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CAN RHYTHM HEAL?
Matthew Collier Date of Presentation: 16th December 2016 Submitted in partial fulfilment of the requirements for the degree of BA (Hons)
University of Wales Trinity Saint David, Swansea
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Faculty of Art and Design This dissertation is presented in partial fulfillment of the requirements for a BA (Hons) Degree in: MUSIC TECHNOLOGY
Certificate of Authenticity I certify that this dissertation is entirely my own work with respect to the research, organisation and writing involved. It is appropriately referenced where necessary. I understand there is a university policy on plagiarism and that sanctions will be set in place.
Signature:
Name: MATTHEW COLLIER
Date: 16th December 2016
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Summary of Topic
Our human relationship to rhythm and its use in a variety of therapeutic settings will
be examined. The neurobiological influence of rhythm and its affects on behaviour
will be investigated.
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TABLE OF CONTENTS
INTRODUCTION ...................................................................................... 5 WHAT IS RHYTHM? ................................................................................ 6 PARKINSON’S DISEASE ......................................................................... 9 SPEECH AND LANGUAGE IMPAIRMENTS ......................................... 13 AUTISM SPECTRUM DISORDER ......................................................... 18 BIOLOGICAL RESPONSES TO DRUMMING ....................................... 23 CONCLUSION ........................................................................................ 24 REFERENCES ....................................................................................... 26
Word count: 5,007
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Introduction
Rhythm inhabits all of our worlds, it surrounds us and it’s within us. Rhythms in
motion, rhythm in time, rhythm in sounds, invisible rhythms and grand rhythms. It
seeps into our unconscious; we are driven to dance, but can it heal us? Why does
the simple repetition of pattern affect us? What can be discovered about how our
brains process and respond to rhythmic sounds?
Renowned ethnomusicologist Curt Sachs held the belief that “Rhythmical structure of
verses and melodies was nothing but a transfusion from the moving body, although
we might add, from a body consciously moving under the firm control of the mind.”
(Sachs, 1962: 112) But what happens if your body is not under the firm control of
your mind? Can rhythm be utilized to gain an element of control?
This research seeks to gain a critical perspective of the beneficial effects hearing
rhythm has on people with a variety of acquired and developmental neurobiological
conditions. The reasons for, and effectiveness of, rhythm-based therapies will be
explored, explained and evaluated, thereby shedding light on the neurological
processes involved in rhythm cognition.
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What is rhythm?
“The dance is the highest symbol of life itself” (Campbell, 1991: 98)
The word rhythm derives from the ancient Greek ‘Rhythmos’; then its literal meaning
would have been in describing a measured flow or movement. The Greeks
commonly applied the term in the context of dance, whereby it refers to momentary
positions taken by dancers in the course of their performance (Hope, 2007). Our
contemporary understanding of rhythm is applied in many contexts; the movement of
the planets, the oscillation of an atom, waves on a seashore, the turning of the
seasons, and of course in music and dance. Regardless of context we all understand
its description as a repeated pattern of sound or movement.
Given that the creation of complex rhythms can be derived from utilising nothing
more than one’s own body, it could be concluded that the creation and use of
rhythms by humans is rooted in our ancient history. All cultures across the globe,
both ancient and modern, display a tradition of making and playing drums. From
twenty first century Samba Bands performing on the streets of Rio de Janeiro to the
sacred drumming of Priestesses in the temples of ancient Mesopotamia, the 120
beats-per-minute of modern dance music to the archaic and complex polyrhythms of
the Malinké and Fulani peoples in Guinea. The sound of humans creating rhythms is,
and was, ubiquitous.
Rhythm use can be observed in a multitude of creatures; the ability to move through
air, in water and on land requires synchronised physical motion, however, “these
actions are the products of central pattern generation and are not dependent on
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externally supplied timing signals in order to run their rhythmic course.” (Merker,
2009: 5) The idea that there are central pattern generators within the brain
responsible for the coordination of habituated motor functions, such as breathing and
walking, has long been established in neuroscience (Buzsáki, 2006). Central pattern
generators require no neurologic input, and work below conscious perception and
without cognitive learning (Thaut, 2016).
