as arranging traditional Newfoundland songs for verbal and non-verbal participants, exploring favourite musical genres, and adapting instruments for various physical abilities. Sam also spent time with some of these peers outside of the music therapy setting by attending other Easter Seals programs and community events such as concerts and hockey games. His participation in the study particularly shed light on some of the sociocultural implications of introducing AUMI to group music therapy sessions. This is not to deny the rich social environment of the children’s group sessions. Sam, however, engaged with his peers more self-consciously, had a more nuanced appreciation for and opinions about music, and was better able to formulate, communicate, and realize his creative intentions. Sam’s analytical and critical thinking abilities extended to AUMI’s effectiveness for his own physical and creative goals in music therapy. He used a motorized wheelchair with most of his controlled movement occurring in his head and face. A communication device was attached to his chair, connected to a head switch, which he uses for dialoguing and work. During Sam’s individual sessions, AUMI was often set to keyboard mode with a very small guide size and the cursor placed on his nose. These parameters enabled him to make use of the entire octave range in his improvisations, while encouraging him to rotate his head in order to trigger sounds. During these sessions, Sam was very responsive to our questions and provided considerable real time feedback about how AUMI was and was not working to benefit his music therapy and music making experience. The scope of his feedback ranged from simple adjustments that could be made on the spot (e.g., volume adjustments, repositioning the cursor, switching instrument sounds) to more substantial, prospective software modifications (e.g., improved text visibility, alternative modes and interfaces, and additional sound patches).
Because of AUMI’s adaptability, incorporating the instrument into any music-making context is a necessarily experimental process. To assist with this process, we utilized a Modes Chart and an Assessment Tool. The Modes Chart enabled us to keep track of the different modes/interfaces, sounds, and parameters participants used for various improvisations and songs in order to observe which adaptations were most beneficial, to maintain consistency over the course of weekly sessions, and to detect any changes in how participants used AUMI. The Assessment Tool is a long-form questionnaire that provided space to document ongoing researcher observations and participant feedback on music therapy goals, physical and musical responses, motivations, creative agency and collaboration, focus, and challenges. Sessions were recorded on video from two points of view: 1) a camera trained on the participants and music therapist; 2) the AUMI session as captured by the internal computer camera (as in Figure 1), which allowed us to review the exact movements of the participant while using the software.
Volunteer helpers. In addition to these tools, volunteer helpers also assisted with operating AUMI. While AUMI is an adaptable hands-free instrument, as a computer program it contains some operational barriers. Before interacting with the instrument, for instance, the computer needs to be set-up, turned on, and the program opened using a mouse or track pad. Likewise, in order to adjust parameters, switch modes, and change sounds, users must scroll through and click on different items. All of these tasks can prove demanding to individuals with mobility issues. A designated helper, then, can act as a mediator between the participant-musician, the therapist, and the software. Such assistance allowed Susan to focus on specific routines and facilitate a group while helpers worked closely with AUMI users in realizing their creative aims, achieving specific therapy goals, adjusting the software as needed, and helping to enhance their ability to contribute musically to the group. Performing this function could be as simple as adjusting the volume, or it might involve a more exploratory exchange, such as scrolling through various percussion sounds to find one that resonated with the musician. Of course, as both the user and the helper became more comfortable with the instrument (and each other in some cases), the helper became increasingly inconspicuous.
The helper role is relatively informal and does not require any special training. AUMI is a user-friendly, intuitive program that can be quickly learned with some casual direction from the music therapist, user, or another knowledgeable participant.  Ideally, then, helpers can be a relative, friend, or volunteer. That said, the convenience of employing a helper points to some of AUMI’s limitations as an adaptable/accessible instrument and evokes traditional modes of supporting people with disabilities such as hand over hand, in which an individual holds and utilizes an instrument with assistance from the therapist or someone else. Like hand over hand assistance, interventions with AUMI are most fruitful when the helper acknowledges the user’s creative agency and maintains respectful communication (Aigen, 1995). This might involve, for instance, frequently checking with users about instrument choice, volume, or parameter settings in ways that respect their decision-making processes. While it might seem that helper interventions are cumbersome, it is important not to overlook their therapeutic potential. Again, like hand over hand, which can enhance the depth of interpersonal relationships through physical contact (Aigen 1995, 45), engagement between helpers and user-musicians can produce opportunities for positive social interactions and relationship building. In music-making contexts such interactions can be viewed not only as supportive interventions, but also as creative collaborations. The helper, in a sense, takes on a co-creative role, improvising in empathy with the user and stretching the boundaries of what constitutes a musical body (Tucker et al 2016).
