Monthly Archives: April 2010

Primary Progressive Aphasia: information,challenges and moving forward

Aphasia can be defined as change in language.  The disorder is acquired after a person suffers some kind of brain damage.  The damage begins to affect the person’s ability to communicate and effectively express thoughts verbally.  In reference specifically to primary progressive aphasia, which is a form of dementia, this disorder has an impact on language only, and for a while does not have an impact on other functions such as mental capabilities. Since it is a form of dementia, primary progressive aphasia is in a group of related disorders that originate in the frontal or temporal parts of the brain.  The disorder preserves other mental functions for a few years, and most patients are able to perform routine activities such as holding a job, taking on hobbies, and taking care of themselves. Eventually, the disorder begins overtaking not only language, but the capability of performing daily activities that the person was once able to accomplish.

Primary progressive aphasia …

  • Usually begins with a problem in articulation and speaking due to a decline in brain cell degeneration. These problems will eventually render the patient unable to speak even though their comprehension and verbal processing remain, for the most part, intact.
  • Another problem patient’s encounter is being able to come up with words, names, and phrases.  This has to do with the decline in the brain activities that harvest these abilities.
  • The symptoms of primary progressive aphasia, at first glance, seem parallel to those symptoms associated with Alzheimer’s. Further insight into diagnosis reveals that the memory remains preserved, therefore, Alzheimer’s is not in effect.

Although not much has been done yet regarding Music Therapy and primary progressive aphasia, it is apparent that therapy in conjunction with music could really benefit a person with this disorder.  The sometimes tedious and exhausting task of focusing on language for an entire session can eventually halt progress.  Peoplewith primary progressive aphasia continue to decline in function, therefore speech therapy, although helpful and crucial, can become frustrating.  Music therapy in conjunction with speech therapy may in fact open new doors.  Music has a wonderful way of masking the extremely important tasks that the individual is working on, and makes those tasks seem more enjoyable and less frustrating.  If the patient enjoys music, using speech therapy techniques with music therapy techniques may allow activities to be easily approached and tackled.

I’ve had some really wonderful experiences working with my client this semester.  The linguistic and motoric techniques that have been put into effect during sessions have shown to have a great impact on my client, and the interdisciplinary work that is happening between Music Therapy and Speech therapy is the first documented form of its kind for Nazareth College.  I wish that I could continue to work with him into next year, but unfortunately it’s not possible.  This disorder has shown to some degree, that Music Therapy is in fact helpful, and allows the client to progress further than traditional speech therapy alone, although VERY important. The collaborative work between speech and music has allowed my client to start his journey toward a very positive experience with this new interdisciplinary work he is receiving.

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Techie Tuesday! “Apple Apps”

Finals week is just around the corner! As everyone is prepping for juries, exams and final practicum hours I wanted to post another Techie Tuesday segment!

I just got the iPhone! You heard right… I finally gave in.  I now spend my days looking through and downloading “Apps.”  I don’t know how many people are aware, but there are dozens of applications that can be used in therapy… both music and speech- which has been a big focus of mine this semester.  Here a few I’ve come across:

The “Aphasia” App

Pros:  Brilliant! It is a great tool to use in the session and outside of the session.  It gives 2 options: icons and video.  The icons offer a fairly substantial amount of vocabulary that speaks the phrase or word.  The video function has a recording of a mouth that allows the client to see the anatomical way the functional speech looks.  Even if your client doesn’t want to use it during a session, it’s great practice at home.  They can watch the videos and it’s like having a person there speaking to you and allows the client to watch the movement of the mouth.

Cons: I’ve found that it can be a little difficult for some clients to get use to (especially the older gen) because of the touch screen on the iPhone, iTouch, or the iPad.  Another thing; I’m not to thrilled that the “free” app has a woman speaking all words and phrases.  My male client didn’t like that.  I’m not sure, but it’s possible that if you purchase the app, you can change the setting.

“Simple Xyman” App

Pros: It’s totally portable, functional and really interesting for tech savvy clients to use.  This app would be great on an iPad because of the larger screen (it would make the instrument seem more life-size).  It offers 3 different choices to set the application on: Pentatonic Xylophone, C-Scale Xylophone and Piano Synthesizer.  I love the pentatonic.  It’s success oriented and sounds cool!

Cons: You can never replace real instruments.  The sound, and physical movement required to play the real thing cant be beat, however, the app would really work on great fine motor skills that is still very much music related.

