Ray My Clinical Reflection

For my clinical paper the client I have chosen was from NHS. My clients name is Ray. He is a child with an intellectual disability and low level of Autism. Ray is normally a very happy child. He works well in a group setting with the other children. He is always willing to participate and cooperate throughout each session. He is very egger to answer any questions I might ask. Throughout the session he is very observant. He follows well in the activities but can get a little out of control and hyper because he’s so excited for music. This paper will reflect on the social functioning of my client. The main focus was to work with him on controlling himself in the group and have him follow directions.
The intervention I have chosen to help Ray
follow directions was called Follow the Beat. I the therapist would start a beat on a drum and sing, “Follow the beat, follow the beat, follow the beat how can it go”. The clients will sing through the song without using the instruments just the therapist. After doing so, I will direct the client’s attention and say a command. For example: fast, slow, left hand, right hand, etc. I will continue to play and sing the song while modeling to the clients how to play their instruments. I will encourage singing as well as make eye contact with the clients to engage them in the intervention. I will ask a client to come up with a new way to play the instrument. Then after each client has gone I will go through the song one more time and then end it by counting down.
My clinical intervention can relate to a few main topics in the literature from class.
One of the topics would be Rhythm from chapter one of Michael Thaut’s book Rhythm, Music, and The Brain. Thaut described “rhythm as a narrow sense, refers to explicit divisions of time or space into intervallic time systems, re-current and often characterized by periodicity”. Thaut also states, “rhythm also modulates the attention of the listener in relationship to the perception of musical events. Rhythm guides the ear and brain to make a sense of acoustical patterns and shape by directing focus to important moments in the unfolding of music”. For my client rhythm played a big part in his process for learning to control himself and follow directions. Since my intervention consisted of keeping a steady beat on the drum, Ray was able to get a sense of the rhythm and was able to become more focused. Another topic from Thaut’s book was pulse. Pulse was defended as something that helps keep a steady beat. Pulse provided structure to the music without that steady beat Ray would have became more hyper then relaxed. Another topic would be cueing. Since Ray was given the proper cueing he was able to play his instruments along with me.
The study, Utilizing Rhythm-Based Strategies to Enhance Self-Expression and Participation in Students with Emotional Behavioral Issues stated the purpose for the study was to see if rhythm strategies would effect of behaviors of students in schools. The study showed
that rhythm activities were able to improve the behaviors for the children. The results stated that there where positive benefits to the activities. Rhythm can have a positive affect the behaviors of children, which helps me understand better how rhythm affected Ray’s behaviors.
In the study The Effect of Music Therapy on Young Children’s Challenging Behaviors, stated that the study would examine the effectiveness of music therapy in the social aspect for children with challenging behaviors. A visual analyses in the study showed that music therapy decreased problem behaviors and increased alternative behaviors for two participants. The music therapist who led the sessions used different interventions to help better the children behavior. The results of the study supported the effectiveness of music therapy on social, communicative, and behavioral skills. This study showed that music interventions can affect a child’s behaviors and can increase better behaviors. This study showed me that musical interventions could help a child change their behavior. I feel that is one of the reasons Ray was able to become more engaged with the group and become focused.
In the study Designing Music Therapy Interventions for Hospitalized Children and Adolescents Using a Contextual Support Model of Music Therapy, it states how music can form a supportive environment and promote different behaviors. Music can create a supportive environment for anyone. One of the main reasons I feel Ray was able to succeed more was because he had a supportive, structured environment during my session. Because he had that environment Ray was able to develop the ability to focus more and follow directions.
The study Music Therapy for the Learning Disabled states, that when combining behavioral therapy approaches with music interventions that it shows to be more effective in elementary children with disabilities.
The study also sates that music therapy is a unique tool to offer to children with disabilities. It gives them the ability to perform with instruments and to learn basic skills. My client Ray an intellectual disability and after reading this study I realized how important music therapy is for him. Music therapy helped to give him a way for expression and a way to control his behaviors in a structured environment. Though Ray has a disability he was still able to reach his goal of following directions and staying calm. If he didn’t have music therapy I feel he would have struggle more on grasping those
skills. The intervention had my client engage more with me the therapist. He followed each direction clearly which showed the intervention got him pay more attention. Each time I changed the command Ray was able to follow along. After the intervention throughout the session he was more engaged in the session. He was listening to me and watching for directions. When I first started the session he was so hyper but when I got to my intervention he calmed down and really started to listen. I could see how each command made him react. When I would say to play the instrument fast he would release his hyper energy. Then when I would say to go slow I could see him start to calm down and relax. After that intervention Ray was calmer and more focused. He was able to maintain that calmness till the session ended.
I collected my data by observing Ray each week from when I started my intervention till the last session. At first he wasn’t able to stay focused or stay calm. He was all over the place getting himself overly excited. By the middle of the semester I saw a change in him. He became more engaged and focused each week after my intervention. Ray would watch me closely as I played the drum and I could tell he was really trying to focus on my playing and wait for my command. Once I made a command he demonstrated it correctly. When I first started the intervention Ray was not able to do that. By the middle of the semester my base line data increased dramatically. It increased because Ray was becoming more focused and following direction. By the end of the semester Ray reached 100% in being focused, calmer and followed direction. Since I saw a dramatic change in Ray from the first session to the last session it proved to me that my intervention was able to improve his behaviors.
Ray was a wonderful client to work with. I learned a great deal working with him and the other children. I was really impressed on how much music therapy impacted him in the sessions. By the last session he was following direction, listening attentively, much calmer and overall excited. Music therapy brought Ray so much joy and it showed me how much I was able to impact him as the therapist.