Drawing on researcher observations, the assessment tools, and feedback from the participants and their guardians, the following sections build on this description by providing ethnographic accounts of AUMI’s integration into music therapy routines. We begin by considering how AUMI was used to work on concrete therapy goals, as well as some of the challenges that surfaced in the process. Then we focus on the social implications and experiences of using AUMI in a group setting.
This research project drew on many of the clinical practices used in music therapy such as improvisation, therapeutic relationship building, assessment, musical analysis, session analysis, ongoing evaluation, program development, and goal development, all culminating in an end-of-year public performance. Stige and Aarø (2012) observed that such music therapy processes “are often linked to practices of health promotion” (p. 229). As such, each participant’s individual therapeutic goals remained the primary consideration during the fieldwork, and AUMI was viewed as an accessible intervention with the potential for enhancing health and personal growth. This approach provided consistent structure for optimal comfort and growth as we introduced the digital instrument into a previously acoustic program and allowed us to determine the software’s potential in each transitional phase: one-on-one sessions, group sessions, and performance.
AUMI may be easy to play in some ways, but learning this musical instrument well required practice on the part of Susan, the music therapist. Learning, for instance, how to quickly access the modes and sounds was essential to maintaining the flow of therapy sessions.  It soon became evident that assigning a helper to assist with operating the program, especially during group sessions, allowed her to facilitate sessions without disruption and maintain an equal focus on each group member. Participants required time to familiarize themselves with the instrument and to establish awareness that their movement within a field on the computer screen was triggering sounds. As Magee and Burland (2008) noted, “providing the client with the opportunity to recognize the cause and effect relationship is a critical stage of the process: only once the client understands that they are making the sounds can the work move into the realms of musical play” (p. 132). Exercises such as cause and effect, stretching, and sound imitation were beneficial for increasing participants' awareness (see Example 1).
Example 1 – Video of Jacob and Susan using AUMI and doing stretch routines:
During music therapy sessions, musical structure evolves from the therapeutic relationship. “Structuring is the art of listening, remembering, repeating, and developing motifs created by the client and therapist. This shapes the experience, provides meaning, and establishes direction and focus in an improvisation context. Remembering material also provides grounding and familiarity to the experience” (LeMessurier Quinn 2002, p. 34). These kinds of music therapy processes were integral to successfully integrating AUMI into the sessions. Maintaining the structure of the therapy session (i.e. opening and closing songs, therapeutic drumming, instrument exploration and improvisation, and song-writing) and consistent evaluation allowed the music therapist and co-researchers to remain focused on the participant goals and therapeutic process while introducing AUMI as an instrumental choice. The uses of AUMI, its modes, sounds, sensitivity levels, and musical choices were than used to support working on participant goals such as strengthening head control, core body strength, focused arm movements, ownership of sound through individual movement, and independent music making.
For the younger participants, the established weekly group sessions overlapped with the start of one-on-one AUMI research sessions. Familiar repertoire, as well as the weekly group drumming and instrument improvisations also remained in the one-on-one and group research session structure for consistency while AUMI modes and sounds were explored.
Incorporating AUMI into a therapeutic setting was similar to introducing any other new acoustic instrument and required practice, goal setting, and adaptation. Each of our participants responded very differently to the digital instrument. Alan, for example, preferred to use AUMI in one-on-one sessions with Susan. Here, the program was most effective in keyboard mode with the sound set to flute, his favourite instrument. When Susan and Alan improvised together with acoustic flute and AUMI flute, he seemed more engaged and would often contribute vocal responses (see Example 2). In the group environment, however, Alan responded more to hand over hand playing and physical connection with individuals. In these sessions he was most responsive when all group members were playing the same sound on acoustic instruments such as ocean sounds, drum, and bell.
Example 2 – Video of Alan and Susan improvising with AUMI:
Participants’ previous exposure to electronics and digital devices also influenced their approaches to AUMI. Alan had not spent a lot of time using digital technologies and was accustomed to hand over hand interactions with caregivers and therapists. Jacob, on the other hand, was quite enthralled with and motivated by electronics. He enjoys using electronic devices at home, so the fact that AUMI was part of a computer was very exciting to him.
Participants were also selective in how they used AUMI for different songs, improvisations, and sessions. For example, Alan benefitted from using AUMI with the same pieces of music each week, as it enhanced his experience and comfort with a particular mode and his physical ability to create the sound. Conversely, Jacob preferred the element of choice within each song. From week-to-week, he liked to vary AUMI’s settings and sounds, and at times would opt for an acoustic instrument instead. This kind of choice was crucial in bringing AUMI into the music therapy program. AUMI, like each of the acoustic instruments, represents just one possibility for participants. This became clear during a session when Jacob chose to abandon his regular AUMI selection for a particular song in order to play the bell (hand over hand) like his peers. The demand for flexibility in this respect challenged our initial focus on exploring and identifying which songs or routines were working best with AUMI.
