Summary: A new music therapy-based tool called MuSICCA may transform how healthcare teams assess consciousness in children with severe brain injuries. Developed to address the lack of reliable diagnostic methods for children aged 2 to 18, MuSICCA uses tailored live music performed by a therapist to evoke and record patient responses.
These responses are measured against a diagnostic scale to evaluate awareness, offering clearer insights into a child’s cognitive state. Initial feedback from professionals and families strongly supports its validity and usefulness in clinical care.
Key Facts:
Source: Anglia Ruskin University
Music could provide a breakthrough in assessing consciousness levels in children who have suffered significant brain injuries, according to new research published in the journal Frontiers in Psychology.
Children with disorders of consciousness rely on those caring for them to provide all aspects of their daily living, including hydration, nutrition, washing and dressing.
There is currently a lack of tools to assess consciousness in children aged between two and 18 and assessing awareness in children is complicated by neurodevelopmental changes that occur as the child ages.
To tackle this, researchers at Anglia Ruskin University (ARU), The Children’s Trust and Temple University have developed the MuSICCA (Music therapy Sensory Instrument for Cognition, Consciousness and Awareness) tool, which involves using musical stimulation to enable the patient to show how conscious they are.
The music is specially selected for the patient and a qualified music therapist performs this live to the patient, manipulating different aspects of the music depending on how the patient responds. The idea is to give the patient the best chance of showing what they can do.
The music therapist observes the child’s behaviours and records these observations against a set of scales. MuSICCA then produces a diagnosis of the level of consciousness.
As part of the study, researchers invited a group of participants including music therapists, family members of children affected by brain injuries, and healthcare professionals to evaluate MuSICCA.
Participants in the study took part in question and answer sessions following a demonstration of the tool and were asked to rate how much they agreed or disagreed with two statements: On initial review, the MuSICCA appears to be an assessment of consciousness and awareness; and on initial review, the MuSICCA appears to be suitable for use with children and young people. Participants were also asked to comment on the strengths and weaknesses of the MuSICCA.
All participants agreed with both statements, with 85% strongly agreeing with each.
Lead author Dr Jonathan Pool, Senior Research Fellow at Anglia Ruskin University’s Cambridge Institute for Music Therapy Research, said: “Children with disorders of consciousness are often almost completely dependent on others to meet their needs.
“Their therapists, nurses and caregivers must interpret very subtle behaviours to help them understand their needs.
“There is often great uncertainty when determining this, which makes it so important to find a reliable way of assessing levels of consciousness in these young people. Currently, there are very few ways of doing this.
“MuSICCA allows the music therapist to conduct a rigorous assessment of the patient’s response to various musical stimuli, giving the therapist a picture of the patient’s level of consciousness and the strengths and weaknesses of their responses.
“The information from MuSICCA is easy to communicate to the rest of the care and medical teams and can support families in understanding what they can do to support their child’s recovery.
“This study strongly suggests that MuSICCA is a suitable and comprehensive assessment method, highlighting its strengths in providing guidance, involving caregivers, and supporting clinical teams.”
Author: Jamie Forsyth
Source: Anglia Ruskin University
Contact: Jamie Forsyth – Anglia Ruskin University
Image: The image is credited to Neuroscience News
Original Research: Open access.
“The development and face validity of the music therapy sensory instrument for cognition, consciousness, and awareness (MuSICCA)” by Jonathan Pool et al. Frontiers in Psychology
Abstract
The development and face validity of the music therapy sensory instrument for cognition, consciousness, and awareness (MuSICCA)
Severe brain injuries in children and young people can result in disorders of consciousness.
This can pose significant challenges for the brain injury survivor as they may struggle to show awareness; for their family, who want to help their child to recover consciousness; and for the team providing treatment and care for them, who need an assessment that will inform optimal treatment and care planning.
Currently, there is a paucity of fully validated behavioral tools to assess consciousness in 2–18-year-olds. Assessing awareness across this age range is challenging and complex due to neurodevelopmental changes that occur during maturation.
This study evaluated the face validity of a music-based behavioral assessment for children and young people with disorders of consciousness. This is known as the Music therapy Sensory Instrument for Cognition, Consciousness and Awareness (MuSICCA).
The study recruited 20 participants to compose a mixed cohort of music therapists, non-music therapy healthcare professionals and family members with lived experience of caring for a child or young person with a disorder of consciousness.
These participants reviewed the MuSICCA and evaluated its suitability as an assessment of consciousness for use with children and young people. They provided feedback by rating their level of agreement with two statements and they also described the perceived strengths and limitations of the MuSICCA.
The results showed substantial agreement among raters that the MuSICCA appears to be an assessment of consciousness and awareness, and that the MuSICCA appears to be suitable for use with children and young people.
Its strengths include being rigorous, comprehensive, providing guidance and opportunity for caregiver involvement, its use of salience in stimulation, and its utility in supporting the wider clinical and care teams.
The findings suggest that the MuSICCA may be a valuable assessment tool in providing treatment and care for children and young people with disorders of consciousness and their families.
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