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Tuning in to special needs

Diana Hinds explains why music therapy is not about teaching music. Sophie Gill, an eight-year-old with cerebral palsy, has always enjoyed music. Her mother sings her nursery rhymes, and she likes to bash the top and bottom notes on their piano with her younger, able-bodied brother.

But her first session of music therapy at the MusicSpace centre in Nottingham has suddenly opened up a possible new way for Sophie to interact and communicate.

Sitting in a circle with several other disabled children and their parents, Sophie has watched and listened as an ocean drum - so called because of the ball-bearings inside that make a sound like the tide - is passed around. She has taken her turn with the drum, while Simone Wies, the therapist, plays a simple tune on her double bass, varying rhythm and pace to chime with each child's drumming experiments. Later she has had a session on her own with Simone, playing notes on the piano, and even exchanging a few fragments of song.

Her mother Eileen admits to being surprised and even a bit stunned at how her daughter has already responded. Sophie is a friendly child, she says, but has few words and finds it hard to relate to other people, often remaining locked in her own world and its repetitive, obsessive patterns of behaviour.

"She can be quite hyperactive, but I noticed, sitting in the group, that she was very calm and attentive, looking at the others, concentrating - and that's a big thing for her.

"When she was with Simone on her own, Simone sang to her and Sophie tried to sing back - it was wonderful. I just thought it was Sophie making different noises and if she had done that at home I wouldn't know how to respond. But Simone spotted that it was Sophie singing. She could see what Sophie was doing, and she was able to bring it out of her by responding in a similar way. "

Music therapy has been practised in this country for the past 30 years, but many people, including members of the health service, have barely heard of it. Although it has been used increasingly as an effective means of treating children and adults with severe learning difficulties, or those suffering from emotional and behavioural disturbances, the misconception persists that music therapy is something rarified and relevant only to those with music talent.

In an effort to generate greater awareness about what it really is, as well as to fund research and expand clinical services, the National Appeal for Musical Therapy was launched last month. Three charities - the British Society for Music Therapy, the Music Therapy Charity and the MusicSpace Trust - have joined forces in a bid to raise Pounds 3 million.

For the point about music therapy is not to teach music. It is not about listening to music simply for enjoyment or relaxation. It is not about learning how to play an instrument, or how to sing in tune, or even how to make a pleasant sound. The idea of the instruments is that they should function as intermediaries, offering an alternative means for people to express themselves, of making themselves heard or understood, of connecting and communicating with others.

"Music can be a great enabler, putting you in touch with feelings you haven't been able to articulate in words," says Dr Leslie Bunt, director of the MusicSpace Trust. "It can also be a great transformer, helping to take you to all sorts of places that sometimes words can't. Words can get in the way of the elemental, feeling world. Words can cover things up, whereas musical expression can be very brutish and honest."

The British Society for Music Therapy was founded in 1958 to promote interest in the profession, but it was not until 1982 that the Department of Health officially recognised music therapists, allowing them to negotiate contracts with hospitals. Since then, provision has been patchy - there are now about 300 qualified music therapists - and the Government's care in the community policy has meant the closure of hospital departments, leaving many therapists to find what work they can, in an isolated, freelance capacity.

Leslie Bunt set up the MusicSpace Trust in response to this in 1989. Two years later, with a combination of public funds and private donations, he opened the first MusicSpace centre in Bristol, which now offers music therapy to about 200 people each week, as well as providing a postgraduate training course with Bristol University.

The Nottingham centre opened in 1993, and is currently working on a two-and-a half year project funded by the health authority. With money raised by the appeal, it is hoped to establish four new community-based centres in Hampshire, west London, the West Midlands and Belfast.

During the sessions, which may be for groups or individuals, the client is encouraged to make use of a range of instruments, including tuned and untuned percussion, and the therapist follows the client's lead as much as possible. In order to do this effectively, he or she needs to be versatile and to have considerable musical skills at his or her fingertips - which is the reason why musical training is a prerequisite.

As Helen Hutchinson, senior therapist at the Nottingham centre, explains. "The most difficult part of the job is knowing what is the main factor in whatever you happen to be playing or singing that is attracting a response from the child, so that you can extend it." Clearly, the therapist cannot work miracles overnight, and there are occasional cases, according to Helen Hutchinson, where a child does not respond. But the benefits of music therapy have been proved time and again, helping, for instance, with emotional or cognitive development, with social interaction and communication, or with physical and perceptual skills.

Lady Elizabeth White, chairwoman until last year of the Bristol MusicSpace centre, is the mother of a profoundly handicapped, autistic child, now 12, who first went to music therapy sessions with Leslie Bunt at the age of two. "Katie was totally enclosed in her own world - she wouldn't look at anyone and couldn't bear to be touched or held. But Leslie was able to get through to her a bit, and as the therapy progressed, we found in her an increased response to other people."

The therapy ended after about 18 months when the funding ran out, but a few years ago, therapists from Bristol MusicSpace began weekly sessions at Katie's special school. She has now learned to hum, says her mother. "Before, she had only been able to use her voice to express pain, hunger or misery, but now she can use it in a way that obviously gives her a lot of pleasure.

Katie's statement of special needs now includes music therapy as a requirement - which means the education authority must provide it. "It may be that, in time, Katie will be able to develop simple speech," says Lady White. "But even if that doesn't happen, she will be able to use her music to ease some of her frustrations, and to develop an alternative means of communicating."

The National Appeal for Music Therapy, St Dunstan's House, 2 4 Carey Lane, London EC2V 8AA. Tel: 0171-600 4696. Fax: 0171-600 4650. If you want to make a donation, send your cheque (made payable to the National Appeal for Music Therapy) to the above address. Use the appeal hotline for credit card donations: 0990 100363.

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