During our research, goals for one-on-one sessions were often different than those for group sessions and AUMI was adjusted accordingly. Time was spent during Alan’s individual sessions using the split screen percussion mode to increase the consistency of purposeful movement with his hands. In these situations, the cursor was placed on his left hand and he would move it across a visual dividing line to produce sounds. The individual sessions allowed Alan the time and support to gradually progress his ability to create music using his hand. However, during the group session, it seemed to be more difficult for Alan to develop this capability, as it required him to create sounds quickly in order to interact with his peers. Here, AUMI was adjusted to respond to the movements he is most comfortable with (i.e., his head movement) rather than working towards increasing his hand movement. Using the keyboard mode, Alan was encouraged to independently keep his head in an upright position, and rotate from side-to-side. Over time, these movements became more consistent and controlled.
Through his AUMI practice, Jacob also developed physical capabilities such as maintaining strong posture and increased control of his upper body movements. This progress, according to his parents, carried over to other activities in his everyday life. Jacob’s parents also observed an increased ability to focus while using AUMI:
“It helped him focus, which was great. To focus on the core strength, too. If he made certain movements...forwards and backwards, he got different sounds. So that helped strengthen his core, because he's like “Oh, I want to make that sound.” You could see from start to finish, there was almost a little bit more strength in everything. The muscles that we probably didn't realize he was working were being worked.” (Jacob’s mother, personal communication Sept. 21, 2012)
Each of the three participants used and seemed to benefit from AUMI in different ways. Observing Alan and Jacob’s sessions, up to this point we have concentrated on how AUMI was integrated into individual therapy programs and on therapeutic goals related to bodily functioning and movement capabilities. In the following sections we shift our focus to Sam’s participation in the teen/young adult group sessions. Here we take a closer look at the experience of using AUMI and some of the social implications.
In many ways, 19-year old Sam’s participation in group music therapy sessions demonstrated AUMI’s potential as an adaptive technology. He indicated his sound and style choices through eye-movement (up for yes, down for no) and using his communication device connected to a head switch. Previously, hand over hand assistance was provided to assist Sam in playing the instruments of his choice, especially drums. Using AUMI, Sam had more independence and freely drummed with his friends in the music therapy group. In individual sessions, we focused on making sound and style choices as well as engaging in improvisations. These choices were then incorporated into the group sessions. Through this process, Sam exhibited a marked ability to freely improvise by controlling his head movements to trigger his musical sounds on cue. Sam’s mind is very active and he demonstrated notable musical knowledge throughout his participation in music therapy programming. His input into music- and decision-making processes was integral to his successes with the AUMI program. One way to demonstrate Sam’s creative music making with AUMI is by describing a particular group music therapy session.
In the months leading up to their public performance, the Easter Seals’s teen/young adult music therapy group worked on arrangements of a few top 40 pop songs and well-known Newfoundland folk songs. With each song, the group members prepared their instruments before launching into a structured improvisation. Sometimes, Susan would lead the group by playing chords on guitar or piano. She and the verbal participants would often sing the lyrics together, and others played their instruments at specified points during the song. This approach produced shifting textures as various instrument combinations weave in and out of the performance. At a certain point during most songs, the group members, much like a jazz ensemble, would take turns performing improvised solos. The arrangements were all discussed and decided upon as a group and Susan cued different instruments during performance. In the local folk song “Wave Over Wave,” for instance, she began with guitar and vocals and some members sang the verse lyrics, which speak to the virtues and pride of living in Newfoundland. During the verse, one member introduced an Omnichord® to the performance, adding a harmonic dimension. Then, as the chorus arrived, Susan cued the fiddle and an ocean drum, which produces wave-like sounds as small beads roll across the drum’s skin. These contributions elevated the session’s energy for a rousing sing-along chorus:
“Where it’s wave over wave/ sea over bow/
I’m as happy a man as the sea will allow/
There’s no other life for a sailor like me/
But to sail the salt sea, boys/ sail the sea/
There’s no other life but to sail the salt sea.” 
