Music as a Form of Therapy in the K-4 Special Education Classroom: A Phenomenological Study

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Music as a Form of Therapy in the K-4 Special Education Music as a Form of Therapy in the K-4 Special Education

Classroom: A Phenomenological Study Classroom: A Phenomenological Study

Roger Hattaway

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Music as a Form of Therapy in the K-4 Special Education Classroom: A

Phenomenological Study

A Dissertation by

Roger B. Hattaway

University of Massachusetts Global

Irvine, California

School of Education

Submitted in partial fulfillment of the requirements for the degree of

Doctor of Education in Organizational Leadership

April 2022

Committee in charge:

Philip O. Pendley, Ed.D., Committee Chair

Shani Cigarroa, Ed.D.

Carlos V. Guzman, Ph.D.

iii

Music as a Form of Therapy in the K-4 Special Education Classroom: A

Phenomenological Study

by Roger B. Hattaway

ACKNOWLEDGEMENTS

This doctoral journey has been an eye opening experience. It has taught me that

time stops for no man and that every second should be cherished. I have taken so much

time away from family and friends to pursue this degree and I want to thank everyone for

their patience during this time.

The conclusion of this journey could not have been made possible without the

support of my dissertation chair and committee. Dr. Pendley has been a great support

element and has given of his time freely to ensure that the journey was fruitful. His

knowledge and dedication have been second to none. Dr. Guzman, I can’t decide if his

teachings or his music has been the greater inspiration, but both are well worth my time.

Just close your eyes and open your mind, the fruits of his labors are ripe for the taking.

Dr. Cigarroa was an inspiration before we even met. I learned so much from her work

and it has helped make this process easier than I had expected it to be. She has been a

true inspiration and a true ambassador of the Brandman program. Thank you all for your

dedication to future doctors.

To my wife, I thank you for not letting me give up when I was tired. The past 25

years have been the most joyous of my life, and it is because of you. You were there

during my 20 years of service in the United States Marine Corps, waiting for me to return

from wherever the Corps took me. You moved with me countless times, never

complaining about having to pick up all that you have and leaving your friends and

family. You have put up with my complaining and grumblings about work, and about

life in general, without making me feel as though I am burdening you. I truly do not

know what I would do without you in my life.

To my children, thank you all for accepting the multiple moves from one side of

the country to the next, and back again, leaving your friends so that I could chase the

dream of retiring from the military. You have sacrificed so much, and I want you to

know that I understand and respect the sacrifices that you have made. I also want to

thank you for understanding when I had to miss weekend events due to schoolwork. I

hope that I have been as inspiring to you as you have been to me. I love you all so much

and hope to be able to help you reach your goals in life, whatever they may be.

My Brandman family, we have put the function in dysfunction. I have grown

from the ups and downs of this Motley Crew and believe that I have a better

understanding of the word empathy. We have shared so much more than just book

knowledge; we have shared life stories that have touched each other’s lives in a way that

will live forever. There were times when I did not believe that we would make it on

some of the team projects, but just when it had to happen, we made it come together, and

it was a work of art. I truly hope that we all get to work together in some capacity and

continue this growing process.

Dr. Hadden, thank you for your mentorship and for putting up with this rowdy

bunch. We made it difficult on you at times, but your tenacity and calm demeanor

brought us through the roughest of times. I hope and pray that your mansion has a deck

for you to sit and watch the ships go by.

Sitting on my deck

The big ships go slowly by

Destination known

ABSTRACT

Music as a Form of Therapy in the K-4 Special Education Classroom: A

Phenomenological Study

by Roger B. Hattaway

Purpose: The purpose of this phenomenological study was to identify and describe the

perceptions of elementary K-4th grade teachers on the effects of music therapy as it

pertains to academics and behavioral incidents in the special education classroom

(Gooding, 2010).

Methodology: This qualitative study used a phenomenological design to ascertain the

perception of the teachers on the impact of music therapy regarding academics of

students in the K-4 grade special education classroom. The data were collected using the

descriptive narrative to ascertain the perception of the changes in academics and behavior

gathered from the interview questions.

Findings: Analysis of the phenomenological qualitative data showed that music has a

positive effect on both academics and behavior in the K-4th grade special needs

classroom. Data shows that music played as background noise allows the students to stay

focused and add a calming effect to the classroom. The study found that music relieves

anxiety and increases peer and staff relationships.

Conclusion: Resulting themes deduced from the qualitative interviews support the

efficacy of music as a form of therapy in relation to academics and behavior in the K-4th

grade classroom as it pertains to students with special needs. These findings prove the

institutional need to support music as a form of therapy in the classroom.

Recommendations: It is recommended that the following six areas be pursued: (a) A

mixed methods study be conducted to include the academic scores from California and

vii

Washington state tests, (b) a study that includes schools from a more diverse region, (c)

include the paraprofessionals to ascertain their perspective, (d) including the perspective

of parents of the special needs students, (e) replicate the study in the general education

classroom to see what effects music as a form of therapy could have, and (f) conduct a

study in later grade levels utilizing music selected by the teacher and music selected by

the students to understand if the choice of music influences the outcome of the study.

viii 
 
TABLE OF CONTENTS 
CHAPTER I: INTRODUCTION ........................................................................................ 1 
Background ......................................................................................................................... 2 
  Historical Perspective of Music Therapy ...................................................................... 2 
  Contemporary Perspective of Music Therapy ............................................................... 5 
  Special Education .......................................................................................................... 7 
  Applying Music Therapy on the Perceptions of Special Education Students ............... 9 
  Gap in Literature ......................................................................................................... 11 
Statement of the Research Problem .................................................................................. 11 
Purpose Statement ............................................................................................................. 12 
Research Questions ........................................................................................................... 12 
Significance of the Study .................................................................................................. 12 
Definitions......................................................................................................................... 14 
Delimitations ..................................................................................................................... 16 
Organization of the Study ................................................................................................. 16 
CHAPTER II: LITERATURE REVIEW ......................................................................... 17 
Historical Perspective of Music Therapy .......................................................................... 17 
  World War II ............................................................................................................... 17 
  Social Aspect ............................................................................................................... 19 
  Physical Rehabilitation ................................................................................................ 20 
  Treatment of Depression ............................................................................................. 22 
  Treatment of Anxiety .................................................................................................. 23 
  Treatment of Stress ...................................................................................................... 25 
Contemporary Perspective of Music Therapy .................................................................. 27 
  Cognitive Development ............................................................................................... 28 
  Emotional Development .............................................................................................. 30 
  Physical Development ................................................................................................. 33 
  Social Development .................................................................................................... 35 
Special Education.............................................................................................................. 38 
  No Child Left Behind Act / Individuals with Disabilities Education Act ................... 38 
  Intervention Strategies ................................................................................................. 41 
Applying Music Therapy .................................................................................................. 43 
Theoretical Framework ..................................................................................................... 44 
Research Gap .................................................................................................................... 45 
Synthesis Matrix ............................................................................................................... 47 
Summary ........................................................................................................................... 47 
CHAPTER III: METHODOLOGY .................................................................................. 49 
Purpose Statement ............................................................................................................. 49 
Research Questions ........................................................................................................... 49 
Research Design................................................................................................................ 50 
  Qualitative Research Design ....................................................................................... 50 
Population ......................................................................................................................... 51 
  Sampling Frame .......................................................................................................... 52 
  Sample ......................................................................................................................... 53 

ix 
 
  Sampling Process ........................................................................................................ 53 
Instrumentation ................................................................................................................. 54 
  Qualitative Instrumentation ......................................................................................... 55 
   Qualitative validity .................................................................................................. 55 
   Qualitative reliability ............................................................................................... 56 
   Qualitative field test ................................................................................................. 56 
Data Collection ................................................................................................................. 56 
  Qualitative Data Collection ......................................................................................... 57 
Ethical Considerations ...................................................................................................... 57 
Data Analysis .................................................................................................................... 57 
  Qualitative Data Analysis ............................................................................................ 58 
Limitations ........................................................................................................................ 58 
Summary ........................................................................................................................... 59 
CHAPTER IV: RESEARCH, DATA COLLECTION, AND FINDINGS....................... 60 
Overview ........................................................................................................................... 60 
Purpose Statement ............................................................................................................. 60 
Research Questions ........................................................................................................... 60 
Research Methods and Data Collection Procedures ......................................................... 61 
Population ......................................................................................................................... 62 
  Sample ......................................................................................................................... 63 
  Sampling Process ........................................................................................................ 63 
Presentation and Analysis of Data .................................................................................... 65 
Interview Question Results ............................................................................................... 66 
  Academic Performance ............................................................................................... 66 
   Interview question 1................................................................................................. 66 
   Interview question 2................................................................................................. 67 
   Interview question 3................................................................................................. 68 
   Interview question 4................................................................................................. 69 
   Interview question 5................................................................................................. 70 
  Behavioral ................................................................................................................... 71 
   Interview question 1................................................................................................. 71 
   Interview question 2................................................................................................. 73 
   Interview question 3................................................................................................. 74 
   Interview question 4................................................................................................. 75 
   Interview question 5................................................................................................. 76 
Interview Conclusion Questions ....................................................................................... 77 
Overall Frequency of Themes for all Research Questions ............................................... 81 
CHAPTER V: FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS ............. 83 
Overview ........................................................................................................................... 83 
Purpose Statement ............................................................................................................. 83 
Research Questions ........................................................................................................... 83 
Methodology ..................................................................................................................... 84 
Population and Sample ..................................................................................................... 84 
Major Findings .................................................................................................................. 86 
  Research Question 1 .................................................................................................... 87 

x 
 
   Major finding 1 ........................................................................................................ 87 
  Research Question 2 .................................................................................................... 87 
   Major finding 2 ........................................................................................................ 88 
   Major finding 3 ........................................................................................................ 88 
Unexpected Findings ........................................................................................................ 89 
Conclusion ........................................................................................................................ 90 
  Conclusion 1 ................................................................................................................ 90 
  Conclusion 2 ................................................................................................................ 91 
Implications for Action ..................................................................................................... 91 
  Implication 1 ................................................................................................................ 91 
  Implication 2 ................................................................................................................ 92 
  Implication 3 ................................................................................................................ 92 
Recommendations for Further Research ........................................................................... 93 
  Recommendation 1 ...................................................................................................... 93 
  Recommendation 2 ...................................................................................................... 93 
  Recommendation 3 ...................................................................................................... 93 
  Recommendation 4 ...................................................................................................... 94 
  Recommendation 5 ...................................................................................................... 94 
  Recommendation 6 ...................................................................................................... 94 
  Recommendation 7 ...................................................................................................... 94 
Concluding Remarks and Reflections ............................................................................... 95 
REFERENCES ................................................................................................................. 96 
APPENDICES ................................................................................................................ 112 
 
 
 
 
 
 
 
 
 
 
 
 

xi 
 
LIST OF TABLES 
 
Table 1.     Teachers Per Grade Level, California ............................................................. 51 
Table 2.     Teachers Per Grade Level, Washington State ................................................ 52 
Table 3.     Participants by District and Grade Levels ...................................................... 54 
Table 4.     Participants by District and Grade Levels ...................................................... 65 
Table 5.     Characteristics of Participants ........................................................................ 65 
Table 6.     Impact of Music Therapy on Students’ Academic Performance in the 
Classroom with Respect to Attention Span .................................................... 67 
Table 7.     Impact of Music Therapy on Students’ Academic Performance in the 
Classroom with Respect to Time on Task ...................................................... 68 
Table 8.     Impact of Music Therapy on Students’ Academic Performance in the 
Classroom with Respect to Completion of Task............................................. 69 
Table 9.     Impact of Music Therapy on Students’ Academic Performance in the  
Classroom with Respect to Accuracy of Completed Work ............................ 70 
Table 10.   Impact of Music Therapy on Students’ Academic Performance in the 
Classroom with Respect to Performance on Assessments .............................. 71 
Table 11.   Impact of Music Therapy on Students’ Behavioral Performance in the 
Classroom with Respect to Interaction with Classmates ................................ 72 
Table 12.   Impact of Music Therapy on Students’ Behavioral Performance in the 
Classroom with Respect to Interaction with Staff .......................................... 74 
Table 13.   Impact of Music Therapy on Students’ Behavioral Performance in the 
Classroom with Respect to Self-Control......................................................... 75 

xii 
 
Table 14.     Impact of Music Therapy on Students’ Behavioral Performance in the 
Classroom with Respect to Following Class Rules ....................................... 76 
Table 15.     Impact of Music Therapy on Students’ Behavioral Performance in the 
Classroom with Respect to Number of Referrals .......................................... 77 
Table 16.    Closing Thoughts on the Impact of Music Therapy on Students’ Academic 
and Behavioral Performance in the Classroom ............................................. 81 
Table 17.    Overall Combined Frequencies of Themes from all Research Questions ..... 82 
 
 
 

CHAPTER I: INTRODUCTION

According to the World Health Organization in 2001, up to 20% of children and

adolescents are affected by mental illness worldwide (Porter et al., 2017).

