Assistant Professor Andrea Cevasco brings music -- her voice and a guitar -- to neonatal intensive care units. It's part of her teaching the music therapy discipline to University of Alabama undergraduates.
Live singing can increase the oxygen uptake and slow the heartbeats of medicine's tiniest patients, and studies show that it may help the babies leave the hospital two to nine days earlier than neonates who don't get music therapy. This is just one of the areas where music therapy can help patients and their families.
"We start with little bitty babies, born after 28 weeks' gestation," said Cevasco. "We sing simple songs, like 'Frere Jacques,' 'Itsy Bitsy Spider,' 'Down by the Station.' We play very simple guitar, at 60 beats per minute.
"We can, over a matter of 15 minutes, watch their oxygen levels increase and heart rates go down," she said.
Music therapy -- recognized as a formal discipline in the United States for 60 years -- has a wider role in the health-care setting than just helping babies. It lends physical, spiritual and emotional comfort to a wide variety of patients and their families.
Examples at UAB Hospital -- which has four board-certified music therapists, all of them trained at the University of Alabama -- include:
• The Palliative and Comfort Care Unit, where a music therapist like Libby Stephens will play a patient's choice of music at the bedside. She can also help patients and families write songs that help to leave a legacy or express anticipatory grief.
• For patients in acute care who are recovering from surgery, waiting for an organ transplant, healing from trauma or burns or facing illness, live music helps reduce anxiety, depression and perceived pain.
• Music can help adult psychiatry patients learn coping skills. Analysis of the lyrics of a song can help patients explore and express their feelings.
Adolescent psychiatry patients can use music games, analysis of lyrics and instrument playing to explore their own feelings and learn how to interact appropriately with peers. Music may help adolescents build trust, leading to a relationship that can facilitate counseling.
In geriatric psychiatry, music can enhance memories and make it easier for patients to move or express themselves.
Stephens said the UAB Hospital music therapists also are involved in spinal cord injury education, teaching patients skills to help them cope with a new way of life. In the neonatal units, the music therapy can help parents bond with their children.
Lyric analysis may help alcoholics, said Carol Prickett, who started the music therapy program at the University of Alabama in 1985 and heads it today. About 30 students are enrolled in the 4½-year major that includes six months of internship work.
Many country music songs show the consequences of misusing alcohol, said Prickett, and the music therapist can go through the song line by line with the patient to help control behavior.
Students need to learn a wide range of music, including tunes they may never have heard before. Older patients, for instance, respond to music from the early 1900s to the 1950s, yet few college students have "Five Foot Two, Eyes of Blue" or "Let Me Call You Sweetheart" on their iPods.
"It's different from musical performance or music as entertainment," Prickett said. "We use music as a therapeutic tool for non-musical objectives in a health-care setting. ... We have to know a lot of different kinds of music and many different aspects of music."
The University of Alabama students are accompanied by Cevasco when they do clinical rotations in psychiatry, hospice, neonatal intensive care and cancer centers. Prickett goes with them to treat dementia patients.
Above all, the students need to learn to respond to the reactions of patients.
"We watch very carefully every response," said Prickett. "We teach students all of the many nuances, so they can make quick changes. ... We coach them to be sympathetic."
Cevasco offered an example of careful watching for reactions.
With neonates of 34 weeks gestation or older, students learn to give multiple stimulation that helps neurological development, such as simultaneously holding the infant, singing and doing a 10-step massage from the head down, she said. "We always watch monitors and outward behavior," Cevasco said. "With one baby, I saw the tongue go out, his eyes clench, his fingers stretch out. He was getting stressed.
"We had to start all over again."
Cevasco also has students working with children who have autism spectrum disorders. Anything that helps socialization is good for children with autism -- sitting in a group, the therapist singing a child's name and making eye contact, the therapist singing a question and getting an answer sung back by a child.
Student Kiemel Lamb, for example, worked to get a group of children with autism to play violins together.
"Parents couldn't believe the results," she said. "They saw a child hold a violin for 45 seconds when she was averse to even being touched."
Stephens said that one patient that stood out for her at UAB Hospital was a 9-year-old girl awaiting a heart transplant for six months.
"I started working with her the first week she came there," Stephens said. The first session I played songs and she played along on the drums. Once she warmed up to me, we started joking around, changing up lyrics to familiar songs."
Then the 9-year-old worked on writing songs to share her feelings about being sick and in the hospital -- songs about the summer vacation she missed, hospital songs, silly songs, songs to thank staff.
Eventually, Stephens said, the girl wrote a song to thank the donor who gave her a new heart, and a new life.
The photo caption above was changed at 12:20 p.m. on Thursday, April 7, 2011, to correct the location.
Join the conversation by clicking to comment or email Hansen at email@example.com.