Aimee Roylance, MT-BC

Aimee, a board certified music therapy, discusses the neurological benefits of music with Bethany and Brennan.

Transcript

Bethany Darragh  

Today on the podcast, we have Aimee Roylance who is a music therapist. Aimee,  to start off will you tell us a little bit about yourself and especially how you became a music therapist.

Aimee Roylance 

Sure, thank you for having me. I am a mom of three,  wife, and this is my second career. Music therapy is and interestingly, I was in the business world before, and I was at home with my kids doing a little bit of performing here and there because I have a music background, and a thought just came into my mind. That's really how it happened. And people can with their different belief systems can say that was a higher power, or manifesting good things in your life and you get great ideas, but I had this random idea. You should do music with your friend's daughter. And this happened for many weeks because in my head I thought I don't know how to do music with her. She was in a chair. She did not have the use of her arms or legs. She didn't speak at all, didn't have a way to communicate, didn’t have an AAC device. She was fed through a feeding tube. And I thought how would I do music with her? So that thought kept coming and I kept kind of pushing it away like oh, she's gonna think I'm crazy. And so one day I finally said, “hey, do you think I might be able to do some music with your daughter?” And she immediately said, “Yes, please. She loves music.” So that's how it started. I went to her house and I started singing with her. I bought my first instrument kit from Walmart, a wood kit in  a little box.  It had a shaker, a tambourine, it had a little drum and I would put the instruments in her hands and help her feel the beat and the rhythm and that went on Gosh, for a couple years really. And then her mom said her teacher at school wants to know if you might come into the classroom and do a little music with her special education class. And I said okay, sure, why not. So I started doing that. And eventually I realized someone else has to do this. There has to be more about this. And I'm kind of not reinventing the wheel here. People probably do music in special education classrooms all the time and I want to learn more about it. So I googled, and there was a thing called music therapy. And there were two schools in my state that offered a master's equivalency programs for music therapy. And that's how I got started.

Bethany Darragh 

That's awesome. So I've had the pleasure of working with Aimee and seeing this in action because we share a client together. So, I can picture exactly what this looks like. But can you kind of describe what music therapy looks like? Or how you go about planning, goal setting, things like that?

Aimee Roylance 

Yeah. When I think about explaining music therapy, I always like to let people know I of course don't own music. Everybody loves music. Most people love music. They use music in their lives. But music therapists are trained to use music to help people accomplish specific goals. So a music therapy session might look goodness there's so many ways because of the different populations in a school setting, which is where I have the pleasure of getting to work with you. I have IEP goals that I'm working on and so I will bring all sorts of instruments.  I have a Mary Poppins bag, which I know you've seen but it has all sorts of instruments, and I plan to try and help this child accomplish those IEP goals. And my tool is music.

Brennan Barber 

That's great. Thanks, Aimee. Can you describe some specific ways in which music therapy has helped children with maybe both developmental and or behavioral challenges? So I would assume, like sensory inputs for instance are really important when it comes to developing say like certain motor skills. How does it impact behavioral development as well?

Aimee Roylance 

That's a great question. Just even thinking about some of my sessions this week. I use music to help organize sometimes when we think about the brain. Music is a help in we listen to the music that goes into the auditory cortex. The motor cortex also is highlighted when we're listening to music even when we are thinking about playing music, research has shown that different parts of our brain will light up. So I try and harness that power to help kids organize their movements. So if I'm working with a child that needs to use their left arm, they have left arm weakness than maybe I'm going to use drums. And if we have a pattern that we're using, they can do right, left, right, left and the music is organizing, right. There's a tempo, there's a beat and the brain loves organization. So in music, if it's 3/4 or 4/4, we know every measure is going to be the same somewhat, and the brain can be primed for that next motion.  I have a couple kiddos coming to mind that really will come into a session and they have so many sensory needs and they're running around and there's a lot of input that they can get from all my instruments. I have xylophones. I have drums. I have a piano. And so one in particular that I guess could explain some behaviors. Let's say someone comes into my office and they go over to the big balance ball, and they're gonna roll back and forth. I might grab my guitar my ukulele and play some music that matches their rhythm. So first, I'm meeting them where they are. That validation of this is the rhythm in their body right now and I can meet them there. And then once I've met them in that moment, we can maybe build on that because their sensory need is met, right? So this week, I remember playing my ukulele and one of my little ones was rolling and then they started beating on the ball with their hand and this one has an AAC device is non-speaking and then they looked at me because they realized, Okay, wait a second. We're mashing together. And I wasn't after this person for running around my room or having a lot of energy. I just met him where he was. So once we got that system working, then he was a little more regulated. And then I started a song that had to do with different modes of transportation that go with different beats, so like helicopters. And then he was listening to the beats that I was giving and trying to get him to mimic them back to me with his mouth vocalizing with his hands or even rhythmically with his body. And so very quickly I was able to jump into the behavior that he had and use that to help him engage with me.

