Teaching disabled students

Share your experiences or ask for help with special needs students

Postby 98-1091274403 » Sat Aug 21, 2004 6:55 pm

Hi to anyone interested....
I am a piano teacher with a degree in music therapy. Would be happy to provide suggestions if needed to anyone working with disabled or special needs students.
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Postby Mins Music » Sun Aug 22, 2004 10:00 pm

Hi Marriane. Welcome to the board! Great to have someone in music therapy, a field which is now being recognised for its importance.

I don't have any students with special needs at the moment, but am very interested in learning about what is involved with music therapy. Do you specialise in a particular field? How did you get involved in this avenue of teaching? What specific challenges are you faced with in your studio?

Look forward to hearing from you.

"I forget what I was taught, I only remember what I've learnt." - Patrick White, Australian novelist.
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Postby 98-1091274403 » Mon Aug 23, 2004 7:48 am

Hi Mins,
Thanks for the welcome. I received a bachelors degree in music therapy in 1984 so have been a music therapist for a lot of years. I did my internship immediately after college with special needs kid and adults at a group facility in Delaware. What an awesome experience! I specialized for many year in the geriatric setting but have included special needs kis in my private piano practice. Music therapy IS an awesome field but unfortunately is seen as a "luxury service" in the area in which I currently live. In a very brief summary, music therapists use many different musical mediums to reach NON-musical goals. We believe strongly that music elicits powerful responses in all individuals. It is a truly therpeutic medium that encompasses all areas of treatment (eg. fine and gross motor skills, cognition, verbal/non-verbal expression, etc)
We use an assessment tool for evaluation and for planning treatments using specific therapeutic goals for each individual. In my piano practice, I am usually not actively
"doing" music therpy, but rather have the skills and knowledge in order to adapt the learning process to meet individual needs and disabilities. There is no child who cannot benefit some way from private piano instruction....the teacher just needs to make sure she/he knows how to adapt the learning situation for the individual child. I know this is a VERY brief synopsis but if you want more info you can explore the American Music Therapy associations website http://www.musictherapy.org/
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Postby pianoannie » Thu Sep 02, 2004 7:14 pm

I had my second lesson today with a 6 y.o. girl with mild cerebral palsy. I didn't know she had cp until the middle of her first lesson when her brother told me. I asked the mom about it after the lesson, and she said it's so mild that she didn't think it was important to mention it. The girl is not currently in any therapy (not sure about the past).

Her right side seems fine, but her fine motor skills on her left side are somewhat limited, ie poor finger independence in LH 3 4 5. I know all children are a bit awkward with their 345's, but, for example, she can't touch her touch her thumb with her 3, 4, or 5 LH. No such problem with RH. With her hands flat on a table, she can individually lift each RH finger, and LH 1 & 2, but LH 345 cannot lift individually, only as a group of all 3 fingers. With hands flat on the table, she can spread all fingers wide apart. (I'm telling you all these details because these are things my Occupational Therapist friend told me to check).

My OT friend also suggested several hand/finger exercises, which I demonstrated today to this girl and her mom.

I just don't know what to expect in terms of future use of her LH fingers. Right now she can play LH 2&3 together (can't play 3 alone), and she can wiggle LH 2 and LH 1 individually. Do you think that with proper therapy her finger independence will improve?

At today's lesson we worked on the hand exercises, playing clusters of LH 2&3 on all the black keys, and everything else was for RH alone. (I pulled out an extra copy of Pianimals that I was glad to have on hand!) She did very very well with the RH pieces.

I'd love to have any input from you that you're willing to share! Thanks!
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Postby 98-1091274403 » Sat Sep 04, 2004 5:33 am