Internationally, mental health disorders account for the most considerable burden of

youth issues. (Gold, Saarikallio, Crooke, & McFerran, 2017). Some of the more common

mental health disorders among youth are attention-deficit/hyperactivity, anxiety,

depression, conduct disorders, bipolar disorder, autism, and psychosis. Attention-

deficit/hyperactivity is a disorder that causes the student to feel tired, depressed, anxious,

or become easily distracted. Depression causes children to feel irritated or sad for long

periods of time. It is estimated by the Center for Disease Control that there are nearly

45,000 American deaths each year from depression-related issues. Anxiety, the most

common illness affecting children, can cause children to become so afraid of situations

that it interferes with their daily activities. “Anxiety disorder and anxiety symptoms

could have a long-term negative impact on adolescents' academic performance,

interpersonal relationships, and psychological well-being” (Kwok, 2018, p. 663).

Music can be used as a mood enhancer. Music, when used as mood enhancers,

changes the way people work within a particular setting (Fletcher, 2004). Playing music

can allow the listener to remove themselves from the monotony of the daily tasks and

provides freedom of expression. Freedom of expression allows the listener to feel more

involved in the process and allows the individual the freedom to be creative and complete

the tasks at hand (Bruce, 2007).

“Emotional states, familiarity, and properties of musical structure combine to

create a psychological environment that is conducive to the generation of visual imagery.

That imagery, in turn, may amplify or modify a necessary emotional experience” (Day &

Thompson, 2019, p. 75).

Background

Historical Perspective of Music Therapy

According to the 1998 working definition, as given by Bruscia, (2014), music

therapy is a structured process of intercession wherein the therapist helps the client to

increase health, using music experiences and the interrelations that develop through them

as energetic forces of change. The World Federation of Music Therapy (WFMT) defines

music therapy as follows:

It is the use of music and musical elements professionally to optimize the quality

of life of individuals, groups, families, or communities and to improve their

physical, social, communicative, spiritual, intellectual, emotional health and well-

being as a means of intervention in educational and medical fields or in daily life.

(as cited in OsmanoĞLu & Yilmaz, 2019, p. 19)

Music has been used as a form of therapy since World War II (Foran, 2009). It

was first used to help those coming back from the war rehabilitate from traumatic brain

injuries (TBI). TBI account for the most significant number of disabilities and death

among children worldwide (Bower, Catroppa, Grocke, & Shoemark, 2014). It has since

been used in many other settings to include helping to relieve the stress of college

students, and students of all grade levels (Ferrer et al., 2012).

The diagnoses covered by music therapy ranges from physical impairments

caused by (a) physical and neurological trauma (amputations, brain injury, burns, spinal

cord injury, coma, fractures, orthopedic impairments, hip dislocation); (b) specific

illnesses and conditions (asthma, arthritis, poliomyelitis, epilepsy, hemophilia, tension

headache); (c) congenital developmental diagnoses (autism, cerebral palsy, learning

disorders, scoliosis, spina bifida, visual impairments); and (d) degenerative diseases (e.g.

dementia, Parkinson's disease, Huntington's disease, multiple sclerosis) (Weller & Baker,

2011). TBI account for the most significant number of disabilities and death among

children worldwide (Bower et al., 2014).

In an advanced American evaluation of 148 studies with children having

intellectual and developmental disability (IDD) it was established that music therapists

earmarked a range of clinical conclusions including learning, behavioral, social, physical,

and communication skills (Thompson & McFerran, 2014). Sensory processing disorder

(SPD) is a disturbance in the organization of sensory input that affects relevant responses

to the insistence of the surroundings. The results of SPD in children may include a

developmental delay as well as behavioral and emotional issues. Music therapy should

be peculiarly suitable for children with an SPD because music and the sensory system are

both connected to the nervous system. This advocates there is a need to greater

understand the correlation between the sensory system and the aspects of music (Simhon,

Elefant, & Orkibi, 2019).

Studies have shown that the use of music in counseling sessions can escalate the

production of all four beneficial hormones present in the human body, namely dopamine,

endorphins, oxytocin, and serotonin (Situmorang, Mulawarman, & Wibowo, 2018). The

release of these positive hormones contributes to the belief that the use of music therapy

with cognitive-behavioral therapy is noteworthy in lessening social anxiety among

schooling adolescents (Egenti et al., 2019). Results in a study suggested a sizeable

reduction in preoperative anxiety for both pediatric patients and their custodians

regardless of active or passive music therapy intercessions (Millett & Gooding, 2018). A

video examination of deliberate communication in music therapy with females who have

Stage III and IV Rett syndrome exhibited an increase in the sound selection of favored

songs, despite the negative learning trajectory expected for people with this

neurodegenerative disorder (Elefant, 2002).

Music can be used socially to allow people to express themselves in a manner that

does not require them to come up with dialog to fit the social setting. To relax, celebrate,

help us think, and to morn, we tend to listen to the different genres of music (Foran,

2009). Music therapy scholars suggest specific characteristics are necessary for the

possession of psychosocial wellbeing profits, such as tailored and client-centered

delivery, that are not easily obliged by music education programs (Crooke & McFerran,

2014). Students with higher social skills tend to have less daily stress, and stress is

known to not only reduce the level of work but is linked to many health problems (Ferrer

et al., 2012). Previous research has proposed that a lack of social competence makes it

difficult to grow constructive relationships with peers and teachers in elementary school

(Birch & Ladd, 1997). Results of a qualitative systematic review conducted by Palazzi,

Wagner Fritzen, and Gauer (2018), showed that music is a dynamic and engaging

stimulus that governs decision-making processes and risk-taking, increases pro-sociality,

and affects behavioral decisions.

As of 2017 figures propose that 2.6% of young people worldwide suffer from

depression; often connected with diminished social functioning and education fulfilment

(Porter et al., 2017). U.S. numbers estimate that 20% of adolescents will encounter a

depressive episode by the age of 18 (Porter et al., 2017). A review of studies using

randomized‐controlled trials (RCTs) and clinical controlled trials (CCTs) of individuals

recognized as having clinical depression and going through either treatment as usual,

psychological therapies, pharmacological therapies or a form of music therapy, showed

that a significant, short‐term improvement in depressive symptoms, level of functioning,

and anxiety can be seen in individuals going through music therapy together with usual

treatment when compared with a group experiencing treatment as usual (Roddis &

Tanner, 2020).

Anxiety disorder and anxiety symptoms may have a long-term negative influence

on adolescents’ interpersonal relationship, academic performance, and psychological

well-being. Past studies also revealed that excessive anxiety impedes children’s coping

ability, causes negative emotional behavior, and leads to disruptive behavior, low self-

concept, attention and learning disorders, and depression in the long-term (Kwok, 2018).

According to OsmanoĞLu and Yilmaz (2019) music can lead us to feel happy, creative,

and enthusiastic and to think positively and can treat mental illnesses caused by anxiety

and stress. “As a result of a review of related literature, it was found that there is a

general agreement on the positive effects of classical music on human psychology in

terms of reducing anxiety and stress and promoting well-being” (OsmanoĞLu & Yilmaz,

2019, p. 20).

Contemporary Perspective of Music Therapy

Cognitive development is believed to begin while we are still in the womb.

Mothers sing to their unborn children in hopes that it will somehow increase the

connection between mother and child. According to Wallace (2000), a fetus will jump to

the beat of a drum. The pregnant mother must pay attention to what she is taking into her

body due to the fetus taking in portions of that same material. It may also be just as vital

for the mother to be cognizant of the sounds around her. Loud noises have shown to

cause the heart rate to increase in the mother and have the same effect on the unborn

fetus. These symptoms can extend beyond the womb and stay with the child throughout

adolescence. Research conducted by Nussberger and Teckenberg (2016) shows that

music therapy used to relax the mother while she is carrying the child reduces the stress

that is felt by the unborn child and reduces the risk of “preterm delivery and perinatal

complications, ante- and postnatal depression, early interaction disturbances”

(Nussberger & Teckenberg, 2016, p. 105).

The reason that people listen to music, and the type of music chosen has been a

topic of research for many years. Many factors can play a significant role in why people

listen to music and determine their musical preference. Many studies have shown all

around that music has been used to bring about emotional states, activate, express, relax,

control emotions, and communicate (Tekin Gurgen, 2016).

Physical therapy may use music in many different forms and for many different

reasons. Vibroacoustic, for example, is the non-invasive technique of using different

frequencies of music to target the different parts of the body providing pain relief from

different ailments. There is evidence that vibroacoustic therapy and its use of low

frequencies can be relaxing and has a physical effect on lower back pain in adolescents

(Dudoniene et al., 2016). Pain is alleviated without the use of medicine using different

frequencies, targeting the different areas of the body.

In physical therapy, music has also been used in the management of pain. Music

administered during physical therapy may provide a form of distraction to the patient

allowing the patient to be more at ease during what some feel to be physically agonizing.

A study approved by the Siena University Hospital ethical committee showed that adult

patients had a significant reduction in the perception of pain during physical therapy

when given music to listen to during the process (Bellieni et al., 2013).

Visually impaired individuals are using therapeutic music devices to help with

movement from one area to another. The Soundbeam device produces sound through

sensor technology that allows students to create music through movement vice the use of

instruments (Coleman, 2017). Using the Soundbeam technology should allow students

who would typically be reluctant to move around a room, due to their inability to see

well, walk around to make music. Moving around in this manner can give visually

impaired students a reason to get up and can add a physical element to their day.

Social skills grow through the interaction of individuals within different settings

and from different backgrounds. Powerful social skills are an important part of

functioning successfully (Gooding, 2010). Studies have shown that adding music

activities in the curriculum promotes social learning by providing a social context for the

acquisition of new skills (Walworth, 2009)

Special Education

According to the Washington Office of Superintendent of Public Education

(2020), “special education is specially designed instruction that addresses the unique

needs of a student eligible to receive special education services” (What is Special

Education section, para. 1). Although a goal of the No Child Left Behind Act (NCLB) of

2001 was to improve academic results for all students, the Individuals with Disabilities

Education Improvement Act (IDEA) focused on this goal by improving access to the

general education curriculum for students with disabilities. Both acts put forward the

belief that students’ outputs and levels of achievement are connected to expectations set

forth by the teachers (Parrish & Stodden, 2009). “The IDEA mandates that each state

must establish, to the maximum extent appropriate, that early intervention services are

provided in natural environments, including the home and community settings in which

children without disabilities live” (Etscheidt, 2006, p. 167).

