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The Orff Music Therapy Active furthering of the development of the child by Gertrud Orff Summarized by Dr. Maritza M. Sadowsky Presented at ISME Music in Special Education Pre-Conference Seminar Curitiba, Brazil July 18 th , 2014

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The Orff Music Therapy. Active furthering of the development of the child by Gertrud Orff Summarized by Dr. Maritza M. Sadowsky Presented at ISME Music in Special Education Pre-Conference Seminar Curitiba, Brazil July 18 th , 2014. OMT. - PowerPoint PPT Presentation

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Page 1: The Orff Music Therapy

The Orff Music TherapyActive furthering of the development of the child

byGertrud Orff

Summarized by Dr. Maritza M. Sadowsky

Presented atISME

Music in Special Education Pre-Conference SeminarCuritiba, BrazilJuly 18th, 2014

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OMT

1. This book is the primary source for understanding Orff Music Therapy (OMT)’s fundamental principles.

2. OMT is a multi-sensory therapy developed by Gertrud Orff from her work done in schools from 1963-73.

3. OMT is developed out of practical work.4. OMT has been applied to a wide range of developmental

problems, such as physical, cognitive and sensory disabilities, as well as psychiatric disorders.

5. It has been used in the Kinderzentrum Munchen in Munich, Germany for over 30 years.

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OMT1. Two factors strongly influenced the philosophy, principles, and practice of

OMT:– the development of music therapy on the basis of practical experience

within a clinical setting of social pediatrics and– the use of elements of the OS approach.

2. OMT was developed organically out of Orff Schulwerk (OS) but they are not identical approaches; the OS idea has been varied and applied to the field of therapy.

3. OS = music in which one takes part as participant (educationally effective).4. OMT = spontaneous, creative music making (educationally AND

therapeutically effective).5. OMT is a stimulus with no ultimate goal.

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OMT1. The OS idea was to create for children a complete dimension of

music within which the child can express himself, experience himself as a person, and make music with others.

2. OMT developed from this idea of ‘dimension of music.’ Its elements are sound and movement, working together in a stimulating play situation.

3. It includes the same means (methods). The levels of expression are (all coordinated with one another):– Language– Rhythm (rhythmic speech; free and metric rhythm)– Melos (in speech and singing)– Movement– Experience of space– Handling of instruments

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OMT1. OMT’s embraces the concept of responsive interaction: The therapist

accepts the child’s ideas and initiative and interacts with the child at her or his level.

2. The OMT process involves activity from the very beginning and the effect of the activity.

3. Relevant to the students with an ASD in that it provides a framework for learning social interaction, responsiveness and sequencing.

4. OMT’s applications in the author’s Multiple Interactions Program for Children with Autism (MIPA) self-contained music class.

A humane teacher, who is naturally gifted teacher of children and in addition has medical and musical training, can bring to light the creative

value of OMT’s creative activities.

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5. Therapy with different kinds of handicap (cont.)

Autism

•The autistic child has no interest in the exploration of the material (sound).•To him a thing is a thing on which he knocks in a purposeless way—he is NOT exploring. His stereotype knocking is done with the back, the rejecting side of the hand.•He lacks the sense of a relationship to anything.•He is afraid of every change, rejects all contact.His sense of perception seems to be absent.•But, they DO perceive, and notice, or he would not put up his defenses so promptly.•They quickly shut their contact to the environment, so that they do not react.•One stops speaking to him because he does not react.•Speech is not developed, but the capacity to speak and understand is there (a vicious cycle).•He is NOT mentally disabled.

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5. Therapy with different kinds of handicap (cont.)

How to create interaction and learningwith children with autism?

•In therapy with an autistic child, things can happen inside him that are not visible.•Through this closed and locked being, we have to try to penetrate and stimulate a reaction from him by getting very close and actually do the same as he is doing (rocked to and fro, stopping, moving, yell, run, bang on chairs, tables, etc.)•They cannot all be unlocked with the same key.•The autistic child demands the most individual of treatment.•He must be challenged: Where there is no challenge, there is no reaction, development is stunted.•The therapist should observe the tiniest indications and by holding oneself ready to be led, the therapist can perhaps reach the innermost locked door.•We come with the child deeper into his world so that we can take him out again with us.•With much patience.

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5. Therapy with different kinds of handicap (cont.)

