However, the role of music in therapy has undergone some dramatic shifts since the early s, driven by new insights from research into music and brain function. A highly complex picture of brain processes involved in the creation and perception of music has emerged. Brain research involving music has shown that music has a distinct influence on the brain by stimulating physiologi- cally complex cognitive, affective, and sensorimotor processes. Furthermore, biomedi- cal researchers have found not only that music is a highly structured auditory language involving complex perception, cognition, and motor control in the brain, but also that this sensory language can effectively be used to retrain and re-educate the injured brain.
This system has resulted in the unprece- dented development of standardized clinical techniques supported by scientific evidence. However, since NMT was developed out of a research database, it will continue to evolve, shaped by the emer- gence of new knowledge.
This transition is a very critical step in the historical understanding of music in therapy and medicine. We can now postulate that music can access control processes in the brain related to control of movement, at- tention, speech production, learning, and memory, which can help to retrain and recover functions in the injured or diseased brain. Six basic definitions articulate the most important principles of NMT:.
Music therapists can meaningfully contribute to and enrich the effectiveness of treatment teams. Non-music therapists who are trained in other al- lied health professions can effectively adapt the principles and materials of NMT for use in their own certified practice.
Michael H. McIntosh, and Volker Hoemberg 3. Research now shows a fascinating reciprocal relationship between music and the brain. Music is a product of the human brain. However, the brain that engages in music is also changed by engaging in music. Brain changes due to music learning and performance have been well documented.
There is also strong evidence that music shares processing centers with speech and language functions. Music processing in the brain does not stop at music. Music processing can engage, train, and retrain non- musical brain and behavior function. This is an important point for music in therapy, because it means that its theoretical models have to be based on an understanding of the processes involved in music percep- tion first, before translational therapeutic concepts can be developed.
There are suggestions in the music therapy literature that such a scientific anchoring of music therapy in psychological and physiological models of musical behavior was origi- nally envisioned by pioneers such as Gaston , Sears , and Unkefer and Thaut in their thinking about the future foundations of music therapy.
NMT has picked up these strands of early thinking and exploration, aiming to build them into a coherent scientific theory and clinical system. The RSMM functions as an epistemological model—that is, a model to show ways of generating knowledge concerning the linkage between music and therapy. In the epis- temological application, the RSMM helps us to know how to know, and to know how to investigate or to learn how to learn. It does not predetermine the specific content of the mechanisms in music that produce therapeutic effects; it shows how to find them in a logical, systematic structure by linking the proper bodies of knowledge and showing what information is needed to logically support the next steps of inquiry and thus build a coherent theory.
The RSMM is based on the premise that the scientific basis of music therapy is found in the neurological, physiological, and psychological foundations of music perception and production. In the second step, these findings are compared for shared processes in the parallel musical functions. If shared processes exist that may entail—at least theoretically or within the music domain—enhancing or optimizing mechanisms, the RSMM model would proceed to a third step, investigating this potential effect.
McIntosh, and Volker Hoemberg 5. Three examples may illustrate this search for shared processes. In music, motor timing is driven by the auditory rhythmic structure of the music.
So can auditory rhythm as a temporal template not only facilitate motor learning on musical instru- ments, but also enhance neuromuscular control and motor planning in re training of functional non-musical upper and lower extremity movements? So can music—by engaging these shared parameters—enhance speech and language perception and production e.
Music is an abstract auditory language that shapes attention, memory, and executive control to a large extent through its intrinsic temporal structure. So can musical structure enhance cognitive processes outside of music, such as non-musical attention and memory? The effect of music on non-musical behavior and brain function at this step may involve studies with healthy subjects or with clinical cohorts, but looking at mechanisms or short-term effects, providing evidence for the feasibility of future clinical research.
For example, Step 3 research has investigated the effect of rhythmic-musical cues on motor control gait, arms or the effect of using musical instruments to simulate func- tional arm and hand movements in upper extremity rehabilitation. Studies have investi- gated whether speech fluency or intelligibility can be enhanced while following a rhythmic timing cue. If significant changes in non-musical behavior with clinical relevance due to music are found, the RSMM would proceed to Step 4.
Step 4 research proceeds with patient populations and looks at meaningful therapeutic effects of music in re training brain and behavior function.