In 2019 it was estimated that approximately 13% of public school children obtain

special education and related services; and psychological and educational evaluations are

used to identify children who may need services, establish eligibility and classification of

students who need supplemental educational services, monitor progress, plan for

interventions, refine educational approaches, and provide accountability (Berman, Feuer,

& Pellegrino, 2019). Although there are federal and state guidelines on what defines a

disability, there are no specified guidelines or assessments on how to determine if a child

has special needs. The students are characterized using subjectivity by the school system

and administration.

In a study conducted by Batchelor and Taylor (2005) there were six identifiable

interventions commonly used within the early childhood setting:

• Child-specific social interventions which are strategies aimed at each

individual child based on their needs.

• Affective interventions which are group focused based on changing the

attitudes of peers towards children with disabilities.

• Friendship activity interventions, which redesign children songs, group

games, and social activities that promote social interactions.

• Incidental teaching of social skills which occurs when the teacher uses

incidents that happen during social interaction.

• Social integration activity interventions, which is pairing children with

disabilities with those who are highly socially competent.

• Peer-mediated intersessions which are programs designed to train typically-

developing peers with the social skills needed to coerce children with

disabilities into the play.

Applying Music Therapy on the Perceptions of Special Education Students

Listening to music in the classroom has shown to have positive effects on

students' relationships, memory, math ability, productivity, emotions, and overall health

(Fletcher, 2004). Music is used in early education to increase the likelihood of learning a

language as well as memory building (Foran, 2009). According to Day and Thompson

(2019), “emotional states, familiarity, and properties of musical structure combine to

create a psychological environment that is conducive to the generation of visual imagery.

That imagery, in turn, may amplify or modify a necessary emotional experience” (Day &

Thompson, 2019, p. 75). Being able to perceive yourself in a comforting place could add

a calming effect to one's outlook. Calming music therapy is effective at helping with

psychological situations, so using music in the classroom to help relieve stress is essential

(Fernandes & D'silva, 2019). It has since been used in many other settings to include

helping to relieve the stress of college students, and students of all grade levels (Ferrer et

al., 2012).

Music therapy approaches have been studied for possible connections between

music therapists' preferences, and opinions concerning the effectiveness of music therapy

methods for the use with adolescence with autism spectrum disorder (ASD) (Eren, 2017).

Results showed that behavioral approach, sensory integration approach to music therapy,

and creative music therapy were found as most preferred and most effective music

therapy approaches (Eren, 2017). Although behavioral approach was the primary

preference of music therapists, sensory integration approach was reported as the most

effective approach for the use with children with ASD (Eren, 2017).

The behavioral approach to music therapy rests on the defining characteristic of

music therapy as the scientific application of music to accomplish therapeutic

aims whether they are behavioral, developmental and/or medical. It is the use of

music and the therapist’s self to influence changes in behavior. (Madsen, Cotter,

& Madsen, 1968, pp. 15-16)

Patterned sensory enhancement involves the translation of musical elements to match the

spatial, temporal, and force components of complex functional movements (Imogen,

Clark, & Taylor, 2012). Using the creative music therapy approach, the music therapist

uses multiple techniques to find what best works for the patient. It could include

humming at a specific rate to allow the patients heartbeat to slow down or speed up

depending on the desired outcome, or it could be the rhythmic beating of a drum to

increase or decrease a patient’s heartbeat, depending on the needs of the patient

(Haslbeck, 2013).

Gap in Literature

The prospects for music programs to encourage psychosocial wellbeing in

mainstream schools is accepted in both policy and research literature. Notwithstanding

this perception, there is a deficiency of consistent research evidence supporting this link

(Crooke & McFerran, 2014). Despite what is known about the generality and effects of

mental health issues in adolescence and the far reaching entanglement for adulthood, the

evidence base for effective intersessions is relatively weak. Currently, the most common

perspectives to treatment are medication and psychotherapy, both of which have an

inadequate evidence support for use with children and adolescents (Porter et al., 2017).

Statement of the Research Problem

“Music therapy in special education differs from music teaching in its emphasis

on the acquisition of non-musical skills, using music as a symbol of emotional and

personal growth rather than as a cognitive skill-set to be learned and practiced” (Rickson

& McFerran, 2007, p. 40). Early education teachers are intimate with using music and

rhythm as tools for teaching language and building memory. However, the prospect of

using music to help across all special education settings is largely unexplored (Foran,

2009).

A child is considered to have special needs if he or she shows deficits in any of

the following areas: (a) cognitive, (b) physical, (c) communicative, (d) social, or (e)

emotional (Rosen, 2011).

Research indicates that deficits in social functioning during childhood are linked

to a variety of negative outcomes including: (a) substandard academic

performance, (b) high incidences of school maladjustment, (c) expulsions and/or

suspensions from school, (d) high dropout rates, (e) high delinquency rates, (f)

impaired social relationships, (g) high incidences of childhood psychopathology

and (h) substance abuse. (Gooding, 2010, p. ix)

Purpose Statement

The purpose of this phenomenological study was to identify and describe the

perceptions of elementary K-4th grade teachers on the effects of music therapy as it

pertains to academics and behavioral incidents in the special education classroom

(Gooding, 2010).

Research Questions

The following research questions were developed to help guide the study:

1. How do K-4 special education teachers describe the impact of music therapy

on academic performance in the classroom with respect to attention span, time

on task, completion of tasks, completed work, and performance on

assessments?

2. How do K-4 special education teachers describe the impact of music therapy

on behavioral performance in the classroom with respect to interaction with

classmates, interaction with staff, self-control, following class rules, and

number of discipline referrals?

Significance of the Study

This study is significant given that it may help determine the effects of music

therapy on special education students as perceived by teachers who work directly with K-

4th grade students. The lack of research in this area allows for limited findings in

addressing the effects of music as a form of therapy in the special education K-4th grade

classroom.

Music may have the ability to influence the social and emotional state of being.

Music helps individuals access the depth of their being, renews memories, fulfills

emotional needs, hints at forgiveness, and ultimately sets the stage for renewal and

growth (Weiler & Gall, 2016). Finding ways to implement music as a form of therapy

for children with special needs might help them grow socially, emotionally, and

academically.

Music therapy aims to create potentials and/or restore functionality of the

individual so that he or she can attain better intra and interpersonal integration and

accordingly a better quality of life through prevention, rehabilitation, or treatment

(Rickson & McFerran, 2007). Music therapy has been used to address a broad spectrum

of diagnoses such as autistic spectrum disorder, Down Syndrome, hearing impairment,

visual impairment, cerebral palsy, global developmental delay, and learning difficulties

(Chiang, 2008). Studies have suggested that developmental changes have a higher

probability to occur for children who receive music therapy than those who do not

(Aldridge, Gustroff, & Neugebauer, 1995).

“Mental health difficulties relate to major interpersonal and social challenges.

Recent qualitative research indicates that music therapy can facilitate many of the core

elements found to promote social recovery and social inclusion” (Solli, 2015, p. 204).

The prospective for music programs to encourage psychosocial wellbeing in mainstream

schools is accepted in both policy and research literature (Crook & McFerran, 2014).

Despite this acknowledgement, there is a lack of research in using music as a

form of therapy to promote this well-being. Recent research into the physiology of music

has shown music to necessitate activation of cooperating hierarchical neural networks

including cognitive, motor, speech, and language neural pathways (Slavin & Fabus,

2018). With the acknowledgement by policy and research as to the effectiveness of

music on the psychosocial wellbeing, as well as the positive outcome of the use of music

for the activation of the neural networks, additional research can help reveal the effects of

music as a form of therapy in the special education K-4th grade classroom. These links

can be important in understanding the potential effects of music as a form of therapy to

ensure the highest quality of life for students with special needs.

Definitions

Terms relevant to the study are defined below to provide ease of understanding

for the reader.

Academic performance. According to Abdullah (2016), academic performance is

the knowledge learned which is evaluated by marks by a teacher and/or educational goals

set by students and teachers to be achieved over a specific time period.

Accuracy of completed work. Accuracy of work, as defined by the Personnel

Department of Santa Cruz County, California, is the extent to which work is free from

errors or omissions.

Attention span. Attention span refers to the length of time during which can

concentrate or remain interested (Merriam-Webster, n.d.).

Behavioral incident. A behavioral incident is a single behavioral event which

happens separately or in a series with other events to create a behavioral sequence. Each

individual event has a well-defined beginning and end. “Although there's

a negative connotation to a behavioral incident, but some of these incidents are just

routine, everyday activities which follow a normal sequence” (Psychology Dictionary,

2013, Behavioral Incident section, para. 2).

Behavioral performance. Behavioral performance results from a balance between

adaptive flexible behavioral choices and more rigid, repetitive choices, which are

supported respectively by brain networks known as goal-directed and habitual brain

systems (Carey, 2009).

Completion of task. Completion of task represented the number of items

(elements) completed per assignment; if a response was provided, whether right or wrong

(Gickling & Armstrong, 1978).

Interaction with classmates. Interaction with classmates refers to the social

interaction between students in the classroom (Hurst, Wallace, & Nixon, 2013).

Interaction with staff. Interaction with staff denotes the emotional, organizational,

and instructional interactions in the classroom (Hafen et al., 2014).

Music therapy. “Music therapy is a systematic process of intervention wherein

the therapist helps the client to promote health, using music experiences and the

relationships that develop through them as dynamic forces of change” (Bruscia, 2014, p.

36).

Special education. According to the Washington Office of Superintendent of

Public Instruction (2020), special education refers to the extra services provided to

students who are deemed to have a disability hindering the learning process. A disability

is a handicap that interferes with a child's ability to learn. In general, the term “child or

student with a disability” is used to describe a child or student who has emotional,

mental, or physical impairments that affect one’s ability to learn.

Time on task. Time on task signifies the amount of time a student is interacting

with instructional content or activity via choral response, raising hand, listening, writing,

reading, responding to teacher instruction, or otherwise completing assigned task (K. C.

Herman, Reinke, Nianbo, & Bradshaw, 2020).

Delimitations

This study was delimited to K-4th grade special education teachers in schools that

provide music therapy in the states of California and Washington, United States.

Organization of the Study

This study is arranged in five chapters. Chapter I included an introduction,

background, problem, and purpose statements, along with research questions and

definitions. Chapter II contains an in-depth look into the literature dealing with music

therapy, physical ailments, mental disorders, treatments, strategies and expected

behaviors. Chapter III details the methodology of the study including the population,

sample, data collection method, analysis, and limitations of this study. Chapter IV

presents the detailed analysis of the study conducted, and Chapter V provides an

executive summary of the research and offers conclusions and recommendations for

future research.

CHAPTER II: LITERATURE REVIEW

The priority for Chapter II was to compile research literature as it pertains to the

use of music as a form of therapy in the K-4th grade special education classrooms, on

academic and behavioral success. The literature review was arranged in four sections

including 15 subsections using a funneling process. The first section offers a look at the

historical perspective of music therapy starting with World War II. Section two describes

contemporary perspective of music therapy in relation to cognitive, emotional, physical,

and social development. Section three was centered on special education to include the

NCLB, the IDEA, diagnosis, treatment options, and intervention strategies. Section four

details the application of music therapy, goals and objectives of music therapy

intervention, and approaches to music therapy. These four sections are followed with a

review of the gap in literature and a summary of literature pertaining to music as a form

of therapy in the K-4th grade classroom with students identified as special needs.

