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	Aneldy's story won first place for the western region in the Society of Professional Journalists Student "Mark of Excellence Contest." It is now a contender for national honors.

Tanner West pressed the lowest note on the keyboard. The usually quiet 6-year-old mimicked the deep tone, attempting a brief duet before grinning widely. On the keyboard were happy face stickers attached to different keys that his mentor, 23-year-old Ryoko Yokoyama, wanted Tanner to press.

Tanner eyed the keys warily before deciding to press all the happy face ones simultaneously rather than the single one Yokoyama instructed him to push. They both laughed as his small arms tried to cover the range of the keyboard, making a dischordant series of tones.

Nothing in the way Tanner played with the instrument or the way he followed Yokoyama's instructions betrayed Tanner as a happy and bright child. Every inch of him from his big brown eyes and brown hair to his untied shoelaces indicated a normal kindergartener with an infectious smile and an innocent curiosity. Not even an expressive language disorder can easily distinguish him as anything but a regular kid.

Tanner tends to speak in sentences that do not follow normal styles of communication, and for that reason he goes to ASU's music therapy clinic, whose therapists use music to treat a variety of patients with physical and mental disabilities.

"With Tanner, the problem is very subtle," explained Robin Rio, director of the ASU music clinic, which is housed in the ASU-owned Community Services Center on Curry Road. "You'd never be able to tell there was anything different unless you spent a lot of time talking with him."

She once asked him how old his dog was and he replied, "Zero."

Tanner's mother, Rhonda West, later explained to the therapy student that the dog had died. She recalled when her son asked whether the dog "was in our world," rather than asking if the pet had passed away.

As part of the music therapy, Yokoyama often engages Tanner in light conversation involving singing or music, making note of what he says and how he says it.

Suddenly, Yokoyama becomes more than just a mentor and musician. She is a senior music therapy student helping Tanner organize his words so that when he talks his sentences convey ideas the way most people convey them.

Music therapy differs from other therapies because it uses music to reach patients who would otherwise have difficulty doing normal activities such as speaking or moving.

Music therapy does not teach patients to play an instrument, but it does use instruments to teach patients how to play. Yokoyama and many of her peers sing to their clients to make them understand their instructions.

In an activity involving alphabet cards, Yokoyama strummed a guitar as she sang, "Can you spell 'Tanner?' T-A-N-N-E-R?"

He found the appropriate letters from the mixed pile of cards on the carpet and arranged them to form his name before Yokoyama even finished her question. She praised him for doing so well, and he gave her a shy smile.

Tanner, who attends Benjamin Franklin Charter School in Gilbert, knows how to express himself in many non-verbal and verbal ways, but the prosaic phrases he uses are not familiar to most people.

For decades, music therapists have been using music to compose the mind while researchers have only begun to explore how it affects the body and senses.

Most people might enjoy music to relax or reflect a mood when they pop a CD into a player or drive around town with the volume pumped up. However, music therapists take advantage of music's healing properties to meet the needs of their clients.

"A music therapist is a trained health professional who uses music as a primary tool for therapeutic interaction," said Barbara J. Crowe, an ASU music professor and the director of the music therapy degree program. "We work with autistic children, the cognitively impaired, adults, children, the elderly and the learning disabled. All kinds of clients."

The ASU clinic is a training facility for degree-seeking students, who conduct all the therapy sessions under the supervision of two certified music therapists, Crowe and Rio.

Only students who have successfully auditioned to prove musical ability are admitted into the Bachelor of Music program for music therapy.

"Music therapists are trained musicians," Crowe said. The students must be able to draw from a variety of music styles for all ages, ethnic backgrounds and geographic locations.

Students are required to serve four semesters in pre-clinical sessions at the ASU music therapy clinic program before moving onto a six-month internship elsewhere and earning their degree and certification.

During each of the four pre-clinical semesters, the students are paired up with a different client to ensure they get breadth of experience. Some work with the elderly in nursing homes and some with groups of mentally retarded children.

Yokoyama is one of eight students conducting sessions for nine clients this semester.

Another student therapist, ASU junior Tracy Borden, 22, has worked with Tammy Cooper, a veteran of music therapy.

Like most other 17-year-olds, Tammy loves hanging out at the mall, flirting with guys and listening to music. Her smiles tell people that she is extremely happy.

Since the age of 3, Tammy has attended music therapy sessions to help develop the motor and communication skills debilitated by her cerebral palsy.

Tammy is multiply handicapped. As an infant, she suffered brain damage and hemorrhaging that resulted in seizures and motor coordination difficulties.

In a typical session, Borden rhythmically tapped a bass bar with a mallet while singing to Tammy. Her voice rang clearly in the room as she sang a combination tune of One little, two little, three little Indians and Skip to My Loo. Tammy laughed while rocking to the rhythm before finally deciding to move closer to the singer.

For Tammy, music is one of the most important connections to the world. She can laugh and cry, but she cannot speak except for the occasional and enthusiastic hello.

