St. Louis Children's Hospital Makes Music Therapy Available to Tiniest Patients

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Music therapist works with infants in the Newborn Intensive Care Unit.

Occupational and music therapists co-treat patients like Jayce Skobel

Occupational and music therapists co-treat patients like Jayce Skobel

Music has a cool way of working around frayed ends in the brain and either rebuilding old pathways or creating new ones.

On the door of Jayce Skobel’s door in the Newborn Intensive Care Unit (NICU) at St. Louis Children’s Hospital hangs a sign that reads, “Limited stimulation.”

Jayce was born October 21, 2013, weighing 1 pound, 2.5 ounces. Months later, he remains a very fragile, often anxious baby, who relies heavily on machines and medicine. But recently, his medical team introduced a different type of therapy to his routine: music.

Once a week, music therapist Christy Merrell stands by Jayce’s bed, and strums the guitar. Jayce’s mother, Amanda Hefner, notices a nearly immediate change.

“When the music starts, he becomes calmer,” she says. “I can feel him relaxing in my arms. He’s definitely a more comfortable baby.”

While Amanda looks at Jayce, Christy watches the monitors above his bed.

“Look at that,” Christy says, nodding toward the blinking numbers.

To the tune of “Twinkle, Twinkle, Little Star” they begin to change. His oxygen level goes up, his heart rate goes down, and the once fidgety Jayce opens his eyes.

See video of Christy singing “Twinkle, Twinkle” to Jayce during a music therapy session.

Christy has been seeing patients in the NICU for the last couple of years, and has observed the many benefits.

“Their faces change when I start to play. Their heart rates come down almost immediately. No doubt, it’s serving a purpose.”

Until recently, distractions like a guitar were frowned upon in the NICU. Clinicians feared such stimulus would prove detrimental to the healing process of such fragile patients. But then, studies started confirming benefits. Bouts of inconsolable crying would happen less frequently and wouldn’t last as long in babies receiving music intervention. And just like with Jayce, the children studied showed improved heart, respiration and oxygen rates. But the results go beyond what the monitors show.

Chris Smyser, MD, is a neurologist who works with pre-term infants.

“We are limited in what we can know about an infant’s brain. But the advantage we have in working with these pre-term babies is that their brains are still very malleable, and the interventions we offer can significantly influence outcomes,” Dr. Smyser says. “We have to rely on these infants to communicate what they need without the advantage of words. Their actions during therapy – where they gaze, how they sit, their responses to stimuli like music – inform not only what interventions we offer now, but those we will prescribe years down the road.”

In the last several months, referrals for music therapy in the NICU have increased. Christy now spends every Thursday morning working in the unit. While she only occasionally sees the most premature patients, children with other extenuating circumstances frequently make her way to her roster: children born with birth defects and those to mothers addicted to drugs – now experiencing withdrawal symptoms. She co-treats with occupational and physical therapists, helping those children reach developmental milestones with greater ease while minimizing pain.

See how the song “Wheels on the Bus” helps therapists track Jayce’s gaze.

“Music has a cool way of working around frayed ends in the brain and either rebuilding old pathways or creating new ones,” Merrell says.

She theorizes that the repetitive nature of music therapy expedites recovery and spurs development.

“We’ve seen these children sing songs they’ve heard over and over before they speak. I can’t explain it, but they’re learning language through music.”

The other day, she ran into one of her very first NICU patients. The little girl is now 5 years old, and was running ahead of her mother in the halls of St. Louis Children’s Hospital. Christy didn’t recognize her, but the child’s mother recognized Christy.

“This little girl is doing so well – and her mom says she still has the baby maraca I gave her as her introduction to the band!”

Jayce also has his maraca. And on June 25, as his mother packed up the items they had collected over nearly nine months in the NICU, she was sure to tuck that maraca safely in their luggage. She was going to need it once she and Jayce arrived home, where she says music will remain a part of their routine.

“We’re cherishing every moment we have with him. And music is now something we can enjoy together. It always will be.”

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Abby Wuellner
St. Louis Children's Hospital
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