Rainey Perry Mary M
University of Melbourne, Australia.
J Music Ther. 2003 Fall;40(3):227-46. doi: 10.1093/jmt/40.3.227.
The effect of different levels of preintentional and intentional communication development on musical interaction with children with severe and multiple disabilities has not been explored in the music therapy literature. Aside from stage of communication development, what are the particular influences of disability on musical interaction with children who have preintentional and early intentional communication? A qualitative research project explored these issues. Ten school-aged children with severe and multiple disabilities participated in the project. The most common medical diagnosis was cerebral palsy. Analysis of video recordings and other data confirmed that the children's level of communication development was reflected in individual music therapy. Specifically, children at different levels of communication development varied in their abilities to initiate, anticipate, and sustain participation in turn taking, and to maintain attention to and engagement in the interaction. Both turn taking and playing and singing together were found to be important forms of communication during music therapy. Communication problems related to disability included: difficulties in using objects as a focus of joint attention, difficulties in interpreting the interactive environment, being sufficiently motivated to communicate, severely limited means of interaction, attaining and maintaining an appropriate level of arousal, and lack of interest in interaction and the outside environment. Further study of how music therapy can be related to general issues in communication for individuals with severe and multiple disabilities is recommended.
音乐治疗文献中尚未探讨不同水平的前意向性和意向性沟通发展对重度和多重残疾儿童音乐互动的影响。除了沟通发展阶段，残疾对具有前意向性和早期意向性沟通的儿童的音乐互动有哪些具体影响？一个定性研究项目探讨了这些问题。十名学龄重度和多重残疾儿童参与了该项目。最常见的医学诊断是脑瘫。对录像和其他数据的分析证实，儿童的沟通发展水平在个别音乐治疗中得到了体现。具体而言，处于不同沟通发展水平的儿童在发起、预期和持续参与轮流互动以及保持对互动的关注和参与方面的能力各不相同。研究发现，轮流互动以及一起演奏和唱歌都是音乐治疗期间重要的沟通形式。与残疾相关的沟通问题包括：难以将物品用作共同关注的焦点、难以解读互动环境、缺乏沟通的足够动机、互动方式极为有限、难以达到并维持适当的唤醒水平，以及对互动和外部环境缺乏兴趣。建议进一步研究音乐治疗如何与重度和多重残疾个体的一般沟通问题相关联。
