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Music therapy can assist toddlers' post-CI communication rehabilitation process

January 2010

Editor: Here's something that is a surprise at first, but makes more sense the longer you think about it. The communication rehabilitation process of toddlers who get cochlear implants (CIs) is improved by exposure to music. The research was done at the University of Haifa.

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Music therapy can assist in the speech acquisition process in toddlers who have undergone cochlear implantation, as revealed in a new study by Dr. Dikla Kerem of the University of Haifa. The study was carried out in Israel as a doctoral thesis for Aalborg University in Denmark (supervised by Prof. Tony Wigram) and presented at a "Brain, Therapy and Crafts" conference at the University of Haifa.

Some infants who are born with impaired hearing and who cannot benefit from hearing aids are likely to gain 90% normal hearing ability by undergoing a cochlear implantation procedure. Following the operation, however, the child - who never heard before - undergoes a long rehabilitation process before he or she can begin to speak.

In the present study, Dr. Kerem examined the particular effects that music therapy has on the potential development of toddlers (aged 2-3 years) who have undergone cochlear implantation, specifically in terms of improving spontaneous communication. "Music comprises various elements that are also components of language and therefore as a non-verbal form of communication is suitable for communication with these children, when they are still unable to use language. Communicative interactions, especially those initiated by the toddlers, are critical in the development of normal communication, as they are prerequisites for developing and acquiring language," explains Dr. Kerem. She adds that the toddlers undergoing rehabilitation are under much pressure from their surroundings - especially the parents - to begin talking, and sometimes this pressure makes them become introverted. As such, music therapy lends itself to strengthening these children's nonverbal communication and thereby lessens the pressure on them for verbal exchange and response.

The study provided sixteen sessions for children after cochlear implantation. Eight of the sessions included music-related activities (such as games with percussion instruments, vocal games and listening to simple songs) and the rest involved playing with toys/games without musical sounds. Each of the sessions was videotaped and then analyzed. The results showed that during those sessions when music therapy was implemented, spontaneous communication was markedly more frequent and prolonged in the children. Derived from the results is the fact that the exposure to music needs to be gradual, through the use of music experiences that involve basic musical parameters (such as intensity and rhythm).

"Music can constitute the bridge between the quiet world that the child knew and the new world of sounds that has been unfolded following the operation. It is also important that the parents and staff learn the best way to expose these children to music, the use of music for communication and the importance of the therapist's undirected approach (which enhanced the children's communication in music therapy and in play to a greater degree than in the directed one). Music therapy is gradually penetrating the field of rehabilitation, but there is still a lot of work to be done in improving awareness of this important area", Dr. Kerem explains.