Step 4 research studies the effects of interventions or intervention models on long-term learning and training. Only the technique known as music in psychosocial training and counseling MPC also utilizes in- terpretative and emotionally expressive functions in musical responses for therapy. Exer- cises in the technique known as associative mood and memory training MMT are based on paradigms of learning and remembering through classical conditioning Hilgard and Bower, and associative network theory mechanisms Bower to connect mood and memory facilitation.
Furthermore, NMT focuses on music as a biological lan- guage whose structural elements, sensory attributes, and expressive qualities engage the human brain comprehensively and in a complex manner. In NMT, music as a therapeutic agent does not operate as a cultural artifact, but rather it operates as core language of the human brain.
In this way, the function of music as a language of learning and retraining the injured brain can be fully comprehended and appraised by clinicians, scientists, and musicians alike. NMT is advanced and evidence-based music therapy practice. However, since the basis for its techniques and the mechanisms whereby music affects the brain are based on neurobiological principles of brain and behavior, NMT allows music to be inte- grated into an interdisciplinary context of rehabilitation modalities.
References Bower G H Mood and memory. American Psychologist, 36, — Gaston E T Music in Therapy. New York: MacMillan Company.
Theories of Learning. Sears W W Processes in music therapy. In: E T Gaston ed. New York: Macmillan Company. Thaut M H Rhythm, Music, and the Brain: scientific foundations and clinical applications. New York: Routledge. Chapter 2. All rehabilitation is aimed at improving the independence of the patient physically as well as psychologically, and at increasing their chances of engaging in activities of daily living by improving their functioning and abilities.
One of the major routes for reaching the patient is language in its broadest and most comprehensive sense. In rehabilitation in par- ticular it is very important that physicians, nurses, therapists, and caregivers speak to the patient and provide appropriate sensory stimulation. Therefore rehabilitative neurology is necessarily interested in exploiting music as a treatment tool. Rhythm is a major characteristic of music.
However, rhythmic oscillations also play a major role in the neurosciences. The human brain waves detected by electroencepha- lography EEG and magnetoencephalography MEG are very good examples of this.
Higher-frequency oscillations in the gamma band above 40 Hz seem to provide clues to the understanding of elementary mechanisms involved in perception Engel et al. One of the intriguing questions arising in this context is whether a sensory stimulus such as music that has a complex spectral and temporal rhythmic—acoustic structure can shape the intrinsic rhythmic brain oscillations underlying cognitive, perceptual, and motor function Crick and Koch, Over the last decade, the focus of interest in the invention, design, and efficacy evalua- tion of motor therapies in neurorehabilitation has changed dramatically.
This has involved three paradigmatic changes. First, there was a change from confession to profession i. Thirdly, both of these developments were accompanied by a transition from intuitively marshaled indi- vidual one-to-one treatments to quality proven group treatments. In parallel with the advances in the neurosciences and behavioral sciences during this period, a very large number of new approaches evolved to guide or refine statistical and biometric methods following the framework of evidence-based medicine EBM.
One prominent research element in EBM has been the emphasis on the design of randomized controlled trials RCTs , which are increasingly being used to evaluate the efficacy of treat- ment approaches in neurorehabilitation for a review, see Hoemberg, In addition, their claim to be based on sound principles of neurophysiol- ogy has received much criticism. In particular, it has a high biometric reliability in avoiding false-positive results known in statistics as type I errors.
Furthermore, within this framework the results from multiple RCTs can be condensed into meta-analyses, and the outcomes can help therapists and clinicians to be more critical when evaluating claims of the effectiveness of certain procedures. However, there are also several disadvantages to relying exclusively on RCTs, which argue against the application of this rationale for decision making about treatment in neurorehabilitation.
The concept of RCTs was primarily designed and is most often used for pharmacological studies, which usually involve fairly large numbers of patients. These studies are generally very expensive to conduct and are commonly sponsored by pharma- ceutical companies. The EBM concept is not readily applicable to the small sample sizes and heterogeneous clinical populations that are often used in neurorehabilitation studies.
A reliance on meta-analyses when making treatment decisions may introduce additional errors and sample biases. Finally, individual treatment responsivity e. Therefore the question arises of the extent to which we should rely on EBM concepts when selecting treatment options. Are there other approaches that can be used to solve this dilemma for clinical practice?