Historical Perspective of Music Therapy

World War II

According to Foran (2009), music as therapy came to light in rehabilitation

settings in the United States for returning World War II veterans. “During this time,

interest in the rehabilitative potential of music exploded, and organizations such as the

National Federation of Music Clubs and the Musicians Emergency Fund organized

volunteers for the purposes of playing in military hospitals” (Vest, 2020, p. 125). Due to

the vigorous efforts of many devoted physicians and musicians during World War II and

its aftereffects, the healing powers of music were observed on an exceptional scale

(Rorke, 1996). In 1942, a Music Advisory Council of the Joint Army and the Navy was

initiated by the Secretaries of War and the Navy to coordinate recreational and education

programs within the armed forces. This council, made up of civilian and military

personnel, met to advise the armed forces in the development of such music programs for

the convalescing soldiers in hospitals (Sullivan, 2007). In a work published in 1966,

Helbig, wrote that the U.S. Surgeon General in October of 1943 sensed “the significance

of music in the lives of soldiers” (p. 29) and therefore, “directed that consideration be

given to music as an integral part of the recondition program [of injured soldiers]” (p.

31).

A 1945 War Department document stated the following regarding the use of

music with the injured soldiers:

Music should be provided along with other activities offered to patients because it

is one of the most effective vehicles for bringing a group together, for releasing

the emotions and for creating a spirit of fellowship and esprit de corps. If he

simply listens to music, his interests are broadened, and his sense of well-being is

generally increased. (Sullivan, 2007, p. 288)

Music was used in the treatment of those with traumatic brain injuries,

neurological conditions, diseases, and battle fatigue, later termed posttraumatic stress

disorder (Foran, 2009).

The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders,

(American Psychiatric Association, 2013), defines PTSD as made up of four clusters of

symptoms including invasive and repeated memories of the trauma, escape of trauma

related stimuli, numbing and/or obstructive changes in mood or cognitions relating to the

trauma, and changes in responsiveness and arousal. Thousands of military personnel

required medical and psychological care following World War II. Recovering personnel

required prolonged medical care and the military recognized the need for recreational

services to sustain morale and emotional well-being. This created a situation in which

music in hospitals could become more commonplace and the effects of music

investigated. This was the impetus that led individuals to investigate the use of music as

a therapeutic modality and the formation of music therapy as an organized profession

(Robb, 1999).

Social Aspect

Socialization, which can be defined as the action of creating and prolonging

relationships, allows individuals to develop the expertise necessary for social competence

(Gooding, 2010). Research has suggested that an absence of social competence makes it

arduous to develop positive relationships with peers and teachers in elementary school

(Visvaldas Legkauskas, 2019). According to a recent study conducted by (Visvaldas

Legkauskas, 2019), social competence had made a notable offering towards the

differences of each school adjustment indicator appraised in the present study, including

academic achievement, participation in bullying, and student-teacher relationship. Even,

interpersonal, and learning-related characteristics of social competence exhibited

different patterns of links to school adaptation indicators.

These struggles tend to evolve into long-term adjustment issues, including lower

academic achievement, skipping classes, substance abuse, unruly behavior, and mental

health issues in adolescence and further on (McClelland, Acock, & Morrison, 2006). A

study on the influence of social interaction on student learning divulged that students

learned from others, thus intensifying comprehension and retention by activating prior

knowledge, making connections, and synthesizing new ideas; social interaction generated

a positive working environment; and social interaction supplied a means for students to

view topics from various perspectives and strengthen their critical thinking and problem-

solving skills (Hurst et al., 2013).

“The potential for music programs to promote psychosocial wellbeing in

mainstream schools is recognized in both policy and research literature” (Crooke &

McFerran, 2014, p. 14). A study conducted by (Pasiali & Clark, 2018) indicated that

music therapy has the probability of being an effective intervention for promoting social

competence of school-aged children with insubstantial resources, specifically in the areas

of communication and low-performance/high-risk behaviors. Music therapy researchers

choosing development of social skills and overall well-being with adolescents found

advancements in communication skills, attitudes toward learning, and relationships with

peers (Porter et al., 2017).

Physical Rehabilitation

Physical rehabilitation requires intensive physical, emotional, and cognitive effort

from the patient. Current and traditional methods of reclamation have been effective in

providing virtuous interventions to build up the patient’s motor potential (Weller &

Baker, 2011).

In 1937, the American Medical Association acknowledged the American

Congress of Physical Therapy as a medical specialty society, followed by the inception of

the American Registry of Physical Therapy Technicians, and the creation of a board of

certification (Scappaticci, 1998). The recognition of physical therapy as a medical

specialty, and the subsequent development of the board of certification led to the ability

to fund research and development in the field of physical therapy, allowing new and

innovative ways to add comfort and independence to those suffering from physical

ailments.

Despite the lack of published research on the subject, the idea of using music to

engage a patient during therapy may be of interest to pediatric clinicians who may

have noticed that singing to children or playing music during the session may help

stimulate movement in a ‘passive’ child, interest a patient resisting therapy, or

comfort a crying baby. (Rahlin, Cech, Rheault, & Stoecker, 2007, p. 106)

Infants cry for many reasons including physical discomfort, emotional stress, hunger, and

social anxiety. If music has a positive ramification on the child’s emotional state, this

may lead to enhanced participation in therapeutic course of action and potentially, an

expanded rate of patient progress. Also, if the child cries less, parent gratification with

the therapy services could consequently improve (Rahlin et al., 2007).

Bruscia (1989) stated that music is put in to practice during the therapeutic

process either as the “primary agent” of change, in which the music has a direct effect on

the client, or as the facilitating agent, which supplements the therapeutic relationship and

leads to change. In rehabilitation medicine, music is used both as the primary agent of

change and as a facilitator. For example, music is considered a primary agent when used

to prompt and control pacing of physical exercise (i.e. determine the tempo of exercise

repetitions), and considered a facilitating agent when used to inspire discussion of socio-

emotional affairs related to disability or injury (Scappaticci, 1998).

Treatment of Depression

In 1998, the American Association for Music Therapy was formed to help combat

the issue of depression. According to a study conducted by Feng et al. (2019) there are

two fundamental methods of music therapy when dealing with depression. The creative

process requires the patient to sing, or play the music themselves, whereas the receptive

method allows the subject to listen to the music already created. This study showed that

music therapy has a significant effect on brain function in both the study group diagnosed

with major depressive disorder, as well as the control group.

National Institute of Mental Health (2018) states that depression is a common but

serious mood disorder. The institute indicates that depression causes severe symptoms

that affect how individuals feel, think, work, and handle daily activities. In an

operational sense, depression is also defined as the medical illness experienced by

individuals who meet necessary criteria as measured by the Beck Depression Inventory

(Burak & Atabek, 2019). Morrison and O’Conner (2005) suggests that depression poses

a greater danger to adolescents than to adults and more than 50% of university students

report depressive symptoms after starting their studies.

In a 10-week music therapy intervention conducted by Chen, Chen, Ho, and Lee

(2019), music therapy reduced depression among early adolescents with high pre-test

scores, based on the Beck Depression Inventory, although adolescents with low pre-test

scores were not affected. This result indicates that music therapy has a greater effect on

adolescents with severe depression more so than adolescents with mild depression. In a

separate study conducted by Aalbers et al. (2020), nine out of 11 students reported

reliable improvement in depression symptoms at post-test and four-week follow-up.

Treatment of Anxiety

“Anxiety is a state of utmost concern and fear that a person experiences when

he/she comes in contact with a stimulus from the outside or inner world and individual

has trouble in preventing negative physical, emotional and mental reactions” (Sargin,

2009, p. 1414). These reactions start at birth as the individual receives stimuli from the

surrounding social environment and culture. These reactions, whether positive or

negative, play a large part in the abilities of the individuals to grow their emotional

experiences and to adapt or be overwhelmed by the anxiety that comes with these

reactions.

According to Egenti et al. (2019), social anxiety is a continuous fear of situations,

and it is considered a common psychological disorder that occurs as the individuals

develop and grow, causing significant impairments to social functioning and could cause

a deficit in social skills practice. These impairments could cause long-term negative

impacts on academic performance, psychological well-being, and inter-personal

relationships. There could also be a significant impact on the individual’s ability to cope

with their environment, leading to disruptive behavior and learning disorders. Egenti et

al. also believes that it is possible that music therapy, along with cognitive behavioral

therapy intervention can help lessen social anxiety among socially concerned schooling

adolescents.

Kwok (2018), devised a study to investigate the efficacy of a design protocol,

integrating positive psychology and components of music therapy, in increasing the

optimism and enhancing emotional competence, hence reducing anxiety, and amplifying

subjective happiness of the adolescents with anxiety symptoms. Kwok used resource-

oriented music therapy, merging positive psychology and music therapy. The goals are

to help recognize, become acquainted with, and express their emotions, and remain

interested in and be encouraged to pursue goal oriented activities. The study shows a

notable decrease in anxiety symptoms when compared to the control group. Results

showed that students in the experimental group had greater hope, emotional competence,

happiness, and less anxiety symptoms than those of the control group.

A music therapist described the case of a 13-year-old rape victim who had low

intellectual functioning and post-traumatic stress disorder. Five sessions of music

therapy, that encouraged her to improvise music, caused her confidence to increase and

helped her better control her extreme anxiety (Henderson, 1996).

In a study conducted by Millett and Gooding (2018), 40 pediatric patient and

caregiver duos undergoing ambulatory surgery were studied to compare and control the

effects of active and passive distraction-based music therapy interventions. Preoperative

anxiety in the pediatric patients was measured pre- and post-intervention using the

modified Yale Pediatric Anxiety Scale, while caregiver anxiety was measured through

self-reporting using the short-form Strait-Trait Anxiety Inventory-Y6. The groups

receiving active or passive interventions were selected at random. The outcome showed

that the two groups had a significant level of anxiety reduction, with neither intervention

having a significant effectiveness over the other intervention strategy. A second study

using active and passive music therapy was designed and aimed to know the efficacy of

counseling group fulfillment of cognitive behavior therapy approach in reducing

academic anxiety among millennial students. Pretest versus posttest showed passive

music therapy techniques showed more promise than active, where posttest vs follow-up

showed that active was more effective after two weeks of therapy (Situmorang et al.,

2018).

Treatment of Stress

“Stress impedes the functioning of the hypothalamic-pituitary-adrenal axis and

the sympathetic nervous system, which notoriously escalates concentrations of the stress

hormone cortisol” (Fallon et al., 2020, p. 20). Stress has long earned a reputation of

causing harm to the physical, emotional, and social well-being of individuals. Stress has

also become a leading cause of immunosuppressive disorders. Short-term stress is

believed to be an immunoprotected device which enhances the fight or flight response

while long-term stress causes the body to decrease its ability to produce adaptive immune

responses (Dhabhar, 2014).

Children exposed to a buildup of stressful life events within a proportionately

short time span are at risk for behavioral and academic difficulties (Tisak, 1989). Stress

can also lead to an increased risk of diseases such as cancer, diabetes, and cardiovascular

disease if left untreated. According to the American Institute of Stress (2012), stress is

the number one health threat to Americans (as cited in Ferrer et al., 2012). Additionally,

if adequate coping skills are lacking, a somatic or psychological dysfunction may be

expressed in the form of persistent pain and illness, gastrointestinal distress, sleep

disturbances, fatigue, high blood pressure, headaches, or stress emotions, such as anger,

anxiety and panic, fright, guilt, shame, sadness, and depression (Yehuda, 2011).

Studies show that music therapy can decrease the amount of salivary α-amylase

(sAA), which is a time and fiscal effective measure of stress in individuals with ASD. A

study conducted by Poquerusse et al. (2018) showed that music therapy consisting of 50-

minute group interactivity and discussion associated to emotions when listening to

composed music, and group-based music ad-libbing with music instruments significantly

decreased baseline sAA levels in students with ASD.