Brennan Barber 

So this is really fascinating Aimee and the description of the child that you mentioned at the beginning that got you into music therapy. It very much matches the profile of my son and he does use an AAC device and he's very into music and we had an appointment recently and his neurologist had asked if he's into music and what his interests are so we were chatting about that. But what's funny is we just started with a new aide that's with him, and she had brought up sort of independently, you know, Elliott, do you want to listen to music? And he said yes. And she made the assumption that it was going to be you know, more like, gokidod music. So she was, I'm gonna put on, you know, Baby shark or something like that, and asked him, What do you want to listen to? And she was very surprised that his choice was Sturgill Simpson and Radiohead had to explain to her that he spent a lot of time with adults so he tends to pick up on some of our tastes, but yeah, it was funny.

Aimee Roylance 

That's the one thing we learned in school very early on, because a lot of people might think music therapy as classical music or some specific type of music and truly it has to be patient or client preferred. So when I was in the NICU during my internship, and we might pair something down into a lullaby, it might have been something like Radiohead, but I might turn it more into lullaby. I did that with T-swift all the time. There would be kiddos in the PICU and parents would say that's their favorite music and I was watching their heart rate and their respiratory rate. So it matched the music to whatever their preferred music might be. I have goodness I'm trying to think of how old one of my clients is that loves heavy metal, so I've had to research heavy metal because that's just not a genre I know much about.

Bethany Darragh 

So explain a little bit of what the services look like as far as like one on one, groups.  I know you're in the schools, or do you also have a location people come to you for one on one sessions?

Aimee Roylance 

Yeah, I have. I have a private practice in Cary and office building where clients can come and work with our therapists there. And then we have contracts at different facilities. Music therapists work in lots of different populations. So that might be helpful if I throw that out there. Music therapists can be found in hospitals, they should be in every Children's Hospital really. They can be found in memory care units, so much research about memory in the brain and music. All the age range of kids from birth to teen at risk youth. Hospice was another area that a lot of music therapists work in because music can be very validating and so that physiological response is the breath pattern. Our hearing is the last thing to go is a lot of what the research says and so music can be a really powerful source at the end of life. So musicians who are trained in psychology and human development who go into music therapy work, really in the whole age range from birth to death. So those populations, you can find us in varying places, right. But I specifically do a lot of one on one work. I do a few groups. We have some early childhood intervention groups. We're starting in the fall which is really exciting. But the school based work that I do is based on children having music implemented on their IEP.

Brennan Barber 

You mentioned starting with some early intervention work, what will that look like?

Aimee Roylance 

The early intervention work when you think about a lot of the music groups that you might see advertised. Music is so important for our development, and that's for anyone's development. We talk about organization, right we talk about being able to teach language, languages taught from the time we're babies, we watch our parents speak to us. The mirror neurons watch facial expressions, and then that parentese which is very musical. When we talk to babies and animals too. I sometimes talk to my frenchie like that. That type of singsong language helps communication in the brain. It helps  the neurons to make connections. So I think a lot of our groups are going to be focused on helping with turn taking musical expression. Probably a little bit of call and response so we can work on their motor planning. Because that executive function in the brain of being able to move and stop takes a lot of thinking and when you're really motivated and want to play something it's hard to want to stop. But yeah, the early, early intervention classes are so exciting because they are little sponges and they soak up and love any type of music not just like you're saying baby music.