Certainly the results from RCTs and associated meta- analyses have to be very carefully read and interpreted in order to avoid statistical type II errors i. Therefore we should probably place greater reliance on positive than on negative results of meta-analyses. However, we also have to consider that there is other important scientific information available to the clinician that can be used to make evidence-based clinical decisions or to devise treatments. For example, as most approaches in motor rehabilitation are related to motor learning, elementary knowl- edge about motor learning derived from the neurosciences and behavioral sciences can offer clues to the design of new and effective therapeutic strategies.
Box 2. The single most important elementary rule in motor learning is probably repetition. A high number of repetitions are necessary to optimize movement trajectories.
The next important elementary rule is the use of feedback i. For this principle, too, elegant experimental studies have provided ample evidence for a nice ex- ample, see Mulder and Hulstijn, The presence of external cues is another important rule for guiding the patient, espe- cially in the absence of sufficient intrinsic cues to control movement. Here rhythmic temporal cues can play a particularly critical role Thaut et al.
Furthermore, for optimal learning it is important to keep the learner at an optimal level of motivation. The teacher has to avoid both creating a boring situation by using task elements that are too easy and triggering frustration by using tasks that are too difficult.
In this sense it is the role of the therapist or coach to select the optimally appropriate level of task difficulty.
In addition, the selected task should be oriented to real-life situations in order to allow an effective transfer into the day-to-day behavior that the patient wants to be prepared for. The first and most important step toward a neuro- biologically based use of music in the treatment of patients with motor problems was the scientific development of the technique of rhythmic auditory stimulation RAS. The therapeutic principles and underlying neurophysiologic mechanisms were primar- ily developed at the laboratory of Michael Thaut and colleagues at Colorado State Univer- sity.
The basic idea behind this concept is that a repetitive rhythmic acoustic sensory signal can entrain and facilitate rhythmic movements. By or- ganizing upper extremity movements or full body coordination into patterned sequences that can be cyclically repeated, these movements can also be rhythmically cued. As an example of this approach, a study using auditory rhythmic cueing as patterned sensory en- hancement PSE showed significant reductions in paretic arm-reaching trajectories after stroke Thaut et al.
The mechanism underlying the facilitatory influence on movement organization and control is based on the theory of rhythmic entrainment, in which acoustical rhythms en- train neural responses in auditory and motor structures, and with regard to cueing of gait couple into central pattern generators in the brainstem and spinal cord Duysens and van de Crommert, Over the past decade, translational research in music and brain function has driven the broadening of the scope of neurologic music therapy to address non-motor functions as well, such as perception, cognition, linguistics, and emotion.
It is safe to say that the research evidence and learning and training rationales for NMT are at least as well evidenced and supported by valid rationales as they are for its sister disciplines in rehabilitation and therapy. Neurologic music therapists are not specialized in separate sub-diagnoses or specific cognitive or motor behaviors. H Repetitive training of isolated movements improves the outcome of motor rehabilitation of the centrally paretic hand.
Journal of the Neurological Sciences, , 59— Crick, F. Towards a neurobiological theory of consciousness. Seminars in the Neurosciences, 2, — Duysens, J. Neural control of locomotion; Part 1: The central pattern generator from cats to humans. Gait and Posture, 7, — Engel, A. Temporal binding, binocular rivalry, and consciousness. Consciousness and Cognition, 8, — Fitts P and Posner M Human Performance.
Gold, I. Does Hz oscillation play a role in visual consciousness? Grillner, S. Central pattern generators for locomotion, with special reference to vertebrates. Annual Review of Neuroscience, 8, — Hoemberg V.
Neurorehabilitation approaches to facilitate motor recovery. Volume New York: Elsevier. Mulder, T. Sensory feedback in the learning of a novel motor task.
Journal of Motor Behavior, 17, — Sterr, A. Exploring a repetitive training regime for upper limb hemiparesis in an in-patient setting: a report on three case studies. Brain Injury, 16, — Thaut, M. The effect of auditory rhythmic cuing on stride and EMG patterns in persons residing in the community after stroke: a placebo- controlled randomized trial.
Archives of Physical Medicine and Rehabilitation, 84, — The effect of auditory rhythmic cuing on stride and EMG patterns in hemiparetic gait of stroke patients. Journal of Neurologic Rehabilitation, 7, 9— Rhythmic facilitation of gait training in hemiparetic stroke rehabilitation. Journal of the Neurological Sciences, , — The connection between rhythmicity and brain function: implications for therapy of movement disorders.
H et al. Movement Disorders, 14, — Functional Neurology, 16, — Kinematic optimization of spatiotemporal patterns in paretic arm training with stroke patients. Neuropsychologia, 40, — Distinct cortico-cerebellar activations in rhythmic auditory motor synchronization.
