Before we are born, we are faced with many circumstances that have the potential to have major effects on our development in positive and negative ways. One of the many circumstances that could impact the development of a newborn infant is a brain-related injury that leads to brain damage within the child. Brain damage is complicated and comes with a variety of unknown factors, but as we dive deeper into the types of brain damage and the effects they may cause, I hope you gain a better understanding of how we can promote the wellbeing of the little humans that are welcomed into this large world of “unknowns”.
CAUSES OF BRAIN DAMAGE
The most frequent brain injury that occurs at birth is due to oxygen deprivation (e.g. anoxia, hypoxia, and birth asphyxia).
Two stages of injury may occur: Brain cell damage is the first stage that occurs within a few minutes of insufficient oxygen. Reperfusion injury occurs once the blood and oxygen flow has been restored.
A stroke is experienced if a disruption of the blood flow and oxygen to the brain occurs.
Typical causes of brain hemorrhages include: head trauma, high blood pressure, aneurysm, blood vessel abnormalities, blood disorders, liver disease, or brain tumors.
When untreated, jaundice can lead to kernicterus. Kernicterus (acute bilirubin encephalopathy) refers to a type of brain damage that can cause athetoid cerebral palsy, hearing loss, vision and teeth problems.
Infants are most at-risk for physical injury upon labor and delivery
Physical trauma can occur due to improper use and placement of birth-assisting tools (e.g. forceps or vacuums) or a rapid delivery.
Maternal infections such as pelvic infections, fevers, preeclampsia, cystitis can lead to brain damage if left untreated.
In terms of birth traumas, the most common brain-related injury is cerebral palsy (CP) which can develop after, oxygen deprivation, infant stroke, and infections.
EFFECTS OF BRAIN DAMAGE
Due to the complexity of the brain and varying degrees of damage, the effects of these brain injuries have the potential to manifest later in the development of the child. However, symptoms of brain damage include abnormal temperament, abnormal physical appearance, or delayed development of the child.
IMPLICATIONS OF MUSIC THERAPY
At such a young and vulnerable age, infants process music in such a powerful way that can lead to many positive outcomes. Music is IN US. As early as 25 weeks, an infant begins to process music in utero (....wow….). Music can be facilitated and promoted by a board certified music therapist to optimize their developmental potential. Music Therapy can be utilized in the hospital as well as through early childhood development.
Music Therapy in the Neonatal Intensive Care Unit (NICU)
Upon arrival, premature infants are faced with a plethora of stressors and complications that impact their development. Due to the stressors they endure, premature infants are at high-risk in obtaining a birth-related brain injury due to the underdevelopment of their organs. Amidst the chaos of their hospital stay, music therapy can be a grounding and supportive therapeutic experience to promote, maintain, and encourage a positive development for the infants as well as an opportunity to promote bonding and provide a sense of control to their parents and caregivers. Research has proven the length of stay of a premature infant decreases significantly when provided music therapy services. Music Therapy within the NICU aids in increasing opportunities for auditory processing, neurological growth and development, and language input. When provided by a trained professional, interventions may include: music listening, neurodevelopmental stimulation (also known as multimodal stimulation), pacifier-activated lullaby (PAL), infant stimulation, and parent counseling.
Music Therapy in Early Childhood
Music is part of our being. At an early age, infants inherently move to music in a rhythmic way, sing a song through cooing or babbling, or move towards a rattle out of curiosity or exploration. Music is motivating, it is fun, it is stimulating. Music has an ability to stimulate all the senses within a human being, facilitating a multitude of developmental skills. Music is processed in both hemispheres of the brain which promotes cognitive functioning. This stimulation of cognitive functioning can be an important tool when an infant is faced with a brain injury at birth. When an infant faces challenges in their development, music can access multiple areas of the brain and essentially override the damaged neural pathways, creating new pathways and optimizing the plasticity of the brain.
Music therapy and early childhood could incorporate a variety of elements (all depending on the age and development of the child): receptive listening, facilitation of movement, a source of stimulation for communication (singing), facilitation of independent play, instrumental playing in gross and fine motor movements, promotion of cognitive development through labeling, and much, much more.
You may ask, “Why does this matter to me?”. On average, there are 130 million babies born each year around the world and millions of these precious babies are affected by birth-related brain injuries. Do all of these children receive music therapy? Absolutely not. Why? Because the funds are not there and recognition of our established profession is not there. This is important to know because advocacy for our profession is a constant act. We need you to understand and promote the positive impact that music therapy can have on these little humans so we (music therapists) can help optimize their potential in their lives and overall well being. Music is powerful. Help us to empower our future generations.
Birth asphyxia- an insufficient amount of oxygen and nutrients occur in an infant’s brain and other organs
Anoxia- an absence of oxygen
Hypoxia- insufficient amount of oxygen delivered to the tissues
Ischemia- insufficient blood flow to the brain
Jaundice- build up of a chemical called bilirubin occurs in an infant’s blood due to an underdeveloped liver (the build up causes the skin to have a yellow coloring)
Preeclampsia- high blood pressure and a presence of protein in the urine
Cerebral Palsy (CP)- damaged or abnormal development of the brain that affects an individual's ability to control his/her muscles.
Brain Hemorrhage- the effects of a stroke causes the blood to flood the brain leading to cell death
Jayne M. Standley’s Music Therapy with Premature Infants: Research and Developmental Interventions