A Music Workshop as a Research Laboratory for Williams Syndrome

Project location: Italy
Project start date: December 2007 - Project end date: December 2010
Project number: 2007-23
Beneficiary: ASS ITAL WILLIAMS SYNDROME

2009 Report

As a result of a three year study concerning music applications on the Williams Syndrome, a new observation protocol has been inserted in 2009. Novel evaluation parameters , necessary for achieving innovative lengthwise observations and to evaluate the fulfilled changes, as well as new therapeutic observations and approaches methods, fundamental to the project. That is why some cognitive tests for a systematic evaluation of the laboratory, and an experimental laboratory (dance - movement therapy) judged by the team as an exhaustive method to evaluate and for the psychomotor development type, have been added.
Inserted observation instruments:
1. BaB: The BaB test (Behavior Assessment Battery) is a systematic behavioral assessment test, suitable for the educational evaluation of serious and most serious disabled persons. It splits the whole behavioral and cognitive repertory in 12 areas adequately covering the basis levels. It's an essential instrument for both initial and planning evaluation for inhomogeneous and fragmented cognitive abilities and make think to basis deficit of the fundamental organizations of intellective function.

2. VAP-H: Evaluation of psychopathologic aspects in the disability: it's set as an observation and collection of information instruments on the behavioral and socio-emotional aspects in the mental retardation subject.

3. Fairy Tale Test (FTT - Fairy Tale Test): it's a projective test for children's personality evaluation. The test uses illustrated tables representing the principal characters of some of the most famous fairy tales that (for their symbolic contents) are able to express the central aspects of the children experience, conflicts and anxieties. The FTT can be used for diagnostic evaluation and as to establish the changes in the development and can even be distributed to children with special educational needs such as learning difficulties and light mental retardation.

4. "Observation file of psychomotor behavior":The check list is useful to evaluate the state of psychomotor, cognitive and emotional abilities of the subject during music therapy sessions. It's both a diagnosis and observation instrument of individual abilities and evolution evaluation of these abilities during the time.

Through participants' observation and the vision of films the following elements have been considered:

Cognitive aspects:
1. Extension of attention times, concentration on the adequate incentive, decrease of distracting forces.
2. Sequence elaboration, ability of prediction and planning, problem solving.
3. Development of language, syntax, content, expression.
Emotional-Relational Aspects
1. Relational abilities, hyper sociality, empathy
2. Emotionality, management of anxiety state, self-consciousness
3. Expression, creativity, communication of emotions
4. Affectivity, relation with the therapist , in the group
5. Self-esteem and research of a positive image of the self
6. Motivation, research of goals and meanings
7. Behavioral aspects, reactions, emotional answer control.
Psychomotor Aspect
1.Effectiveness on motor symptomatology (muscular tone, articulation, fine and big coordination, perambulation)
2. Visual-spatial abilities' increase (orientation, eye-motor coordination, planning and visual-spatial memory)
3. Reactions' decrease due to Hyperacusis.
The methods used in the different spheres, result partially modified with respect to the previous year  for didactic, methodological and logistic necessities; basically:
Singing and harmonic adaptations' research
Sonorous and multi-sensory games
Body expression
Learning and adaptation rhythm-melody exercises
Planning musical interventions
Group Improvisation
Dance and movement
Listening and relax

Instruments research
The research has been conducted with the following method:

Clinical study: action research, perspective, un-probabilistic sampling
Sample: 5 Williams subject, with associated pathologies and mental retardation
Semi-structured interview (personal characteristic, sonorous background, attitudes, abilities)
Participant observation
Cognitive evaluation test
Psychopathologic evaluation protocol

Results

In the individual observation these parameters have been evaluated:
Consciousness of emotions
Increase of creative abilities
Increase of self control and self management abilities
Planning activities directed to specific goals achievements following their own interests, desires, ambitions.

Conclusions
Mt experience is effective in increasing  musical abilities of the subject, because, it expresses a more suitable condition for comprehension. From the musical comprehension point of view, the group shows innate or pre-acquired adaptation and creative improvisation abilities, while existing evident lack in music syntactic abilities comprehension in a traditional way. Music demonstrates an excellent inquiry instrument on the behavior, but even of improvement of basis and complex abilities, showing the possibility to influence in a positive way autonomy, the relation and learning, in the daily.