Bethany Darragh 

Yeah, and I think that goes along with what you were saying earlier about how rhythm and neuroplasticity or how the brain changes and grows, how they work together. And I would love to hear you talk about that some more. I think all therapists, I think, I hope know this, but you know if you are using rhythm, and then you're preparing the brain for what's next you are going to build those pathways faster because the brain is following and can but I would love to hear more from your point of view. 

Aimee Roylance 

Absolutely. So I find it so interesting, the brain research that they are doing now because of our love of music so I think it was the National Institute of Health, put Renee Fleming in a functional MRI machine and had her sing and she was a famous opera singer for anyone who doesn't know who she is. And they wanted to watch which areas of the brain lit up when she was singing, thinking about singing. And they found it really interesting that some areas of the brain lit up more when she just imagined she was singing. And so when we are thinking about skills that we're teaching, maybe a child is thinking about doing what we're asking them to do. And that is lighting up in their brain, right. And then there's a power to then actually do the function that we're asking him to do which an OT right, we're using a lot of fine motor. So I love that when we think about music and helping with these goals that we have in pediatric therapies. When you use music, we are using lots of different areas of the brain. So they found that the motor cortex, of course, that lights up when we dance, when we play, when we imagine things we have lots of communication areas, Broca's and Wernicke’s, the auditory cortex of course. So using music really helps so many parts of the brain. And that's why one area of population I didn't mention was rehab work. Music therapists also work in rehab, because there's so much research that talks about how when we are trying to help someone walk, right, we're making the the gait pattern, start again in their body, the music prime's their motor system to then make a movement and because it's organized in the beat and the rhythm like you were talking about is there. Their body then is preparing to make that motion with their body.

Bethany Darragh 

Yeah, I totally agree. I've used music as a tool in my occupational therapy with Parkinson's patients, dementia, CP, autism, you know, because primitive reflexes I mean, all of it because it just kind of prepares the brain, lays the groundwork, you know, and you can grow on that or you can help with you know, especially with Parkinson's when they get frozen, you know, let's dance they get really upset about this is happening to me I can see myself frozen. And there was one patient in particular that I would say, well, let's dance. And then as soon as I turn on the music, and we started dancing, he was walking down the hall again.  I use music as a tool for my therapy because I find it amplifies my outcomes every time so and even if it's just as simple as having my if I'm not feeling creative, having my metronome. I have a metronome app on my phone and I'll pull that thing out all the time. And I'll say, okay, you can do this, but can you do it at this beat? Can we change it slower? Can we change it faster? And it helps so much. 

Aimee Roylance 

There’s brain research that you are doing exactly what they are researching, and a lot of neuroscience right now is the metronome. That beat is so powerful, and when it comes to the motivation, which is also so highly embedded in music because people enjoy music. That repetition then is built in, right, we have something consistent and repetitive because after time, we kind of get bored or tired of doing something over and over. So I love when other therapists tell me how they use music and use it in ways to help their clients because music is so fun and so powerful.

Brennan Barber 

You talked a little bit too about language development in speech. And I'm just curious if you've noticed any correlations with say maybe the demand for music therapy for speech and language improvement, just following COVID because one of the things anecdotally that I've heard, and it was that as during that period when you know, for good reason a lot of people were wearing masks to stay safe. That by covering the mouth children were having a harder time actually, you know, seeing some of the the motor skills, the motor movements that were needed for certain language patterns, and I wasn't sure if that was something that you saw as well over time that there was maybe a greater need coming out of that period.