While Sam’s personal music tastes veered more towards Newfoundland-Irish music and contemporary local artists, one of his favourite songs to perform with the group was Katy Perry’s top-40 hit “Firework.” With this song, group members used a variety of percussion instruments to play a steady “four on the floor” beat over a studio recording. The song has an anthemic build-up going into the chorus, and as the intensity escalated, Susan called on the group to play louder. The outcome was thunderous and the energy in the room was electric as group members moved their bodies vigorously or sang along with excitement. While it was difficult for Sam to maintain a 4/4 beat using AUMI, he too expressed elation and moved more intently to trigger sounds in the program’s relative movement percussion (RMP) mode.
As with all of his creative decisions, Sam chose to use the RMP mode after experimenting with different modes and sounds over the course of several sessions. This setting offered an array of sounds that would work for the group’s percussion-heavy arrangement of “Firework.” However, unlike the split and quarter screen percussion modes, which require the user to guide the cursor over a visual line to trigger sounds, in RMP mode different sounds are attached to four directional movements (i.e., up, down, left, and right) and the user can move freely, with no cursor, to trigger the sounds. This interface, then, allowed Sam to enjoy the visceral experience of music making—that is, to “rock out” with his peers—while maintaining some structure and sense of purpose in his contributions.
In RMP mode, finding the appropriate balance of challenge and playability involved further experimentation with the movement sensitivity parameter, which can be adjusted by moving a slider between low and high sensitivities. When the sensitivity was set too low—requiring larger movements—Sam found it difficult to make sounds, which could leave him feeling dissatisfied because he was unable to contribute as he wished. Conversely, when the sensitivity was set too high, sounds were triggered with very small movements. This could prove equally dissatisfying when something as minute as Sam’s breathing motions triggered clusters of unintentional sounds. Through trial and error and communication with Mark, who was acting as a helper, Sam found that the sensitivity worked best for him when set very high (but not all the way up), requiring small, but controllable movements to trigger sound.
Initially, Sam also experimented with sound patches during the group’s “Firework” improvisations. At one point he tried several different percussion sounds such as a snare drum, conga, and cowbell, designated to different directional movements. After some time, however, he decided to set up the RMP mode so that each directional movement would trigger a conga sound. One reason for this choice was audibility. At the height of “Firework’s” intensity, when everyone’s instruments were resounding, the music became quite loud, drowning out AUMI. When this happened neither Sam nor the group could hear his contributions. He discovered, however, that the timbre and attack of the conga patch was able to cut through the group’s volume. What’s more, he was drawn to the conga’s sonic resemblance to the pop of an exploding firework. Again, the process of experimenting with and selecting parameters/sounds involved communication with Mark. Through continuous eye contact, gestures, and Mark’s verbal inquiries, the two were able to adapt AUMI not only to Sam’s range of motion, but to his creative vision and the broader music-making context. This took Mark out of his other roles as an aid and researcher, and brought him into a collaborative artistic relationship with Sam. As Mark responded to Sam’s cues, offered his own feedback and ideas, listened to the surroundings, and adjusted settings in the moment of performance, at times the two engaged in their own peripheral improvisation.
During “Firework’s” bridge, Susan cued the participants in sequence for their solos: a djembe, followed by a snare, then a tambourine, and so on. Sam delivered the final solo just as the song entered a pared down version of the chorus. This provided an ideal opportunity for him to focus on the sound of his instrument and interact with the song’s reduced instrumentation. He moved his head and triggered conga sounds, intermittently landing on and around the beat. As the sounds were produced, Sam smiled and chuckled, but his facial expressions also exhibited a great amount of concentration and, at times, physical exertion. During one session, Susan observed him struggling to produce sounds at the end of his solo. “Do you have more, Sam?” she asked. With this he extended and shook his head, producing a small cluster of conga sounds just before the chorus ramped up again and everyone contributed in unison for a spirited finale. Sam’s enthusiasm continued right up until the end of the song, and his head movements triggered a conga sound just as the recording ended. It was unclear whether or not the contribution was intentional, so Susan asked him and the rest of the group if they would like to repeat the final chorus, this time adding a few of Sam’s congas to the closing arrangement. Sam directed his eyes upwards, indicating “yes,” and the group took it from the chorus. Now, as the song ended, Sam produced a few conga sounds by rotating his head. Susan and a few other group members applauded the contribution to their arrangement. Some laughed and clapped. One participant offered his support with an encouraging, “good job!” Sam smiled with delight (see Example 3)
Example 3: Video of Sam using AUMI to improvise with Firework:
Sam’s experiences using AUMI shed light on some of the sociocultural potentials of introducing adaptive digital technologies to a community music therapy setting. Community music therapy involves a push and pull between the individual and his/her presence in a group. As such, the therapist balances individual therapeutic and social goals with the aim of facilitating a “social field” (Ruud, 1998, p. 82–83) for music making that is dynamic, imbued with both shared and divergent values, and open to different styles of participation. This approach to music therapy asserts the significance of sociocultural experiences and quotidian contexts within more conventional Western biomedical frameworks of health and healing. Paraphrasing Ruud (1980) in his overview of community music therapy’s roots, Stige (2002) stated “therapy must be directed towards the context and milieu of the client” and observes how the circumstances of community music therapy are entangled with external social and cultural elements: “Sometimes the therapist will need to deal with the political and social forces that shape this field and create the conditions within which people live, grow, and develop” (Even Ruud section, para. 5).