A separate study examining the effects of music therapy on stress and pain control

was conducted to gather the discernment of staff members on the efficacy of music

therapy in hospital emergency departments. During the three-year study over 1,500

patients were engaged in music therapy including music-assisted relaxation, therapeutic

listening and musical requests, musical deviation, song writing, and therapeutic singing.

Significant improvements were seen in both stress and pain for music therapy patients. A

staff questionnaire showed that 92% of respondents would be likely to recommend music

therapy sessions for future patients to reduce pain and stress, and 80% indicated that the

music therapist’s practice improved their caregiving experience (Mandel, Davis, & Secic,

2019).

A study developed and conducted at the Salisbury University suggests that

listening to music has a greater positive effect on stress reduction than that of music

improvisation. This study consisted of 105 participants completing a stressor task and

then being appointed to one of three groups: (a) control group, (b) music listening group,

or (c) music improvisation group (Fallon et al., 2020). The changes in measurements

between the baseline sessions and the post-stressor sessions showed an increase in

irritation and distraction confirming the stressor task to be successful. There was also a

significant change from the stressor to recover sessions in the music listening group, but

no significant change in the music improvisation or control groups during this same

timeframe (Fallon et al., 2020).

Contemporary Perspective of Music Therapy

Music therapy in today’s scientific domain is developing as an integrative

discipline that picks up its methodological principles in holistic approaches to the

individual and his sufferings in philosophy, cultural anthropology, and

psychology, finding ways of producing results and discovering rehabilitative

mechanisms in the practice of restorative medicine in combination with the

methods of musical education and psychology. (Toropova & L’vova, 2018, p. 53)

To understand how music can be used in the K-4th grade special education

classroom, we looked at way’s music was used in therapy. Many different types of

therapy use music as a tool for improvement, from cognitive to physical, emotional, and

social. Music therapy contains elements of a “meaningful and flexible treatment”

modality, as music experiences are characteristically structured, yet creative. Many

children react positively to music encounters, potentially increasing engagement for

learning (LaGasse, 2014). “Studies show music therapy to promote improvement of

clinical and social status in preterm newborns, improving, among other conditions, heart

and respiratory rate, level of oxygen saturation, decreasing crying episodes, and thus,

promoting quality of sleep” (Moran et al., 2015, p. 177).

The diagnoses covered by music therapy ranges from disabilities caused by (a)

physical and neurological trauma (amputations, burns, brain injury, spinal cord injury,

hip dislocation, coma, fractures, orthopedic impairments); (b) specific illnesses and

conditions (arthritis, asthma, epilepsy, poliomyelitis, hemophilia, tension headache); (c)

congenital developmental diagnoses (autism, cerebral palsy, learning disorders, scoliosis,

spina bifida, visual impairments); and (d) degenerative diseases (e.g., dementia,

Huntington's disease, multiple sclerosis, Parkinson's disease) (Weller & Baker, 2011).

Music therapy has been employed for people with many different mental health

problems, including anxiety disorders, depressive disorders, dementia, schizophrenia,

autism, trauma-induced disorders, substance use disorders, and learning disabilities,

(Paul, Lotter, & van Staden, 2020).

In 2011, a master’s thesis administered by a board-certified music therapist

explored the effect of live music therapy on 30 adult emergency room patients and found

a notable self-reported decrease in pain and a remarkable increase in comfort, calculated

through visual analog scales for pre/post comparison. The thesis also reported that all of

the patients suggested that they would request music therapy services if admitted to the

emergency room again (Mandel et al., 2019).

Cognitive Development

According to the “temporal opportunity” conception of environmental stimulation

during brain development, encounters in childhood and adolescence are important to

many abilities in adult life, which makes the choice of what education to supply to a child

a serious matter. Although many longitudinal developmental studies of music education

incorporate a well-matched control group, such as an arts program, there is only little

research contrasting instrumental training in childhood with dance or sports, which could

offer engrossing avenues in pliability research and aid the parents in making a well

informed decision. Thus, although all arts and sports programs do have gratifying effects

on cognitive development, instrumental musical training appears distinctive in the wide

array of observed long-term effects (Miendlarzewska & Trost, 2013).

Training to play an instrument is a multisensory motor experience. Studies have

shown that music influences cognitive development and the earlier the introduction of

music, the better the effects. Some studies have also shown that the type of music

instruction also influences the type of cognitive development taking place. One study

found that nine-year-old children given piano instructions scored higher than the control

groups on spatial-temporal tasks immediately after the instructions was given. There was

no difference noted after a two-year hiatus from the instruction (Rauscher, 2003). A

follow-up study showed that participants who received music instruction before age five

scored appreciably higher than those who did not receive instruction. A final study

showed that children who received keyboard instruction starting at age three, and

continued for two years, scored higher on spatial-temporal and arithmetic tasks two years

after instruction had ended (Rauscher, 2003).

A study conducted on the effects of music training on the brain and cognitive

development of underprivileged children, ages three to five showed powerful and

remarkable improvements in non-verbal IQ and numeracy and spatial cognition (Schlaug,

Norton, Overy, & Winner, 2005). The extent and improvements were indistinguishable

in the children receiving music training, attention training, and consistent Head Start

instruction in smaller class settings advocating that the size of the class and amount of

attention being given to each child may be a fundamental factor in the cognitive

development.

A separate study facilitated by the University of Geneva, Geneva, Switzerland

showed that “children who experience musical training have better verbal memory,

second language pronunciation accuracy, reading ability and executive functions”

(Miendlarzewska & Trost, 2013, p. 1). It was concluded that musical training uniquely

engenders near and far transfer effects, developing a foundation for a gamut of skills, and

thus promoting cognitive development (Miendlarzewska & Trost, 2013).

Cognitive rehabilitation is important after a TBI to ensure that the patient is

allowed to recover as well as possible. According to Bower, Catroppa, Grocke, and

Shoemark (2014) TBI is the number one cause of death and acquired affliction in

children worldwide. Along with amnesia, it is common for patients post TBI to exhibit

impaired cognition and awareness along with agitation. The live singing of known songs

has been reported in clinical vignettes to energize a range of physiological, behavioral,

communicative, and emotional responses expressive of coma arousal and increased

cognitive awareness. It was also reported in these scenarios that music therapy

successfully lessened negative behaviors, physical agitation, and calling out during coma

emergence (Bower et al., 2014).

Emotional Development

Research suggests that numerous individuals experience visual imagery when

they listen to music, and this imagery relates to their emotional response to the music

(Day & Thompson, 2019). According to the BRECVEMA framework the following

eight core mechanisms account for the evocation of emotional experience by music:

• Brain stem reflexes

• Rhythmic entertainment

• Evaluation conditioning

• Contagion

• Visual imagery

• Episodic memories

• Aesthetic judgement

• Cognitive appraisals (as cited in Day & Thompson, 2019, p. 75).

In this discussion of visual imagery, they suggested that visual images form in the mind

of the listener and emotions are then practiced as a result of an “interaction between the

music and the images.”

The power of music to elicit an emotional response is used by film directors,

advertising companies, and mothers singing their babies to sleep (Levitin, 2006). Music

is used to build suspense, the drums beat louder and faster just before an intense scene, or

the organ plays deeper tones to set the audience up for a jump scare. Music and song are

also used to help soothe the crying baby back to sleep after a frightful awakening.

Neuroimaging studies have shown that musically prompted emotions involve very similar

brain regions that are also involved in non-musical basic emotions, such as the reward

system, insula, and orbitofrontal cortex, amygdala, and hippocampus (Salimpoor,

Benovoy, Larcher, Dagher, & Zatorre, 2011). In commercials, music is used to evoke an

emotional response that steers the audience in the decision-making process. The use of

music to help regulate emotions in the special education classroom, however, has largely

been unexplored.

Levitin (2006), a neuroscientist, former musician and record producer, has

scrutinized in detail how music affects brains, thoughts, and emotions. The regions of the

brain that develop into the auditory cortex, the sensory cortex, and the visual cortex are

all not differentiated in the human infant. Levitin finds that music engages all the sensory

areas and advances their differentiation and development. By engaging the cerebellum,

the motor cortex, and the frontal lobes, music also plays a paramount role in language

development (Levitin, 2006).

According to Levitin (2006), a specific beat is needed for music to cause us to be

moved. When the right beat is set the auditory cortex is activated, the frontal lobes light

up, the limbic system starts transmitting dopamine, and finally the brains nucleus

accumbens. This insight led Levitin to formulate that the brain is wired to allow music to

change the mood of those who hear it.

Studies show that young adults in the United State and the United Kingdom listen

to music for two main reasons, “to leave an impression on others” (Tekin Gurgen, 2016,

p. 231) and to “satisfy their emotional needs” (Tekin Gurgen, 2016, p. 231). According

to a study completed in Turkey, enjoyment and emotional mood are the two most

frequent reasons for listening to music, with environmental factors coming in second

(Tekin Gurgen, 2016).

F. Herman (1996), a music therapist, chronicled a case in which a nine-year-old

boy with a traumatic history reacted to music therapy after other therapies had failed.

The nine-year-old boy experienced hardship from severe depression, aggressive acting

out, and emotional dysregulation which had kept him from participating in school. Initial

music-therapy sessions concentrated on increasing his attention span and helping him to

enjoy self-expression. Over time, his ability to take turns was refined and he was able to

curb his impulsivity. F. Herman reported that after fulfilling the formal music-therapy

sessions, the nine-year-old boy was able to take part in school and learn to read.

Physical Development

Physiotherapists and occupational therapists furnish physical rehabilitation to

optimize independence of those with compromised function. Qualified music therapists

have delivered interventions to aided physical rehabilitation for more than 20 years.

Findings suggest that music therapy enhances cognitive, emotional, physical, and

psychological functioning within physical rehabilitation (Weller & Baker, 2011).

In 2000, Staum and Brotons shouldered a systematic literature review of 235

studies on the use of music for physical rehabilitation enveloping the literature from 1950

until 1999. The diagnoses covered were substantial, ranging from physical disabilities

caused by (a) physical and neurological trauma (amputations, burns, spinal cord injury,

brain injury, coma, fractures, hip dislocation, orthopedic impairments); (b) specific

illnesses and conditions (arthritis, asthma, epilepsy, hemophilia, poliomyelitis, tension

headache); (c) congenital developmental diagnoses (autism, cerebral palsy, learning

disorders, scoliosis, spina bifida, visual impairments); and (d) degenerative diseases (e.g.

dementia, Huntington’s disease, multiple sclerosis, Parkinson’s disease). Staum and

Brotons deduced that music was inspiring for repetition of movement, was able to

energize movement and singing, and wind instruments were found advantages in

improving respiration (as cited in Weller & Baker, 2011).

The use of music as a means of therapy is vital in the world of neonatal care, just

as it is in adult care. According to Moran et al. (2015), music has been shown to have

many positive effects on patients in the neonatal intensive care unit. Most patients within

the NICU do not get enough social interaction to stimulate their senses. The use of music

in these situations has shown to have positive effects on the patients’ respiratory rate and

oxygen saturation levels (Moran et al., 2015)

The positive effects also show up when dealing with the physiologic responses of

infants in the cardiac intensive care unit (CICU). According to a single case withdrawal

study approved by the institutional review board of Nationwide Children's Hospital, four

of five infants had significant improvement in heart and respiratory rates when given

music entertainment three to five times per week for up to three weeks. The study

showed that the heart rate decreases by allowing the tempo of music entertainment to

reduce in four of the five infants. Being able to control the heart rate of an infant who has

a congenital heart disease using music therapy is a huge positive.