What can music do?•Very little.•The autistic child rejects all sound.•It does not change him.•Tactile movements, that stimulates the senses is also foreign.•Rocking and jumping = form•Interrupting their stereotype nature, there is object confrontation: e.g. Rocking to and fro (substitute ‘fro’ to ‘jumping’ creates an AB form) interrupts his stereotyped movement and makes an approach to object confrontation – ob = towards)•Musical therapy must be, in such cases, a secondary consideration. What matters then is the social application.

Music certainly encourages social attitudes, but if the necessary threshold of attraction for music is not reached, then it can achieve nothing.

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Outline of the activities described in the book

Preface by Carl Orff and Gertrud Orff1.Premise2.The Orff Music Therapy3.The therapy’s specific agent4.Practical work5.Therapy with different kinds of handicap6.Suggestion for treatment7.Individual therapy8.The relationship between parents and therapists9.Some case histories10.The secret of the therapy

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About the book and Gertrud Orff

“The Orff Music Therapy: Active furthering of the development of the child”

•was written by Gertrud Orff (1914-2000), a German music therapist and the second wife of Carl Orff (1895-1982) from 1939-1953.•She had been working with music therapy since 1963 and in 1986 she received the Order of Merit of the Federal Republic of Germany.

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About the book and Gertrud Orff (cont.)

• Gertrud also used The Orff Music Therapy (OMT) in her work in the U.S. with children with various disabilities.

• The book provides the first statement of fundamental principles of OMT and gives practical examples and pictures of particular cases.

• It was first published in 1974 in Munich, Germany.

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Preface by Carl Orff

• “This book gives, for the first time, a glimpse of Gertrud’s extremely personal way of applying music therapy in the field of special education.”

• “Her own knowledge has been consolidated and complemented through long years of work with doctors, psychologists and teachers in special education both in Germany and abroad.”

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1. Premise• Orff Music Therapy (OMT) is developed organically out of Orff-Schulwerk (movement, dance and

speech)—music in which one takes part as a participant • OMT is a Multi-sensory therapy.• Developed out of practical work.• OMT is concerned with

– musike (a total presentation in word, sound and movement)– therapy (the nursing, care and healing of the patient).

• It adopts the idea of spontaneous, creative music making and makes use of the Orff-Schulwerk Instrumentarium

• It uses:– phonetic-rhythmic speech– free and metric rhythm– movement– melody (melos) in speech and singing– the handling of instruments

• Addresses itself to all the senses:– by focusing just where an important sense organ is weak or damaged– with the child’s creative activity for him to express himself freely, give form to his expression,

and use it in social relationships.

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1. Premise (cont.)

• OMT supports other forms of therapies when it is coordinated with them. It can be used with:– Mental and physical disabilities– Disturbances of behavior– Development of the ability of communicate– And children with autism

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2. The Orff Music Therapy and its relationship to Orff-Schulwerk

• Starting point – THE CHILD

• Material – anything that stimulates, that leads to acceptance (a feather, xylophone, etc.)

• The Therapy Situation:–Stimulus – a help for the child–Communication - without pressure, at the child’s capacity–Environment - orderly organized–Accommodation

• Means (method) – the multi-sensory use of means applies to things in the environment, to ourselves, and to the instruments.

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3. The therapy’s specific agentInstrumentarium

•Can be played and experienced pre-melodic and pre-rhythmic, non-verbally and without rules, which makes development of participation, patience, and concentration.•Each instrument has a multi-dimension function:

1. Tactile - playing the instruments by touch without a beater.2. Visual – awareness of sizes and shapes in 3D (air) and 2D

(floor).3. Acoustic – tone color, length (remove the bars, stretched

strings, etc.); used in group or individually.

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3. The therapy’s specific agent (cont.)

General application of the instrumentarium1. An instrument conveys meaning:

Tactile-acoustic: helps the blindTactile-visual: helps the deafAcoustic: mentally disabled

The association of an instrument with a thing or an event has a communicative character.

2. An instrument should not be used in a perverted way:melodic barred instruments with removed bars for pentatonic scale—small children and the mentally disabled need something that is WHOLE.

The effectiveness of the therapy bears a close relationship to the genuineness of the therapeutic approach.

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3. The therapy’s specific agent (cont.)

3. The instruments should be used economically:Prepare the materials ahead of timeNot too many selections at onceMany selection=attention spans for one object is minimizedRules to use the instruments should be applied

Limiting the material produces concentration and stimulates the imagination.