As a social field, two primary sociocultural forces shape the Easter Seals teen/young adult music therapy group: 1) disability culture and 2) Western youth culture. Acknowledging that notions and experiences of disability are not homogenous, the former refers to a cultural movement toward recognizing the unique lifeways of people with disabilities, advocacy for more inclusive and accessible spaces, and, perhaps above all, life-affirming, as opposed to tragedy-laden perspectives on disability (Brown, 2002). The latter, a more widespread concept, refers to the presumed beliefs, values, and practices of young people as a shifting cultural phenomenon. Since the mid-twentieth century, the notion of a youth culture in Western society has attained a heightened degree of cultural capital, market potential, and privilege in its association with “hip” fashion, lifestyle, and taste (Danesi, 2003, p. 11–21). At the same time, for more alarmist observers, youth culture’s association with risk, danger, and rebellion has been a source of concern and moral panic (Huq, 2006, 2–3). Scholars have also considered how, like disability culture, youth culture is not homogenous, most notably in the study of fragmented “subcultures” (Brake, 1985; Hebdige, 1979). Given the increased mobility, mass media flows, and networking possibilities in a post-industrial, globalized world, Rupa Huq (2006) sought to “diversify discourses” of youth culture beyond contained subcultures and a predominantly Western context (p. 25).
Despite these attempts to unfurl and nuance notions of youth culture, young people with disabilities are often excluded from traditional youth domains. In particular, disabled bodies conflict with prevailing constructs of youthful, “healthy,” able bodies and the kinds of unencumbered, frenetic activity conventionally associated with being young (Danesi, 2003, p. 32-39; Slater, 2012, p. 201). In cases where young people are non-ambulatory and/or non-verbal and require everyday assistance from other individuals and/or specialized technologies, these exclusions can be amplified in ways that impact young people’s agency in formulating and maintaining identities. Huq (2006) observed that individualization and lifestyle choices have a heightened significance in contemporary youth culture (p. 31). These decision-making processes usually involve the ongoing forging of alliances and creation of distance through fashion, taste (e.g., music), worldview, and activity. Just as youth might align with punk, geek, or extreme sports culture, young people with disabilities and able-bodied peers might establish allegiances to disability culture.  Conversely, young people with disabilities might reject and distance themselves from the predominant values of disability culture.
Teen/young adult community music therapy groups present a social field that illuminates how disability and youth cultures are entwined and provide opportunities for young people to construct and negotiate identities in relation to their peers. For individuals like Sam, AUMI’s adaptability has the potential to enrich these opportunities by enabling him to indulge and experiment with his own cultural/aesthetic tastes. It provides techniques for Sam to pitch his tastes and his creative ideas into his surroundings. Such practices and experiences are formative in the ongoing construction of self. As Stige (2002) observed (via a discussion of Frohne-Hagemann’s research), for individuals with language impairments, “work through music and other expressive modalities may be helpful for the development of the needed identity and awareness of oneself in relation to others” (Isabelle Frohne-Hagemann section, para. 6). During the community music therapy sessions in this study, Sam situated himself within the group by evaluating and manipulating musical sounds using AUMI. This kind of contribution to the broader context also has more fundamental developmental implications. Antoine Hennion (2007) argued that cultural taste is not only a set of inherited values, but also an experiential activity. “To taste,” he suggested, “is to make feel, and to make oneself feel, and also, by the sensations of the body […] to feel oneself doing” (p. 101; emphasis in original). This, like DeNora’s (2000) notion of music as a resource for “world making” (p. 15), positions individuals as agents who “produce, reinforce and elaborate what determines them” (Hennion, 2007, p. 102). “Tasting” and “world making,” however, are not processes that occur in isolation. Rather, they are informed by (and shape) the broader social field and involve reflexive engagement with others. The reciprocity of collective musical improvisation exemplifies this dynamic and productive social environment. During the group sessions, Sam listened to the music in his surroundings, considered the contributions of his peers and responded emotionally, intellectually, and viscerally by projecting his own sounds that other listener-improvisers might respond to and that ultimately transform the soundscape. “Taste,” Hennion asserted, “lived by each but fashioned by all, is a history of oneself permanently remade together with others” (p. 103). Sam’s contributions were, for the most part, rooted in his individual aesthetic preferences and sense of taste but they brought him into contact with and were negotiated alongside other creative agents. In a community music therapy context, this includes other therapy participants and the music therapist. Moreover, AUMI affords additional points of encounter and collaboration.
