Telehealth with Children with High Needs | #10

Today Maggie walks us through her experience working with children and adolescents with high needs in the school system. She walks us through available research and includes some tips and considerations she’s learned along the way.

Show Notes

Delivery of Virtual Music Therapy (per the article Virtual Music Therapy: Developing New Approaches to Service Deliver):

1. Curate Online Resources

   • identify pre-existing content available online that reinforce the therapeutic uses of music or social and emotional learning concepts

2. Create Original Content

   • develop audio and/or video recordings of original music and interventions to meet therapeutic objectives

3. Implement Telehealth

   • consider different approaches and the needs of your clients and facilities/organizations you work with.

Pros to telehealth music therapy:

• increased access to services including those individuals in rural areas and who have severe mobility or health issues

• serving more clients due to a decrease in travel time

• continuation of therapeutic services

Cons to telehealth music therapy:

• internet connection issues

• live and interactive music making can be difficult

• lack of instrumentation in the classroom

• telehealth does not represent the general reality of these individuals in generalizing these behaviors

• lack of physical energy, ability to read their body language or physically interact in live music making

Things to consider:

1. Effectiveness - some clients may thrive in this format, while other may show little to no progress and may need to postpone services until in-person services are available.

2. Patience - have patience with your client and yourself

   • give ample time for a client to respond to your prompt

   • have realistic expectations for progress

   • be flexible and patient with yourself because you will need to try new things, re-work old ideas and be prepared to adapt and change at a moments notice.

3. Consistency & Predictability - be extra vigilant in this matter

   • be prepared at the same time each week - try to have as consistent a schedule as possible

   • be consistent in how you show up in your therapy session:

     • consistent and predictable tone & responses

     • consistent and predictable consequences (positive and negative)

     • consistent and predictable session structure

4. Building Agency - support clients with opportunities to build resilience and choice

   • give abundant opportunities for choices

5. Utilizing the Teacher/Paraprofessional/Caregiver/Parent

   • Utilize their presence:

     • Example: instruct them on where to position the student, computer/iPad/tablet, instrument, etc.

     • Example: instruct them on how to provide hand-under-hand assistance or other physical positioning and prompts, when appropriate.

     • Example: model and instruct them to utilize rhythmic cueing and prompting

     • Example: model and instruct them to utilize social interaction prompts with greetings, signing, assistive devices, etc.

   • Build rapport:

     • remember their names

     • involve them in conversation

     • create a welcoming environment for them, as well as, the student

     • offering ideas to use in the classroom/outside of the therapy session (may include sensory strategies, etc.)

     • Be gracious and affirm the things you liked seeing and encourage them!

Resources & Tips:

1. Access the wider music therapy community:

   • Facebook Groups:

     • Ex. Music Therapy Teletherapy Intervention Swap

     • Ex. Music Therapy Song Share

2. Seek Supervision - brainstorm with your team of people

   • if you are the only music therapist in your workplace, reach out to the music therapy community and seek out supervision.

3. Audio/Visual Interface

   • WebEx & Zoom

     • prefer Zoom - audio and video streaming are clearer

     • If WEbEx - you will need to download an extension onto the app in order to share your computer’s sound.

   • Audio

     • Focusrite 2i2 interface with a microphone works well

     • being able to share your computer sound is helpful

   • Instrumentation

     • guitar is the most compatible (I’ve found) with telehealth

     • piano can also be based on the distance from the screen and your microphone and audio input setup

     • instruments like drums, shakers with warmer timbre come through better than tambourines or high pitched xylophones.

Links:

David Knott, MM, MT-BC, Seneca Block, MA, MT-BC, Virtual Music Therapy: Developing New Approaches to Service Delivery, Music Therapy Perspectives, Volume 38, Issue 2, Fall 2020, Pages 151–156, https://doi.org/10.1093/mtp/miaa017

Creative Therapy Umbrella: https://creativetherapyumbrella.com 

Online Stories (Free): https://www.youtube.com/c/BrightlyStorytime/featured 

Rachel Rambach (Music Therapy Interventions): https://listenlearnmusic.com 

Spectrum Creative Arts: https://spectrumcreativearts.org 

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