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Hearing Impairments and Music Therapy
Journal Articles
Compiled by Jess Bruch - December 1999
TL- Testing hearing loss in young
TL 1. Music in Therapy edited by Thayer Gaston ML392.M897This book gives an overview on all aspects of music therapy. The main goals of music therapy when working with the hearing impaired are given. Uses of rhythm in body coordination, speech pattern, and social skills are all discussed. The use of the tactile sense in the deaf to "hear" music is explained along with a description about how the deaf are able to discriminate between pitches. The book includes one case study which shows how music is used to determine the degree of hearing loss in infants
TL 2. Baird, Sally. "A Technique to Access the Preference for Intensity of Musical Stimuli in Young Hard-of-Hearing Children." Journal of Music Therapy, 6 No. 1 (1969): 6. Location-Current.
It is difficult to measure accurately the degree of hearing loss in the young hard-of-hearing. Retarded communication skills and inability to understand directions are basic problems which make traditional means of testing neither effective nor feasible. Often no audio program is present in the child's records. Therefore, teachers have no accurate means of knowing the degree of hearing loss. In the field of music therapy several studies have supported observations that music can be used as a behavioral consequence to maintain given behaviors in children and adults. This study attempted to determine what decibel level of auditory stimuli (music) would maintain response in young hard-of-hearing children - i.e., what decibel level each child preferred.
VB-Aspects of Vibration
VB 1. Music Therapy and Education for the Handicapped ML3920.M8976|"Technology for Music for Deaf and Hard of Hearing People", by Gordon Dalgarno
This brief article discusses ways technology can be used to help the hearing impaired perceive music. It focuses mainly on sensori-neural hearing impairments and explains ways technology increases musical experience. It explains the problems of distortion associated with large volume increases and provides alternatives to increased volume that allow the deaf to feel music better. The concepts behind vibrotactile stimulation and "vitamusic" are also briefly discussed.
VB 2. Darrow, Alice-Ann. "The Effect of Vibrotactile Stimuli via the SOMATRON on the Identification of Pitch Change by Hearing Impaired Children." Journal of Music Therapy , 29-30 No. 2 (1992-93): 103. Location-Current.text to identify article>
This particular study examined the effect of vibrotactile stimuli via the SOMATRON on the identification of pitch change by hearing impaired children. The researcher wanted to find out if vibrotactile stimuli assist hearing impaired children in developing tonal concepts normally acquired by hearing children through the auditory channel. The subjects for this particular study were 17 hearing impaired students from a state school for the deaf. Using a Yamaha synthesized PSR-90, ten alternating patterns of octaves, perfect fifths, and major thirds, ascending and descending were recorded in random order on audio tapes. Subjects were tested individually for identification of pitch change under two conditions. The first condition was the use of auditory skills only, and the second condition was the use of auditory skills supported by vibrotactile stimuli. Identification of pitch change was indicated by subject's response on a mechanical auditory signal device. Audiotape recordings of subject data were analyzed for identification of pitch change. Data were recorded for correct and incorrect responses. Incorrect responses included omissions or indications of pitch change when no change occurred. Of the 17 subjects, 10 identified more pitch changes under the use of auditory skills supported by vibrotactile stimuli condition. Four subjects identified more changes under the use of auditory skills only condition, and three subjects identified the same number of changes under both conditions. The data analysis examined differences occurring on the bases of number of beats preceding a change, size of the melodic interval, or discrepancy in change, and age of subjects.
VB 3. Madsen, Clifford K., and Mears, Wilfred G. "The Effects of Sound Upon the Tactile Threshold of Deaf Subjects." Journal of Music Therapy, 2 No. 2 (1965): 64. Location-Current.
Although experimentation has been done relating to the various senses, nothing could be found to indicate that air vibrations (sound) have any effect upon the tactile threshold. It was observed that deaf people attend musical concerts. This observation suggested the possibility that sight and sensitivity to vibrations through bond conduction and resonance might be related. It was speculated that sound vibrations might also cause the skin itself to vibrate and that this might be a factor in a deaf person's perception of music. The problem was: (1) to determine if sound vibrations on the skin have a significant effect upon the threshold of the tactile sense, and (2) to determine what differences, if any, exist between tactile thresholds and selected intensity and frequency levels of sound.
