Reuben’s Case Study
Reuben is a young boy who has Autism. He was referred to music therapy by his mother in order to help develop his language skills, improve emotional regulation and to help with social interaction. Reuben received a total of 32 individual music therapy sessions which took place at his home.
When I first met Reuben he had a very short attention span, going from instrument to instrument and often becoming distracted by toys or other objects around the room. As the sessions progressed and our therapeutic relationship developed, Reuben was able to stay focused for the duration of the session (30 minutes). Additionally on first meeting Reuben’s music was very insular and I noticed he found it difficult to connect with me musically, but as our relationship developed and we played musical games together, he allowed me to join in with him and take turns too. He was able to see that he could allow other people to become a part of his world.
Control was an important part of the work for Reuben. Reuben was struggling at a mainstream school and as a result his behaviour was affected and mum described him often hitting out or screaming or harming himself.
Music therapy offered Reuben a space entirely dedicated to him, where he could just “be” and it is through having this space supported by a qualified music therapist that Reuben was able to develop and grow in confidence and also learn to regulate and understand his emotions.
Reuben’s communication also developed hugely as a result of the work, he was a lot more words at the end of the work compared to when we first started working together. He always looked forward to sessions and as I arrived he would say my name and invite me into the room and get the instruments out ready for the hello song.
Matching became an important part of the work for Reuben. Within the therapy I worked to allow Reuben to feel acknowledged both for who he is and for how he is feeling. We did a lot of copying both through musical interactions (copying each other’s voices) and improvisations (copying each other’s music) but also physically.
Reuben enjoyed yoga and he would often make yoga poses and encourage me to “copy” him and as time progressed he was able to allow us to take turns at being the leader and follower. This was fantastic and proof of his social skills developing.
The music therapy star allows us to assess progress in music therapy. The first star was done at the start of the work (September 2021) and the second at the end of the work (August 2022). The key areas discussed with mum to improve were relating, attention/awareness and use of voice.
Reuben was given the following goals:
Relating – To build a healthy relationship with the music therapist and feel confident and safe in expressing emotions in sessions.
Attention/Awareness – To stay focused on an activity or instrument for 5 minutes
Use of voice – To communicate what he wants using his voice e.g. I want to play the xylophone
“Reuben loved playing with the musical instruments, especially the rain drum. It was great to see him engaged with someone who was really understanding of his needs. Reuben would become really excited to have his music therapy and see Amelia. He would be able to focus on amelia and the music for long periods of time (for him)”
Reuben worked extremely well over the course of sessions to achieve these aims and they were in fact achieved within the first 10 sessions so it was decided that a further aim would be for Reuben to take turns and allow Amelia to lead some of the interactions. This aim became slightly more challenging for Reuben but once again was one which he was able to achieve by the end of his block of therapy.
As you can see from the stars Reuben made huge improvements in all areas of the Music Therapy Star. It has been a pleasure to support Reuben in his emotional regulation and communication. I have seen him grow in confidence and have also been pleased to hear that he has become much more settled at school and at home and has been having less meltdowns than previously. For Reuben music was the key to helping him understand himself and his emotions supported by a qualified music therapist.