In a research study conducted on an eight-month-old patient with Erb’s Palsy

results showed that the subject’s rate of crying, parents’ contentment with physical

therapy services and the child’s amount of gross motor progress increased with the

introduction of music during the physical therapy sessions (Rahlin et al., 2007). Results

of this study were recorded using a crying log, a parental satisfaction survey given

throughout the therapy duration, and the use of The Toddler and Infant Motor Evaluation

(T.I.M.E.) model, which consists of five primary subtests, including (a) mobility, (b)

motor organization, (c) stability, (d) social-emotional abilities, and (e) functional

performance (Rahlin et al., 2007).

During a study conducted by Bellieni et al. (2013), 25 adult patients experienced

physical therapy to evaluate the analgesic effect of diversion with the use of music during

physical therapy. Patients randomly underwent physical therapy once with music

provided by an iPod and once without music. In both sessions patients experienced

identical physical procedures. At the end of both sessions, patients filled out a five-item

questionnaire where they scored pain and other variables, such as stress, enjoyment,

interaction, and satisfaction, on 10-cm visual analog scale. The culmination of the study

is that music provided through a portable media player has an analgesic effect and can

therefore be employed as effective analgesic strategy during painful physical therapy

(Bellieni et al., 2013).

Social Development

Music can give adolescents the occasion to open channels of self-expression at a

deeply personal level. Music can be used as an instrument for socializing and

encouraging the interaction between people. Many studies that used different designs,

sample sizes, and scales showed pragmatic benefits of music intervention on anxiety

disorder (Egenti, 2019).

Distinct to social competency, research has stipulated that music therapy can

increase social skills incorporating joint attention behaviors, social greeting routines,

communication skills, peer interactions, and cognitive social skills (LaGasse, 2014). In

the current music therapy literature, most of the research examining social skills

development has concentrated on children and adolescents with developmental delays

(Pasiali & Clark, 2018). Research indicates that children’s learning-related abilities

(including self-regulation and social competence) contribute to early school success

(McClelland et al., 2006). Dormant growth curves indicated that learning-related skills

had a distinct effect on children’s reading and math scores between kindergarten and 6th

grade and anticipated growth in reading and math between kindergarten and 2nd grade

(McClelland et al., 2006). Research suggests that children’s self-regulation and social

competence are necessary for timely school success (McClelland et al., 2006). Music

therapy researchers earmarking development of social skills and overall well-being with

adolescents found advances in communication skills, attitudes toward learning, and

relationships with peers (Porter et al., 2017).

In a three-setting study conducted to investigate the effect of a music therapy-

based intervention program on refining social skills competence in children and

adolescents with social skills deficits, it was found that music therapy-based intervention

was beneficial in all three settings (Gooding, 2010). The first study was conducted in an

educational setting, using a one-group pretest-posttest design. The dependent variables

of the first study included: (a) Teacher ratings of participants’ social functioning via

research-created social skills rating system, (b) subject self-reporting ratings of social

functioning using Likert-type ratings, (c) researcher ratings of social functioning using

Likert-type ratings, and (d) behavioral observations of on-task social behaviors in group

sessions. The second study was administered at a private residential program utilizing

the pretest-posttest design. The dependent variables for this study included: (a) subject

self-reported social functioning using the Social Skills Assessment for Adolescents, (b)

subject peer-reported social status via an adapted sociometric scale, (c) staff social

competence ratings via the Home and Community Social Behavior Scales—Social

Competence and Antisocial Subscales, and (d) behavioral examinations of on-task social

behaviors in group sessions. The third study was managed at an inner-city after-school

program. A pretest-posttest control group arrangement was used for this study with

participants indiscriminately assigned to either the control or the experimental group and

used the following criteria: (a) Subject self-reported social functioning using the Social

Skills Assessment for elementary age, (b) staff social competence ratings via the Home

and Community Social Behavior Scales, (c) Behavior Scales-Social Competence and

Antisocial Subscales, and (d) behavioral observations of on-task social behavior of the

experimental group during treatment (Gooding, 2010).

In another study published by Hurst, Wallace, and Nixon (2013), students were

studied to examine the perceived value of social relationship on their learning. The

students were asked at the end of each class period to evaluate their perception of social

interaction as it pertained to their learning. The findings disclosed that students in all

three courses of instruction discerned social interaction to improve their learning by

magnifying their knowledge of literacy and teaching and their critical thinking and

problem-solving skills (Hurst et al., 2013).

Outlooks on social skills development of individuals with ASD highlight the

interplay between motor and social skills (Yoo & Kim, 2018). Studies also suggest that

motor development is related to social skills development in children with ASD (Koehne,

Hatri, Cacioppo, & Dziobek, 2016). Research shows that music therapy can refine social

behaviors and joint attention in children with ASD (LaGasse, 2014). A study conducted

by (Pater, Spreen, & van Yperen, 2021) showed that after 20 weeks of music therapy

sessions the development of social behavior of children with ASD had accelerated.

There was a moderate improvement in the areas of ‘makes eye contact,’ ‘is able to

focus for five minutes on a game,’ ‘is able to cope with changes,’ ‘behavior has

adapted to changes,’ ‘behavior has adjusted to the situation,’ ‘communicates

verbally,’ ‘is able to focus on something together,’ ‘is able to take another person

into account,’ and ‘takes initiative’. (Pater et al., 2021, p. 1)

Special Education

Music therapy in special education is different from music teaching in its

insistence on the accretion of non-musical skills, using music as a representation of

emotional and personal growth rather than as a cognitive skill-set to be learned and

practiced. The profession is guided by ethical policies grounded in the admission of the

importance of the parallel between client and therapist (Rickson & McFerran, 2007).

Since the National Center for Education Statistics (NCES) first documented the

educational placing of students with ASD in the United States, the number of such pupils

taking part in U.S. public schools has increased, and ASD is now the quickest growing

developmental disability, becoming the fourth largest IDEA disability group (McKeithan

& Sabornie, 2019).

No Child Left Behind Act / Individuals with Disabilities Education Act

Children with disabilities are among the most at risk students in public schools.

They are the most likely to be bullied, beleaguered, restrained, or segregated. For these

and other reasons, they also have the most substandard academic outcomes. Overcoming

these challenges requires full use of the laws authorized to protect these students’

affirmative right to equivalent access and an environment free from discrimination (Raj,

2021).

The NCLB Act of 2001 was adopted to ensure that schools were held responsible

for student achievement based on the risk of resulting sanctions are incented to raise

student achievement and that the disaggregation of student attainment data by subgroup

would ameliorate long-standing fulfillment gaps between students of varying race and

socioeconomic status by incentivizing schools to raise achievement for all students rather

than just by increasing the school’s average achievement. There were five directives in

NCLB through which this theory of action was implemented. The states were mandated

to (a) develop meticulous standardized tests aligned with the state’s own content area

standards and regularly deliver them to students; (b) develop a sequential plan in which

each year a substantial percentage of students, overall and within targeted subgroups,

would attain a state-determined proficiency benchmark on the standardized tests until

100% of students reach proficiency in reading and math in 2014; (c) penalize schools that

do not meet the yearly required percentages with consequences of escalating severity; (d)

implement teaching strategies based on scientific studies of their efficacy or

effectiveness; and (e) require all teachers to reach a state-defined standard of “highly

qualified” (Elpus, 2014).

Under NCLB, on an annual basis schools are required to satisfy a series of

academic performance goals to achieve Adequate Yearly Progress (AYP). Schools

receiving Title I funding, monies allocated for compensatory education, to local

education agencies or schools with high percentages of children from low-income

families, that fail to meet AYP for two consecutive years are deemed “in need of

improvement” or “needing improvement,” and “sanctioned” (Bogin & Nguyen -Hoang,

2014, p. 788). This designation of failing caused property values in the local area to

decrease causing an unintended negative affect on the schools and the neighborhoods that

the law was enacted to improve. This led to a “race to the bottom” as schools started to

set their own standards, implementing easier assessments to avoid sanctions and thus

receive funding, eventually leading to the Common Core State Standards (Vegel, 2019).

The IDEA of 2004 is a law establishing services to children with disabilities

throughout the nation. The IDEA obligates public schools to ensure that all qualified

students with disabilities receive a substantive level of education, defined as a Free

Appropriate Public Education (FAPE). FAPE is conferred through a personalized

education program (IEP), which, in turn, has its own highly specific criteria. To qualify

for IDEA services, a child must meet the statute’s definition of a child with a disability,

meaning the child must fall into one of the 13 recognized categories of disability, with the

disability negatively impacting education, and the child must need special education and

associated services as a result (Raj, 2021). IDEA governs how states and public agencies

furnish early intervention, special education, and related services to more than 6.5 million

entitled infants, toddlers, children, and youth with disabilities. Infants and toddlers with

disabilities (birth-2) and their families receive early intervention services under IDEA

Part C. Children and youth (ages 3-21) receive special education and related services

under IDEA Part B (Individuals with Disabilities Education Act, 2018).

The Least Restrictive Environment (LRE) portion of the IDEA states that,

to the maximum extent suitable, children with disabilities are educated with

children who are not disabled, and special classes, separate schooling, or other

removal of children with disabilities from the regular educational environment

occurs only when the nature or severity of the disability of a child is such that

education in regular classroom with the use of supplementary aids and services

cannot be achieved satisfactorily. (as cited in Stone, 2019, p. 526)

This ensures that the students receive the additional curriculum needed, but also ensures

that the student has access to the regular classroom environment, aides, and services.

Research scientists have surmised that the earliest possible intervention for

students with learning disabilities is significant for long-term success because un-

remediated deficits are likely to grow more profound over time. This problem is termed

the “Matthew effect” to signal that early achievement shortfalls spawn faster rates of

subsequent deficits (Colker, 2013). Today, schools can deliver effective screening tests

as early as kindergarten and 1st grade to ascertain which children are likely to have a

learning disability so that early intervention can take place before large educational

deficits have materialized (Colker, 2013).

The purpose of the IDEA is to make certain that students with disabilities receive

an appropriate education under an IEP. The IEP considers the barriers they may face due

to their ailment as well as their individualized educational needs (Colker, 2013). The

IDEA ensures certain actions when school personnel act to change the placement of a

student protected under IDEA for more than 10 days. Whether or not the behavior is

found to be an illustration of the disability, the student has a right to “receive, as

appropriate, a functional behavioral assessment, behavioral intervention services and

modifications, that are designed to address the behavior violations so that it does not

recur” (Dalton, 2019, p. 152).

Intervention Strategies

Music therapy interventions have revealed to improve social behaviors within

groups of children. Studies show that music therapy enhanced sustained attention to

peers, especially with the use of a musical object in a play-based setting. Furthermore,

children’s attraction to music improved interaction with peers in an outdoor play setting.

Children also engaged better to group academic learning (interactive reading materials)

when coupled with music (LaGasse, 2014).

Intervention components that balance physiological systems can be translated into

successful clinical music therapy interventions, allowing for the refining of music therapy

practice to critical components with evidence-based biological targets, ultimately leading

to an increase in the clinical effectiveness of music therapy. Specifically, the autonomic

nervous system (ANS) and hypothalamic–pituitary–adrenal (HPA) axis are useful

physiological systems to examine in comparative music therapy research, as they index

overall stress and arousal levels, are often altered in psychiatric disorders, and are easily

assayed by noninvasive physiological markers (McPherson, 2019).

The most beneficial approach to the use of music therapy as an educational

intervention in schools for students with acute disabilities may be to focus on its use as

factors for teaching and practicing early communication skills (Meadows, 1997). Music

therapy has been recommended as a successful treatment intervention for social

interaction, verbal communication, and socioemotional interchange. The distinctive

stimulus of music provides an appealing way for children with ASD to engage socially

and work toward nonmusical social outcomes (LaGasse, 2017). Music therapy

professionals construct music-based interventions that facilitate social, communicative,

motor/sensory, emotional, cognitive, and music skills in individuals. Music therapy

services are specific to the person’s preferences and abilities, and these can be provided

in cooperation with families and treatment teams (LaGasse, 2017).