VB 4. "The Music Vibration Table (MVT) : Developing a Technology and Conceptual Model for Pain Relief" Music Therapy Perspectives Vol.9 pg.32
This article first discusses the basic principles behind vibrotactile technology; however, no studies have been completed. The usual uses of pain relief in music are through distraction and relaxation. This article discusses the effects of musical vibrations on pain relief. There is a large background section about neurophysiology that explains in depth the different aspects of pain perception. The second part of this article describes the use of the music vibration table. Included are three case studies showing that the use of the music vibration table had significantly reduced pain. Although no studies have been done specifically on the hearing impaired, the music vibration table could serve as a beneficial resource.
TG-Teaching and Instructional Guides
TG 1. Music Therapy and Education for the Handicapped ML3920.M8976 "An Approach through Emotional Expression to Music Education for the Deaf" by Lau Chiu Kay pg. 147 (1992)This article gives instructional guidelines on how to teach emotional expression by using music with deaf children. Although it does not provide a detailed instruction plan, this article gives an overview to approaches for use with emotional expression and explains how each approach can be taught by a music therapist to a deaf child. The principles of each approach are described along with the different teaching techniques.
TG 2. "Information Sharing: A Model for the Integration of Music Therapy Within Preschool Classrooms for Children with Physical Disabilities or Language Delays"
Music Therapy Perspectives Vol. 8 pg. 82 (1991)
This article is a directional guide on how to implement a music therapy program in school settings. The article stresses the importance of an interdisciplinary team of therapists working together. An explanation describes factors to consider when assigning students to certain groups. Emphasis on integration of handicapped and normal children is mad. Special considerations for hearing impaired children are also listed.
TG 3. "Music for the Deaf" by Alice Ann-Darrow
Music Educators Journal (Feb 1985) pg. 33
This article stresses the importance of music education for hearing impaired children. The different instruments that can be perceived by the hearing impaired are described. The use of music in forming prosodic features of speech are discussed. For example, rhythm and body movement are useful in developing speech patterns. Music therapy also helps develop auditory training and teaches the hearing impaired children to interpret sounds.
TG 4. Darrow, Alice-Ann, and Gfeller, Kate. "A Study of Public School Music Programs Mainstreaming Hearing Impaired Students." Journal of Music Therapy , 27-28 No. 1 (1990-91): 23. Location-Current.
The purposes of this study were to: (a) examine the status of public school music instruction for hearing impaired students and (b) examine the factors that contribute to the successful mainstreaming of hearing impaired students in the regular music classroom. A questionnaire was developed with items concerning educational preparation, items concerning demographic information, extent of instructional and administrative support, factors related to the successful mainstreaming of hearing impaired students, the extent to which musical and non music goals are set by music educators, obstructions to mainstreaming, and activities and curricula successfully implemented in mainstreaming programs. Results of the study revealed the following: (a) more than half of all hearing impaired students attend regular music classes; (b) of those students not mainstreamed, less than half receive no music education in the self-contained classroom or otherwise; (c) many music educators are lacking in the educational preparation necessary for teaching hearing impaired students; (d) important instructional or administrative support is often not available; (e) several factors, such as lack of appropriate curricula or poor communication with other professionals, are identified as obstructions to the successful mainstreaming of hearing impaired students; (f) only 35% of the respondents reported that they have the same objectives for hearing impaired students as for normal hearing students; and (g) methodologies, materials, and activities were identified that were helpful in integrating hearing impaired students into the regular music classroom. Implications for public school music educators are cited.
TG 5. Buechler, Jean. "Music Therapy for Handicapped Children: Hearing Impaired." c. (1982) Location-ML3920.B8
This book focuses on first understanding the disability of hearing impairment. It provides the reader with specific definitions of hearing disability and dimensions of hearing ability. It also contains several diagrams of the ear and classifies hearing loss. It explores considerations for music therapy. Helpful tips and thought-provoking questions are provided to enrich the background knowledge of the music therapist in the area of hearing impairments or disabilities. A venue of activities that may be used with a client who has a hearing impairment is included, and a select number of manual signs are provided in appendix H of the book. Overall, the book targets informing interested persons about using music therapy to improve or make advancements in those individuals who have hearing impairments.