First, like any instrument, the character and limits of Sam’s musical participation are influenced remotely by the creative vision and processes of AUMI’s designers. Currently AUMI has a bank of about 120 open source sounds that are of medium quality: a saxophone sample is recognizable as a saxophone, but the timbre is not nearly as rich as the real thing. The early version that we worked with, AUMI 2.0, was also quite limited with regard to modes, key signatures, flexibility, and other timbral elements such as attack, decay, and tone. The software’s interfaces were geared towards particular styles of motion. The interfaces are highly adaptable—to the point where nearly anyone can produce a sound with AUMI—but still impose limits (e.g., In AUMI 2.0 and 3.0 percussion sounds could not be set to diagonal movements; the split screen mode in AUMI 2.0 privileged lateral movements by offering only vertical dividing lines). The team’s decision to keep AUMI free means that resources for program improvements are necessarily constrained.  Incorporating a licensed bank of high-end sound samples would be a costly addition. Further, since organizations such as Easter Seals also work within tight budgets and equipment is not often renewed, AUMI needs to remain compatible across both computer platforms and generations. Sam’s music making, then, occurs in response to the conventions, imagination, and economic constraints of computer engineers and software programmers. It should be noted, however, that even this is a reciprocal creative relationship. As detailed below, feedback from Sam and other users was forwarded to AUMI’s designers and has been incorporated into subsequent versions.
Second, when using AUMI, Sam communicated with Mark, who tried to assist him in realizing his musical vision. “Effective improvisation depends on dialogical techniques of listening, recognition, and responsiveness” (Waterman, 2016, p. 283). To be effective, Mark needed to be sensitive and respond to moments of (dis)satisfaction, struggle, and ease of playing. He communicated with Sam about different sound options, parameters, and whether or not something “worked” as anticipated. In this sense he collaborated with Sam and, in the moment of performance, became a mediator of AUMI’s adaptability. Moving beyond conventional notions of individualized musicianship, this relationship illuminates the social nature of music making and the reality of collaborative living that shapes the lives of many people with disabilities. The purpose of such improvising “across abilities is to stretch sound, communities, and consciousness” (Tucker et al., 2016, 198). Using AUMI, then, we see a blurring of roles as helpers (and therapists) are not just professionals or dedicated assistants, but maintain reciprocal social ties as co-creators and colleagues.
As Sam improvised with the group, the social interactions described above extended beyond one-on-one collaboration and the AUMI interface. In a most fundamental sense, musical improvisation encompasses the acts of listening to sounds and silences and responding with (or without) sound. In a group context, however, these sounds can represent just the surface of an intense, intersubjective social experience that dissolves the boundary between the self and the other. “The act of improvising,” Williams and Sonderkamp (2012) elaborated, “brings us to think and feel through each other, as well as through our instruments and other factors in the performative environment” (para. 2). Improvisation, then, has the capacity to produce a sense of “fellow-feeling” (Blacking, 1977), in which individuals in music-making contexts are attuned to one another’s movements, gestures, and resonances and even correspond as a unified body. AUMI not only brought Sam into collaborative relationships with his peers, Susan, and Mark, but, by adapting to his own movement patterns and enabling him to freely produce sounds, the instrument has the potential to immerse him into this more sensual form of social interaction. This is probably most evident during moments like the final chorus of “Firework,” when the collective energy during the session is at its height and the musicians “fall into phase” (Blacking, 1983, p. 57) with their percussion instruments—the moments when Sam and his peers nod their heads, laugh, sing-out, and/or furrow their brows with intensity. These moments of fellow-feeling have self-actualizing outcomes, in which a space is produced, collectively, for individuals to explore, express, and develop their various capacities (Sager, 2006, p. 147).