4. The instruments can take over the function of a signal (this non-verbal communication reinforces the attention of group or individual):

Audio signal (march, walk, fast slow)Visual signal (helps with impaired perception)

Working with signals demands flexibility, the making of decisions and the taking responsibility. These tasks have a communicative value.

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3. The therapy’s specific agent (cont.)

5. The material should be interchangeable:One instrument in use and each individual uses it for only a short time.

Exchanging sounds:–strike a cymbal and “give him the sound!”–walk with a drum around the circle and gives each one in passing a “cluster of raindrops” or something else, by gently tapping the drum with his fingers as he holds it over their heads.

The interchange of material demands and encourages social tolerance and spontaneous performance at the right time.

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3. The therapy specific agent (cont.)

The perception of the instrumentariumReaction of the child in relation to the instruments: seeing, hearing, and doing.

1.How does the child react to the instrument when it conveys meaning?Ex. 1: FLOWER-GLOCKENSPIEL - conjuring up flowers by means of a glockenspiel

(mentally disabled children, IQ about 40)

Pentatonic I I I I I I I I I I(easier to see)With all the bars I I I I I I I I I I I I I

Each child was asked to name a flower and to make a sound for their flower on the instrument.Then asked to remember which flower it was and to play it again (mental note of the phrase).Then asked to paint their flowers.

Therapeutic Features (TF):Mentally disabled children’s common concentration on a themeIndividual achievement of a small formUse of imaginationAbility to repeat a form from memory

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3. The therapy specific agent (cont.)

The perception of the instrumentarium

Ex. 2: The instrument as exchangeable with the wordPlaying a triangle between the verses of a song (without making association between the words of the song and the triangle -- “ah! The bird!”(severally mental disabled with behavior disturbance)

4/4 A A A F G A AThree pi- geons on my head--

A A A F E DThree pi- geons on my hand--

TF:•Spontaneous association•Response through tone quality with those who have acute behavior disturbance and retarded development

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3. The therapy specific agent (cont.)

The perception of the instrumentarium

Ex. 3: A poem with diminishing images(mentally retarded and stutterers)

The children chose the instruments:

There was once a large garden large cymbalAnd in the garden there was a tree drumAnd in the tree there was a nest triangleAnd in the nest an egg finger cymbalsAnd in the egg a bird sleigh bells. . . And it’s hatched out! Tremolo on all instruments

TF:•Repetition: “I will be the tree again!•Stutterers can speak short sentences fluently•Motivation by the production of their own sound

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3. The therapy specific agent (cont.)2. Can an instrument in the hand of a child be perverted at all?

Ex. 4: A Mother Goose poem (hare was child and run around until a sound is heard and it is caught– another child chooses the “sound”).

One, two, three,Four and five,I caught a hare alive;Six, seven, eight,Nine and ten,I let him go again.

•TF:Role play•Communication through group activity•Deciding about the musical signal•Child’s choose a metallophone and “caressed” the hare by playing gentle sounds

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3. The therapy as specific agent (cont.)

3. Is the child aware that the instruments are being used economically and does this use of them satisfy him?

Ex. 5: Making music statements on barred instruments. (class of 35 students divided in groups, and each group has a barred instrument)

Gr. 1: use only two notes of their choice (not so good)Gr. 2: use only three notes (OK)Gr. 3: 4 notes (OK)Gr. 5: 5 notes (prefer to use 3 notes, instead of 5.

TF:Creating a form within set limitations.

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3. The therapy as specific agent (cont.)

Ex. 6: Conversation on two drums: buying shoes, without communicating verbally(6-year-old stutterers)

They were to think what they wanted to say internally and reproduce it externally on the drums.

TF:•Involvement•Internal flow of speech as a help for spoken language•Concentration in communication•Training the imagination through representing speech at a non-verbally communicative level on the timpani

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3. The therapy as specific agent (cont.) 4. Does the signal function mean anything to the child and can he make use of it to express himself?

Ex. 7: The timpani gives the signal – for different ways of travelling (slow walk, fast walk, skipping, jumping, etc.); first played by the teacher and then by a student.(hearing disabled children)

Soft played = tiptoe or walk quietly?

TF:Non-verbal communication through signalsResponsiveness through listeningSense-reinforced for the hearing-disabled

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3. The therapy as specific agent (cont.)

