Page 27 - SEN115 - November/December 2021

PMLD
About the author
Madeline Aslan is a music therapist in Coram’s Creative Therapies team. Coram provides specialist educational provisions in both art and music therapy, working with children and young people with severe learning disabilities (SLD), social and emotional mental health issues (SEMH), as well as PMLD.
creativetherapyadmin@coram.org.uk
“Found this incredibly funny and would laugh”
laid out for him and because of his physical challenges, this took effort and consideration. After a few minutes in the room together I began to play the piano and sing a calm ‘hello song’. When William heard me sing his name he immediately looked at me and grinned. I realised very early on in our work together that he had a good sense of humour, and this became a big part of our relationship.
It was important to think about appropriate instruments before we started our sessions due to William’s challenges with fine motor skills. I chose various handheld percussion which he could easily hold but that would also make a lot of sound with little movement needed. I also placed the keyboard low to the ground within his reach. Although I knew I would need to support William with some of the instruments, it was necessary for him to have a reasonable level of autonomy in our sessions.
In this first session, I picked up on William’s early anxiety and was aware that he had not accessed these instruments before, so I sat down on the floor and began to show him the different sounds they could make - this caught his attention. Supported by his TA, William boldly took the instrument from my hands whilst shaking his head and smiling. We spent the rest of the session trying every instrument together and putting them all back in the box one by one. This was William’s idea.
As the sessions progressed, William confidently chose the instruments he wanted to play and learned very quickly that if
he made a sound I would respond on the piano or guitar. We did a lot of musical turn taking and had long musical exchanges. When William didn’t want to play he communicated through shaking his head or by pushing instruments away. William would often sit on his chair and avoid looking at me and was able to communicate what he needed in that moment without using words. Sometimes I would just be with William, but other times I could see he was trying extremely hard not to laugh and was desperately avoiding eye contact, so I decided to play along and started responding to his body movements musically. William found this incredibly funny and would laugh and move his arms and legs or shake his head, just so I would play something on the piano in response. He would ask to be helped up by pointing and was supported by his TA to do magical dances across the room. William would suddenly stop and look at me with control, put his finger to his lips and say ‘shhh’, so I was quiet. Other times William would gently rock
back and forth on his chair and watch me, so I played the piano to match him and we would fall into a steady pulse. I followed William’s lead.
This type of musical mirroring may seem somewhat intrusive, however with a child with PMLD it can often provide a rich, shared experience. Matching their movements with sound can support them to feel more grounded and aware of their body. William controlled his body in a very deliberate way. He was aware of cause and effect and really knew what he was doing.
Music therapy sessions have traditional therapeutic boundaries of time and space. I always use ‘hello’ and ‘goodbye’ songs
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■ Creating music. senmagazine.co.uk