Applying Music Therapy

Music therapy incorporates elements of a “meaningful and flexible treatment”

modality, as music occurrences are inherently structured, yet creative. Many children

respond positively to music experiences, conceivably increasing engagement for learning

(LaGasse, 2014).

Studies of the effect of music on mental states and functions are important for the

scientific foundation of “listener-oriented” music therapy, for example, data showing that

background music increases productivity, raises learning efficiency, accelerates

memorization, improves mood, and lessens psycho-emotional stress (Toropova, 2018).

Pedagogy and psychology, in cooperation with preventive medicine, should join efforts

in a search for paths for a socially arranged program of preventive work with children to

remove psychosomatic syndromes in the early phases of the ontogenesis of the

personality (Toropova, 2018).

Meadows (1997) in a review of music therapy for children with acute and

profound multiple disabilities, expressed six goals of music therapy for this population.

The first is fulfilling the child's basic needs which incorporates creating a

trustworthy and responsive environment. The second is developing the child's

sense of self where the child constructs relationships with musical instruments,

music, and the therapist. The third is establishing or re-establishing interpersonal

relationships. The fourth is developing specific skills such as eye contact,

reaching, or using a switch within musical activities. The fifth is dispelling

pathological behavior, and the sixth is developing an awareness and sensitivity to

the beauty of music. (Meadows, 1997, pp. 4-5)

It is imperative that all six goals be accomplished to allow the student to develop the

social and emotional skills required to move forward in life.

Music therapy has been shown to regulate heart-rate variability and salivary stress

markers, physiological markers of the ANS and HPA axes, characteristically. Given the

important role of arousal and stress physiology in many psychiatric disorders, music

therapy has the capability to provide therapeutic benefits in psychiatry. Active music

therapy calls for patients to engage rhythmically with music; as opposed to, passive

music therapy requiring patients to listen to music, removing the rhythmic movement

seen in active music therapy. Yet, it remains unknown whether active or passive music

therapy differentially adjusts arousal and stress physiology (McPherson, 2019).

Theoretical Framework

The theoretical premise for this study, that music therapy can have a positive

impact upon student performance, is taken from the research of Stephenson and LaGasse.

Stephenson (2006) summarized his research as follows:

...the use of music as a therapeutic tool for restoration, maintenance, and

improvement of psychological, mental and physiological health and for the

habilitation, rehabilitation, and maintenance of behavioral, developmental,

physical and social skills all within the context of a client-therapist relationship.

(p. 290)

LaGasse (2014) further supported this premise by stating that music therapy

incorporates elements of a “meaningful and flexible treatment” modality, as music

occurrences are inherently structured, yet creative. Many children respond positively to

music experiences, conceivably increasing engagement for learning (LaGasse, 2014).

The specific classroom variables addressed were taken from a variety of sources

that address the issues of academic performance and classroom behavior. The specific

variables were:

Academic Performance:

• Attention span

• Time on task

• Completion of tasks

• Completed work

• Performance on assessments

Classroom Behavior:

• Interaction with classmates

• Interaction with staff

• Self-control

• Following class rules

• Number of discipline referrals

Research Gap

Upon the review of this literature there were found multiple studies conducted on

the use of music as a form of therapy. The gaps in the research lie in the lack of studies

conducted with K-4th grade students diagnosed as special needs. Research also shows

that there is a lack of standard the effects of labeling a student as having special needs

(DeRoche, 2015).

Despite obvious clinical benefits, the mechanism of action underlying music

therapy is not clearly understood (McPherson, 2019). Numerous studies conducted at the

collegiate level prove that the use of music as a form of therapy reduces stress, and

anxiety. A study conducted by (Ferrer et al., 2012) showed that self-perceived stress

levels were reduced in multiple categories when the student chooses the songs that are

played during the therapy session. The findings of a separate study conducted by

(OsmanoĞLu & Yilmaz, 2019) have unveiled that while listening to classical music for a

60-day period did not have any notable effect on the students’ state anxiety scores but did

lead to a statistically noteworthy effect on their trait anxiety and psychological well-being

scores. These studies are deemed too difficult to reproduce at the elementary school level

due to the logistics in administering the music for the therapy sessions.

An experiment conducted by Kvalsund and Bele (2010), showed that attending

special classes in upper secondary school has a negative influence on social inclusion in

early adult life for students formerly identified as having special needs. This negative

impact can lead to further difficulties with anxiety, depression, and stress in later years

causing further repercussions on the health of individuals previously labeled as special

needs. Research is required in this area to better understand the effects that music as a

form of therapy could have on the reduction of the negative impact of labeling these

individuals.

Perceived gains from music therapy in qualitative terms have scarcely been

reported for depressive disorder and schizophrenia spectrum disorders. Qualitative

studies, moreover, have reported patients’ encounters during music therapy but not after a

completed course of individual music therapy (Paul et al., 2020). Individual music

therapy allows the therapist to remove factors outside of the music therapy that may

contribute to the lack of results from the study conducted.

Synthesis Matrix

A synthesis matrix was designed to support the organization of references in the

literature review (see Appendix A). A synthesis matrix is imperative in research to allow

summarization of common themes related to the research study. The columns of the

matrix were created using the Level II headings in the literature review. This allowed the

researcher to categorize the literature more easily into sections and subsections in the

review.

Summary

The review of literature disclosed a great deal of positive impacts of music as a

form of therapy, not only in the field of elementary education but in the areas of all

physical, mental, social, and emotional needs. Internationally, mental health disorders

account for the most considerable burden of youth issues (Gold et al., 2017). Anxiety

and depression take away from one's social well-being, and as stated by Gooding (2010),

the development of social skills plays a significant role in developing one's social

competence. Research has shown the positive emotional response music has on the

people within our society and the social well-being of those people. There is evidence

that using music therapy on mothers carrying their unborn children has positive effects on

the child after birth. Professionals from music therapists to occupational therapists use

music in a vast number of fields, and significantly different ways to help achieve the

desired result. Using music as a form of therapy increases not only the well-being of the

individual receiving the therapy but also improves the lives of those who encounter those

individuals or groups.

The literature review investigated the efficacy of music as a form of therapy in the

K-4th grade special education classroom pertaining to academics and behavior. Music is

used as a driver of emotion and enhance the learning environment. The need to provide

every advantage to those who are at a disadvantage is paramount to ensure their full

potential is reached. Music therapy can add to the lives of these students by decreasing

the disadvantage related to the social-emotional disconnect, anxiety, depression, stress,

and physical disabilities.

CHAPTER III: METHODOLOGY

This study concentrated on the effects of music therapy as it pertains to academics

and behavior in K-4th grade special needs students. This chapter describes the

methodology used to administer this study. Included in this chapter are the purpose

statement and research questions to provide clarity of movement throughout the study.

The study used a phenomenological approach to ascertain the teacher’s perception of the

impact of music on the students’ academic and behavioral performance. The data was

collected through interviews. The data collection and analysis are explained, and the

limitations are annotated.

Purpose Statement

The purpose of this phenomenological study was to identify and describe the

perceptions of elementary K-4th grade teachers on the effects of music therapy as it

pertains to academics and behavioral incidents in the special education classroom

(Gooding, 2010).

Research Questions

The following research questions were developed to help guide the study:

1. How do K-4 special education teachers describe the impact of music therapy

on academic performance in the classroom with respect to attention span, time

on task, completion of tasks, completed work, and performance on

assessments?

2. How do K-4 special education teachers describe the impact of music therapy

on behavioral performance in the classroom with respect to interaction with

classmates, interaction with staff, self-control, following class rules, and

number of discipline referrals?

Research Design

A phenomenological research design was used to identify the impact of music

therapy on the academic and behavioral performance of K-4th grade students with special

needs. This study is descriptive in its use of the data to show the impact of music therapy

on the students’ attention span, time on task, completion of tasks, completed work,

accuracy of completed work, interaction with classmates, interaction with staff, self-

control, following the rules, and number of discipline referrals.

Qualitative Research Design

Qualitative designs focus on gathering data on naturally occurring phenomena and

use words rather than numbers to describe the findings (Schumacher, 2014). In a

qualitative study, the researcher gathers data from interviews with open-ended questions,

observations, and fieldwork, by providing an extensive description and documents in the

form of written material (Patton, 2015). The purpose of this study was to understand the

perspectives of the teachers’ perceptions of music therapy on K-4th grade students with

special needs making the qualitative portion of this research a phenomenological study

(Schumacher, 2014). The phenomenological method was designed to capture the essence

of the lived experience of the individuals (Patton, 2015).

The qualitative element of this study consisted of interviews with teachers of K-

4th grade students with special needs. Qualitative interviewing begins with the

assumption that those being interviewed have knowledge of and can articulate their

perspectives about the research (Patton, 2002). The interview questions were designed to

capture the experiences that the researcher could not directly observe. The interview

questions also allowed the participants to conduct their observations without the bias of,

or interference of the researcher being present.

Population

According to McMillan and Schumacher (2010), the population is a group of

individuals or happenings from which a sample is taken and to which results can be

surmised. The population for this study was teachers in the states of California and

Washington. Table 1 shows the number of teachers broken down by grade in the state of

California. Table 2 shows the number of teachers broken down by grade in the state of

Washington. Studying such a large group would require time and financial resources that

are not readily available, so a sampling frame was identified for the purpose of this study.

Table 1

Teachers Per Grade Level, California

Grade Level

Number of Teachers

Elementary Teachers (K-5th Grade)

146,521

Middle and Junior High Schools

47,374

High Schools

83,206

Other (Includes Continuation Schools)

41,903

Total Full Time Equivalent Teachers

319,004

Note. K = Kindergarten. Data has duplicate count of teachers if they teach multiple

agencies. Adapted from “Fingertip Facts on Education in California,” by California

Department of Education, 2020. Retrieved from

https://www.cde.ca.gov/ds/ad/ceffingertipfacts.asp

Table 2

Teachers Per Grade Level, Washington State

Grade Level

Number of Teachers

Prekindergarten Teachers

Kindergarten Teachers

2,574

Elementary Teachers

24,112

Secondary Teachers

22,372

Teachers of Ungraded Classes

5,281

Total Full Time Equivalent Teachers

54,428

Note. The total number of teachers includes full time teachers in charter schools.

Adapted from Washington State Board of Education, 2020. Retrieved from

https://www.sbe.wa.gov/

Sampling Frame

A sampling frame is a group of individuals with the same characteristics

(Creswell, 2014). Taherdoost (2016) states that, “A sampling frame is a list of the actual

cases from which the sample will be drawn” (p. 20). The sampling frame for a research

study is the collective group for which the study's data and findings can be generalized.

The sampling frame for this study is K-4th grade teachers teaching special education in

California and Washington State.

According to CalEdFacts (2020) about 12.5% of students in California are

classified as special education. Extrapolation this percentage to the California teaching

population would mean approximately 12.5% of the 319,004 teachers in California are

special education. This means approximately 39,875 teachers in California are special

education teachers.

According to the Washington State Department of Education (2020) about 14% of

students in Washington are classified as qualifying for special education. Extrapolation

this percentage to the Washington teaching population would mean approximately 14%

of the 54,428 teachers in Washington are special education. This means approximately

7,620 teachers in Washington are special education teachers.

