Music Therapy Assessment Early Intervention to Early Elementary Elizabeth K. Schwartz LCAT MT-BC Raising Harmony: Music Therapy for Young Children Elizabeth@RaisingHarmony.com
Music Therapy Assessment: Early Intervention to Early Elementary Learning Objectives: Objective #1. Participants will demonstrate knowledge of at least 3 factors impacting a clinician s ability to review and select music therapy assessment instruments and procedures. (CBMT Scope of Practice 2010: I.A.8.) Objective #2. Participants will develop or improve their ability to select, adapt, or develop an assessment instrument and procedures for a specific client and specific clinical setting. (CBMT Scope of Practice 2010: I.A.9, 10.)
Early Childhood Music Therapy Assessment Part 1 Function and use of music therapy assessments: purposes and procedures. Review of assessment items in the AMTA Standards of Clinical Practice and the CBMT Scope of Practice. Synopsis of current and published early childhood music therapy assessment tools and explore their use in terms of eligibility, levels of functioning, treatment planning and evaluation procedures. Value and reliability of music-based assessments in early childhood music therapy.
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The Five O s of the Music Therapy Assessment Process Overview Opinion Orientation Organization Observation E. K. Schwartz 2013
American Music Therapy Association Standards of Clinical Practice-Assessment 2.0 Standard II - Assessment A client will be assessed by a Music Therapist for music therapy services. 2.1 The music therapy assessment will include the general categories of psychological, cognitive, communicative, social, and physiological functioning focused on the client's needs and strengths. The assessment will also determine the client's responses to music, music skills and musical preferences. 2.2 The music therapy assessment will explore the client's culture. This can include but is not limited to race, ethnicity, language, religion/spirituality, socioeconomic status, family experiences, sexual orientation, gender identity or expression, and social organizations. 2.3 All music therapy assessment methods will be appropriate for the client's chronological age, diagnoses, functioning level, and culture(s). The methods may include, but need not be limited to, observation during music or other situations, interview, verbal and nonverbal interventions, and testing. Information may also be obtained from different disciplines or sources such as the past and present medical and social history in accordance with HIPAA permission regulation. 2.4 All interpretations of test results will be based on appropriate norms or criterion referenced data. 2.5 The music therapy assessment procedures and results will become a part of the client's file. 2.6 The final decision to accept a client for music therapy services, either direct or consultative, will be made by a Music Therapist and, when applicable, will be in conjunction with the interdisciplinary team. Screening may be used as part of this process. 2.7 The results, conclusions, and implications of the music therapy assessment will become the basis for the client's music therapy program and will be communicated to others involved with provision of services to the client. When appropriate, the results will be communicated to the client. 2.8 When assessment indicates the client's need for other services, the Music Therapist will make an appropriate referral.
Certification Board for Music Therapists Scope of Practice - Assessment A. Assessment 1. Observe client in music or non-music settings. 2. Obtain client information from available resources (e.g., documentation, client, other professionals, family members). 3. Within the following domains (e.g., perceptual, sensory, physical, affective, cognitive, communicative, social, and spiritual), identify the client s: a) functioning level. b) strengths. c) areas of need. 4. Identify client s: a) active symptoms. b) behaviors. c) cultural and spiritual background, when indicated. d) issues related to family dynamics and interpersonal relationships. e) learning styles. f) manifestations of affective state. g) music background, skills. h) preferences. i) stressors related to present status.
Certification Board for Music Therapists Scope of Practice - Assessment 5. Document intake and assessment information. 6. Evaluate the appropriateness of a referral. 7. Identify the effects of medical and psychotropic drugs. 8. Review and select music therapy assessment instruments and procedures. 9. Adapt existing music therapy assessment instruments and procedures. 10. Develop new music therapy assessment instruments and procedures. 11. Create an assessment environment or space conducive to the assessment protocol and/or client s needs. 12. Engage client in music experiences to obtain assessment data. 13. Identify how the client responds to different types of music experiences (e.g., improvising, recreating, composing, and listening) and their variations. 14. Identify how the client responds to different styles of music. 15. Identify how the client responds to the different elements of music (e.g., tempo, pitch, timbre, melody, harmony, rhythm, meter, dynamics).
Certification Board for Music Therapists Scope of Practice - Assessment B. Interpret Assessment Information and Communicate Results 1. Evaluate reliability and presence of bias in information from available resources. 2. Identify factors which may impact accuracy of information gathered during assessment (e.g., precipitating events, medications, health considerations). 3. Draw conclusions and make recommendations based on analysis and synthesis of assessment findings. 4. Acknowledge therapist s bias and limitations in interpreting assessment information (e.g., cultural differences, clinical orientation). 5. Communicate assessment findings and recommendations in oral, written, or other forms (e.g., video, audio).
