This blog will include both person-first language (“a person with autism”) and identity-first language (“an autistic person”) to reflect the differences in preferred language in the autistic community. You should always directly ask a person’s preferred language. All references are hyperlinked. Neurodiversity is a term used to describe the differences in the way people’s brains work. It is the idea that there is no “right” or “wrong” way for the brain to function and that people perceive and respond to the world in different ways. It is often used in the context of autism spectrum disorder (ASD) but it also refers to ADHD, downs syndrome, dyspraxia (movement processing difficulties) and dyslexia (language processing difficulties) to name a few. The term was coined by Australian sociologist Judy Singer in the 1990s to promote equality and inclusion, as well as highlight the benefits of neurodiversity. The DSM-V describes autism spectrum disorder as a developmental disability characterized by difficulties with social communication and interaction, and restricted and repetitive behaviors. Historically autism research focuses on the social communication and interaction aspects of the disorder, often neglecting the sensory and motor needs of persons with autism. We have eight senses - sight, hearing, smell, taste, touch, vestibular, proprioceptive and interoceptive. The vestibular system senses balance and posture, while the proprioceptive system senses movement, action and location. The lesser-known interoceptive sense is responsible for understanding our body’s internal sensations, like whether we’re hungry, cold or tired. Autistic people often have difficulty interpreting sensory information which can result in difficulties with self-regulation. If you have trouble interpreting sensory information your body might feel uncomfortable but you don’t know why. This feeling of “not being in your body” can result in sensory seeking or sensory avoiding behaviors. A sensory seeking behavior might look like stomping one’s feet or squeezing one’s hand and a sensory avoiding behavior might look like avoiding physical touch with others. As a result persons with autism have difficulty with arousal regulation. If you’re over- or under-stimulated, it is more difficult to interact with others and to regulate your emotions. Unfortunately these sensory seeking and avoiding behaviors are often mislabeled as difficult behaviors related to the socio-emotional aspects of the disorder. Music therapy is often used to support autistic individuals with arousal and sensory integration, interaction and communication, and emotion regulation. Here are some ways music might be used! Movement to music can aid in the integration of the senses, such as auditory perception and the integration of the visual, tactile and kinesthetic senses to improve body awareness. Music and deep pressure input, such as hand squeezes, can also provide functional sensory input and reduce sensory seeking behaviors. The rhythmic component of music helps to organize the motor system. Music can then be used to improve gait, as well as fine and gross motor skills. For example, playing the piano to improve finger dexterity or hitting a drum bilaterally to practice trunk rotation. A music therapist might use developmentally appropriate songs to enhance speech and language development in children with autism. Through singing, instrument playing and movement children can learn things like the days of the week or how to get dressed independently. Singing can also be used to help with vowel and consonant production or word learning to support speech and language development. Improvisational music playing can be used to mimic social situations in order to teach turn taking, listening and responding and joint attention. For autistic individuals who are non-verbal, music can be a form of communication and self-expression. Singing, songwriting, improvisational music playing and music listening can be used to help identify and express emotions. The different qualities of music can help us to convey emotions without using words. Music can also promote relaxation. A guided meditation or progressive muscle relaxation with music can help calm the body and mind, as well as improve body awareness. These are just some of the ways that music can support persons with autism.

Parkinson’s disease is a progressive disorder that is caused by degeneration of nerve cells in a part of the brain called the substantia nigra, which is responsible for controlling movement. It’s the most common movement-related brain disease, affecting approximately 1% of people 60 years and over worldwide (AANS, 2023). When you hear Parkinson’s disease, what comes to mind? Most people will think of slowed movements (bradykinesia), tremors and rigidity, a stooped posture and shuffling (or festinating) walking pattern. But did you know that Parkinson’s disease heavily impacts the voice? Approximately 90% of people with Parkinson’s disease experience something called dysarthria (Moya-Galé, 2019). Dysarthria refers to a group of motor speech disorders characterized by weakness, slowness or poor coordination of the speech muscles. It is referred to as an execution disorder because the weakened speech muscles result in consistent speech errors. Signs of dysarthria might include an inability to speak loudly, abnormal speech rhythm, a strained, raspy or nasal sound voice, monotonous speech, difficulty moving the tongue and facial muscles, slow and/or slurred speech and rapid speech that is difficult to understand. While there are seven types of dysarthria, hypokinetic and hyperkinetic dysarthria are most commonly associated with Parkinson’s Disease. Hypokinetic dysarthria is marked by difficulty initiating speech, rigidity, short rushes of speech, a harsh of breathy sound, monopitch and monoloudness. In contrast, hyperkinetic dysarthria is marked by difficulty inhibiting speech, irregular articulation, emotions and facial expressions, as well as tremor, dystonia (involuntary muscle contraction) and tics. With all dysarthrias, the main concern is intelligibility of speech. Did you know that music therapy can be used to treat symptoms of dysarthria? In Neurologic Music Therapy, there are two main techniques I have used when working with client’s with Parkinson’s Disease. The first technique is Rhythmic Speech Cueing (RSC). In RSC, the rate of speech is controlled via auditory rhythm (Thaut & Hoemberg, 2016, p. 151). By practicing speech to a metronome the temporal characteristics of speech, such as fluency, rate of speech and intelligibility improve. The beat of the metronome is determined by assessing the client’s fluency and rate of speech. From here, functional sentences can be practiced. For example, if working on metric cueing, each syllable would be matched to one beat of the metronome (“I – want – a – glass – of – wa – ter”). The second technique is Vocal Intonation Therapy (VIT). In VIT, vocal exercises are used to maintain and rehabilitate aspects of voice control such as inflection, pitch, breath control, timbre and dynamics (Thaut & Hoemberg, 2016, p. 179). These exercises are similar to those used in vocal warm up. Another concern among those with Parkinson’s disease is monoloudness and reduced loudness because it can be difficult to communicate with others if they cannot hear you. A music therapist might use an exercise that has the client crescendo their voice to practice singing more loudly, and then transfer this skill to speaking. With the prevalence of Parkinson’s disease it is important to think about all aspects of the disorder – especially the voice – because it allows us to communicate with one another. In persons with Parkinson’s disease, singing can then be used as an effective tool for maintaining vocal function in an engaging and motivating way.