TG 6. Robbins, Carol and Clive. Music for the Hearing Impaired and Other Special Groups: A Resource Manual and Curriculum Guide. c. (1980).
Location-ML3920.R63
This resource is a manual which was designed and written to meet the needs of hearing impaired children, yet it has a wide scope of application to normally hearing children in music therapy, music in special education, and regular music in education. It contains songs and instructions which can be used as a wonderful guide to the music therapist looking for assistance and practical application tools in working with students who have hearing impairments.
LD- Language Development
LD 1. "A Cognitive-Linguistic Approach to Language Development for the Preschool Child with Hearing Impairment : Implications for Music Therapy Practice"Music Therapy Perspectives Vol. 8 pg. 47 (1990)
This article describes different stages of development and explains the therapy goals for each stage. The use of action songs to help introduce concepts to children and provide motor experiences that build foundations for language are described. Music can be used with hearing impaired children to help develop the four major content areas including : a) classification (grouping), b) seriation (ordering), c) spatial relations, and d) temporal relations. A list and explanation of special concerns associated with people with language impairments is given. The main goals of music therapy in language development are also listed.
LD 2. Roskam, Kay. "Music Therapy as an Aid for Increasing Auditory Awareness and Improving Reading Skill." Journal of Music Therapy , 16 No. 1 (1979): 31. Location-Current.
This study investigated the effectiveness of a planned series of music activities designed to expand auditory perception and improve language skills in learning disabled children. It was intended to substantiate the relationships between audition and language, behavior and language, and music and language. The subjects for this study were 36 children. The children were divided into three groups of 12 children. These groups consisted of a music therapy treatment group, a learning disabilities group (which received the usual prescribed learning disabilities remedial activities), and a group which received a combination of music therapy and prescribed learning disabilities remediation. All children were pretested and posttested for skill in reading recognition, spelling, reading comprehension, nonverbal auditory awareness, and verbal auditory awareness. Although the music therapy group showed the highest mean difference in both the pretest and posttest scores, an analysis of variance showed no statistical differences among the three groups.
LD 3. Michel, Donald E., PhD., RMT-BC., and Janet L. Jones, MA., RMT-BC. "Expressive Language for the Hearing Impaired." Music for Developing Speech and Language Skills in Children , c. (1992): 25. Location-ML3920.M47.
In the area of expressive language, signing words to songs can be an excellent way to increase vocabulary. Deaf children can participate actively in group sing-alongs and respond particularly to songs with holiday themes. An effective means of teaching a song in sign language is to illustrate visually the words to a song by making a chart with magazine pictures, simple drawings done by the therapist/teacher, or drawings done by the children. Examples of songs that have been easy to illustrate are "Oh, What a Beautiful Morning," "Blue Skies," "My Favorite Things," "Happiness," and "You've Got a Friend." Increasing vocalizations is another area in which music therapists can serve as an important tool. A fun and motivating place to begin is by making animal sounds. Not only can children imitate sounds by watching the therapist's mouth and placing their hands on the therapist's throat to feel the vibrations, they can also increase vocabulary by learning the signs that represent the animals.
LD 4. Gfeller, K., and Baumann, A.A. "Assessment Procedures for Music Therapy with Hearing Impaired Children: Language Development." Journal of Music Therapy, 25 No. 4 (1988-89): 192. Location-Current.
This article focuses on assessment procedures appropriate for language development goals in Music Therapy with the hearing impaired. The article includes: (a) an overview of language problems common to children with severe hearing loss, (b) a brief overview of major treatment goals and approaches in speech pathology and music therapy, and (c) prominent assessment procedures used in measuring language development.
GMT-General Music Therapy Applications
GMT 1. "Music and Healing" Music Therapy Vol.6A pg.4 (1986)This article provides a good definition for music therapy. The healing properties associated with music are described. Although it does not directly address hearing impaired clients , it explores music therapy as a whole. Descriptions of different aspects of music therapy as well as a section on how to select the correct music for a client are included.
GMT 2. Music Therapy An Introduction by Jacqueline S. Peters pg.73
This page from a text book gives descriptions of hearing impairments and a list of problems and needs of hearing impaired clients. Special considerations that need to be made by music therapists working with hearing impaired clients are included.