Eligibility Skills/Domains Development Assessment
Early Childhood Assessment & Music Therapy Focus on development rather than diagnosis Equal weight for all domains Well documented and extensive list of expected skills and needs Clear scaffolding of skill acquisition Developmental progression of how and why child interacts with environment Music Responses in early childhood: Discrete area of development Directly tied to other developmental benchmarks Developmental progression of how and why child interacts with musical environment
Eligibility No current, widely accepted tool to determine eligibility Frequent use of therapist-created tools Common use of music vs. non-music comparison Reliance on assessment information from other disciplines
Eligibility Four Step Assessment Model (Lazar 2007) Kern, P. & Humpal, M. (Eds.) (2012). Assessment and goals : Determining eligibility, gathering information and generating treatment goals for music therapy services in Early childhood music therapy and autism spectrum disorders: Developing potential in young children and their families. Philadelphia and London: Jessica Kingsley Publishers. Determine necessity of music-based support on IEP
Skills/Domains A Hierarchical Approach to Group Music Therapy Intervention Kaplan, R. S. (2006). Step by step: A hierarchical approach to group music therapy intervention in preschool settings. In M. Humpal & C. Colwell (Eds.), Effective Clinical Practice in Music Therapy: Early Childhood and School Age Educational Settings (pp. 97 109). Silver Spring, MD: American Music Therapy Association. Assessment of levels of educational readiness for pre-school aged children on IEPs.
Skills/Domains The Music Therapy Communication and Social Interaction Scale (MTCSI) Bell, A. B., Perry,R., Peng, M., & Miller, A.J. (2014). The music therapy communication and social interaction scale (MTCSI): Developing a new Nordoff- Robbins scale and examining interrater reliability Music Therapy Perspectives Volume 32, Number 1. pp 61-70. Measuring communication and social interaction. Available at Nordoff.robbins@nyu.edu or 212 998 5151.
Comprehensive Development The Cleveland Music Therapy Assessment of Infants and Toddlers Liberatore, A. M., & Layman, D. L. (1999). The Cleveland Music Therapy Assessment of Infants and Toddlers: A Practical Guide to Assessing and Developing Intervention Strategies. Cleveland, OH: The Cleveland Music School Settlement. Checklist of developmental benchmarks as observed in music assessment session. Tied to typical chronological age from birth to 3. Available for purchase at http://themusicsettlement.org/music-therapy/contact or call (216) 421-5806 ext.140.
Comprehensive Development Developmental Skill Charts Grouped by Ages (6-24 months) Walworth, D. (2013). Bright start music: A developmental program for music therapists, parents, and teachers of young children. Silver Spring, MD: American Music Therapy Association. Although not designed as an assessment tool, pages 243-266 of this extensive music curriculum provides detailed information on developmental skills ages 6-24 months.
Music Development Sounds of Intent Vogiatzoglou, A., Ockelford. A., Welch, G., & Himonides, E. (2011). Sounds of intent: Software to assess the musical development of children and young people with complex needs. Music and Medicine, 2011(3), 189. Framework using interactive software used to assess musical engagement and development in young children with complex needs. Access available for free at http://soundsofintent.org/.
Comprehensive Development The Early Childhood Strengths, Needs and Resources Review (ECSNRR) Schwartz, E. K. (2013). Early intervention. In M.R. Hintz (Ed.) Guidelines for Music Therapy Practice in Developmental Health. ( pp. 8-49) University Park, IL: Barcelona Publishers.
Music Development Music Indicators of Early Childhood Development (MIECD) Schwartz, E. (2008). Music, therapy, and early childhood: A developmental approach. Gilsum, NH: Barcelona Publishers. Simple to use, sequenced checklist of musical responses across the developmental range of young children used to determine developmental level purely through music responses.
Further Early Childhood Music Therapy Assessment Resources: Carpente, J. A. (2013). Individual music-centered assessment profile for neurodevelopmental disorders: A clinical manual. N. Balwin, NY: Developmental Music Health. Jacobsen, S., & Wigram, T. (2007). Music therapy for the assessment of parental competencies for children in need of care. Nordic Journal of Music Therapy, 16(2), 129. Rainey Perry, M. M. (2003). Relating improvisational music therapy with severely and multiply disabled children to communication development. Journal of Music Therapy, 40(3), 227 246. Ringwalt, S. (2008). Developmental screening and assessment instruments with an emphasis on social and emotional development for young children ages birth through five. The National Early Childhood Technical Assistance Center. www.nectac.org. Standley, J. M., & Hughes, J. E. (1996). Documenting developmentally appropriate objectives and benefits of a music therapy program for early intervention: A behavioral analysis. Music Therapy Perspectives, 14, 87 94.