Making Real Music

For a variety of reasons, some of my music therapy friends find it particularly challenging to make their own music or to participate actively in group music experiences. These individuals – from toddlers to octogenarians – have significant physical or cognitive limitations or other issues resulting in minimal ability to sing, play instruments, engage in group experiences, listen actively, and/or interact with other people. One focus in my music therapy sessions in this case is to make music more accessible, giving each individual opportunities to take an active part in the music making. Granted, sometimes the “active” participation may be very minimal and individuals may need a great deal of assistance, but what a thrill when their efforts result in bona fide music!

When planning effective music therapy sessions for my friends with significant limitations of various types, I take many factors into consideration. For example, I am careful to, among other things, select appropriate instruments for the person’s interests and abilities, to consider positioning and logistical issues, to build on their strengths, and to design strategies to compensate for more challenging areas. Many other factors must be reviewed in planning for these folks, but, for this discussion, I am focusing just on the good ol’ music therapy standard, that of customizing music arrangements.

Strategy #1. Cue Up the Music

Lots of great songs out there allow our friends to make a significant contribution to the ensemble by simply holding a mallet or using their hand to tap a drum or other percussion instrument on specific musical cues during the song. For example, tap on the words“Hurrah, Hurrah” in “Johnny Comes Marching Home” or tap at the appropriate time in the old standard “Happy & You Know It” with adapted lyrics, e.g., “If your name is Sherrie, make some music (tap, tap).” Some of my MT friends seem to enjoy the anticipation of resting while waiting for their musical cues as much as they like booming the drum or tapping the tambourine or dinging a bell. Other standard favorites with noticeable music cues are:
> playing during the “boom-dee-ah-dah” section of the old camp song I Love the Mountains.
> playing on the numbers one, five, and nine in the Elvis classic, Rock Around the Clock
> playing on “boom, boom, boom” for Ants Go Marching In
> playing on “uh, huh” phrase of Frog Went a’Courting

Note: Don’t get bogged down with my choices of overused MT songs. The possibilities for specific cues in songs are endless across all styles and generations of music, so let your imagination go wild.

Strategy #2. Johnny One-Chord

The title of this section adapted from Johnny One Note by Richard Rodgers & Lorenz Hart for 1937 musical, Babes in Arms.

Many of my music therapy friends seem to enjoy strumming an open-tuned guitar, electric guitar, harp, autoharp, banjo, mandolin, or other stringed instruments when the instruments are positioned in a way that makes the strings accessible. Some use their fingers to strum lightly, or use a soft mallet to tap, or use a soft kitchen spatula as an oversized pick. Notice the key word in the first sentence: “open-tuned.” I usually tune stringed instruments to C Major since it fits well with resonator bells, handbells, boom whackers, and other easy-to-play tuned instruments. I’ve even had MT friends with significant limitations play open-tuned violins. Can’t wait until I have the budget to purchase a cello for music therapy :-)

So, how do we make music with these open-tuned, one-chord instruments? Using some of my friend’s favorite songs, I start the song out with the standard melody, but improvise the melody of the rest of the song to blend with that one chord. And we simply rest during the bridge or when particularly notable parts of the song’s melody doesn’t fit well with the one chord, then start strumming or playing again when the melody moves back to tonic.

This open-tuning strategy works particularly well in group music therapy sessions, allowing a participant who has very limited abilities to play the open tuned electric guitar or another very cool instrument in an ensemble with his more able peers.

Strategy #3. Takin’ Turns Boogie

This is another strategy where the anticipation – i.e., the rest – section of the music seems to bring as much enjoyment as playing the instrument. Using any instrument accessible to my music therapy friend, I start out singing and playing a 4-measure phrase while they wait their turn. I usually use scat, but sometimes lyrics. Then, when my short section is finished, they make music while I rest. They might echo my section or play/sing something new. We keep trading off for eight or more sections. In the last segment, I bring the song to a close.

For a variety of reasons, many of my MT friends with significant limitations are not able and/or willing to sing in their sections, but they sure seem to enjoy playing their “own kind of music” on their choice of instruments during their own section while I sing or scat. Interestingly, even individuals who have very limited cognitive or motor skills are able to create some interesting musical phrases, and might play rhythmically rather than randomly.

Check Out This MT Toolbox

Our popular self-study “Severe Disabilities Toolbox: Accessible Music for People with Significant Limitations” e-course at provides a boatload of additional ideas for expanding horizons and maximizing potential. The e-course consistently receives high ratings from MT professionals, and it helps participants recognize the expanse of options available for helping people enjoy making their own music, thereby enhancing the quality of life for individuals with significant disabilities and those around them.

As the subtitle “Accessible Music for People with Significant Limitations” implies, this e-course encourages music therapists to explore the fine art of designing music experiences to specifically meet the needs of the individuals with severe disabilities. By making music more accessible, we can make a real difference in the lives of our clients and students week to week, giving them opportunities to take an active part in making music and to gain maximum benefit from their music therapy sessions. Details here