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Music Therapy for Premature and Newborn Infants

br2005_53Nocker-Ribaupierre, Monika (Ed.) (2005). Music Therapy for Premature and Newborn Infants. Gilsum, NH: Barcelona Publishers. 225 pages, ISBN 1-891278-20-7.

From the realm of MusicMedicine/Music therapy, which encompasses all relationships between human health and music (Lippin, 1992), has come this excellent and comprehensive book, edited by Monika Nocker-Ribaupierre, on the benefits of music and music therapy for premature and newborn infants and their families in Newborn Intensive Care Units. Seventeen international music therapists and other professionals contributed their approaches in research and clinical practice to this interdisciplinary book, which elaborates on different issues from medicine, developmental psychology, psychoanalysis, bonding research and music therapy.

The book is very well organized and is comprised of two parts. In the interest of brevity, rather than writing about each of the 12 chapters separately, I prefer to cite concisely from Nocker-Ribuapierre’s preface:

“The first part deals with the basic theories- current research on auditive development, the meaning of the mother’s voice from the onset of the prenatal life and attachment formation with these very low birth weight infants. The treatment concept, NIDCAP, which is also based on the infant’s development and the significance of the auditory system, leads to the second part of the book on music therapy. This presents an overview of individual music therapy approaches in research and clinical research with functional and psychotherapeutical aspects, using a wide palette of music and/or musical elements” (p. xiii).

The book begins with an excellent foreword by Mechthild Papousek about the preterm infant’s experiences as well as the family’s, and the strong impact of music as a non-verbal communication when it is used in early intervention programs in neonatal care. At the end of the book (rather than for each chapter), there is a rich and comprehensive bibliography and subject index, but no author index.

There is a balance, in my opinion, between theory, practice and research, between the different perspectives and the room given for each of them. Some of the chapters include case studies that are very interesting and present different perspectives of working with these infants and their families. Some of the cases are really touching e.g., the case of Sandra (p.151), Dylan (p.155), or that of Ms. R’s son (p.114).

This relatively small area of applying music therapy in neonatal care is rapidly growing. What is fascinating to see is that music therapy (as well as touch and baby massage), is especially well suited for these infants. The documented researches’ short and long-term results in this book speak for themselves, e.g., decrease of stress response, improvement of sleep, increase of oxygen levels and weight gain, faster growth of head circumference, decrease in length (3-5 days) of hospital stay, advanced motor and verbal development, etc. The mothers’ benefits are described as well, e.g., greater frequency of breast feeding, less emotional burden, more stability, etc.

The music therapy material throughout the book is relevant to clinical work as well as to research and includes: The rationale for developing a program, examples of referral and assessment forms, physiological and psychological effects of various forms of music therapy, practical ideas and techniques, the different roles of the music therapist, guidelines for implementing a program, therapeutic interventions and reflections of therapists.

Having related to the overall aspects of the book, I would like to turn to several issues that are more specific:

In the chapter written by Hanson Abromeit, she writes: “A more non traditional form of documentation is videotaping…these tapes provide a vivid description of the music therapy program and individual infant’s response during a session. They provide a visual documentation, offering another valuable tool to evaluate the music therapy program” (p.184). If one or more of these authors have done any videotaping, it is a pity that in our high tech. life, a DVD demonstrating clinical examples was not included along with the book. It could have been a wonderful addition to the written material. I am stressing this point because when it is possible, it also validates our work. It is exactly as if an art therapist was to present the clinical work without presenting examples of the artwork.

I found the writing style of all chapters clear and flowing, but there are many medical terms mentioned in some of the chapters. As an interdisciplinary book, which is directed to music therapists and to other professionals who do not necessarily have this specific medical knowledge, I would have expected that a glossary, in which terms are defined as clearly and simply as possible, would have been included at the end of the book. Such a glossary would make the material readily accessible instead of having to seek it out in a medical dictionary. Including such a glossary is becoming increasingly common nowadays.

As mentioned before, the book is comprised of chapters written by different authors. Therefore, the reader sometimes meets the same cited references in the literature reviews. Rather than considering these citations as redundant material, I consider them as valuable insights into what the authors find central to the issues at hand.

My last comment relates to a piece of information mentioned in the study of Nocker-Ribaupierre about auditive stimulation with the mother’s voice. She touches on the fact that only two mothers out of more than 200, were able to sing to their babies in such an extremely desolate situation (p.105). Especially for the music therapists, it would have been very interesting to read more about these mothers and their singing- maybe as separate case studies- because those two mothers presented such a unique experience (The other mothers chose to read something personal written for their babies or from a book, and recorded it for listening while they were absent).

In summary, the book provoked in me much thought about related topics, e.g., the non-auditory experience of the deaf fetus and its meaning for mother-child interaction later on in infancy; the complexity of working with families in general; the whole concept of intuitive parenting; the position of the father; death of a premature baby or of clients in general, as well as many other thoughts and insights.

As a music therapist, I feel I got deep theoretical and practical information from this book. The book succeeds in delivering the message of the importance of this work. This field has become increasingly important. I highly recommend the book to music therapists, to other professionals who work with these vulnerable babies and to colleagues from the other creative art therapies in general as well.

Reference

Spintge, R., & Droh. R. (Eds.) (1992). MusicMedicine. St. Louis, MO, USA: MMB Music, Inc.

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