Child Development Disorders, Specific Clinical Trial
Official title:
Feasibility Study: Improvised Music to Enhance the Effectiveness of Intensive Interaction in Developing Interpersonal Communication of Profoundly Intellectually Disabled Children and Young People
The project will investigate the effectiveness of a specialised musical-clinical approach
used as an adjunct to an established non-musical intervention in the enhancement of
interpersonal interaction.
6 school pupils with profound disability will be randomly allocated to experimental and
control groups. The control group will receive only Intensive Interaction for 16 sessions.
The experimental group will receive four sessions of Intensive Interaction, followed by
twelve sessions of Intensive Interaction plus improvised music. Music therapists will follow
a flexible manual written to ensure that their music supports the interaction between pupil
and learning support assistant (LSA) without direct social interaction with either.
Changes in capacity for interpersonal interaction will be assessed by a standardised
assessment instrument, the Pre-Verbal Communication Schedule (PVCS), administered to both
experimental and control groups before the 1st session and after the 16th session.
There will also be a qualitative process study of the experimental group conducted by video
observation by the researchers involved.
The project is funded in equal shares by the Music Therapy Charity and Beacon Hill Academy.
This is a small feasibility study to be conducted at a single research site, a special school
for sensory and physical needs. The study is intended both to trial the research methodology
and to estimate the effect size likely to be found if a larger study were carried out.
Intensive Interaction is a form of behavioural intervention developed by Nind and Hewett and
extensively practised in schools and other institutions caring for people with profound
intellectual disability who require special support in order to develop (non-verbal)
interpersonal communication. Whilst the term Intensive Interaction can describe the attitude
and behavioural style of staff throughout their contact with subjects, it can also, as in
this study, refer to specific scheduled times in which the approach is adopted by staff with
individual pupils or service users.
The subjects of this study are among those for whom Intensive Interaction is most beneficial,
as assessed by the speech and language therapist at the research site. As these pupils would
normally receive this intervention on account of their assessed needs, Intensive Interaction
is designated the 'active comparator' (otherwise known as 'treatment as usual').
Since in the experimental condition two staff support each subject simultaneously, there is a
need to distinguish effects attributable to the additional music from those attributable to
the behaviour of the primary interactors. By treating Intensive Interaction as the active
comparator it is hoped any effects of added music may be isolated.
Improvised music is in this study being trialed as an adjunctive therapy to Intensive
Interaction. Previous research suggests that music improvised music therapist can under
certain conditions facilitate the development of interpersonal interaction between subject
and support worker. To replicate the conditions under which the previous study found this to
be the case, the musical intervention has been manualised to guide the 2 music therapists who
will provide the improvised supportive music. They will add music from session 5 of a total
of 16, having observed the progress of Intensive Interaction without music during the first 4
sessions in order to make a detailed assessment of needs and how music might meet them.
A standardised assessment instrument, the Pre-Verbal Communication Schedule (PVCS), will be
administered before each subject's first session of Intensive Interaction, and again after
her/his 16th session to obtain a global view of non-verbal communicative behaviour. Pre- and
post-test scores will be compared. The theoretical basis of both Intensive Interaction and
the specific use of adjunctive improvised music is primarily affective, but it is important
that any benefits should also be detectable in functional terms, hence the choice of PVCS
rather than a more affectively orientated measure.
Additionally, qualitative data on the therapeutic process will be extracted from post-session
notes and observations of video recordings of the sessions by those involved in the work with
each participant.
Should the effectiveness of the specialised musical-clinical approach be supported by the
results, a larger study could then establish the approach as an additional psycho-social
resource for developing the interpersonal interaction skills of those with profound
intellectual disability. The approach requires a modest level of additional training for a
registered music therapist, but no additional qualification.
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