GMT 3. Music Therapy and Education for the Handicapped ML3920.M8976 "A Music Curriculum for the Hearing Impaired in Norway" by Jorum Mantor
This article describes one music therapy program in Norway. It explains the importance of bringing normal children and hearing impaired children together for music therapy sessions. A role reversal was noted, as the normal children seemed to be learning from the hearing impaired children. It was also found that hearing impaired children enrolled in music therapy programs at young ages were better able to deal with prejudices against them and other school frustrations. The article describes results of established music therapy programs for the deaf and how music therapy programs work.
GMT 4. Benenzon, Rolando O., M.D. "Music Therapy for Patients With Impaired Hearing." Music Therapy Manual , c. (1981): 117. Location-ML3920.B413.
There are three types of hard of hearing patients: those who have an auditory experience; those who only suffer from impaired hearing, i.e. who are partially deaf; and those who are completely deaf from birth. Music therapy enables us to communicate with the patient, to make contact with him, and to motivate him strongly for recovery by the use of sounds. The most important systems created capable of perceiving sound are the sensory and tactile systems. Together with the visual, they could replace the auditory system. The waves produced by the body in vibration and transmitted by the air may be felt by the skin, the muscles, the bones, and the autonomic nervous system (sympathetic and parasympathetic) so the hard of hearing person can catch such elements as rhythm, accentuation, pitch , intensity, and duration. Sessions can be individual or group, but in general there is a tendency to adopt the second method and basically to integrate these patients in groups of normal hearing persons. The place of work must fulfill the same general conditions set out for the mentally deficient; the wooden floor is particularly important, as these patients will generally work barefooted. It is of the utmost importance for the music therapist to break the limits of an instrument, i.e. the traditional limits, and to obtain and create new possibilities in each case.
GMT 5. Darrow, Alice-Ann. "Music Therapy for Hearing Impaired Clients." Ed. Tony Wilgram, Bruce Saperston, and Robert West. The Art and Science of Music Therapy , c. (1995): 363. Location-ML3920.A783.
The term "therapy" usually implies the remedial treatment of a disease or other physical or mental disorder. Because of this connotation, there are many hearing impaired individuals and professionals in the field of music therapy who could, and understandably so, take exception to music therapy for hearing impaired clients. The loss of hearing has many implications for the development of communication skills. It is during the process of acquiring communication skills that music therapists can contribute to the development of hearing impaired individuals. The ability to adapt music therapy procedures to the learning characteristics and communication styles of hearing impaired individuals requires specialized preparation. Background information in the following areas should be particularly helpful to the music therapist: speech and hearing science, audiology, aural habitation, manual and oral communication methods, and the impact of hearing loss on speech, reading, and language development. An individual's hearing impairment is generally described in terms of slight, mild, moderate, severe, and profound, based on their average hearing level, in decibels throughout the frequencies most important for understanding speech (500 to 2,000 Hz). Each level of hearing loss will have a different effect on the client's interaction with the clinical environment.
GMT 9. "Computer and Electronic Music Application with Students in Special Education : From Program Proposal to Progress Evaluation" Music Therapy Perspectives Vol. 11 pg. 28 (1993)
This article describes a study with five children with hearing impairments. The objectives were listed as " giving children enjoyment of music, improving confidence, and improving computer skills. The involved music therapy activities allowed the children to perceive music physically. The instruments used were chosen based on each child's tactile feedback. The instruments were used in combination with computers and specially designed software. Four out of the five children demonstrated improvement in all skill areas including " basic music skills, independent computer use, and independent synthesizer use.
PM-Pitch matching
PM 1. "The Effect of Programmed Pitch Practice and Private Instruction on the Vocal Reproduction Accuracy of Children with Hearing Impairments : Two Case Studies" Music Therapy Perspectives Vol. 9 pg. 61 (1991)This article describes how singing can be used in self-expression and to help language development in children with hearing impairments. There are two case studies given. The fist client used the PitchMaster , which is explained in detail, and the results indicated that pitch matching increased but only after at least six weeks of intense daily practice. In the second study, weekly voice lessons were given for three months and pitch matching also significantly increased. The importance of having lessons in a room with a wooden floor and giving the client the opportunity to touch the piano are also mentioned. Special considerations for hearing impaired students involved in school choral programs are given along with suggestions for improving vocal accuracy.
