I picked up a new client a few weeks ago. Young man, autism, let’s call him D. I went for his intake, got a chance to meet him, asked some questions, was all ready to go. Two weeks ago, I went in for his initial assessment.
I have never had someone react so negatively to a hello song. He began biting his hand, screaming, and banging the side of his head with his palm. Usually, people give me a little bit of time before they start acting out. The reaction I typically get is either one of being excited, pleasantly surprised, or at the very least, vaguely interested. I don’t always get a huge reaction, but I’ve never had someone act like I was actively trying to cause him harm before. Not in the hello song – I’ve gotten that plenty of times at other points in the session.
D’s staff had to come help try to calm him down. Eventually, we moved D down to the other end of the table from me, and he calmed. He listened as I played. But when I tried to engage him in playing instruments, he was not having it. In fact, the only instrument he didn’t shove away was the egg shakers, and that’s because he thought they were Easter eggs and was trying to open them.
I didn’t see him last week because I needed a copy of D’s behavioral support plan to find out what I needed to do in this situation. I would have been more prepared, but I got nothing about these behavior problems from the intake interview. Today, however, I went again, and the agitation started before I began playing. This time, I didn’t let him get away with it. I remained close by the entire session, and while his staff had to help him calm, he still refused to participate in anything. The only instrument he took this time was a maraca so he could toss it away.
So now I’m faced with a dilemma I’ve never been faced with in my professional music therapy career – is music therapy really going to be appropriate for D? He will sit and listen as long as I’m not asking him to do anything – I actually got a smile out of him while playing Take Me Home Country Roads. But is that really therapeutic? I mean, teaching coping skills is one thing, but if my presence causes more stress, shouldn’t we be looking at other options?
I’m not ready to give up – not yet. The smile represents a glimmer of hope. However, I have to be ready. I’ve never turned down anyone for music therapy services. I’ve had people decide that they didn’t want to continue with music, but I’ve never been the one to say “no” at the beginning. It’s not a precedent I really want to set, but it’s an option that I have to consider. Especially in this case.
Thanks for reading!