Audible and visible rhythm generation, known as synchronous chorusing, is an
instinctual behaviour found in the animal kingdom; crickets, fireflies, frogs, and
katydids all emit rhythmic signals, usually in the quest to attract the opposite sex
during mating season (Greenfield, 1994). What distinguishes these displays is that
they are group behaviours, and for these signals to remain synchronised predictive,
isochronous, timing must be present, thereby making the “next beat in the sequence
perfectly predictable.” (Merker, 2009: 5) This ability recognises the core feature of
rhythm; it’s the interval between the beats that creates the pattern, and thus a
repeated sequence of spaces punctuated by beats constitutes rhythm (Merchant,
2015).
An ability to perceive a rhythm appears innate in some creatures, and having an
awareness of rhythmic stimuli appears to offer certain survival advantages and thus
be naturally selected for. The most primitive of organisms need to synchronise their
biological rhythms to environmental cycles for survival (Clayton, 2004). And in more
developed organisms the ability to detect, and react to, ecological and environmental
rhythms is utilised in more complex activities, such as hunting or predator avoidance.
These powers of detection would also extend an evolutionary advantage (Phillips-
Silver, 2010). This perception can extend simultaneously across multiple, and
uniquely evolved, sensory pathways.
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We humans inhabit a world where rhythm surrounds us, ours is both a subconscious
and conscious relationship. Beat perception is a “cognitive ability that allows the
detection of a regular pulse (or beat) in music and permits synchronous responding
to this pulse during dancing and musical ensemble playing.” (Merchant, 2015: 1)
Meaning that not only do we have the ability to distinguish rhythm, but we also
possess an additional rhythmic trait; we have the capacity to entrain to the beat.
The Dutch physicist Christian Huygens was fascinated to observe that the two
pendulums clocks that hung in his hallway would eventually synchronise their motion,
regardless of their starting positions. After researching this phenomenon, he declared
in 1666 that Entrainment had been discovered. Entrainment is a natural law “which
describes the interaction and consequent synchronization of two or more rhythmic
processes or oscillators.” (Clayton, 2004: 2) The fields of astronomy, neurology,
biology, psychology, pharmacology, medicine, sociology and chemistry have all
scientifically validated its existence. In the context of music, “the synchronization of
bodily rhythms with music entails entrainment phenomena at different levels of the
organism, which can take place at the motor level, the autonomic physiological level,
the attentional level, and even the social level.” (Trost, 2014: 56) If rhythm and
entrainment can have such an expansive physiological connection with people, then
it is worthy of exploration in the context of therapy.
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Parkinson’s Disease
“Rhythm is the artful motion of bodies” Plato
(Filmer, 2003: 91)
Parkinson’s is a progressive neurological condition. Currently one in every five
hundred people has the condition, equating to 127,000 people in the United
Kingdom. Loss of nerve cells in the brain causes Parkinson’s; the main symptoms
are tremor, rigidity and slowness of movement, and there is currently no known cure
(NHS UK, 2016). A range of treatments and therapies are applied to the condition,
including drugs that seek to increase depleted levels of dopamine in the brain and
stimulate the areas were dopamine works. Drugs are also used to repair certain
nerve cells and mitochondria, and to alleviate debilitating symptoms. Therapies
include occupational therapy, speech and language therapy, physiotherapy, and
complementary therapies, which include acupuncture, reflexology and music therapy.
The majority of these applied therapies seek to help with mobility, relaxation, speech,
motor symptoms and pain relief (Parkinson's UK, 2016). The most important issues
requiring research to help improve the quality of life for Parkinson’s sufferers are
deemed to be problems with mobility, stress and anxiety, uncontrollable movements,
memory problems, sleep and relaxation, and dexterity (Parkinson's UK, 2016).
Music therapy used to help Parkinson’s sufferers has traditionally centred on aims of
“improving movement and speech, and help people to relax or talk about feelings or
ideas they have.” (Parkinson's UK, 2015: 53) It focuses on relational and emotional
well-being. However, contemporary view points believe rhythm could have a role to
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play in rehabilitation, and here lies a distinction between relational and rehabilitative
approaches using music therapy; relational aims at psychological improvements
through empathetic relationships, the rehabilitative approach seeks to address motor,
cognitive and sensory function caused by neurological damage (Raglio, 2015). Thaut
et al state “The insights from rhythmic auditory-motor studies led to a complete re-
conceptualization of the role of complex auditory stimuli such as music for therapy
and rehabilitation.” (Thaut, 2015: 3) Rehabilitative rhythmic auditory stimulation
approaches applied in the context of Parkinson’s disease targets the control of motor
timing functions in the brain, and thus helping with coordinated tasks such as
walking.