DMT Laboratory: The movement/trail trace
(by Sandra Bertani, psychologist and dance therapist APID)

The patients found themselves facing a new articulate route on few meetings but of intense stimulation. The route started from the research of a coming out movement, emerging from the interior. During the individual session each one had his own space (temporal and physical) to move through the research of a movement that was genuine, born from one's own need to follow and to go through the available space. Surely stimulating and rich of personal elements, the route, starting from the authentic movement, brought to identify instruments, colors and traces on paper, signal of an exquisite and exclusive creation. The patients could quietly and funnily live the approach, the "warm up" driving to the meeting with the "intelligent body", the body in which there are past traces of their own being in relationship with other people, happiness and pain traces, possibility traces permitting a transformation. The sensibility and the availability to work in a serious and constant way, have permitted the creation of a virtual bridge with the previous laboratory DMT experience, that yet with other objective and aims, has obviously a setting structural continuity, of method and participation. It could be possible to observe,  that each participant followed their own route facing the relation with the body in movement. Through this, it has been possible to live different and opposite emotions, living experience starting from "as if" of the role play to know and to recognize oneself in a movement. Some movements have been transformed, renewed by new forces and changed in opposites. Other stereotypes have been kept uncrystallized, developed through creative processes that got in new light and energy. The organization discovered the intention to go to a point, identified with autonomy, experimenting new tactile sensations through the self perception to pass the attention to the exterior. Concluding, in my opinion, it's necessary to consider how much the function of time is fundamental in a process. This year the organization worked with remarkable aims in a very restricted time. This was a strong incentive in the here and now of the meeting. As just happened in this context, in the quick development of events and creative requests powerful elements come out, risking to stay isolated in a special time and space and intentionally created for the incidental experience. This is no doubt a good occasion to live wealthy moments, but a necessity should come out: this shouldn't be restricted to punctiform interventions. I tell this because the connected opportunity of the use of the DMT could reinforce living experiences and make them available outside the laboratory. The DMT, to be considered like this, needs times in which you can choose creative hints, but even times to remember to relive, to repeat. The repetition is the reinforcement. If you wish to make the DMT experience comparable to the music therapy laboratory's route, it would be necessary to consider this element.

Typology and criteria of the intervention

GOAL/S TO REACH : Individualization of potential expressions of the individuals and how these hidden characteristics can somehow come out through comparison and exchange even at a cognitive level. Reinforcement of knowledge, will, the courage to participate and the ability to welcome oneself. Sonorous Identity
Readjustment of the sphere: SONOROUS - MUSICAL
MOTOR - POSTURAL
HANDLING

LABORATORY'S ACTIVITIES
Musical activity has always been characterized, both in individual meetings and in group, by the need to make emerge creating music together and by recognizing the readjusting original function.
Individual activity is based on:
a) Free sonorous articulation: sudden language, without etymological root. Invention, not trusting on the meaning its contents. It's centered on the reason relating to the emotional aspect
b) Gestural codification of the five pure sounds. Each vowel is represented by the hands. The director's request comes from this code and can easily create the sequence of vowels that should be executed from the group, merging them together, without continuity interruption. On shifts the director is changed until everyone tried to direct the "choir".
c) Research , listening and transmission on the instrument, of its own interior rhythm.
d) Practical rhythm exercises on percussion instruments
e) Rhythmic singing
f) Conducted singing based on repeating simple proposed melodies in a measure or two of 4/4. The phrase is constantly varied.
g) Attitude observation and individuation of fitting instruments to empower the expressive individual ability
h) Invention of a singing tale. An argument is chosen, and with the accompaniment of a barrel organ, the group improvises simultaneously singing and text. They travel with fantasy, describing places and people. Interior travel that leads to information, memories, points of view, imagining ability, even private visions of the "singer".
i) Dynamical Exercises. Intensity opposition achievements.
Ex. Route in three different phases, from silence, DAWN - DAY - SUNSET to silence. This exercise is considered excellent, to learn, control and govern one's energy.
j) Motor - Postural Exercise to stabilize and interiorize the instinct of time. (thought time). It takes place walking and signing in pace with the proposed value. To make it easy and to give more color an animal is associated to each value. Slug, ant, cat, hare, horse, etc. It's easier to understand physical lacks and deficits due to balance. The carriage and the miming aspect, sometimes the partial use of body inform us and press us always to find new rehabilitative strategies' intervention, fitting to the single subject.
k) Sonorous breath: measuring breath's length is a pretext to  bring consciousness to one's own pneumonic wideness and discover deep abdominal breathing. Represented as two rooms. First of all we change the air in the "deepest room", putting together a hand movement on the belly to mime the window's opening and closing (diaphragm). The vowel fix tuning sound (kept for all the length of the breath) testifies the level achievement's grade. Make immediately clear, through a pleasant competition, the possibility to improve again times and length of a better autonomy and a good breath management. This exercise is very pleasant for those who practice. Besides it prepares the "unmasking" of the voice, with a tone improvement. Trusting the emission length's extension and (any) fix tone, we start to have enough time to listen to oneself and drown into the sound becoming a whole thing with it. The relapse is remarkable, due to echo on a physic and sub-atomic level.
l) Listening and silence analysis: "The tail's sound"
In this sphere we discover how much music is able to modify our feeling and how these changes created by sound can be kept through a deep listening and silence that has to follow. The research is addressed to our interior truth, the attention is moved from the external to the internal where it's still perceivable the echo of what we were listening, in the shape of a still active movement, perceivable in our mind and in our cells.