Aimee Roylance 

You know, it's interesting because my practice started in 2020. And so it was right during COVID I moved to North Carolina the week the world shut down. So motor and communication is so highly connected. That's why a lot of music therapists during COVID were trying to find the masks that had the clear view because of how important it is to be able to watch visually. And I do find a lot of clients reaching out to me want to work on communication. And I think part of that is because when you have a hard time communicating, you have a hard time connecting, right and we have that basic desire of wanting to connect with one another. And I have seen music be used as a voice in so many of the kids that I've worked with. I've seen a xylophone be used as a child's voice who had extreme anxiety and didn't want to talk about anything. And so I would back and forth model with them, mirror. First I modeled and showed I can play the xylophone and then let them have a turn and then they would play and then they realized that I would mimic and mirror what they were doing. And so we started having a conversation call and response through a xylophone and it was allowing this child to communicate with me and gain a little more confidence and trust in me to then maybe use her spoken voice. I've seen a piano definitely be used as a voice for another child who's non speaking and hasn't quite learned how to use their AAC device. It's more stressful for them and so they will use the piano and put my hands on it. And I'll play and we'll play and dance together. And then there's a button on one of my pianos that does the synchronized ending. And they laugh and it does this grand ending and I stop and I say ,oh my goodness, you stopped our music and this communication goes back and forth. So, I think building that bridge for those kids who don't have any communication to them, those who do have spoken language, who can vocalize and maybe they're working on certain vowels. Then we can do songs that they know and they can do fill in the blank, but doesn't fill in the blank doesn't always work for the Gestalt language processors because phrases are better for them, that I'm learning now and trying to change some of my songs that I've written that have a lot of fill in the blank, but then their body can prime to then say something through the music.

Brennan Barber

Aimee, can you tell us a little bit about just generally speaking, what success looks like with music therapy and what kind of improvement you see and how you measure that?

Aimee Roylance 

I was talking about this in an IEP meeting the other day, because one of the teachers said, Well, I don't want to sing, I'm afraid to sing. I don't have a good voice. So I want you to do the singing. But what if the skills you're working on doesn't really transfer to my classroom? And it's a really fair question and a good point because if what we're doing in a session doesn't have transferability into their real life, then I am no help. It's really fun to make music with someone. But I also I'm there to support you know, my client in their wellness and their real world, not just in this session with me. So we try to quantify data. Absolutely. That's one thing we try and do absolutely in the school district. With if we give them eight opportunities to do something, then maybe they do it six times, right. If there's an academic goal, it's harder when we have more subjective goals like how someone feels or if they are really inflexible, and they are rigid. And then I see this growth in them exploring an instrument. And that's sometimes hard for me to write in a progress note, right. And for a parent to understand that I've seen such growth in their creativity and their expression, which I think in turn helps them in their real life. So we definitely measure progress through the goals. We start with a goal and we work on the goal, and then we try and measure it. Music is sometimes subjective, right? It's a hard thing. And the more that I've been in practice, the more I'm trying to find ways and talk with other music therapists too. Sometimes we use scales right, just like any other therapists to start and have a baseline and then see if we can improve on it. But increased engagement is one I feel right now is a huge part of my job. If they will increase in their engagement with me and that level of trust can begin then I can really work on a lot of these other goals that maybe I can measure easier. But the quantifiable data is always great. To have and then also the qualitative so having to learn a little research in grad school helped me understand they both are important, and we do try and find both and music therapy.

Bethany Darragh

That makes me think of, I was teaching a parent how to help their kids learn how to clap, like a one year old baby.  You know you are modeling clapping and they just look at you.  If you sing Happy and You know it and you clap and then the second time you sing it you act like you are going to clap, but you don’t, those babies are going to make you clap your hands. I’ll show you, you do like this.  It works almost every time.  It trains them with the anticipation, I am confident I know what goes here.  Music gives them so much confidence and helps them feel confident to do what’s next.  I bet a bunch of parents are looking up music therapy near them right now.  I bet there are also some musicians that are interested in doing this.  

Aimee Roylance

I had a music background but I did not have a degree in music.  All board certified music therapists has passed the board certification test, gone to school for a 4 year degree or an equivalency degree and they have 2500 clinical hours, they work with a supervisor, they work in different populations.  The hard part is not every state recognizes music therapy as a profession that is protected.  

Bethany Darragh 

Before we sign off, we want to make a quick update on the Theralinq app.  We are currently in our second beta trial and plan to have a product in the app store in the fall.  If you are a parent that wants activities and exercises to enhance your child’s motor development, this app is for you.  If you are a pediatric therapist this app is for you. To stay in the know about Theralinq app, drop your email on our website, at theralinq.com, that’s t-h-e-r-a-l-i-n-q.com.