What’s the Best Musical Choice—Classical or Rock?

I began to contemplate why Karen’s abilities in music were so very advanced and how this affiliation with music could interfere with her self-injurious gouging behaviors. After seeing many people for whom this was true, I set up an experiment to move beyond observation to investigation. The experiment was an intra-subject design meaning that the same person served as both a subject in the control condition (without music) and the experimental condition (with music). The study began with the psychology team evaluating the frequency and types of self-injurious behaviors for the eight participants. In pilot sessions and then the actual sessions, we played music groups for periods of 20 minutes. Two psychologists rated whether the subjects were self-stimulating or not (binary assess) every thirty seconds.

The study was inspired by the observation that many residents with self-stimulatory behaviors decreased with musical engagement. This experiment was also a means to assess what was the ‘right’ music to play in the living areas of this state institution. We had recently installed a music system in the nurses’ station that had speakers in the dining area, bathing area, and open area of the dormitories in which these people lived. There had been disagreement amongst staff as to whether the music should be classical or rock. The divide was great and I felt that the research experiment would help define what was best and the various ways to measure that meaningfully. In these areas of the residence, people were generally on their own waiting for a bath, a diaper change, or a meal to come. There was often a television running that may or may not have been engaging for them. Self-injurious behaviors were thus observed to be high during these unprogrammed times.

For the study, I selected three pieces of music in each of the two genres, classical and rock. The music varied overall from simple to complex rhythmicity. Many of these self-injurious behaviors were highly rhythmic. As rhythm is a powerful organizer for movement, I chose music that varied from being rhythmically straightforward and predictive to music that was less predictive and accelerated and decelerated. For example, Bruce Springsteen’s ‘Born in the USA’ has a highly predictable beat with strong drum strikes on 2 and 4. This contrasted with the Police recording.

The results were quite surprising. Karen and her peers showed statistically significant declines in self-stimulatory behavior during the most predictive music. Genre did not matter. This was a big lesson about the power and influence of rhythms.

Our brains are pattern-seeking organs. We make sense of the world through pattern recognition and discrimination. The patterns of the Police and Brahms’ music were not as distinct as Springsteen and Bach and after a few minutes, most of the subjects went back to their typical self-stimulatory behaviors.

What is fascinating about the participants of this study is that they were all residents of a state institution for intellectually disabled people. They all functioned in the severe to profound range of intellectual disability. They were all nonverbal and many of them were nonambulatory, like Karen. And yet their perception of music, their attention to music interfered with the self-stimulatory behaviors that occupied so much of their days. The music appeared to provide a sensory stimulation experience that they craved, needed, and benefitted from.

The results of this study helped us determine music programming in the unit that served the needs of the residents. We would come to program music that was more energetic prior to mealtime as so many of the people had low tone or were very challenged to eat by mouth. They were more alert and participatory if they were primed by music first. We also came to program sedative music toward the end of the night to facilitate sleepiness and readiness to sleep. We also programmed periods of silence for they too are an important part of the music and an important part of auditory perceptual experiences.

What this demonstrated is the power of music with the least amongst us. The brain damage, usually from birth was severe enough to merit 24/7 care in a state institution. And yet, they were musically abled, musically influenced, musically productive. It taught me about the power of music elements (rhythm, melody, harmony, timbre, preferences, memories) and the reliance on them to optimize results.