For some children on the autistic spectrum, music's clearly defined rules can improve social ability better than any standard treatment.
Jeremy raced into the room, his bare feet stomping on the carpeted floor. His wavy brown hair flopped around as he made a beeline for the brown piano at the center of the music therapy room at the Rebecca School in Manhattan, a school for children with neurodevelopmental disorders. Jeremy is 13, but with his toothy grin, reddened cheeks and flat pudgy nose, he looks eight. As he began to play on the piano, two notes at a time, Jesse Asch, an intern at the school, picked up a guitar and strummed along with him.
For the last four years, Jeremy, whose name has been changed to respect his family’s privacy, has been attending the school for music therapy - broadly defined as the clinical use of music for treatment of people with mental, physical or emotional issues. Jeremy was born without a corpus callosum - the flat bundle of cells that connects the left and right sides of the brain, facilitating communication between the two hemispheres. He has minimal speaking skills, said Dr. Gil Tippy, the Rebecca School's clinical director, but it's made up for by a penchant for music.
The term "music therapy" first appeared in The Columbia Magazine back in 1789, but it wasn't until the 1940s that music therapy began to emerge as a clinical profession when hospitals used music to treat World War II soldiers suffering from shell shock. Using music as a therapeutic medium has been shown to facilitate motivation, communication skills and social interaction, and it improves attention spans among children with autism.
Jeremy hasn't been diagnosed with autism, though he exhibits most of the criteria associated with the disorder, said Tippy. While any child on the autism spectrum can benefit from music therapy, the Rebecca School focuses mostly on students like Jeremy. "They actually get the toughest kids at the school because they have the most difficulty with speech and language," he said.
Developmental milestones such as walking, talking and reading are typically delayed for children lacking the vital connection between the brain's hemispheres. When Jeremy first arrived at the Manhattan-based school, Stacey Hensel, his music therapist, said he would walk around with his back bent and his arms positioned awkwardly by his sides, a trait he has overcome in the last four years.
In his music therapy session, Jeremy switched from his piano to a percussion set, moving swiftly between drums and cymbals. Asch accompanied him on the guitar at a languid pace, trying to slow Jeremy down. Oblivious to Asch's bluesy guitar tune, the child continued his rapid drum solo.
This is called "regulation," Hensel explained. "We slow down the music when we want him to slow down." It teaches him to respond to outside cues.
Gradually, Jeremy fell in sync with Asch. Having abandoned the drumsticks, he positioned his foot on the pedal of the bass drum and watched Asch on the guitar. Jeremy pounded once on the drums and waited for a response. When Asch strummed with equal fervor, Jeremy pedaled the drum once more. It was the first time during the session that Jeremy had responded to a musical idea that wasn't his own, letting someone else step into his world of rhythm and beat.
Jeremy's case is rare, but the Rebecca School also helps children deal with more common neurodevelopmental disorders like autism and Asperger's syndrome, using a kind of therapy called the Developmental, Individual-Difference, Relationship-Based model (DIR) -- more popularly known as "Floortime." Floortime involves meeting children at their current developmental level and building upon a particular set of strengths. Tippy said that with the combination of music therapy and the DIR model's emphasis on interaction, Jeremy relates to more people around him. Now, when Jeremy gets in the elevator, he says "hi" to people.
"He never used to do that," said Tippy. "We're rewiring these kids brains so they begin to pay attention to the notion of relationships."
Individuals with ASD often find it challenging to maneuver social situations. That's because they tend to focus on details, which restricts their ability to understand implicit social cues, said Andrew Gerber, an assistant professor of clinical psychiatry in the Division of Child and Adolescent Psychiatry at Columbia Medical Center. That explains why music is often more appealing: the rules are better defined. "One of the real advantages of using music for a kid with autism is that it's a chance to be able to teach him rules that are knowable," said Gerber. "They can feel like they've mastered something. It makes sense to them."
Jeremy found his calling in percussion. At the age of 2, his mother, Julie, whose name has also been changed, noticed him drumming on almost any object around the house. While he would often do it out of anxiety, his beat was always rhythmic, she said. "It became a source of pride for him because people would respond to it," she added. At 6, Jeremy was enrolled at the Nordoff-Robbins Center for Music Therapy at New York University, where he remained for two years. She later enrolled him at the Rebecca School, one of the few DIR-based schools in New York.
But along with attending therapeutic DIR-model schools, Jeremy has undergone biomedical intervention for years, Julie said. Increased cholesterol intake has improved his posture, she said, even though he still hunches sometimes.
Just back from school, Jeremy darted around his house, a spacious Chelsea loft where he lives with his mother and his sister Zoe, 15. A pair of white earphones dangled from Jeremy's ears, connected to a matchbox-sized iPod. In spite of his poor fine-motor skills and thumbs that are slightly longer and lower-set than usual, Jeremy swiped deftly through the list of songs on the device's tiny screen.
"It's his favorite thing in the whole wide world," said Julie, who recently noticed her son listening to the sultry rhythm of Bob Dylan and Jerry Joseph. "Thank God!" she added. "It's better than Chris Brown."
For his 13th birthday, she bought him a bright blue drum set. Along the wall, five other drums are lined up -- two tablas, an Indian hand drum, a children's one made of plastic and two African cylindrical drums. A guitar lay on a side-table, unnoticed.
Seated on an ottoman, two brushes in one hand and a drumstick in the other, Jeremy began to play. As he drummed a beat, Julie danced, waving her arms and stomping her feet to his rhythm.
"In music, he functions at a higher level," she said.