“Autism Flashcards” App

I haven’t used this one all that much, however, it is Autism Awareness month and these apps are free all April.  Each app has a different topic: animals, numbers, letters, and colors.  They present a colorful picture of the topic, say the word, and on some play a classical piece of music to accompany the card.  It’s a neat little feature that can come in handy instead of traditional flash cards.

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Tech-ie Tuesday! “Incorporating Technology into your Sessions and Professional Life”

So here is the plan! Every Tuesday from here on out I will be posting a tip on how to incorporate technology into your music therapy life, whether it be with a client, a group, or social networking as a professional.  Each one of these realms is very important.  Technology is taking over the world whether we’re ready or not, and it’s best we embrace it! Most client’s (unless you’re working with an older population) are used having technology inserted into their lives, and rapport with younger generations will be even stronger because that is how most older children and adolescents communicate these days.  Showing your clients that you’re not afraid to incorporate technology into their sessions is really something special.  So here is tip numero uno in the Tech-ie Tuesday line-up!

Working with my client this semester at the Aphasia clinic sprung up an idea.  I recently purchased a Macbook (which I highly recommend; they are wonderful!), and I really wanted to incorporate some of its features into my session.  He is working on speech and language exercises, and often cannot tell he is not  using his lips and tongue the correct way to form the vocal sounds we are working on.  The speech clinic would often give him a small mirror (it resembled the child size mirror I would used when I put on my mom’s make-up when I was 5).  I decided to try and use the Macbook “Photobooth” feature which brings up your webcam onto the screen and sets it to real time.  It basically acted as a “gadgety mirror” that was fun and interesting for him to use.  I noticed right away that he started to pay closer attention to his mouth when I set the laptop in front of him.  Photobooth gave my client a crystal clear image of his mouth, that was “way cooler” than a small mirror.  I’m not saying you have to use it in just this way, but it’s an idea!

Stay tuned for more “Tech-ie Tuesday” ideas!

Sarah

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Rhythm Rings!

Rhythm rings are all the rage! O.K, at least in my mind they are. I picked up these handy little shakers at the Mid-Atlantic Region Conference and cannot get enough of them.  The extremely helpful man at the exhibition hall stand was demonstrating them in the next booth when I caught a glimpse of them and had to have them.  I’ve recently used them at “Kirkhaven” (see previous post) where it really added something special to the percussive accompaniment. A bunch of things ran through my head of how I was going to use them. Let’s go through a few:

  • So adaptable! No matter what population you’re working with they can strap on to anyone’s fingers- from child to adult!
  • Instant success! No matter what you hit, or if you just shake your hands they make a sound.
  • As a therapist, you can use them while playing other instruments.  With a guitar in your hands it’s very hard to try and play a shaker. Now you can!
  • Great in a drum circle, or percussion activity for the therapist or the client.
  • So many possibilities!
  • They’re adorable!

So strap on some rhythm rings and start using them as you jam out, or in your sessions. You can find rhythm rings at http://www.westmusic.com.  Here’s a little demo video for rhythm rings.

Sarah

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Experience at “Kirkhaven”

Just a quick post…

Yesterday I went over to Kirkhaven in Rochester, NY with 2 other student Music Therapists (Caitlin and Brian :)). Caitlin had her clinic placement there last semester, and wanted to do some community work there this semester. It is a “transitional and long-term care” facility for seniors with several floors including a dementia floor.  We were on the second floor yesterday. Unfortunately it got delayed until now, and it was also unfortunate that only the 3 of us were able to go.  It was a GREAT experience! We basically served more as entertainment during their “happy hour” complete with kahula and milk and lays potato chips (which we were graciously given a bag of by a member of the community:)) There is a music therapist on site, although i’m not sure about all the details (perhaps Caitlin will give us a run down post sometime).  The seniors just really enjoy music.  It’s hard to tell because the “audience response” that musicians are used to judging human enjoyment from is very different.  Light claps, and distant solo voices singing along to popular tunes such as “Let me call you sweetheart,” began assuring us that they were enjoying themselves.  Although we were not as rehearsed and prepared as we would have like, we came equipped with a guitar,my personal percussion accessory collection, and a keyboard that was set up for us.  When the three of us discussed afterward what worked and what didn’t we came up with these points:

  • The elderly population loves familiar repertoire (Oh when the saints, I’ve been working on the railroad, You are my sunshine)
  • It’s okay to break the barrier between you and them (in a non-therapy situation).  Once we warmed up and handed out instruments, the whole air in the room lifted and we were all having more fun!
  • Even if they’re not hooting and hollering, they really are enjoying themselves
  • Music evokes VERY strong memories and responses for them

During a short “meet and greet” afterward the sweet reactions, and “thank-yous” were more than enough to gurarantee our appearence there again.  An older couple confessed how much they enjoy listen to music and how very strong memories come back when they listen to it.  Another lady sang sweetly along with us as we sang her “Danny Boy” a capella as per her request.  As we left the room, another lady brought out her harmonica and began playing (by memory) some of the songs we had just performed.

