Treatment techniques of neurological music therapy according to Thaut for cognitive training are described here.
The rehabilitation of cognitive functions can be sustainably improved through music therapy techniques. Cognitive performance is inherent in making music. This enables the development of specific musical exercises for perception, attention, memory and thinking.
Musical activation of alertness and awareness
Quantitative consciousness disorders are coma (not awakenable), Sopor (can be briefly awakened to pain stimulus), and Somnolence (can be awakened for a longer period of time upon contact). Awake people can be in one vegetative status (alertness without consciousness), in one minimally responsive status (Wakefulness with partial consciousness) or over complete awareness feature. Awake and conscious people can in one acute psychosyndrome suffer from severe neuropsychological disorders. These include extreme slowdowns, a lack of focus, clinging to individual environmental stimuli, disorientation, a lack of day-to-day memory, a lack of voluntary reactions, a lack of awareness of the illness (anosognosia), psychomotor agitation, aggressiveness or apathy. For these severely affected patients, the Musical Sensory Orientation Training (MSOT) offers a first therapeutic approach.
It contains two parts:
(1) Goals of early musical stimulation are the initiation of wakefulness, awareness, basic orientation to body, space and time as well as initial reactions appropriate to the situation.
(2) Building on that with simple active musical exercises Continued attention is encouraged, regardless of the correctness of the reactions.
Musical perception training
In contrast to the visual system, there are hardly any neuropsychological exercise methods for the hearing system, despite the high importance in everyday life. With musical exercises, neurological disorders of auditory perception can be treated well.
The auditory perception training- Auditory perception training (APT) comprises two parts:
(1) In auditory perception training the distinction between different sound components is practiced, e.g. pitch, duration, tempo and rhythm.
(2) At the sensory integration different sensory modalities are combined: listening to music with sensation (e.g. vibration), with movement (e.g. weighing) and with seeing (setting images, e.g. clouds).
Musical neglect training
With a neglect, perception and attention to the area of the body and body opposite the brain damage are impaired. A neglect is usually multimodal, ie the patients neglect visual, acoustic and tactile stimuli on the affected side and / or move the limbs on this side too little. Seeing, hearing, sensitivity and movement are basically preserved. A further complication for the therapy is that the patient is not aware of the disorder (anosognosia).
In the musical neglect training (MNT), the patient involuntarily directs sight, hearing, movement and attention to the neglected side during active instrumental playing. Musical structures and the spatial arrangement of the instruments in the direction of the neglected side are excellent tools for this.
Musical attention training
Neurological disturbances in attention lead to a reduction in general responsiveness, slowing down, incorrect working methods, impaired attention sharing, distractibility and reduced permanent attention.
As part of the musical attention training - Musical attention control training (MACT) specific music interventions have been developed to promote the various attention components:
(1) Sustained attention is built through general reactions to changing musical stimuli.
(2) Selective attention is promoted by directing attention to a specific musical stimulus, by carrying out a targeted reaction to this stimulus and by masking out other musical disturbance stimuli.
(3) Alternating attention is promoted by alternating attention between two or more stimuli.
(4) Divided attention is trained by the simultaneous attention to several musical stimuli and the implementation of certain reactions to each of these stimuli.
Musical memory training
As a complex system, memory comprises many different sub-components. Memory disorders can affect linguistic content (e.g. texts) and / or pictorial spatial material (e.g. faces, paths). Neutral information (e.g. news) or personal experiences (e.g. vacation), short or long-term information (minutes to years) as well as conscious content (e.g. conversation information) or unconscious routines (e.g. movement sequences) can be disturbed. When learning, the repeated impressing of new information (e.g. vocabulary) and the so-called prospective memory (memory for the future) can impair the memory for appointments and agreements.
In musical mnemonic training (MMT), musical stimuli (songs, easy-to-remember melodies) serve as memory templates in which non-musical memory information (e.g. names, information for orientation) is integrated. The memory of the musical structure makes it easier to retrieve the non-musical memory information.
A variant is the mood-dependent memory training- Associative Mood and Memory Training (AMMT), in which memory information is linked to a mood induced by music and thus the learned information is linked to the mental nodes.
Musical planning training
Executive functions include the planning, execution, control and evaluation of actions on a practical, linguistic and intellectual level. The highest human brain power here is the ability to abstract. This enables concrete things to be exceeded through the formation of conceptual concepts. Accordingly, executive disruptions include a lack of ability to abstract and reduced flexibility, a lack of decision-making ability, impaired implementation of plans in actions, premature use of non-targeted actions, rule violations, lack of error control and lack of learning from errors, quick giving up, justification for problems and a lack of awareness of errors. In the Musical Executive Function Training (MEFT), all of these components can be trained with musical exercises in a group or individually. Group therapy is particularly suitable for practicing targeted dialogue and collaboration.