Ex. 8: Two drums representing a folding door.(4-5 year old children with ‘agnosia’ – they hear but do not understand; language has no meaning)

Children bang the rhythm: o-pen door! On one of the drums (modeled by an adult first).

TF:•Conception (open, shut, door, walk, again) - Execution – Result•Strengthening the impulses through intensification of the sense impressions.

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3. The therapy as specific agent (cont.)

5. Can the child tolerate the exchange of material and does he gain from this experience?

Ex. 9: From example 2—mongol girl did not stop playing the triangle when it was time to stop. Teacher did not say ‘stop.” Instead, said: ‘How beautiful is your playing!’ Next day, she stopped playing when all stopped playing.

TF:•Mongol child experiences ‘time’ and ‘responsibility.’

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3. The therapy as specific agent (cont.) Ex. 10: Player and Beater-Holder

1 soprano metallophone with Bb, 10 children sit around it. 2 children in the center: the player and the beater-holder. All sing the song:

Wake me in the morning, pleaseGet me up on time.

(spoken) Not too soon and not too late,(spoken) When the churches bells ring.

The Beater-Holder gives the player the mallets and he plays play after all sing the song.

TF:•Tolerance within the group•Own responsibility for playing in terms of rhythmic structure, tempo, and quality.

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3. The therapy as specific agent (cont.)

Speech

•An essential part of OS – introduced as a rhythmic-sound quality.•Problem:

– Often this condition is NOT present among students with disability.– Lacking of understanding this condition.

•Possible solution:– Therapist has to create a fascinating, acoustic-speech atmosphere with

meaningful and significant visual support.– Child must feel full expectancy for something that is going to happen with his

attention directed towards this happening.

All speech material should be palpable, formative and graphic—the material makes an impression of itself.

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3. The therapy as specific agent (cont.)Speech is introduced as:1.Rhythmic sequence (RS)-(with r, s, t – they have more rhythmic character)2.Meditative condition (MC)-(no r, s, t)

Examples:Raven, Raven scraggyleg, (RS)

People say you’ve only one, (RS)Only one, only one. (MC)

One duck, two ducks, theDucks are walking barefoot.

Thomas, Robert,Evelyn, Cyprian

meditative only: House full, yard fullYou can’t catch a

Spoonful.

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3. The therapy as specific agent (cont.)

Examples (cont.):

•using the word ‘chinchilla’ with different rhythms (p.41)•speaking names in a rhythmic context (according to their rhythmic syllabic pattern)•use of poetry•phonetic sounds (Roooooooose……………Phlox)•use of rhyme—does not disturb mentally disturbed children at all; they will not perceive rhyme as a guiding thread

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3. The therapy as specific agent (cont.)

Spastics (affected by spams) – can be stimulated by speech impulses.Stutterer – externalizes the speech through clapping its rhythm.

•The verbalization of rhythm helps to understand and remember it.•Transcribing verbal patterns onto a non-verbal rhythmic plane through clapping, walking, etc., produces tension and internalizes the speech.

Ex: open door (speak, body movement, play instrument, dance)

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3. The therapy as specific agent (cont.)Movement

Generally, when the motivation to movement is lacking, in children with disability, the social factor is also missing.

Autism:•a movement entirely directs inward;•warding off movement (movements that pushes away from self) -- using the back of the hand or tapping with the back of the finger.

The close connection between music and movement helps movement and helps music. Movement, to accompany music, has various forms: mime, gesture, locomotor and non-locomotor, body movement, echo form, in and out the circle – with the same rhythm but using different syllables.With movement, NOTHING needs to be explained, the non-verbal communication is there.Ex:•“Wall walk”•Walking/ running supported by a drum, etc•“Be my echo” with clapping different rhythms•Holding hands in a circle (or a circle of feet) creates an electric circuit and has a strong, socially •communicative effect

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3. The therapy as specific agent (cont.)Supplementary material …

… that can be used as non-verbal invitations for different activities:

Ex. 1: A 2x2 meter rug surrounded by small carpet squares with different colors, as a way to organizing the spaces, suggests non-verbal imitations for:

– Rhythmic walking patterns– Walking in the spaces in between them– Skipping, tiptoeing on the carpets– Stamping in the spaces– Tapping on the carpet, on the floor, on both (in front, behind, etc.)– Representations of shapes, houses, island– Red carpet moves, white stays still– Good morning Mr. Red! Good morning Mr. White!– A place to put instruments.