Cortex, 45, 44— Chapter 3. However, as a group, music therapists have perhaps been slower to embrace these technologies in their clinical work, often favoring the use of traditional instruments. It seems that both an inclination toward and a reticence about the use of technology in music therapy exist among clinicians, fueled by a number of factors.
Some have turned to technology for assistance because the requirements of therapeutic service delivery to individuals and groups of clients can exceed those that one therapist can provide. Others have utilized technology to facilitate activity and interaction among those who are most severely physically impaired, so that maximal sound is achieved through minimal action.
Paradoxically, this very issue is what causes some clinicians to be disinclined to utilize one or any of the music technologies in their practice. Cost may seem prohibitive to some, in addition to concern about investing in hardware and software technologies that will quickly become obsolete or require ongoing expenses to remain current.
Wendy Magee has reported that music therapists in the UK and the USA seem to agree on a key element of music technology in healthcare, in that they generally view electronic music technology as capable of providing access to clients and therapists alike Magee, , ; Magee and Burland, Magee asserts that more clinicians would probably utilize the various technologies if they had a better understanding of how to select the vari- ous tools based on their capabilities, appropriate populations, applications, and intended outcomes.
Although this chapter cannot be exhaustive toward that effort, due to restric- tions on its length, and moreover we do not want to provide so much detail that the novice is overwhelmed a common complaint , an overview is provided as well as introductory applications of electronic hardware instruments , software, and hand-held devices. Roth The musical instrument digital interface MIDI has been a major development and force driving the explosive growth in music technology in the last 15 to 20 years, allowing musicians at all levels of skill to utilize electronic instruments for performance and com- positional purposes.
Its onset dates back to the early s, with the original goal of allow- ing electronic instruments from different manufacturers to connect with each other using the same electronic coding to control various note, timing, patch instrument , and pedal events. This was originally achieved by simply cabling the instruments to each other and to a single controller, which was eventually replaced when computers became available.
There are exceptions, of course, and one example is connecting a computer to a single device such as a musical keyboard.
In this. More often, however, an intermediary device known as a MIDI interface is required to connect your computer to your instruments, and in particular if you have more than one instrument, for example, a MIDI keyboard, drum set, guitar, and mallet instrument. The series of connections begins from the USB port on your computer to the USB port on the MIDI interface, and then the series of connections between the interface and various instruments see Figure 3.
That is to say, the player of the instrument applies force by striking, strumming, or supplying air pressure to a series of sensors inside the instrument, which actuates a sound. Regardless of the shape and appearance of the instrument, it sends a similar signal to some source of sound generation, usually a keyboard or computer. These data are converted into sounds that are selected by the player or therapist.
As mentioned earlier, this provides clients who have limited mobility—due to either strength or range-of-motion issues—to effect maximum sound by only lightly touching an instrument. Of course, the opposite is true as well, in that the instruments can be calibrated so that they have to be played with greater force, perhaps even more than on an acoustic version of the instrument—for example, to evoke a sound in an exercise to develop strength.
In some set-ups, the keyboard functions as either the single or central unit by which music is produced and therapeutic exercises are delivered, and there is a wide range of MIDI-capable keyboards with a spectrum of capabilities and prices. Determining how you will use your keyboard will help you to decide which will best suit your needs.
Will you travel from room to room within a single building? Will patients travel to you to engage in therapy in your clinic, studio, or therapy room? Do you have to use a car to travel from site to site? Will you or your clients actually play the keyboard or are you using it simply as a sound source for other MIDI instruments?
If the clients are going to play the keyboard, for what purposes will they play it? If your clients will actually play the keyboard in order to develop strength and coordina- tion, a keyboard with weighted or semi-weighted keys is preferable as it provides resistance and a stronger finish point to each keystroke, both of which are useful in rehabilitation exercises.
Alternatively, if you require greater portability or you will primarily use your keyboard as a sound bank with minimal musical input, a keyboard or MIDI controller without weighted keys, with a smaller number of keys, and that can be easily fitted into a small case or bag will be more useful for you.
If you work in a clinic or your use of a keyboard does not require portability, and you have an ample budget, the Yamaha Disklavier can be an enormously useful instrument in rehabilitation therapy.
Furthermore, because the information is stored digitally, it can be manipulated to adjust for individual patient needs with minimal effort and disruption to the therapy session.
