Piano in the Key of Therapy
by David Loftus
[A version of this feature appeared in the Portland Oregonian on July 8, 1999.]
Should piano lessons be denied to children who have attention deficit disorder, difficulties with fine motor coordination, lack of eyesight, or even autism?
Renee Jacobson answers with a resounding no!
So every week she finds herself at a keyboard with students like Baylie Nixon, an eight-year-old whose attention span is three minutes or less, and Morgan Steward, who is blind and autistic.
Jacobson knew she wanted to be a piano teacher from the age of 16. "The rewards were watching kids grow. They get piano playing, yes, but they get so much more than that. Their hand and eye coordination is developed faster, their spatial reasoning is there, and number one is they really feel good about themselves when they can do something."
A native of Montana, Jacobson got her music degree and teaching certificate , then added a degree as a certified occupational therapy assistant to supplement her piano teaching income.
Occupational therapy -- OT -- is geared to helping children and adults with disabilities to maximize the skills they need for daily activities. OT specialists may work with everyone from toddlers to spinal cord injury victims and nursing home residents on muscle development, psychological issues, and adjustments to the physical environment.
"That was one of the things that attracted me to OT," Jacobson recalls. "It was so individualized and holistic."
Gradually, she realized she could combine her two careers into one. She noticed how certain children were dumped or even refused by some piano teachers: "They'd only take certain students, kids that would make them look good. They wouldn't even consider working with some kids."
For three years Jacobson flew to Dominican College in New York every third weekend to get the training for what she wanted to do. She racked up a quarter million frequent flyer miles, husband Bob did the housework so she would have only jet lag and homework to contend with, and they mortgaged the house to pay the cost.
Upon her graduation in the spring of 1998, the moms descended.
"The most unexpected development was the phone calls I started getting, when I was just thinking about it. When you have a child with special needs, you get together with other parents and they say, 'what's your resource?' and word gets around."
Deirdre Nixon, a physical therapist herself, readily understood what Jacobson could do for her daughter Baylie.
Faced with challenging fine motor tasks, the girl yawns, acts bored, and goes limp or squirrelly without lots of encouragement, timeouts, and rewards. For each completed exercise, Baylie gets a moment with an Etch A Sketch. Or, like other students, she enjoys a break to pet Max, Jacobson's shaggy grey mutt, and Lamb Chop the cat.
Physical contact and extra weight help to ground and focus children, make them feel more secure when facing a challenge. At her request, Baylie's mother "squishes" her with a pillow and the girl wears weights on her ankles during lessons.
Morgan has been Jacobson's greatest challenge.
Born four months premature -- the brother of a twin who died -- he spent the first five months of life in an intensive care unit. He suffered from dyspraxia, the impairment of messages from brain to body. He had bilateral coordination problems and hypotonia (droopy muscle tone), and was functionally blind.
Morgan can perceive light and dark but is not expected ever to be able to read. His autism only became evident after several years.
Though to the untrained ear, his speech sounds like unformed barks, Morgan clearly understands what is said to him, he reads braille, and he can type full sentences into a computer that converts written word to speech.
And his parents noticed from the start that music lit him up.
By the age of four, he could reproduce music on the piano using whatever combination of fingers would do the job. Morgan is a musical savant. "This kid is incredible," Jacobson marvels. "He'll hear things on a record and he just sits there and does the whole thing, harmonies and everything."
Morgan was so possessive of his piano that the first time Jacobson sat down to play it, he shoved her off the bench. She had to earn his trust and teach him the social skills of sharing and taking turns.
For reinforcement, after each successful task he gets 10 seconds of a beloved recording, during which he plasters himself against the plexiglass-covered sound system as if to hug the music.
Although a pioneer in combining piano teaching with OT, Jacobson remains "just a piano teacher": Ninety percent of her students do not have special needs.
And because her first teacher gave her a cut rate when her parents decided to cease her lessons, found her fundraising opportunities, and refunded all the money when Jacobson left for college, she passes on the gift.
"This one little gal, she can't afford it, but I'm not going to be the one who denies her an education. Giving these kids something so they can go on to college and do something special -- I just want to be a part of that."
Music Therapy Helps People Tune Up Their Emotions and Energy
Jacobson's marriage of occupational therapy and piano teaching is a unique experiment, but it's also a sort of "tip of a multi-peaked iceberg" in the use of music for persons with special needs.
The long established discipline of Music Therapy employs music to help people relax, focus, concentrate, develop hearing, and revive memories, mostly in a clinical or institutional setting.
Jody Winnwalker, a Portland music therapist, specializes in treating people with Alzheimer's, using the autoharp, guitar, chimes, and rhythm instruments to reawaken memories, encourage exercise and dance, and song.
"For patients and autistics, music brings comfort and healing," says Sister Maureen Niedermeyer, a chaplain at Portland Providence Medical Center who plays piano and a hand-crafted Celtic harp. "I have played for people who are dying, for new babies, for people just coming out of surgery." Music lowers anxiety and stress, and thus levels of required medication.
"The music helps the person tune in to the world, and seems to help them organize the brain, get a better sense of their own verticality and position in space," according to Judy Belk, a speech language pathologist and audiologist who directs the Center for Communication and Learning Skills in Lake Oswego.
For children with underdeveloped hearing or adult survivors of abuse, Belk may treat with recordings of Mozart and their parents' voices filtered to sound as they would have to the patient in the womb -- as a method of starting over from square one.
The difference with Jacobson is that creating music at the piano is the goal, whereas in music therapy the music is a tool toward the primary goal of self-realization. Although she still does on-call occupational therapy in clinics and nursing homes, when Jacobson sits down at the keyboard with a student, "I'm still just a piano teacher . . . with a little extra bag of tricks."