Strategies to enhance treatment fidelity and music-based intervention reporting in dementia research.

Creative solutions are needed to address the well-being of the growing number of individuals living with dementia. Music-based interventions (MBIs) are promising and can be cost-effective; however, empirical evidence for MBIs is limited and published findings have not been widely translated into practice. Here, we describe how we implemented strategies to enhance rigor in a randomized clinical trial of an MBI for persons with dementia. We examined the impact of a singing-based MBI on feelings, emotions, and social engagement, relative to a non-music treatment (verbal discussion), delivered in small group format (25 minutes, 3 times/week for 2 weeks). We implemented National Institutes of Health Behavior Change Consortium strategies regarding: (i) design, (ii) interventionist training, (iii) treatment delivery, (iv) treatment receipt, and (v) treatment skills enactment. We applied the MBI Reporting Criteria including: (i) theoretical framework, (ii) musical content, (iii) dosage, (iv) interventionist, (v) treatment fidelity, (vi) setting, and (vii) delivery unit. We analyzed data with a separate linear mixed model for each dependent variable. 32 older adults with dementia (65-97 years) participated. The MBI yielded significant positive effects on all measured outcomes (all p's < .05). Application of established guidelines enhanced methodological rigor and MBI reproducibility. To support translation of research into practice, clinicians should understand how to implement an MBI reported in research. Our study illustrates practical steps to address the need for improved MBI research in persons with dementia and can provide a model for others to enhance evidence-based practice with this population.

Music-based interventions (MBIs) can be very effective in improving the psychosocial well-being of persons with dementia. Nonetheless, scientific evidence to support the use and appropriate application of MBIs for this population is very limited and often not applied in care settings. Here, we describe how we used established guidelines to conduct a rigorous experiment of an MBI for persons with dementia in nursing homes. Specifically, we examined the impact of a live singing-based MBI on feelings, emotions, and social engagement, relative to a non-music treatment (verbal discussion). We implemented National Institutes of Health Behavior Change Consortium strategies regarding study design and implementation and the MBI Reporting Criteria to thoroughly describe implementation principles and components of the MBI. We learned that the MBI resulted in significant, positive effects on all measured outcomes. Application of established guidelines helped ensure that our study was rigorous and the MBI could be reproduced in practice. Clinicians should understand how to implement an MBI reported in research. Our study illustrates practical steps to appropriately describe an MBI and addresses the need for improved MBI research in persons with dementia. Our work provides a model for how such an approach could be used in other similar work.

Music Therapy Increases Social and Emotional Well-Being in Persons With Dementia: A Randomized Clinical Crossover Trial Comparing Singing to Verbal Discussion.

The number of people living with Alzheimer's disease and related dementias (ADRD) is growing proportional to our aging population. Although music-based interventions may offer meaningful support to these individuals, most music therapy research lacks well-matched comparison conditions and specific intervention focus, which limits evaluation of intervention effectiveness and possible mechanisms. Here, we report a randomized clinical crossover trial in which we examined the impact of a singing-based music therapy intervention on feelings, emotions, and social engagement in 32 care facility residents with ADRD (aged 65-97 years), relative to an analogous nonmusic condition (verbal discussion). Both conditions were informed by the Clinical Practice Model for Persons with Dementia and occurred in a small group format, three times per week for two weeks (six 25-minute sessions), with a two-week washout at crossover. We followed National Institutes of Health Behavior Change Consortium strategies to enhance methodological rigor. We predicted that music therapy would improve feelings, positive emotions, and social engagement, significantly more so than the comparison condition. We used a linear mixed model approach to analysis. In support of our hypotheses, the music therapy intervention yielded significant positive effects on feelings, emotions, and social engagement, particularly for those with moderate dementia. Our study contributes empirical support for the use of music therapy to improve psychosocial well-being in this population. Results also highlight the importance of considering patient characteristics in intervention design and offer practical implications for music selection and implementation within interventions for persons with ADRD.

Paula Lind Ayers: "song-physician" for troops with shell shock during World War I.

BACKGROUND: Little is known about the therapeutic uses of music during the First World War. This historical study provides a biography of Paula Lind Ayers (1891-1974), a vocalist, actress, and YMCA Entertainer who became known as "the girl who could sing away shell shock." OBJECTIVE: The purpose of this study is to describe Paula Lind Ayers' respite services during World War I and provide a contextual biography of her life. METHODS: The author conducted an exhaustive search regarding Paula Lind Ayers' life and her activities during World War I. Numerous databases were used to locate print sources. Libraries, archives, and organizations were consulted to obtain unpublished primary sources. The author evaluated materials via a recursive process that included corroborating evidence, assessing source reliability, and contextualizing information. Data were synthesized and analyzed for emergent themes. RESULTS: Findings suggest that Paula Lind Ayers developed a systematic approach using familiar, live singing that was effective in alleviating symptoms of shell shock. Her method was replicated by others overseas during World War I. After the war, she returned to a successful performance career until the Great Depression. No information was found about Ayers' life from the year 1929 until her death in 1974. CONCLUSIONS: Understanding Paula Lind Ayers' contribution to music therapy provides a deeper awareness of past therapeutic uses of music with soldiers who experienced shell shock. Such understanding helps shape the way we view the present conception of music therapy with veterans and how we might answer questions that will affect the future of the field.

History of music therapy treatment interventions for children with autism.

The purpose of this paper is to provide a systematic review of the history of music therapy research and treatment of children with autism. Understanding such history is important in order to improve clinical efficacy and inform future research. This paper includes a history of autism diagnosis, reviews strengths and limitations of music therapy practice with children with autism from 1940-2009, and suggests direction for future music therapy research and clinical practice with this population. Literature was limited to the English language and obtained with the following search terms: autism, autistic, (early) infantile autism, child, therapeutic music, musical therapy, and music therapy. Table of contents from music therapy journals were searched, and reference lists from obtained articles were perused for additional articles. This historical review focused primarily on journal articles, however, books and book chapters that appeared to hold particular historical significance were also included.