A significant obstacle to using the Disklavier in therapy can be its price tag, which often is the equivalent of total annual expenses or exceeds the budget for many therapy departments and individual practitioners. Drum sets are produced and distributed by multiple companies. Roland also produces a digital hand drum called the HandSonic that includes a great deal of the technology used in their V-drums drum sets. It includes 15 separate pads that can trigger up to 15 different sounds simultaneously, so it can be used in both individual and small group therapy 15 people cannot fit around the instrument to play it at the same time.
The HandSonic 15 includes over percussion sounds, including typical band and orchestral instruments as well as tra- ditional instruments from around the world. The authenticity of the sound is rather remarkable, and when played in conjunction with other percussion instruments, depending on the quality of the amplification system, it is difficult to tell the differ- ence between the acoustic instruments and their reproduced counterparts on the HandSonic.
Edward A. It comes with three octaves as standard, and expan- sion models can be purchased that extend its range to four or five octaves. The pads are made of a soft foam-like material, and are intended to be played with marimba or vibraphone mallets.
This instrument has been useful in motor exercises such as those involving range of motion at the shoulder, elbow, and wrist. Like other MIDI triggers, it can produce any sound available from the sound source, providing a great deal of flex- ibility depending on the purpose of the therapeutic exercise.
The main difference, of course, is that passing air over a pressure-sensitive sensor and bite plate rather than striking a key or pad produces the sound. Most models allow for various fingering configurations that are customizable for individual client needs. However, the data are expressed in digital music parameters, not clinical language, so translating the musical data e. Where other systems utilize video-based sonification systems Lem and Paine, , the Soundbeam tracks the perturbation of a signal or beam generated by the device and sends it back to the sensor for sonification, via either MIDI or an available sound module.
Like other MIDI trigger devices, it sends data back to its own sound mod- ule or to a computer for conversion into audio output.
Similar to other MIDI instruments, the sound that is produced is based on the available sounds on the module, keyboard, or computer to which it is connected. As a person moves their whole body, individual body part, or even an instrument such as a drum stick or mallet through space, the sensor s track the movement and send spatial data back to the sound source for conversion and sound production.
This takes place at a speed that provides the experience of simultane- ous movement to sound reproduction. In the later stages of recovery of consciousness through an MSOT experience, the pa- tient can reconnect their physical behavior to the outside world with the auditory feedback provided as a result of their movement.
Because the sound is electronically produced, vol- ume levels can be adjusted to clinically appropriate levels, and harmonic structures can be electronically calibrated to include only desirable pitch combinations or sequences. This is an important clinical consideration that should be monitored closely by the therapist so that the client experi- ences success afforded by the device, but is continually challenged toward improvement by not using Soundbeam to overcompensate for deficits in movement.
The applications of Soundbeam to PSE expand beyond the following description, but have been primarily useful in the creation of the auditory cueing sequences used in PSE experiences. If connected to a computer, a therapist can record a movement sequence to later be practiced by the client, such as sit-to-stand exercises, and the spatial and temporal characteristics of the movement are captured by the Soundbeam sensors, which can later be used to produce the optimal auditory cueing sequences.
An important missing feature is the ability of Soundbeam to capture and reproduce force characteristics of a given move- ment sequence. This will have to be done via software manipulation so that the cueing of muscle contraction and release sequences is appropriately conveyed through dynamic expressions in the sound. Headphones can be used when ecologically required, and a headphone splitter can be utilized so that the client and therapist both hear the music simultaneously.
This is particularly helpful when a patient requires hands-on assistance for mobility, making it impossible for the neurologic music therapist to provide a live cue. Some apps pro- vide all three and other capabilities, so that the client can create a chord progression, add preloaded or acoustically recorded loops, and improvise by tapping instrument im- ages that then reproduce the appropriate related timbres. In addition to the facilitation of domain-specific goal attainment e.
As well as being a touch- activated synthesizer, it functions as a loop recorder in that multiple tracks that are 1, 2, 4, 8, or 16 beats long can be input and stacked on top of each other to produce a rich arrange- ment of grooves, beats, and effects. When functioning in this way it can be a useful tool in the compositional application of MEFT to aid the development of decision-making and organizational skills.
In a similar way to the Soundbeam, the Kaossilator can be a useful instrument in an MSOT exercise in that clients with extremely limited mobility, dexterity, and strength can manipulate the sound in satisfying ways with small finger movements across the touch pad.