PM 2. Darrow, Alice-Ann. "The Effect of Frequency Adjustment on the Vocal Reproduction Accuracy of Hearing Impaired Children." Journal of Music Therapy , 27-28 No. 1 (1990-91): 24. Location-Current.
The effect of frequency adjustment of auditory stimuli to accommodate individual audiological response curves on the vocal reproduction accuracy of hearing impaired children was examined in this study. Subjects in this study were 8 hearing impaired public school students in an oral education program. Classification of hearing losses ranged from moderately to severely hearing impaired. All subjects had participated in the regular school music program for at least two years. Subjects were asked to reproduce given pitches under two conditions. The first condition consisted of normal listening conditions, and the second condition dealt with frequency adjustments made in the presentation of the stimulus pitches to accommodate individual audiological response curves. Frequency measurements of subjects' vocal responses were compared to frequency measurements of each stimulus tone, and a cents deviation score was computed. Results of a t test for dependent measures indicated a significant reduction in cents deviation under Condition 2, frequency adjustments made in the presentation of the stimuli according to subjects' audiological curves (t = 4.96. df = 7, p < .01). These data were further examined for difference in amounts deviation based intervals resulting from sequence of random pitches. Data were also examined for direction of deviation (above or below the stimulus pitch). Implications for music educators of hearing impaired students are discussed.
PM 3. Ford, Theresa A. "The Effect of Musical Experiences and Age on Ability of Deaf Children to Discriminate Pitch. Journal of Music Therapy, 25 No. 1 (1988-89): 2. Location-Current.
This study investigated the effects of school musical experiences and age on the ability of deaf children to discriminate pitch at 250 Hertz and 500 Hertz. The reason this test was done was because speech therapists, audiologists and educators of hearing impaired students have identified that there is a possible relationship between the ability to discriminate changes in pitch and the ability to perceive and discriminate speech. The results of this test suggest that some deaf children may benefit from appropriate pitch related activities regardless of the extent of hearing deficiency.
PM 4. . Darrow, Alice-Ann. "An Assessment and Comparison of Hearing Impaired Children's Preference for Timbre and Musical Instruments." Journal of Music Therapy , 27-28 No. 1 (1990-91): 48. Location-Current.
These two studies were conducted to examine the timbre and musical instrument preferences of hearing impaired children. In the first study, 34 children from a state school for the deaf served as subjects. After a 15-minute presentation of six selected instruments representing the woodwind, string, and brass families, subjects were individually taken into an observation room and allowed to play the instruments for 5 minutes. For the purposes of this study, "play" was defined as the physical manipulation of musical instruments. The children's videotaped playing behaviors were analyzed for preference in the following ways: the order in which the instruments were selected, the amount of time spent playing each instrument, and a signed report of preference (the equivalent of verbal report for hearing children). Total playing time across all subjects indicated preference for the instruments in the following order: trumpet, clarinet, viola, trombone, violin and flute. The data of individual subjects indicated, however, that more time was spent with the violin. Signed responses from the subjects revealed that the violin and trombone were the most preferred instruments. The preference data have implications for clinical practice, although agreement among the three measures of preference was not significant. Aural and novelty feedback appeared to be factors related to the subjects' interest in specific instruments. The purpose of Study 2 was to examine hearing impaired children's preference for timbre without reference to a musical instrument. A test designed to measure an individual's preference for the tone quality of various instruments was administered to 21 hearing impaired children at a state residential school for the deaf. Results of the Instrument Timbre Preference Test (Gordon, 1984) indicated a group preference for the clarinet and sax/ french horn timbres. Individual subject timbre preferences were also found. Data from this study corroborated previous studies which indicated that preferences are more apparent in older children and that preferences may have a cultural bias. Implications for music therapists and audiologists are also given.
MV-Movement and Sign Language
MV 1. "Movement as a Musical Expression in a Music Therapy Session" Music Therapy Vol.4 no. 1 pg. 91 (1984)This article gives a better understanding of musical expression through movement. It was found that deaf children use their bodies to experience music. Emotional expression through movement is not discussed in application to the deaf. Although the study did not examine deaf musical expression, the article gives details that can be used in application with deaf clients. The article also discusses the relationship between music and dance therapies.
