Melbourne Conservatorium of Music - Theses
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ItemMusic therapy for a 10-year old child experiencing agitation during posttraumatic amnesia: an intrinsic mixed methods case study( 2010)A mixed methods case study was developed to explore the use of music therapy for children, aged 2-14 years, experiencing agitation during the posttraumatic amnesia phase of recovery following severe traumatic brain injury. The study developed pragmatically within a real world research context, and was undertaken in the Children’s Neuroscience Centre at The Royal Children’s Hospital Melbourne (Australia). The collection of qualitative data was embedded in a quantitative protocol, and data was collected concurrently. During the recruitment phase of the study, only one participant met the full eligibility criteria. The study subsequently evolved as an intrinsic case study. Data collection took place every day (excluding weekends) for the first ten days of posttraumatic amnesia. Data collection included the participant being video recorded pre, during, and post each daily music therapy intervention. The music therapy intervention involved the music therapist-researcher singing familiar songs. The aim of the quantitative data collection and analysis was to measure the effect of music therapy on agitation, and included two independent reviewers viewing the video data and rating the participant’s agitation pre, during, and post each music therapy intervention using the Agitated Behavior Scale (Corrigan, 1989). These ratings were then analysed statistically. The analysis of qualitative data aimed to explore the responses of both the participant and the music therapist-researcher during the music therapy interventions, and was an emergent process undertaken using Morse and Pooler’s (2002) tri-tiered method of analysis for videotaped data. The participant (a 10-year old girl) sustained an extremely severe traumatic brain injury as a result of a transport accident. Severe cognitive impairments and a significantly reduced level of consciousness resulted in the participant presenting with only Islands of Awareness during the music therapy interventions. Analysis of the quantitative data yielded inconclusive results as to the effect of music therapy in reducing agitation during and post each music therapy intervention. Micro-description and analysis of the qualitative data revealed that the participant displayed four distinct categories of behaviours during the music therapy interventions: Neutral, Acceptance, Recruitment and Rejection. The final three categories of participant behaviours were responses to the familiar songs. Further, the music therapist-researcher responded to the participant’s behaviours in four distinct, corresponding ways; Holding, Affirming, Enticing, and Containing. The interpretation of these categories of behaviours and responses was that through offering a consistent musical holding for the participant’s behaviours, and adaptation of the familiar songs in a contingent manner in response to the participant, the music therapist-researcher offered an Environment of Potential to maximise the participant’s Islands of Awareness. The Environment of Potential maximised early stimulation to optimise the participant’s early recovery of consciousness and cognitive abilities.