Music-based intervention for hospitalized newborn infants has traditionally been based in a biomedical model, with physiological stability as the prime objective. More recent applications are grounded in other theories, including attachment, trauma and neurological models in which infant, parent and the dyadic interaction may be viewed as a dynamic system bound by the common context of the NICU. The immature state of the preterm infant’s neurological system and particularly auditory system means that no assumptions can be made about auditory processing and stimulation should proceed with caution. The infant’s experience of an unpredictable auditory environment is further compromised by a potential lack of meaningful auditory stimulation. Parents often feel disconnected from their own capacities to nurture their infant. The implications for the infant’s neurobehavioral and psychological well-being are life-long. This perspectives paper will outline the likely neurological considerations for auditory processing in the premature infant as well as establishing a premise for music-based interventions. A hypothetical clinical case will illustrate the application of music by a music therapist with an infant and family in NICU.

Music therapy in the Neonatal Intensive Care Unit (NICU) is often restricted to infants and families most in need because of limited time. This study explored the translation of basic aspects of the therapist-delivered contingent singing method into a program of parent-infant interaction information. A purposive sample of 13 mothers evaluated the parent education program called Time Together. The feasibility issues of acceptability and implementation were qualitatively evaluated using Rallis and Rossman’s (2003) program evaluation method to identify both strengths and weaknesses. Participants reported the program to be useful, with the most positive response for the content about infant behavioral cues for interaction. The weakest aspects of translation were for key language and some aspects of visual content in the program booklet. Findings indicated that for these participants, the Time Together program provided meaningful learning about parent-infant interaction in one session.

Objective: The primary aim of this case study was to explore the behavioural changes of a paediatric patient in post-traumatic amnesia (PTA) during a music therapy session. A secondary objective was to measure the effect of the music therapy intervention on agitation. Method: Video data from pre, during and post-music therapy sessions were collected and analysed using video micro-analysis and the Agitated Behaviour Scale. Results: The participant displayed four discrete categories of behaviours: Neutral, Acceptance, Recruitment and Rejection. Further analysis revealed brief but consistent and repeated periods of awareness and responsiveness to the live singing of familiar songs, which were classified as Islands of Awareness. Song offered an Environment of Potential to maximise these periods of emerging consciousness. The quantitative data analysis yielded inconclusive results in determining if music therapy was effective in reducing agitation during and immediately post the music therapy sessions. Conclusion: The process of micro-analysis illuminated four discrete participant behaviours not apparent in the immediate clinical setting. The results of this case suggest that the use of familiar song as a music therapy intervention may harness early patient responsiveness to foster cognitive rehabilitation in the early acute phase post-TBI.