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Playing favourite music with people with intellectual disabilities – using age inappropriate music in music therapy

December 5, 2014

The use of favourite music is a basic tenet of music therapy and method in practice. There are many benefits of using the client’s favourite song. It increases connection. The client feels understood by the therapist and their music choices are validated. The client receives pleasure from hearing a cover version of the song. The therapist can modify the tempo to match the client if they are playing a drum for instance. The key can be changed to suit the vocal ability of the client. There can be pauses to enable the client to fill in the words or to finish phrase endings. Particular verses or the chorus can be repeated, the ending can be extended, the song repeated. The client knows the song so they can immediately be involved and respond.

What happens then when the client is a young person with an intellectual disability? In ongoing therapy what role does this favourite song have and what does it mean to continue to play this music when it is age inappropriate? 

It would seem to be a common experience when working with the intellectually disabled population for some young people and adults to continue to prefer nursery and children’s music. 

 Three thoughts come to mind for me on this. Firstly it is important, especially initially, to use the client’s music as it develops rapport. Secondly it is equally important to continue to introduce new music which is age appropriate. This has social value whereas the nursery rhymes serve to infantalise the person with a disability. 

 We know from the literature on the elderly that people form their music preferences in their 20’s and these preferences remain into old age. This partly occurs because of the association within the music to such events like falling in love and other key milestones attached to such music which occur in young adulthood. These songs are also repeated frequently as a result of this association. The songs become stored in the long term memory in the cortex and are retrieved with great success to treat people with Alzheimer’s disease and dementia.

 Returning to people with Intellectual disabilities, there is some contention about the use of favourite non age appropriate music.

 If the music is favourite, what benefit is there for the person in a therapeutic context?  The music clearly makes them feel good and happy. The music can be used in a variety of ways, potentially to encourage vocalising and interaction such as choice making. I can deduce that the music is meaningful to them and has positive associations and makes the person feel validated and good about themselves

So why do I feel uneasy about using age inappropriate music ? 

 Partly because by reinforcing this music I am potentially not introducing the person to other enjoyable music - and creating new favourites.

Partly because other childen without disabilities are not listening to this music. Why should that bother me? If we are encouraging interaction within society, the music they prefer and connect with is better if it is like their non disabled peers. It increases the young persons acceptance  and potentially decreases the barriers to creating connections with non disabled peers. This was a tenet of Social Role valorisation, popularised by Bentje Nirje and Wolf Wolfensberger in the 1970’s.If the music they are listening to continues to infantalise them are we doing them a disservice by not promoting new music to learn to enjoy as well?

 It could be argued that with the advent of ipods and the prevalent use of head and ear phones that the listening to age inappropriate music may not stigmatise. However there is also the consideration of the other social aspects and the marketing of music.

Recently I have had two clients for whom age inappropriate music was a concern for me. One person was a young adult with verbal skills and intellectually disabled. He participated in a group music therapy session and frequently requested Playschool songs such as ‘The wheels on the bus”, “What do you think name is“  and so on.  Other group members would complain and openly disparage this group member. I felt his need to hear and make the choice of a favourite song was important but that group considerations (ie tolerance for ‘childish’ music) were equally important. 

 I therefore allowed one song a session towards the end of the session and often the group member would stay on a bit afterwards and sing a few more songs a capella with me. I felt that this young man also viewed himself as a child and we use the song ‘We will rock you’ to explore issues of identity and his stage of life. This song conveniently discusses a boy, a young man and an old man in each verse giving a potted version of the broad stages of life and allowed discussion within the group regarding age and development.

The other client is a non- verbal teenager who listens to preschool music constantly via an ipod. The music is integral to him and he carries it everywhere. In the music therapy session the ipod is switched off. Additionally this young person is fascinated by the guitar and will rush into my music room several times a day to find the guitar, hold it and stroke it. In sessions his fixation on the guitar began to hinder the progress of the session so I have removed the guitar and use piano solely for accompaniment. In discussing this behaviour with one of the senior teaching staff, his interpretation of this behaviour in his experience was that the student was trying to use the guitar to play the music that he has in his head. With this teacher the guitar was approached, stroked and observed but also abandoned.  The teacher felt that when he played to the student, the student would eventually smile when the song “matched” the song in his head. This occurred to Humpty Dumpty. It is an interesting theory of mind construct but one that doesnot fully resonate for me.  The student may have simply been wanting to hear that song and/or recognised it.

I will continue to use the preferred music of my clients. This is a basic tenet of our work , that the music  which works is the music preferred by the client . However for the people I work with who have intellectual disabilities, who can be stigmatised and marginalised by society despite our best efforts , I will encourage and expose them to the fun and joy of all music including a range of styles and era’s. 


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The use of favourite music is a basic tenet of music therapy and method in practice. There are many benefits of using the client’s favourite song. It...

Playing favourite music with people with intellectual disabilities – using age inappropriate music in music therapy

December 5, 2014

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