Teacher plays a recorder, drum and children walk for as long as they hear it. It is good to have the same “melodic” ending:

G G A B C C Cfind a per- fect stop- ping place!ti ti ti ti ti ti tah

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3. The therapy as specific agent (cont.)Ex. 2.1: Hoops (w/ children with impaired hearing) in a AB form:

– Lay a hoop around a small rug and make it our ‘waking up place;’– Children sit circle position and play chime bars (resonator bells);– One child walks around clapping;– When this child no longer hears the others playing he goes to the small rug and ‘falls sleep;’– Teacher plays a drum and he ‘wakes up;’

The aim of the therapy using hoops was to interest the child so that he could forget his own ‘problem.’

2.2: Lay down two hoops with two different instruments inside.Part “A”: one person plays one sound on the instrument inside hoop “1” and two sounds on the instrument inside hoop “2.”Part “B”: all play jingles while teacher turns hoop around in horizontal position – all sing: “Hoop, hoop, round you go!” Dynamic changed as the hoop came to rest on the floor.

2.3: W/ a group of blind children:– A child follows the “sound path” until reaching the hoop;– Inside the hoop there is a glockenspiel and he plays it – another child may come after him and the two

children interact with the glockenspiel (echo game, dialogue, etc.)– With older children the sound path can be built on thirds, fourths, etc.

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4. Practical workCoordination of materials combined w/ speech, movement, rhythm, etc.)

1.Linear (horizontal - next to one another) – applied to children with disturbed behavior due to brain damage. These children are stimulated when they take part without too many demands. Used in all cases where stepwise progress, repetition, work aimed at the condition of the child can be influential.

1.Vertical (on top of one another) used:•Where impairment of the senses exists (in the hope that one sense will be reached);•Where there is aggressive behavior disturbance (in order to gain their interest);•With severe spastics and the physically disabled (to give them motivation towards external self-expression).

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4. Practical work (cont.)Example 1:Material: speech, movement, instrument used virtually, possibly also acoustically.Target: mentally handicapped; NEVER children with autism; partner relationship.Procedure:“Drum, hide Marion!” – one hold a drum in front of one’s face; spoken more intensity; tonic to dominant.“Drum, beside Marion!” – one takes the drum away sideways so that the face can look out again; spoken less intensity; dominant to third to tonic.Therapeutic Feature: stimulation through new impulse effect.

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4. Practical work (cont.)Example 2:Material: speech, movement, drum.Target: all except those w/ visual disability.TF: coordination, tolerance development, individual contribution, handling the instruments.Procedure:•All sit in a circle and speak the verse, clapping to it or patting knees or touching the floor•Therapist goes around the circle playing the drum and singing:•“The drum goes round, don’t you look round!!”•She stops by a child and says: “now you look round!” -- this child takes the drum and walks round, and so on.

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4. Practical work (cont.)Rules

•No more than 8 children in a therapy group.•Therapist plays with the children and follows the same rules.•Disguise the rules in the game.•Stimulate the group.•Interaction•No correction should interrupt the flow of what is happening.•The process is what counts, not the product.•The method is to make the way interesting – engagement – accommodations.•Negative contribution = example of contrast (e.g. walking fast and one slowly).•Flexibility (see ex. P. 61)•Creativity, exploitation of the moment provides stimulation and control.•Experiencing:

1. own’s personality (association, sensitivity)2. social life (reaction and interaction through the senses)3. physical reality (understanding objects, space, time)

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4. Practical work (cont.)Technical form

Technique = art, skill (gr.)

•Preparation (forethought/memoria)•The way the session runs (activity/cantus)•The work done after the session (reflection/meditatio)

If we cultivate memoria (knowledge of what has been done), cantus (time in the present) and meditatio (reflection), and allow them to become effective, we have a correct and rounded technique.

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5. Therapy with different kinds of handicap

• In all therapy, the manner of approach is important, but in no cases so decisive as in those of disturbed behavior.

• Musical forms (rondo, imitation) provide a means for binding a group of disturbed people together (social integration) and they make it possible for a musical happening that is non-verbal to be maintained through its own momentum.

• Instruments have a distancing function, a communicative function, and an integrative/connection function.

Defects of hearing (deaf) and speech (mute, stutterers)

• A child does not ONLY hear with his ears.• A child with damaged hearing is most likely to experience an access

to sound.

