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Notes for change

Priyanka Sharma / New Delhi March 03, 2012, 0:02 IST

Still at a nascent stage, music therapy for autistic children is slowly gaining ground in India. Priyanka Sharma visits a special school offering music therapy in the capital and finds out how it works Anxious parents wait outside Open Door, the school at the Action for Autism centre in Delhi, for their children to come out and tell them about their day. Sahil Kumar (name changed on request), 13, walks out of the classroom and purposefully towards another one. He is excited about his music class, informs his smiling mother. In the well-lit music room, there are several instruments a tabla, guitar, keyboard, bongo, rattle and drum set. Sahil enters the room reluctantly at first, but is encouraged by Somesh Purey, a trained clinical music therapist who sings good morning Sahil in a soothing voice, while playing the guitar. Sahil recognises the sound of his name and responds to Pureys high notes by shaking his head to the beat. Observing Sahils positive reaction to his pitch and note, Purey guides him to a chair, singing welcome Sahil. The music session has been organised by The Music Therapy Trust (TMTT), a foundation set up in 2005 by Margaret Lobo, the founder and director of the Otakar Kraus Music Trust, a registered charity in the United Kingdom. Lobo visited India to give a lecture on the use of music therapy the overwhelming response she received led her to set up a similar organisation in India. The trust offers a post-graduate diploma in music therapy, a part-time, two-year course. The students, who need to possess preliminary music skills, are trained in various disciplines such as child psychology, psychiatry and psychotherapy. But the most important requirement is patience and compassion, says Lucanne Magill, a senior tutor at the trust. Magill, along with Purey, conducts 30-minute sessions with children from different age groups. Sahil was diagnosed with high functioning autism at the age of two a neuro-developmental disorder characterised by poor communication and social skills as well as restricted behaviour and interests. It usually manifests itself before children turn three, but is seldom diagnosed in time because of the diversity of clinical profiles. Music therapy is particularly useful with autistic children because it is a nonverbal, non-threatening medium. Sahil has never spoken a word. But whenever he listens to music, he responds, says his mother. *** In the last few months, her biggest challenge has been to prevent Sahil from being hitting himself when he wishes to express himself or was upset. One day, she made a startling observation. Every time he heard music on TV, Sahil would bang the table to replicate the tune, and would feel very happy. She remembers that Sahil loved listening to music on his Walkman when he was younger his taste spanned all genres, she adds. Sahil also enjoys humming tunes of popular nursery rhymes. Every time I say the word star, he hums twinkle twinkle, little star...He has flawless memory, says the proud mother. Sahil also hums the national anthem at his school. In his second session of music therapy, Sahil appears agitated. The biggest challenge for me is to hold his attention, says Purey. Autistic children do not respond to most stimulants, and have difficulty maintaining eye contact. Purey tries a new strategy. Looking Sahil straight in the eye, he hits the tabla with his hand, repeating the movement several times. At first, Sahil looks away. After
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several minutes, Purey smiles as Sahil begins to track the sound and Pureys hand with his eyes. Eye contact can express suspicion, anger and even joy. That Sahil has focused on something is a breakthrough as it means he acknowledges me, which is crucial to form a relationship, says Purey. Several times during the session, Sahil walks out. Observing that the bright lights outside the room are distracting him, Purey switches them off. When even that fails to calm him, Magill holds out her green dupatta. Sahil seems to like the opacity of the fabric and sits down, clinging to it. I just remembered that he liked my scarf in the last session so I carried it, informs Magill. The dupatta, she says acts as a transitional object that helps me gauge Sahils responses to the therapy. Unlike in Europe and the US, the use of music therapy to manage autism is still at a very nascent stage in India. Though the traditional view of raga therapy may be understood, the clinical view of the same is not, feels Magill. In the next 20 minutes, Sahil is introduced to new sounds using different instruments. Another breakthrough occurs when Sahil initiates a sound himself by strumming his fingers against a wind chime. Noting that he uses his right hand, the therapists try to ascertain which side of his brain is more responsive. In another room, students of TMTT observe the session and take notes. They discuss their assessments with the tutors, give suggestions and set goals for Sahil. *** Music, as a therapy, can improve attention span, communication skills, auditory processing and help autistic children express their emotions, says K John Vijay Sagar an associate professor in the department of child and adolescent psychiatry at the National Institute of Mental Health and Neuro Sciences in Bangalore, which treats around 100 children with autism every year. Though NIMHANS does not offer music therapy for autism, Sagar encourages parents to explore the use of music to alleviate the effects of autism. It provides sensory stimulation. Music can be used as a reward or reinforcer to elicit desired responses from a child, he adds. Stuti Chandhok, a former student of TMTT and founder of Madhur Mantra, a school which imparts Hindustani classical music training to children through puppets, percussions and movement, believes that there are no rules in treating children with autism. I improvise and create music for that moment, she says. She remembers an autistic child who was sensitive to sound and would react violently to noise. It took Chandhok 10 months she experimented with different instruments and notes to get a response from him. Today, he repeats songs after me. While autistic children may not be able to form phrases, they are more likely to repeat sounds others make, a condition known as Echolalia. Chandhok does not stress on the words or correct the melody. I draw them out of their shell and make them comfortable with another person. The ability to respond to music is unimpaired in every child.

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