MV 2. Galloway, Jr. Herbert F., and Bean, Marjorie F. "The Effects of Action Songs on Development of Body Image and Body-Part Identification in Hearing-Impaired Preschool Children." Journal of Music Therapy, 11 No. 3 (1974): 125. Location-Current.
An investigation was conducted to study the application of music action songs to the specific tasks of body-image development and improvement in hearing-impaired children. Body image in this study was defined as the individual's awareness and knowledge of the physical and spatial characteristics of his own body. The children took pre-and post-measurements . There were two parts to the test - the drawing task and physical identification. The drawing task included being able to represent the head by some circular configuration, or by drawing a straight line down from the head to represent a body trunk. The physical identification included being able to "physically identify" 22 body parts when individually asked to do so- i.e., "put your finger on your (Nose)." The results of this study suggest that music may be a useful method in teaching selected concepts to hearing-impaired children.
RM-Uses of Rhythm
RM 1. Darrow, Alice-Ann. "The Beat Reproduction Response of Subjects with Normal and Impaired Hearing: An Empirical Comparison." Journal of Music Therapy , 16 No. 2 (1979): 91. Location-Current.This study was designed to examine the beat reproduction responses of normal and hearing impaired subjects on the basis of four considerations: a) auditory experience, (b) auditory involvement during stimulus presentation, (c) auditory deprivation, and (d) tempo. Data were analyzed for temporal deviation in auditory and tempo conditions. A two-way analysis of variance indicated a significant temporal deviation difference between normal and hearing impaired subjects. A significant temporal deviation difference was also found among four selected tempi. Observation of data indicated group tendencies for fastness or slowness.
RM 2. Darrow, Alice-Ann. "A Comparison of Rhythmic Responsiveness in Normal and Hearing Impaired Children and an Investigation of the Rhythmic Responsiveness to the Supra Segmental Aspects of Speech Perception." Journal of Music Therapy, 21 No. 2 (1984): 48. Location-Current.
The study described in this article had two major objectives: (1) to compare the rhythmic responsiveness of normal hearing and hearing impaired students on six sub-tests designed to measure beat identification, tempo change, accent as a factor in meter discrimination, melodic rhythm duplication, rhythm pattern duplication, and rhythm pattern maintenance; and (2) to investigate the relationship of rhythmic responsiveness in hearing impaired students to the non-linguistic aspect of speech perception which involves rhythm discrimination. The results indicated that the hearing impaired performed better than the normal hearing students in the areas of beat identification, tempo change, accent as a factor in meter discrimination, and rhythm pattern maintenance.
RM 3. Korduba, Olga M. "Duplicated Rhythmic Patterns Between Deaf and Normal Hearing Children." Journal of Music Therapy, 12 No. 3 (1975): 136. Location-Current.
This study examined the validity of the hypothesis that there would not be any significant differences in the comparison of errors in duplicated patterns of 15 deaf and 15 normal hearing children which were presented with 20 different stimuli. Results indicated that deaf students averaged fewer errors on both measures- beat and rhythm error scores. Normal hearing children averaged twice as many errors as the deaf when the measure was beats. Rhythm error scores indicated no sizeable difference in mean error scores; however, there were fewer errors recorded in deaf students than in normal hearing children.
CI-Cochlear Implants
CI 1. Gfeller, Kate, and Charissa Lansing. "Musical Perception of Cochlear Implant Users as Measured by the Primary Measures of Music Audiation: An Item Analysis." Journal of Music Therapy , 29-30 No. 1 (1992-93): 18. Location-Current.The Primary Measures of Music Audiation (PMMA) were evaluated in this study as a test of musical perception for post-lingually deafened adult cochlear implant (CI) users. This study also reported the tested outcome on the Rhythm and Tonal sub-tests of the PMMA. Correlations between speech perception tasks and PMMA scores were calculated. The subjects that determined the outcomes of the tests were 34 post-lingually deafened adults with CI experience. Subject performance on the PMMA was analyzed to determine test usability and technical adequacy (reliability, item discrimination, and difficulty) for this population. Two different implant types (Nucleus and Ineraid devices) and Rhythm and Tonal subtests were compared. The PMMA was found to be usable with minor adjustments. The Rhythm or Tonal subtest across devices showed no significant differences in accuracy. However, CI (Nucleus and Ineraid) uses were significantly more accurate on the Rhythm that the Tonal sub-test.