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5. Therapy with different kinds of handicaps (cont.)

Ex. 1.1:•circle position•one therapist gives the drum to another following clear gestures and verbal explanations to take the drum to the next child and encourages the child to play the drum and do the same;•drum can be played next to the ear, on the knee, etc.;•all accompanied by the following speech stimulus:

Hear my drumming, hear my drumming,hear my drumming one, two, three

Ta ta ta ta ta ta ta ta ta ta ta ta ta ta ta rest

One can alternate: speaking and playing the drum loudly, or softly.

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5. Therapy of different kinds of handicap (cont.)

Ex. 1.2:

Ninny ninny zouseTi-ti ti-ti tah rest

the fox runs round the houseTi ti- ti ti - ti tah rest

•Circle position.•Each child holds one drum on each hand.•They play the edges of the drum on the floor.

•One child is the fox and runs outside the circle trying to get in.•He knocks on one of the drums, the drum is lifted, and he is inside the circle.

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5. Therapy with different kinds of handicap (cont.)

Ex. 2: Experiencing sound and silence, awareness of form, vibration in the accompaniment.

•Circle position.•Each child has two bars. They all make up a “G” major chord when they play together.•Therapist plays on a recorder.•At the end of the phrase, a child runs or walks, etc. around the circle.•At a signal, all stop playing, and the child who is walking goes back to his place.

Variation:•Therapist plays a rhythm pattern on the drum.•Children matches the rhythm pattern on their drums.•When she stops playing, the child walking goes back to its place.

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5. Therapy with different kinds of handicap (cont.)

Ex. 2.2: Play a chime bar (or two with different lengths) next to the ear and feel the vibration – use the bass metallophone, if possible.

Ex. 2.3: Strong rhythmic speech.

I- rambi- rambren- dom butTi ti ti ti ti ti tah

I- rambi- ramhere’s a nut.Ti- ti ti- ti ti- ti tah

What kind of nut?a walnut…a hazelnut… etc. (= gesture the kind of nut)

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5. Therapy with different kinds of handicap (cont.)

Ex. 2.3: Cadential melodies with dominant to tonic tensions. Speech - Focus the end of a sentence.

I saw the apple – fall!He throws a snowball at – me!He throws the snow ball at – you!He throws the snow ball – away!Come now, or it’ll be – too late!

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5. Therapy with different kinds of handicap (cont.)

The blind and visually—handicapped

•The tactile sense can be stimulated by the sense of hearing.•With the help of music and musical materials the blind can come into contact with other children.•The touch of a drum skin can stimulate the child to want to produce the sound.•The sound source can entice the child towards this source.•A verse spoken in rhythm can catch the attention of a blind child.•Let a child touch a stool, and ask her: how many legs does it have? Then give a xylophone to a child and ask them to echo-play you with 4 sounds and ask how many sounds did he play?•Throw a cushion ball back and forth to a child and say: ball, you, ball, me.

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5. Therapy with different kinds of handicap (cont.)

Through motivation, released through sound, rhythm and play, movement that would otherwise be neglected can be brought into play.

Balancing exercises for cerebral palsied children become meaningful when supported with rhythmically sound (jumping, climbing, marching).

Hemiplegia – imitation games on an instrument.

Most mentally disabled children can manage a rhythmically organic sequence and make up melodies and remember them.

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Next chapters

• 6. Suggestions for treatment– Establishing contact– Structuring the session– Guiding threads– The outsider

7. Individual therapy8. The relationship between parents and

therapists9. Some case histories (stories)

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10. The secret of the OMT• The OMT is carried out with: tangible materials, play with forms, gestures, speech, sound, and

notes.• The reaction of a child is the sign that the impulse has found its mark.• There are different reactions for different kinds of disability.• In group therapy the initial central place taken by a therapist is changed to a shifting central place,

each one has a turn at being in the center, with the attention focused entirely on him. The secret of the group therapy lies in the flexibility of this central place.

The secret of bringing it about lies in trusting the good moment, the good session.

It is achieved through:– Good preparation– Thorough meditation about the individual members of the group– The flexibility of the therapist– Active involvement– To grasp the creative moment– Exploration is motivation to activity– Remaining alert– In the development of a positive relationship in the first moment– Word and way are a secret: your word, your way.

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Maritza Mascarenhas Sadowsky, D.M.A.

[email protected]

http://enhancinglivability.net/DoctorM.html