Many of my clients and patients have developmental delays. In the Newborn Intensive Care Unit (NICU), I often get referrals for patients who have been born very prematurely, but have grown up and reached or passed their due date. These patients often are already delayed or are at least at great risk for developmental delays, because the typical course of development that occurs when babies are born near their due dates is altered when they are born early.
I once received a referral for a baby boy who had been born about 3 months early, but was now 5 months old – 2 months past his due date. He had a feeding tube, but didn’t need to be on any respiratory support, and was able to be held. His mother wasn’t able to be at bedside, and the nurses knew that letting him lay alone in his crib day after day would certainly slow his development even further, so they referred him to music therapy, physical therapy, and occupational therapy.
He was awake and fussing in his crib when I arrived. I brought in a few small instruments and a storybook with many contrasting colors in the pictures. I picked him up, rocked him, and sang a hello song. He kept his head turned away rather than looking towards me, which I knew could mean that he was overstimulated, so I stopped rocking and singing and simply held him for a few moments. He lay calmly in my arms, so I started humming a new song. I added in the words during the second time through. He turned his head towards me and made eye contact as I started the song over a third time.
I praised him for making eye contact. “Look at your beautiful eyes! Are you looking at me? I’m looking at you!” I gave him a big smile and he gave me one in return as we started a new song called “I See You.”
Since he was doing so well with visual focusing, I decided to show him the storybook. He looked at the cover as I held it up next to our faces. His eyes widened as I opened the book to a page with bright, contrasting colors. “What do you see? Are you looking at the giraffe?” I sang a song about visiting the zoo as he looked at the animal pictures. As I sang, I moved the book slightly, encouraging him to move his eyes and head to keep looking at the pictures.
He reached one of his hands out, so I put a small toy against his fingers. He opened his hands up and grasped the toy. “Great job! You are holding the toy!” I put some pressure on the back of his opposite elbow to encourage him to reach his other hand to the toy as well. When he had the toy with both hands, I sang a song about the colors on the toy.
He yawned a few times during the color song, so I sang it again while rocking him and snuggling him closer to my body. He sucked on his thumb and his eyes became heavy. He fell asleep as I sang lullabies.
To someone walking by the room, it may have looked like I was simply playing with this baby. In fact, I was intentionally creating specific experiences to help him work on the following goals:
- Increasing tolerance to stimulation
- Promoting social engagement (eye contact)
- Improving motor skills (reaching out for toys, bringing hands to midline)
- Improving visual tracking ability
- promoting comfort and age-appropriate soothing skills
Do you have or know a young child who is at risk for developmental delays? A music therapist might be able to help! Contact Joyful Melodies for help finding a music therapist near you.