Because of its motivational qualities for some patients, the Kaossila- tor may be an effective tool in compositional exercises aimed at mood modification within an MPC format. Although it has many functions with several creative applications, at its core GarageBand is music- sequencing software that includes hundreds of digital and pre-recorded audio loops, as well as serving as an on-board mixer and recording studio for live acoustic instruments. The client can be given or asked to provide a relevant theme or scenario on which to build their composition.
Directions to select appropriate musical representations of some aspect of their chosen theme or scene from the available loops which also include a series of sound effects require the client to exercise both abstract thinking and decision-making behavior.
Layering the different tracks and timbres on top of each other allows the practicing of sequencing and organizational skills, as the client is encouraged to consider and select those compositional features that best fit each other to represent their chosen compositional theme.
Live recordings of acoustic instruments and voice can be directly added as tracks into the composition. This is just one simple example, and the software provides for a wide range of complex features in a simple-to-learn format for recording, performance, and improvisational purposes. C, F7, Dm, G13b9 , selects from the hundreds of available style presets, and BIAB creates a stylistically congruent arrangement that typically includes piano, bass, drums, guitar, and strings or horns.
The quality of the arrangements has improved dramatically over the years, and the software now includes digitally recorded samples, which increases the qual- ity of the audio output as well. This is useful in performance and improvisational experiences.
One useful feature is the ability to save songs in MIDI. GarageBand for further editing, conversion to. This functionality is available in multiple applications. However, Ableton Live is particularly useful in that it allows you to embed a metronomic click on the strong beats to cue heel strikes using a tim- bre of your choice e. This is a scalable feature, so you can create music that is esthetically compatible with the client without sacrificing the necessary cueing for optimal motor synchronization.
In a gross simplification for the purposes of brevity, the most common approach involves the conversion of EEG signals into musical sequences based on the translation of mathematical representations of brain activity into some pre-determined musical analog as a form of auditory biofeedback.
The notion is that as the patient gains the ability to control some function or behavior e. Miranda et al. The patient was able to quickly understand and utilize the procedures toward the intended behavioral and musical outcomes.
Miranda and colleagues suggest that for patients who have acquired severe physical limitations as a result of damage to the central nervous system, this type of brain—music interface system could be employed to provide them with the ability to exer- cise control over their environment while engaging in active music-making experiences for cognitive and emotional rehabilitation. These researchers argue for the application of the system with the goal of increased socialization through simultaneous use of multiple units in a group format.
People who have experienced neurological damage or disease commonly show loss of emotional stability and sense of self. Benveniste et al. In both modalities, the patient—with assistance from a therapist—points the Wiimote hand-held remote at a television or video screen which controls a white dot that appears over a sequence of 8 or 12 preselected notes. When the patient clicks the Wiimote, it causes whichever note they are aiming at to sound.
Parameters of the task, audio output, and on-screen images allowed the participants to experience musical success, resulting in vivid and comprehensive recollections, which the participants experienced as motivating and socially connecting. As great progress has been made toward the useful adaptation and application of music technology in clinical scenarios, further refinement is required to avoid the need to com- promise clinical logic or esthetic quality in the delivery of therapeutic music interventions.
Ramsey has identified several salient issues in the development of music hardware and software to be used specifically in rehabilitation medicine. These issues are reflected in the description of instrument and software applications that differ from available MIDI and other electronic resources in that they are being developed for the specific purpose of motor rehabilitation therapy.
They appear to be in prototype stages of development, but a cursory review indicates the potential for promising results. Until such software and instruments are available commercially, music therapists will probably need to continue to modify and translate both MIDI hardware and software applications for purposeful use in the delivery of music therapy services.
While simultaneous enthusiasm and counter-indications exist for the use of music tech- nology in therapy and medicine Whitehead-Pleaux et al. As others have cautioned Magee et al. References Benveniste, S. Entertainment Computing, 3, — Lem, A. Dynamic sonification as a free music improvisation tool for physically disabled adults. Music and Medicine, 3, —8. Magee, W. Electronic technologies in clinical music therapy: a survey of practice and attitudes.
Technology and Disability, 18, — Music technology for health and well-being: the bridge between the arts and science. Music and Medicine, 3, —3. An exploratory study of the use of electronic music technologies in clinical music therapy. Nordic Journal of Music Therapy, 17, — Magee W L et al.
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