Sample

A sample is defined as a subset of the sampling frame that the researcher proposes

to study for generalizing the target population (Creswell, 2014). The sample for this

study is composed of K-4th grade teachers teaching special education who use music

therapy in elementary schools located in the Moreno Valley Unified School District,

Riverside County, California; Oak Harbor School District, Oak Harbor, Washington; and

the Richland School District, West Richland, Washington.

Sampling Process

At the time of this study, there was no official list of schools using music therapy

for either the state of California or the state of Washington (Certification Board of Music

Therapists, 2020). As a result, the researcher had to use a snowball sampling method to

identify potential participants. Snowball sampling, or chain-referral sampling, is defined

as a non-probability sampling technique in which the samples have traits that are rare to

find (QuestionPro, 2022). This is a sampling technique, in which existing subjects

provide referrals to recruit samples required for a research study (QuestionPro, 2022).

The researcher discovered that the number of schools using music therapy is low

under normal circumstances. In addition, the use of distance learning during the COVID-

19 pandemic made the use of music therapy difficult if not impossible. Finally,

willingness to participate during a time of high stress and unsettled school conditions

made some schools and potential participants reluctant to participate. The re-start of

music therapy programs after COVID-19 was found to be inconsistent and spotty. With

the help of professionals in both states, the researcher was able to identify a small group

of participants using the following process:

• With the assistance of a local district superintendent in Washington and a

local school administrator in southern California, the researcher identified a

small initial group of participants.

• Each participant was contacted and participation in the study was requested

(see Appendix B).

• For those individuals that agreed to participate, a study summary, Informed

Consent, Participant Bill of Rights, and other consent materials were provided

(see Appendix C, D, and E).

• Each participant was asked to identify other potential participants.

• This process was repeated until a total of 10 participants was secured for the

study.

Table 3 identifies the participants selected through this process.

Table 3

Participants by District and Grade Levels

School District

Grade Level

Moreno Valley Unified, CA

Oak Harbor, WA

Richland, WA

Note. CA = California; K = Kindergarten; WA = Washington.

Instrumentation

To determine the perceptions of teachers of music therapy as it pertains to K-4th

grade classrooms having students with special needs, qualitative data were collected

(Schumacher, 2014). The researcher was the primary data collection instrument as he

was the sole person conducting the interviews. The qualitative data collected were used

to provide a clear picture of the results of the research.

Qualitative Instrumentation

Interviews of K-4th grade teachers working with special needs students were used

as the method of collecting data. The use of interviews allowed the participants to

describe the experience as they saw it unfold. The interview used a combination of open-

ended questions with the ability for the participants to ask clarifying questions. The

researcher acted as the only interviewer. The interview was recorded for later

transcription with the knowledge and consent of the participants. An Interview Question

Development Matrix (IQDM) was used to specifically align research questions and

variables (see Appendix F).

Qualitative validity. The qualitative research study provided an increase in

validity and reliability by offering explanations on why the survey questions were rated.

The interview process allowed the researcher to go more in-depth on the survey questions

and allowed the participants the time to reflect on the survey and give additional

information regarding their evaluations.

The interview questions were developed by the researcher requesting information

from experts in the field of music therapy and special education, adding to the validity

and reliability of the research. The field experts reviewed the questions and provided

feedback to ensure that the respondents could offer as much observed information

possible, increasing the validity and reliability of the research. The variables for the

study were identified from the literature and expert input on music therapy, assuring

alignment of the variables with the research questions. An IQDM was used to

specifically align research questions and variables.

Qualitative reliability. Reliability is defined as the degree in which an instrument

consistently calculates something from one time to another (Roberts, 2010). To ensure

reliability of the study the survey and interview questions were selected based on

previous studies examined during the literature review process and gathering information

from music therapists and teachers of special needs students. According to Patten (2018),

“To be useful, a measure must be both reasonably valid and reasonably reliable” (p. 71).

Qualitative field test. The interview protocol, created by the researcher, was

designed to directly correspond to the research questions of this study (see Appendix G).

The protocol was field tested with an experienced and informed test group of voluntary

participants, comprised of teachers who were not study participants. The participants in

the field study agreed to be interviewed for the validity of the protocol but not for the

study itself. The field test was conducted to confirm accuracy of the alignment between

survey questions, responses, and research questions. Pilot interviews were also

documented using the Rev Transcription program. Following the field test, feedback was

gathered from each field-test participant on the researcher’s techniques for interview,

interview questions, overall length of interview, and interview process, and changes were

made based on that feedback.

Data Collection

Prior to any data being collected for this study, the researcher submitted the study

proposal to and received approval of the proposal from the University of Massachusetts

Global Institutional Review Board to conduct the study (see Appendix H). Prior to data

collection, certification in the Collaborative Institutional Training Initiative (CITI) was

completed in human subject research: Social-behavioral-educational researchers’ basic

course (Appendix I).

Qualitative Data Collection

Emails were sent to teachers asking for volunteers to be interviewed for the

research. Those willing to participate were then sent a follow-up email requesting a time

and place to conduct the interview. The interviews were conducted via Zoom, using the

10 volunteers from the snowball selection process pool. The meeting time was chosen

and confirmed by each participant based on their time restraints. All interviews were

recorded and later transcribed. Once transcribed, the interview transcriptions were made

available to the individual participants for clarity of understanding and verification of

information.

Ethical Considerations

Prior to conducting the study, the researcher was given approval from the

Institutional Review Board. The procedures, risks, purpose, and voluntary participation

were explained to each participant and documented for future use. Each respondent was

ensured of anonymity and was informed that they could withdraw, without penalty, at

any time during the study.

Data Analysis

In identifying and describing K-4th grade teachers’ perceptions of music as a

form of therapy research questions were asked and the results were analyzed. Qualitative

data were collected, and opinions and themes were coded.

Qualitative Data Analysis

The qualitative data were collected through interviews with teachers of students in

the K-4th grade classroom identified to have special needs. The interviews were held via

Zoom to create a safe environment for the participants, and during a time identified by

the participants to ensure maximum availability and comfort for the respondents. The

audio from the interviews were recorded and later transcribed. Upon completion of

transcription a copy was sent to the individual participants to review for validity of

response. The data collected was then coded, using NVivo software providing themes

and frequency of occurrence. A doctoral colleague trained in coding served as an Inter-

Coder Rater to reduce researcher bias. The Inter-Coder Rater coded 40% of the data and

then those results were compared to the researcher’s results. If a 90% or better match

was found, the coding was considered reliable. If the results were less than 90% the

researcher and Inter-Coder discussed and compared results to achieve agreement. The

information was then reported in frequency tables followed by a qualitative narrative,

interpreting the findings of each research question for this study using intercoder

reliability.

Limitations

Limitations are elements that could negatively affect a study and limit the

researcher’s ability to generalize to other populations, (Patton, 2015). One such

limitation was the fact that the pool of potential participants was small due to the limited

number of music therapy programs, COVID-19 impacts, and the resulting small sample

size due to reluctance of potential participants. Having the sample come from a three

school districts could mitigate this impact, but the sample is still comparatively small. A

second limitation was the researcher acted as the interviewer which could have an

influence on the outcome of the research results. Finally, a third limitation is that this is

the first year back to normal activity following a pandemic which disrupted the previous

school year and could influence the students’ academic and behavioral performance.

Summary

Chapter III described the methodology used in this study, restated the research

questions, gave in-depth analysis of the process of gathering information. The purpose of

this phenomenological study was to analyze the teacher’s perception of the effects of

music therapy on K-4th grade students with special needs. Qualitative data was gathered

analyzing the results of interview questions asked by the researcher. Coding and

descriptive statistics were used to analyze the data and create trends analysis. Chapter IV

describes the results of the analysis and how these results can be used to further the

education in the field of music therapy in the instance of students with special needs.

CHAPTER IV: RESEARCH, DATA COLLECTION, AND FINDINGS

Overview

This qualitative phenomenological study unveils the perceptions of teachers in the

K-4th grade classroom on the impact of music as a form of therapy for students

designated as special needs. Chapter IV provides a summary of the purpose, research

questions, methodology, data collection procedures, population, and population sample.

The interviews of participating teachers from California and Washington State are also

summarized, coded, and inter-coded for validity. This chapter also provides a synopsis of

the findings, based on the collection of data related to the research questions. Chapter IV

concludes with a summary of the findings.

Purpose Statement

The purpose of this phenomenological study was to identify and describe the

perceptions of elementary K-4th grade teachers on the effects of music therapy as it

pertains to academics and behavioral incidents in the special education classroom

(Gooding, 2010).

Research Questions

The following research questions were developed to help guide the study:

1. How do K-4 special education teachers describe the impact of music therapy

on academic performance in the classroom with respect to attention span, time

on task, completion of tasks, completed work, and performance on

assessments?

2. How do K-4 special education teachers describe the impact of music therapy

on behavioral performance in the classroom with respect to interaction with

classmates, interaction with staff, self-control, following class rules, and

number of discipline referrals?

Research Methods and Data Collection Procedures

This qualitative study used a phenomenological method to describe the

perceptions of elementary K-4th grade teachers on the effects of music therapy as it

pertains to academics and behavioral incidents in the special education classroom

(Gooding, 2010). The phenomenological method of collecting data through semi-

structured open-ended interviews allowed the researcher to delve into the lived

experiences of the K-4th grade teachers of special needs students to retrieve the teachers’

perceptions of music as a form of therapy in their classroom.

The study participants were provided with the University of Massachusetts Global

Participant’s Bill of Rights, informed consent, audio release, interview protocol, and a

copy of the researcher’s CITI completion certificate documents prior to the interview

process. Before the start of the interview process the researcher applied for and received

approval from the University of Massachusetts Global Institutional Review Board.

The researcher conducted five interviews via Zoom, and five interviews via face-

to-face meetings with teachers in their classroom based on the results of the invitation to

participate. The interview protocol was used by the researcher during each interview to

determine the perception of each teacher as it pertained to each research question. Each

interview was recorded, transcribed, and then authenticated by each teacher. Each

interview lasted between 15 and 30 minutes. The interview recordings were paused as

needed to accommodate the needs of the participants. The data for this study were

obtained from the interview transcripts of the K-4th grade teachers.

The transcripts were used by the researcher to analyze the collected data. The

first step in data analysis was a preliminary review of the transcripts to determine themes

interwoven throughout the interview process. These themes were then coded using

NVivo software. NVivo is a software that enables the user to input unstructured data

from interview transcripts, among other data forms, and form structured qualitative data.

Using NVivo the researcher could identify common themes among the research

participants based on the transcripts. The researcher placed these themes in frequency

tables to pursue the frequency of the themes throughout the data collection process.

Consequentially, the researcher was able to use this data to describe the perceptions of

teachers in the K-4th grade of music as a form of therapy for their students identified as

special needs.

Population

Population, as defined by McMillian and Schumacher (2010) is “the total group

for which results can be generalized” (p.163). The population for this phenomenological

qualitative study was teachers from the states of California and Washington State.

According to CalEdFacts (2020), and the Washington Department of Education (2020),

there were 319,004 full-time certified teachers in the state of California and 54,428 full-

time certified teachers in the state of Washington. Studying such a large group would

require time and financial resources that are not readily available, so a sampling frame

was identified for the purpose of this study.

According to the California Department of Education (2020), about 12.5% of

students in California are classified as special education. Extrapolation this percentage to

the California teaching population would mean approximately 12.5% of the 319,004

teachers in California are special education. This means approximately 39,875 teachers

in California are special education teachers.

According to the Washington Office of Superintendent of Public Instruction

(2020), about 14% of students in Washington are classified as qualifying for special

education. Extrapolation this percentage to the Washington teaching population would

mean approximately 14% of the 54,428 teachers in Washington are special education.

This means approximately 7,620 teachers in Washington are special education teachers.