It was truly a wonderful experience.  I haven’t had an opportunity to work directly with this population, however, our time there really touched me.  I hope to see the folks from Kirkhaven over the summer again.

Sarah

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Being Part of an Interdisciplinary Team

Working with an interdisciplinary team can be a really great experience but it does present challenges. Anytime you must collaborate with more professionals other than  yourself, different opinions, different ways  of doing things, and different disciplines  are added to the mix. This semester I am  doing my practicum at the Nazareth  College Aphasia clinic. This has given me the opportunity and now, the experience, of being in a co-treatment situation as well as working with a team of people other than music therapists. As the semester winds down, I look back and reflect on the experience with all of its positives and negatives:

Myexperience has been a mixture of both sides of the chart. There have been times of miscommunication and bad collaboration from one end. This tends to make the experience less enjoyable but also a good learning experience. When this happens, it is in your best interest not to be a complain, but rather, keep your composure and professionalism. This will speak well for you. Situations like this allow you to demonstrate the kind of therapist you will be, as well as your leadership skills.

I was given the opportunity this past Tuesday to write up Nazareth’s first interdisciplinary report with the speech therapist I am co-treating with, and both of our supervisor’s. I enjoyed the collaboration as we created this document. It is difficult to bind two disciplines together and focus in on one client, however when both professionals are working toward the same goal, the process is much easier.

If given the opportunity as a student to participate in something like this, I highly recommend it. It is a great window of opportunity that gives you experience that one normally wouldn’t get until you are a professional

Sarah

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How to Impress Your Clinic Supervisor!

I’ve taken in an ear-full this semester from many of the music therapy professors on campus.  It’s becoming clear that there are certain things that are clearly expected from you as a student, an aspiring professional, and as a music therapy clinical student.  Here are some pointers to make the most out of your practicum and leave a lasting impression with your school and your site:

Arrive early! – At least 15 minutes before the session to tune up, set up, and ask last minute questions.

Hand paper work in on time– most supervisors want session plans a few days before.  Yes, I’m aware that this is usually inconvenient for our insane student schedules, and last minute tendencies.  Most supervisors have many clients and many other things to manage besides you.  Make it easier for them and they will be much more fond of you! J

Ask questions– this shows you actually have an interest in what your doing, genuine concern for what you offer to your client, and want to improve your clinical self!

Take initiative– This includes asking questions or coming up with solutions by yourself! Let’s put on our big-therapist pants!

Be passionate– Self-explanatory. Like what your doing, or at least pretend.

Original ideas– this is part of initiating ideas, problem solving for things that went well and looking ahead on what to improve.

Write your own songs– “Hello” and “Goodbye” songs are the easiest and can really leave a lasting impact on your supervisor and client.

Demonstrate an understanding of clinical principles– Know what you are talking about and try to use professional terms rather than beating around the bush.

Act professional (that includes dressing the part)- If you want to be taken seriously, look serious and act serious.

Don’t cancel (unless it’s an absolute emergency)

Take feedback and apply it the very next session– That means write it down and look at it!

Be organized– Don’t drive your client nuts by not knowing what your doing next and what instruments you need. Have a session plan next to you, know your activities, and have everything ready to go!

Have back-up plans– Client throws their self on the floor? Non-responsive? Having an off day? Make sure you’re prepared for anything, and work to the best of your ability with what you have.

Plan accordingly– Make sure you’re addressing your goals and objectives and meeting the clients needs.  Were not there to play sing-a-long.

If a group- observe each individual in the group– This was especially hard for me.  Whether one person wants all the attention, or another person is fading into the background; each client is a human being and deserves your very best skills and attention.

Be Yourself! –  Your best assets come from who you are.  Still be yourself.  It will be much easier for you and your client to form a therpeutical relationship.

Thanks for checking back!

Sarah

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