"She'll do anything for music," said her mother, Karen Cooper. "She'll rock, she'll hum, she'll sing. She'll forget her pain."

Because Tammy cannot walk on her own, she sits on the carpeted floor, reluctant to move. Her therapist will stand on the far side of the room and repeatedly sing the command for Tammy to crawl toward her.

When it suits her fancy, Tammy will happily go.

Music therapists, and those in training such as Borden and Yokoyama, can play different instruments such as flute, keyboard and metallophone to stimulate responses from their clients.

According to their parents, Tanner and Tammy seem to respond more to music than they do to the traditional therapies just from the physical interaction.

"She doesn't realize she's working. She thinks this is all a game," said Cooper, who also takes her daughter to speech therapy and horseback riding therapy.

West takes her son to speech therapy, but said that music therapy has a different effect on him.

"I think he enjoys music therapy more because it involves him more," West said.

She added, however, that Tanner's progress is measured by how his sentence formation improves and he speaks more in speech therapy than he does in music therapy.

But because music therapy has him moving around, playing instruments and doing cognitive activities, she said it activates more of his senses.

Yokoyama, who has worked with Tanner since January, has watched the gradual changes the shy boy has undergone.

"He talks more," Yokoyama said. "His social interaction has gotten better and he expresses himself more and more."

Unlike the more common speech and hearing therapy, music therapy employs the use of patterns and tones, which can reach parts of the brain that spoken words do not.

When we hear sound, it comes to us as noise. The brain's sound system, the auditory cortex, processes the noise.

The auditory cortex is made up of different components that work together helping people hear and speak, very much like a little home stereo system, but in our brains. Sounds identified as words go to Wernicke's area, a region in the left temporal lobe of the brain. Wernicke's area controls speech comprehension. Without it, words would sound like noise.

On the other hand, researchers have long suspected that music comes in through the left hemisphere, but is processed in the right hemisphere.

Analytic and language functions are handled on the left side of the brain more than 95 percent of the time, while musical perception is handled primarily in the right temporal lobe.

Because music seems to be processed in different areas of areas separate from Wernicke's area, people such as Tanner and Tammy are sometimes able to better understand the words sung to them more than ones spoken to them.

Tanner, for example, used to struggle with reading the hands of a clock. Tanner would say "eight, oh, oh," instead of 8 o'clock, and "Oh, oh, oh, oh," instead of midnight, noon or 12 o'clock.

He had been reading the hands of the clock the way he writes time on paper. For example, he will write "8:00," but not "8 o'clock." To him, the beginning of a 24-hour day logically begins with "00:00."

It is only recently that he could say 8 o'clock after Yokoyama had read the clock with him, singing the times and having him repeat after her.

About three to 10 percent of all school-age children have expressive language disorder. The disorder probably originates from a problem in or near Broca's area, the region of the brain a few inches in front of Wernicke's area in the left hemisphere. Broca's area is responsible for the physical coordination of speaking and saying the words that a person thinks.

"Autistic children and people with learning disorders will have certain processes that are more difficult for them to integrate, but they'll still be able to do things 'normal' people may not," said Dr. Robert Spetzler of the Barrow Neurological Institute in Phoenix. Spetzler is the director of the institute and a renowned neurosurgeon.

"The music center is not the same place as the spoken center," Spetzler said. The doctor's observation helps explain why Tanner seems to have perfect control over his musical activities, but still has difficulty expressing his thoughts the way they would be understood in American culture.

Singing and speaking may seem too similar to have much distinction because they both involve pitch changes, rhythm, tempo, tones and other factors. However, speech requires short-term sequencing involving short-term memory. Music, on the other hand, usually involves long-term memory and patterns.

In other words, music therapy can often help patients perform activities they would otherwise be incapable of doing.

"People who won't speak can sing and vice versa," Borden said.

Recent findings show that music may be used to treat physical disorders such as common forms of epilepsy.

"Tammy has seizures 24/7 and the only way to calm them is with music," her mother said.

According to a 1998 study reported in the journal, Clinical Electroencephalography, music was found to reduce brain seizures. John Hughes, Yaman Daaboul, John Fino and Gordon L. Shaw studied 29 epileptic patients from three to 47 years of age, all of whom had frequent seizures.

They measured how brain waves acted during silence, a Mozart piece, a following period of silence, some old time pop tunes and another period of silence. The scientists found that the seizures decreased in 23 of the 29 cases. The average amount of time these 23 patients had seizures was reduced from 62 percent to 21 percent.

Unsurprisingly, the effect occurred only with Mozart's music.

"It would be natural to consider that Mozart was more relaxing or enjoyable, but being relaxed does not necessarily prevent seizures," said Professor N.M. Weinberger of the University of California at Irvine. "Moreover, the music was effective even in patients who were comatose, so they presumably were not consciously aware of the music."