Blacking argued that the state of fellow-feeling emerges in “framed situations” that “help suppress the cultural rules that have inhibited [such somatic states’s] natural expression” (Blacking in Frith 1996, p. 216). Community music therapy sessions involving young people with disabilities provide such frames by subverting prevalent cultural norms around what it means to participate in youth culture. Moreover, the group’s improvisations challenge Western cultural rules about who can make music and how. Diverting from the conventional notion of individualized instrumental performance, the sessions present music making as a potent social practice and experience. AUMI adds further depth to Sam’s experience. It enabled him to contribute to the session in a more fluid, less physically restricted manner; it also acknowledged his individual creative agency while inviting collaboration with his peers, helper, and music therapist.
In her exposition of the “Principles of Universal Design,” Molly Follette Story (1998) drew a distinction between accessible and adaptable design. The former relates to additional design features that enable people with disabilities to access and utilize spaces and/or tools otherwise designed for able-bodied people. Such design features usually appear as “add-ons” and are often a response to building or consumer codes. Because of this, Story argued, “accessible features reflect the designers' failure to consider people with limitations until after the fact, often until forced to by law" (p. 4). While they are also geared toward accessibility, adaptable design features conventionally take the form of “modifications to a standard design” (p. 4) that can be adjusted as necessary. Similarly, adaptable designs can also have a stigmatizing “tacked on” aesthetic (p. 4). The notion of “universal design” is informed by the ideals of accessible design and utilizes adaptable design approaches with a “goal […] to minimize the need to change the individual or employ assistive technology and to make everyone's use of products and environments as smooth as possible” (p. 5). 
As an evolving digital instrument, AUMI embodies the principles of universal design as outlined by North Carolina State University’s Center for Universal Design. These principles include: 1) equitable use; 2) flexibility in use; 3) simple and intuitive use; 4) perceptible information; 5) tolerance for error; 6) low physical effort; and 7) size and space for approach and use (Story, 1998, p. 7). Unlike accessible technologies commonly used in music therapy, such as specialized instrument stands, AUMI is adaptable to individual needs, capabilities, and situations.  Its parameters allow a flexibility that caters to a broad range of abilities and creative visions; it is relatively intuitive and easy to learn; it requires very little physical effort to produce sounds; and, perhaps most importantly, it is intended for use by people with diverse abilities (Ibid.). While AUMI was inspired by a desire to create an adaptive instrument for people with disabilities, and this research took place in a music therapy context, nothing in the program’s design indicates that it is necessarily for people with disabilities. Rather, AUMI is available to anyone who wishes to make music through free movement.
Adaptability and the principles of universal design—especially with regards to equitability, flexibility, and tolerance for error—complement improvisation in community music therapy contexts. As participants in our research improvised one-on-one with Susan and in a group, they were also directly and indirectly communicating with volunteer helpers, who adjusted AUMI’s parameters on an as-needed basis. This in-the-moment experimentation with sounds, sensitivities, cursors, and visual fields was itself a kind of collaborative improvisation that, over time, became more fluid as those involved grew increasingly comfortable with AUMI and with each other.
Even though such collaborations can result in rich social and therapeutic experiences, the reliance on helpers to adjust parameters is, at first glance, incompatible with notions of universal design. Indeed, conventional computers are limited in their accessibility and adaptability to people with physical disabilities and/or sensory impairments. AUMI’s development, however, is a continuous process, and feedback from the music therapy sessions with Alan, Jacob, and Sam (along with other Consortium research projects) has informed work on the software in ways that better align it with the principles of universal design.  Such feedback resulted in AUMI 3, which features additional settings and parameters such as larger cursors, more visible text, and full-spectrum colour adjustment for the cursor and dividing lines which can also be adjusted for size and thickness, as well as horizontal dividing lines more suitable for triggering sounds with up-down motions. These kinds of developments are ongoing. In early 2017, for instance, the AUMI design team, made up largely of university researchers and graduate students in Canada and the United States, will release AUMI Version 4.0, which features a completely redesigned user interface for more intuitive program navigation. The interaction modes and instruments can now be arranged in any combination. AUMI 4.0 features a new radial tracker interaction mode and a new sequence editor that allows for flexible melodic pattern construction. Additional sounds have been added to the sample player along with new visual display and appearance controls, including adjustable user feedback options. More camera settings have been added to work with a wide range of systems. Other developments include a new preset storage system, an improved built-in help system, and a redesigned and greatly improved code foundation that will make future upgrades and expansions easier. (Thomas Ciufo, email correspondence, September 29, 2016)  Meanwhile maintaining compatibility across different, and aging platforms is an unceasing challenge. As new platforms emerge, however, the design team is presented with additional opportunities to enhance AUMI’s adaptability and user experience. In recent years an Apple® iOS version of AUMI has been developed for iPad® and iPhone®. The particular features and constraints of iOS have resulted in a highly portable and distinct instrument that has been employed in mixed-ability music and dance ensemble contexts. 
