Music Therapy for Premature and Newborn Infants
Bradt, Joke, Music Therapy Perspectives
Nöcker-Ribaupierre, M. (2004). Music therapy for premature and newborn infants. Gilsum, NH: Barcelona Publishers. 226 pages. ISBN 1-891278-20-7. $28.00.
Improved medical care has resulted in a dramatic increase in the survival rate of pre-term infants. However, these infants remain at great risk for emotional and neurodevelopmental problems because of the abrupt separation from the intrauterine environment. In recent years, the care for premature infants has shifted from a pure survival approach to an individualized developmental care approach. Professionals, including music therapists, have used a variety of interventions in the neonatal intensive care unit (NICU) in an attempt to give infants sensory and social stimulation that would have been provided for in uterus. Music Therapy for Premature and Newborn Infants, edited by Monika Nöcker-Ribaupierre, sets out to bring a deeper understanding of the role of music therapy in the neonatal care environment. The first part of the book provides us with theories and models from related disciplines including medicine, developmental psychology, and psychoanalytic psychology, leading to a deeper understanding of the impact of premature birth on the infant and the mother. The second part of the book focuses on clinical applications and research in neonatal music therapy.
In the first chapter, Christine Fisher and Heidelise Als present us with a well-written and informative discussion on individualized relationship-based developmental care in the NICU. The chapter begins with a concise overview of normal neurological development throughout the prenatal period. Although this information will not be new to many readers, it provides a great background to contrast with the extra-uterine experience of the pre-term neonate. And this is exactly what these authors set out to do: contrasting the experience of this 'displaced fetus/ as termed by AIs, with what would have been in the womb. The authors succeed in convincing the reader for the need of an individualized developmental approach to counterbalance the severe "sensory mismatch." The chapter concludes with guidelines for the implementation of a developmentally supportive NICU.
In the second chapter, Kenneth Cerhardt and Robert Abrams give detailed information about the intrauterine sound environment and the transmission of sound to this environment. This is followed by a review of the prenatal auditory development. The authors emphasize that knowledge about the intrauterine experience of sound elements is paramount to our understanding of the impact of sound on the pre-term infant. It becomes clear that the immature auditory system of the preterm neonate is not equipped to respond to the highfrequency stimuli characteristic of the NICU environment and is not ready to tolerate sound intensities never encountered before. Recommendations are made for the NICU sound environment, specifically as it is related to musical stimuli. The insights provided by this chapter raise several concerns related to the use of music with preterm infants. Do we have sufficient information about the effects of added sounds, such as music, on the auditory experience and the development of the premature infant? I eagerly continued to read the subsequent chapters, hoping to find some answers.
The third chapter provides insights into the development and the quality of attachment relationships between preterm infants and their mothers. Tina Gutbrod and Dieter Wolke, two experts in child development, present a comprehensive review of research findings and discuss the meaning of these according to a transactional perspective. Although one would assume that a prolonged stay in the NICU puts the preterm infant at risk for insecure attachment, the extensive review provided by the authors suggests that research on this subject is inconclusive at this time. Throughout the chapter, the authors make many useful recommendations for future research. …