Weinberger has monitored the relationship between music and neuroscience for many years as a professor at UC Irvine's Center for the Neurobiology of Learning and Memory.

Studies such as this one indicate that music may later prove to be a very powerful treatment for epileptic seizures.

Unfortunately, music can also induce epileptic seizures in the brain. While rare, this phenomenon indicates the potential power of music and its disadvantages.

"When somebody has seizures, they have a trigger point in their brains that releases an electrical signal which becomes apparent in the form of seizures," said Spetzler; "There is certain music that can be soothing and calming, but there is some music that can trigger seizures."

A person can be given medicine, or be put in a situation where the trigger point is enhanced or dampened. In some cases, the person's trigger is activated by certain sounds, including music.

"Tammy hates phones and beepers," said Cooper with a laugh; "She likes jazz, Johnny Lang, BB King, and some country. She's so picky."

Other studies have shown that music therapy may be effective because of the way music can reorganize brain function and that such change could be detected by analyzing "brain waves."

In 1996, Russian scientists T.N. Malyarenko and his colleagues wrote in the journal Human Physiology about music's ability to alter brain waves.

They played classical music one hour per day over the course of six months to 4-year-olds in a preschool setting. The control group was exposed only to normal classroom sounds.

It turned out that the classical music group showed an increase in coherence between different regions of the brain, especially in the frontal lobes.

Greater coherence is thought by some to indicate better cooperation among brain regions while others view it as typical of increased relaxation. The more the different brain regions work together, the better and more efficiently the brain works. Brain wave changes occurred even though the children were not required to pay attention to the music.

Of course, even with these recent revelations about music's effects on seizures and brain waves, nobody can pinpoint the exact mechanism that makes music therapy effective.

Sometimes the lines are blurred when determining whether the music therapy works because of the neurological basis or the emotional interaction.

"Music is very motivating, especially in children," Crowe said. "Music very much does touch and evoke emotion, and not only is that important for someone who is in a psychiatric facility, but also for a child who is dealing with frustrations."

Music evokes memories and emotions, too.

"You can have a person who has learned a language as a child, grows up speaking another language, then have a stroke, then cannot speak the language they've spoken the last 50 years, and yet still be able speak the language they spoke as a child," Spetzler said.

Crowe said, "Now we know how important emotions are in forming memories and in terms of memory encoding, so when you're dealing with people who have memory disabilities like head injuries or Alzheimer's patients, then music can be very critical because of that emotional link."

Alzheimer's patients with severe dementia are barely able to organize the muscle groups to walk.

In working with elderly Alzheimer's patients, music therapists will play music from the person's past in order to establish a connection and hope that the music will trigger a memory.

"We try to use music to help them get aware of their feelings," Rio said. From there on, the music therapist can work to help the patient gain speech or mobility.

Crowe remembers one patient who couldn't walk until the therapists played some swing tunes from his youth. Then he started dancing.

"The music provided a way to organize his behavior so that he could dance," she said. But with some patients, music is purely motivational, Crowe added.

"They're motivated to do something because they like the music," she said. "They're not going to work on a motor skill unless you get them motivated about using it."

Among the problems music therapists have is the acceptance of the field as a legitimate therapy in mainstream society.

"One of the drawbacks we run into as a profession is that we have a concept of what music is. Everybody has some kind of relationship with music," Crowe said. "Most of the general public, including the healthcare professionals, see music as entertainment."

In reality, music therapy began as a medical profession, primarily in psychiatric or mental health in the 1950s. The music therapy program at ASU has existed since the 1970s.

Like other medical professionals, music therapists begin by assessing the client's needs and tailoring activities involving music to meet those therapeutic needs. "Often, the first reaction people have when they hear of music therapy is that they don't get it," Crowe said. "You buy a CD; you go to a concert or you watch a television special-and that's the only concept people have of music."

Music therapists and clients know that music is a valuable tool for therapeutic interaction because of all its neurological and emotional connections.

"You're there to try to help them, you're not there to entertain them," Borden said. "Mothers and elementary school teachers have no trouble when I talk about music therapy because they use music with their children to help them gain motor skills and learning ability," Crowe said.

Cooper learned long ago to adapt to Tammy's special relationship with music.

"Playing music is the only way I can get her to do anything," she said.

For Tammy, the years in music therapy have made her happy and sociable despite her pains and motor difficulties. She's learning to use her hands and move her body to the music that has become her link to the world.

Tanner has also grown in the nine months he's attended music therapy. He freely participates in the activities Yokoyama arranges, whereas he used to hesitate. Tanner's last activity during one of his sessions with Yokoyama was dancing to a song from Disney's The Lion King. Both stood up and touched their heads in unison, then their shoulders, then their waists.

Ever so quietly, Tanner tried to sing along to the music.

"Oh, I just can't wait to be king..."

Copyright 1999 Aneldy Leaf
A version of this story ran in The ASU Bulldog, May 1999.

If you are interested in purchasing this story for publication,
contact Ed Sylvester.