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An animated group of adults -- some in wheelchairs, some not -- rock and sway, shake their heads and sing as a guitar-wielding Kali Cooke leads them in singing "Amazing Grace."
To Cooke and her audience at the Beaufort County Department of Special Needs in Burton, the guitar is not just a musical instrument. It's an instrument of healing. As a music therapist, Cooke uses her guitar, voice and other instruments to help people struggling with various conditions.
Program director Bill Love said Cooke has worked with the center's clients for about three years.
"When I say, 'Kali's coming,' ... they light up," Love said. "The music is such a nice way for them to connect in a way that a lot of them can't connect."
Cooke also uses music therapy to work individually with kids who have autism and attention deficit hyperactivity disorder, people in assisted and independent living communities, and dementia patients.
What is music therapy?
The lively crowd in the special needs program shouts, "Go, Tina! Go, Tina!" as a woman prepares to throw a small, soft ball in a game of "karaoke bowling." Five pins down means Tina gets to sing "He's Got the Whole World in His Hands."
She steps up to the microphone and gets her moment in the spotlight, her chance to shine. Her peers show support by clapping and cheering her on.
According to Cooke, music therapy is a treatment method that uses music to achieve various nonmusical goals. Those goals might be to improve social skills, reach physical goals or promote emotional well-being. Just as physical therapy uses exercise equipment, music therapy uses musical instruments.
She said a simple musical game can teach participants social skills, such as taking turns and following directions. It can help people reach physical goals, such as improving balance through dance. And it can bring joy to those involved, improving their overall emotional well-being.
"Music therapy is a lot of fun," Cooke said. "It works great with kids because they don't know they're working. When you go to see a speech therapist, you're doing flash cards, and it may not be all that much fun for a child. When they come to music therapy, they're singing and using instruments."
Kids and music
Cooke said she uses adaptive music lessons with several clients. During adaptive music lessons, her clients learn how to play an instrument. The goal, however, is not only to teach them how to play, but also to help then with attention and self-esteem. In a typical piano lesson, students have to focus throughout an entire song without stopping to talk or play. It teaches them to stay on task and follow directions.
She said some students who started out only being able to play for two or three minutes and are now doing entire lessons and playing at recitals.
"When they're able to play for their first recital, it's a big deal, especially for kids with ADHD because so many of them feel unsuccessful," Cooke said. "They have academic issues and peer troubles."
She said there's a lot of research that shows when kids are involved in music, they do better academically. Music lessons help with reading and math skills, with which many ADHD kids struggle.
"It's been really neat to watch that transition," Cooke said. "I've had parents tell me that their child's grades in math and reading have gone up significantly since starting to do music."
She said her clients also are working on fine motor skills through playing the piano or guitar, balance by dancing and muscle strength through playing a variety of instruments.
"The neat thing about music is you can work on all those things at once," Cooke said. "One game of 'Hokey Pokey' with a child, you're working on gross and fine motor skills. You're working on language with them through song. You're working on social skills if you're with a group."
Finding a voice
Cooke said nonverbal autistic children also do well with music therapy. Active musicmaking works with both sides of the brain, so song is another way to work on speech and language.
The same goes for stroke victims. Cooke said music can help them learn to speak again. And rhythm can teach them to walk. She said she starts with a slow beat that matches where they are and gradually speeds up the rhythm until they have a comfortable gait again.
Autistic children also learn to make eye contact, follow directions and stay in their seats through music therapy.
"I've had lots of success with kids that have not had success in speech therapy with learning how to talk," Cooke said. "But they'll come to music and within a few short weeks, they're filling in blanks to my song."
Cooke said music therapy is also great for people with Alzheimer's and other forms of dementia.
"Music is the last part of the brain to go," she explained. "You may not be able to have a conversation with an older adult with dementia. But they'll remember the words to every song they knew growing up. And so through that you can sometimes elicit a memory from them or a response from them that you wouldn't be able to just talking."
Another local music therapist, Mary Scovel, uses music to help the terminally ill through Hospice Care of the Lowcountry. She said music actually alleviates pain for some patients.
For example, Scovel works with an 82-year-old woman who suffers from a lot of pain due to cancer and Parkinson's disease. When Scovel arrives for music therapy, she asks the woman what her pain level is on a scale of one to 10. Scovel said the woman always says her pain is a 10. After the woman plays the instrument and sings, she says her pain is gone.
Scovel said Hospice tells her ahead of time about the needs of each patient. If someone is feeling anxious, she will try to help them relax through music. She asks the patients what kind of music they like and plays or sings that for them. She tries to get them involved in the music by getting them to sing or play along if they are able.
Scovel said she helps some patients write songs, which can be very therapeutic because they are able to express themselves.
And when her patients are at the end of their lives, Scovel said she sometimes sings quietly to them as they go.
Scovel said the dying patients aren't the only ones who benefit from therapy. Family members are often in the room and become very engaged in the therapy as well.
"It's a great honor to be invited into their homes," she said. "It's just a sacred moment."
Music and mood
While Scovel uses music to help her patients transition out of this life, Cooke uses music to make life better for her clients.
Love said he can see a huge difference in the behavior of his clients at Disabilities and Special Needs after one of Cooke's music therapy sessions. He said they become more engaged. They interact with each other much more than usual. The music puts them in a good mood for the rest of the day. It gives them something to look forward to, and it motivates them to behave themselves beforehand.
"When I'm having a bad day, I love to just sit down and play the piano," Cooke said. "Something about it just makes you feel better."