Have you ever wondered what happens in the brain when you listen to music? This question falls under something called the neuroscience of music. It helps us to explain things like why we move to the beat when we’re listening to music, or why that one specific song transports us back in time. Did you know there’s something called neurologic music therapy? Neurologic music therapy or NMT for short, is an evidence-based treatment model based in the neuroscience of music cognition, perception and performance. It uses the different elements of music, like rhythm, melody, harmony, tempo, and dynamics, to achieve functional goals in the domains of cognition, sensorimotor, speech and language. By manipulating the different elements of music, a neurologic music therapist can optimize brain function or even create new neural pathways in the brain. Guided by research, a neurologic music therapist focuses on the neuroscience of music and how the different elements of music can drive changes in the brain and influence new behaviors and functions. Curious to learn more? Dr. Corene Hurt-Thaut’s presentation “The Effects of Neurologic Music Therapy” at the Music Care Conference on Saturday November 5, 2022 will explore how music can drive the change within us. Dr. Corene Hurt-Thaut is a neurologic music therapist and educator. She is the director of the MMus in Applied Music and Health at the University of Toronto, an associate professor at the ArtEZ School of Music - ArtEZ Conservatorium in the Netherlands and the co-founder and program director of The Academy of Neurologic Music Therapy. She is internationally recognized for her clinical expertise in the evidence-based practice of Neurologic Music Therapy with numerous research publications on music and motor control. Whether you’re attending live in New Westminster, BC, or virtually from your home, you will experience the transformative power of music in the areas of cognition, sensorimotor, and speech and language through case studies on clients with Parkinson’s Disease, dementia and acquired brain injury. Register today at musiccareconference.com. Student, senior and group pricing available.

The arrival of June can stir up feelings of renewal with the start of summer and yet in the same breath, June symbolizes a sense of closure for people and organizations that follow a school year calendar. As Room 217 ends our season of education offerings and prepares for the fall, I wonder if we’ve taken a moment to pause, reflect, and ask ourselves “are we okay?” With summer on our doorstep, it is the perfect time to consider creating a playlist of songs for self-care that bring a smile to our faces and inspire a moment of joyful reflection. This is one of the beautiful attributes of music when thinking about person-centred care that applies to self-care too. We are all unique beings and our experience with music is as individual as our fingerprint. We write our own stories with music through life and are the sole owners of this book. Take a moment after thinking about songs that bring you joy and contemplate how you can fill out this playlist. Consider adding some songs that create the kind of space you are seeking. Are you looking for songs that motivate and inspire? Perhaps you need a playlist to create a sense of peace or calm. Fill out your joyful moments of reminiscence through music with songs that create a mood you wish to sit in relish for a moment. The intentional use of music helps us create a space for ourselves that connects to self-care. This is music care. On May 27th, The National Music Centre launched a Music & Wellness Exhibition which will be permanent and outlines the organizations commitment to curating events and exhibits dedicated to the power of music. According to the website, this exhibit ‘taps into the power of music on physical and mental health’ and the NMC hopes that it ‘will continue to provide space for wellness-related programs and expert talks.’ If your summer travels take you to Alberta, be sure to check out more information on this exhibit at www.studiobell.ca . You never know, you may stumble across a few new songs to add to your summer playlist for self-care! Which reminds me, have you thought about a road trip playlist…?

Voice is lauded as the most accessible way into music, but, as many of us know, ‘singing’ can strike fear into the hearts of the most brave. Many of us have come across people in our practices who feel their voices are ‘not good enough’. As Dr. Helen Pridmore writes,