Yusliza Yusof (Group B)

Case Study 1

Area of Intervention: Intervention to further develop on Annie’s speech, communication and social skills.

(i) Intervention

The intervention that I will recommend Annie to further develop on her speech, communication and social skills is music therapy. According to this article by Bower and Shoemark (2009) music therapy has tremendously helped a child who has encountered an Acquired Brain Injury (ABI) and had just emerged from coma and post traumatic amnesia (PTA) to be able to construct some speech. This intervention is carried out within five to six sessions. Through this intervention, it is able to promote basic interpersonal interaction skills, other than just helping the child in his/her speech and language skills. It is important that this intervention helps to further enhance Annie’s speech and language development as Annie has poor social interaction with her peers. By carrying out music therapy, provides Annie with the ability to co-facilitate speech pathology interventions thus allowing her to be successfully engaged in musical interactions. According to the article in Bower and Shoemark (2009), music therapy can also provide her opportunity to show musically appropriate interpersonal interactions which further enhances on her social capacity. As such, she will then be able to respond to the musical elements of early interpersonal or social interactions before she acquired the ability to process language. This intervention offers Annie the opportunity to address the fundamental needs of process language and hence reducing the chance of her being isolated by her peers.

(ii) Effectiveness

The effectiveness of this intervention has been reported to be successful in increasing the vocal range and intonation. Vocal and breathing exercise done during the intervention has been proven to be beneficial as it increases the breath support for prolonged phonation. The use of rhythmic speech cueing has also seen to be improving the rate of speech and speech clarity. The use of music therapy mainly the singing instruction is seen to be potentially a stimulating, fun and reminiscent medium that increase motivation and focus during speech rehabilitation exercises.

As stated as an example in the article by Bower and Shoemark (2009), a boy who has undergone this intervention has benefited tremendously. He is able to develop the proper language to greet and convey his goodbye to his peers. With this positive communication, he is able to better interact with his peers. Apart from that, through this intervention, he was also given the chance to try out rhythmic activities such as free drumming improvisation as it facilitate non-verbal interactions between the boy and the music therapist. Hence, it subsequently increases the awareness of the therapist initiated interpersonal interactions. Throughout the course of co-facilitated music therapy and speech pathology, the boy was able to participate actively and shows interest to what he was doing.

(iii) Personal evaluation how the child will benefit from this intervention

As Annie displays some behavioral and social difficulties, I strongly feel that this intervention will help to reduce her behavioral problems. Personally, I believe that the behavioral problems occurs as she feels frustrated with her own disabilities and finds it hard to be involved with the activities provided in school. Aside from being extremely shy and withdrawn, she also felt tense and frustrated which then resulted in her biting her classmates. Moreover she is teased by her peers because of her facial deformities. With this intervention that is to include the element of music allows Annie to be more involved socially with her peers.

Through this intervention too, it helps Annie to firstly further develop her language skills. With proper speech, Annie is being understood by her peers, and thus allowing her to have better communication skills with everyone around her. Hence, her friends will be able to be more understanding of the difficulties that Annie is going through with her language and social emotional development. Having to go through this intervention process one step at a time, we are able to monitor Annie’s both social emotional and language development just like the example given in Bower and Shoemark (2009) that the boy benefited tremendously having to adopt this music therapy as an intervention.

(iv) Suggestions how adjustments can be made to cater to the needs of the child and to facilitate integration of the child / the intervention activity into the classroom.

I believe that to carry out this intervention efficiently for Annie, the teacher will have to do more research on music therapy thus making improvisations to meet developmental needs. Apart from that, the teacher will have to work closely with Annie’s parents and speech therapist to constantly keep track of her speech and language progression. When the teacher is knowledgeable to Annie’s strengths and weaknesses, the teacher is able to make appropriate improvisations to the intervention. The music therapy intervention mentioned in Bower and Shoemark (2009), it goes through various number of sessions. Each session will have different objectives to be met according to Annie’s improvement and progression made.

As stated in Bower and Shoemark (2009), drum is used to help the boy however, to facilitate integration to the child; the teacher can introduce items for Annie to be involved with according to her interest. The teacher can split this intervention to a few sessions which starts off with a simple music activity to introduce Annie to a song. The song can be a simple song to teach Annie and the other children about greeting one another. This is followed by a simple goodbye song to cue the conclusion of the session. The teacher will then observe Annie’s progression. As Annie is able to make improvements, teacher will then introduce different kinds of songs. With simple greeting songs like that will help Annie with her language as she is able to sing it repeatedly. Through active engagement in the activities, Annie will gradually develop interpersonal interactions as she mingle and work with her peers. Since Annie has difficulty with her speech, teacher can also aid her speech by having picture cards to teach the routines during this therapy. With the picture cards too, it will be easier for Annie to interact with the teacher and her peers.

Reference
Bower, J., & Shoemark, H. (2009, July). Music therapy to promote interpersonal interactions in early paediatric neurorehabilitation. Australian Journal of Music Therapy, 20, 59-75. Retrieved September 5, 2009, from CINAHL Plus with Full Text database.