Our research has demonstrated the potential for adaptive digital instruments in a community music therapy setting. While AUMI is not without its limitations, the instrument’s adaptability provided avenues for Alan, Jacob, and Sam to exercise their creative agency and contribute to improvisation sessions freely and on their own terms. At times, improvising with AUMI drew them into rich social interactions and fruitful collaborations with their peers, family, volunteers, and professionals. Going forward, these experiences resonate beyond the music therapy context as our participants indirectly collaborate with designers who strive to develop an increasingly pliable digital instrument.
 Oliveros et al., 2011 provided an in depth description of AUMI’s interfaces and functionality.
 Easter Seals is an international network of charitable organizations that provides services and advocacy for people with disabilities and/or special needs. Our research was generously funded by a grant from the Vice President Research, Memorial University of Newfoundland.
 Pauline Oliveros (b. 1932) is a pioneer of electronic music and one of the most influential composer/improvisers of our time. She has published widely on her philosophy of Deep Listening. Oliveros founded the Deep Listening Institute (DLI) in 1985 to promote her philosophy of mindful listening as a social practice that forms a “unique approach to music, literature, art, meditation, technology and healing. It fosters creative innovation across boundaries and across abilities, among artists and audience, musicians and non-musicians, healers and the physically or cognitively challenged, and children of all ages.” (http://deeplistening.org/site/content/about) In 2014, DLI was moved to Rensselaer Polytechnic Institute where Oliveros has taught since 2001. It is now the Center for Deep Listening .
 Beginning in 2013, iPad® and iPhone® versions of AUMI became available at a nominal fee.
 Members of the AUMI Consortium include Rensselaer Polytechnic Institute, Carleton University, Kansas University InterArts, Lakehead University, McGill University and Memorial University of Newfoundland. Most of these sites are outgrowths of the ICASP research project, which is now in a new phase of funded research as the International Institute for Critical Studies in Improvisation (funded by a 7-year Partnership Grant from the Social Sciences and Humanities Research Council of Canada, 2013–2020).
 It should be noted, that while people with disabilities are often marginalized, the authors do not intend to present the research participants as “victims”. Many of the people involved in this study maintain rich social lives and enjoy many social opportunities through organizations like Easter Seals and independently through their own peer/family networks.
 Our research was conducted in accordance with the Tri-Council Ethics Protocol under a certificate from the Memorial University Interdisciplinary Committee on Ethics in Human Research. Names have been changed for confidentiality.
 The ages given for our research participants represent the age they were at the time the study was conducted.
 Indeed, the intentional simplicity of AUMI differentiates it from more complex software music sequencers such as Ableton Live® (widely used in live electronic music performance) that are very powerful and flexible, but that require a considerable investment in time and a high degree of comfort with computer music-making to master.
 The early version of the instrument that we worked with, AUMI 2.0, had some technological glitches that made the use of a helper even more essential. For example, particular lighting conditions or coloured clothing could interfere with the cursor’s tracking ability. These issues have been resolved in subsequent versions.
 Used with permission from the composer, Jim Payne. http://www.singsonginc.ca/index.php/artists/jim-payne
 Of course, for people with disabilities, engagement with disability culture is influenced by circumstances that transcend basic lifestyle choices. It should also be mentioned that allegiances to different lifestyles/cultural identities are manifold and malleable.
 AUMI has benefited from the generous support of Cycling ‘74, the company behind the visual programming language Max/MSP®. AUMI research has also been supported by the International Institute for Critical Studies in Improvisation (and its former research project Improvisation Community and Social Practice), both funded by the Social Sciences and Humanities Research Council of Canada.
 Story also noted that universal design encompasses transgenerational design, which “considers the changes that happen to people as they age” (p. 5).
 It should be noted that accessible designs like specialized guitar holders are a valuable tool in many peoples’ music therapy programs.
 Other important projects that have provided useful feedback for AUMI’s development include Leaf Miller’s work at Abilities First Public School in Poughkeepsie, New York and Eric Lewis’s and Keiko Shikako-Thomas’s research at the Mackay Centre School in Montreal.
] Many programmers have dedicated their time and talents to AUMI. The software was first developed by Zane Van Duzen and Zevin Polzin, with later improvements by Doug Van Nort, Jaclyn Heyen, Aaron Krajeski and Ian Hattwick. Thomas Ciufo, Ivan de Almeida Soares Franco, and John Sullivan have developed AUMI 4. Henry Lowengard is the inventor of AUMI app for iPad® and iPhone®.
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