Congratulations on your interest and in taking the time to consult an OT regarding your 6 yr. old student with CP! She is a very fortunate little girl to have a teacher as interested and dedicated as you!
As a music therapist , I have worked with several children with CP involvement either in both extremities or just one side of the body. The steps you have taken to work with her are terrific and I would add one other thing. It may be better to work with this student on a portable electronic keyboard. The key action on a piano is quite different from that of a keyboard as you know, so it would be less frustrating for her to produce a sound with a keyboard (and less taxing on her fingers initially). I would encourage her to make -up simple songs on the keyboard, but as a game, tell her she may only use her 3rd, 4th and 5th fingers. Be honest with her though and let her know everyone has difficulty with the strength in these finger and that your game is to work on building independence in each of these. Then I would write out her song on manuscript paper and provide an interesting accompanient. Allowing her name her own song is also fun for a 6 yr. old and very rewarding!
I do not believe it is the piano teachers place to provide therapy for students however, and there may come a time that you need to just work on right hand pieces or arrange your own music with simple LH accompaniments using only the 1st and 2nd fingers. From your letter, it appears she enjoys the lessons and there is so much to be gained .
Because I am a music therapist, if I notice or am informed by parents that a child has a specific disability, we discuss at length the parents goals for the child. Music therapist do not actually work to attain musical goals....we use music and music mediums to attain NON-MUSICAL goals. So as a therapist, if our goal is to improve fine motor control and eye hand coordination, I would provide a variety of musical activities to accomplish a very specific goal . (for example, the goal may be : "Laura will demonstrate improved fine-motor control as evidenced by independent use of the 3rd and 4th fingers on the keyboard with 80% accuracy for 10 consecutive sessions" ). Goals are only written however ,after an initial music therapy written evaluation which assesses many different areas including cognitive, physical , psycho-social , etc. Music therapists would then use a variety of activities to achieve these goals. Sometimes, music is simply the motivating factor in the therapy session.
While I am not suggesting you write these kinds of goals for your student, I did want you to be aware of fact that even when I receive a student with a disability, I need to keep in mind that if the goal is simply to be able to play the piano, I am not a therapist at that point. I can, however, use specific therapeutic techniques to assist the child.
Being aware of this childs limitations and working within those limitations will certainly benefit this 6 yr. old child. I suspect she is more interested in just "making music" at this point and has no dreams of becoming a concert pianist! Simple children's folk songs are a perfect avenue for keeping her motivated and interested. She will still be learning to read music and perform! Perhaps her brother could play a duet with her.... he would perform the LH and she the RH . What a terrific brother/sister duo in a recital!
I hope that I have been of some help.... I could give more specific techniques, however, these would be more geared toward a therapeutic setting rather than emphasizing a positive musical experience. Hopefully this little girl will begin to receive OT in the school setting.
You are a great piano instructor and your children benefit from your genuine interest and caring about them ! .
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Postby pianoannie » Sun Sep 05, 2004 2:40 pm

Hi Marianne,
Thanks for your reply. Some of the things you mentioned are things that had already crossed my mind (ie using a keyboard, having brother play LH) but of course I want to help her do as much as possible with her own LH. The problem is, it will be hard for me to know how much to push, to know when something is difficult simply because it's new and requires effort versus when something is difficult because of her CP limitations.
I do hope she gets some OT or PT, and ideally I would even have opportunity to talk with her therapist (although I suppose patient confidentiality stuff might make that impossible).
At any rate, I think I will be able to teach her many things, even if we do work mostly on RH. I will post again as questions and successes come up in lessons.
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Postby 98-1091274403 » Mon Sep 06, 2004 6:51 am

I believe that your questions regarding whether she is having "normal" difficulties with her LH vs. the CP involvement are valid. However, remember that even in a therapeutic setting I would naturally "assume" there will be improvement over time. As I am sure you are already aware even with your other students, we must always be sensitive to the student and not "overwhelm" or frustrate them. I would strongly recommend working on LH exercises as games with this 6 yr. old (not focusing on technique at this point). Certainly you will know when she is just totally frustrated by the inability to "make her LH function" properly. If she has spastic tendencies or rigidness in the LH and not just finger/hand weakness this may exacerbate the problem. If this is the case I would not recommend much LH work at this point. Is SHE okay with just playing RH melodies? What are her parents goals with regard to piano instruction?
I still believe that you are doing all you can as a piano instructor as you are sensitive to her individual needs as a student.
If you can provide anymore specific information I will try to be of further assistance.
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Postby pianoannie » Fri Nov 19, 2004 9:05 pm

Here's an update on my student with CP, who started with me in September. My strategy had been to assign exercises (at the piano as well as hand exercises away from the piano) to increase the use of her LH fingers. For actual piano pieces, I have been modifying most of the pieces in her book so that she would play with all 5 RH fingers, but just 1 and 2 of LH (these 2 fingers work fairly well).
Recently the mom told me that she prefers I not modify her pieces, because her LH will never get stronger that way. I explained my thinking, which was that to learn proper rhythm and to be able to play smoothly and musically, I thought we should omit the weak fingers (yet strengthen them via exercises). But apparently the mom's goals are more therapeutic than musical, so I am now trying to accomodate that somewhat. I will continue to have at least some of her pieces be for only her strong fingersthough.
When she tries to play with LH 3, 4, or 5, it takes 2-3 seconds for her to twist her arm into a position that she can press her finger into the key. Her hand and fingers will be completely perpendicular to the keys for LH 3 or 4. For LH 5, she turns her hand on its side (picture shaking someone's hand, but with LH), and then she presses the entire side of LH 5 into the key. I describe all of this so you can see how very awkward and choppy it is.
I've told the mom that regular sessions with a physical/occupational therapist would probably help her much more than trying to use all of her fingers for piano would help. But for now, I continue to do what I can, and hope that we will see some great improvement eventually.
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