The region of the brain that has been identified as the source of our beat perception
is in the basal ganglia and is called the putamen, and this is an area of the brain that
receives damage as a
consequence of Parkinson’s
disease (Grahn, 2009). The
function of rhythmic auditory
stimulation in treating
Parkinson’s disease is to assist
the deficient internal clock,
offering an external timing
device by which patients can pace to. This serves to help regulate gait disturbances
caused by neurological damage (Murgia, 2015). Gait disturbance can manifest a
variety of issues including decreased hip, knee, trunk and pelvis range of motion,
action freezing, poor balance and excessiveness slowness (Thaut, 2016). The
Figure 1. Putamen Figure 1
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practical application of this therapy seeks to improve a persons control over gait
performance.
Rhythmic auditory stimulation gait training consists of six steps; firstly an assessment
of the patients’ current gait parameters, primarily to measure their cadence or rate of
steps per minute. Secondly the therapist will set an external timing device, such as a
metronome, to the client’s measured cadence and will begin to play an instrument or
recorded music at that particular tempo. Next, when it has been observed that the
patient has perceived and entrained to that rhythm, the therapist will then begin to
increase the tempo of the music in increments of five to ten per cent. Repeating this
exercise over time has been shown to significantly improve gait control (Thaut,
2015). The fourth step in gait training involves using the same methodology but
applied in different contexts; changing direction, adjusting pace, walking on uneven
surfaces, negotiating obstacles, ascending and descending stairs, and with the
absence of a walking aid. The fifth step aims to remove the rhythmic auditory
stimulation, encouraging the patient to internalise the rhythmic cueing. Lastly, a
reassessment of the patients gait parameters to ascertain the level of any
improvement in performance (Thaut, 2016). A study by Kadivar et al researched
rhythmic auditory stimulation on functional performance in Parkinson’s patients, and
concluded “significant functional improvements relative to baseline were maintained
longer for the RAS participants than the no RAS participants.” (Kadivar, 2011: 633)
This therapy achieves positive results in the context of improving gait control in
Parkinson’s disease sufferers because rhythm activates neural circuits involved in
motor processing, and these neuroanatomical connections allow auditory rhythm to
cue movement. The presence of regular beats in auditory stimuli is also believed to
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increase activity in the putamen, which compensates for the lack of dopaminergic
stimulation (Nombela, 2013).
This therapeutic approach highlights the close neurological connections between our
auditory system and motor system. When auditory neurons within the brain are
stimulated they entrain the firing pattern of motor neurons, a process called neural
entrainment. Auditory stimulation also primes the motor system in readiness for
movement, and the influence of rhythmic auditory stimulation creates anticipatory
timescales. Anticipation is deemed crucial in improving movement quality, “Rhythm
provides precise anticipatory time cues for the brain to plan ahead and be ready.
Furthermore, successful movement anticipation is based on foreknowledge of the
duration of the cue period.” (Thaut, 2015: 2)
The rhythmic auditory stimulation gait training described here has also been applied
with success in additional therapeutic contexts; children with Spastic Cerebral Palsy
(Kwak, 2007), Multiple Sclerosis sufferers (Baram, 2007), and with Stroke and
traumatic brain injury victims (Thaut, 2015). Further research in rhythmic auditory
stimulation has yielded the hypothesis that ecological sounds, such as recorded
footsteps, could enhance the therapy process results due to the awakening of mirror
neurons within the brain (Murgia, 2015).
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Speech and Language Impairments
Speech disorders are described as a difficulty producing speech sounds correctly,
pronunciation difficulties or stuttering are examples. A language disorder can affect
the understanding of others, or inhibit the sharing of ideas, feelings and thoughts.
Adults and children can have speech and language impairments, and they can be the
result of trauma, medical problem, or indeed have no known cause (American
Speech-Language-Hearing Association, 2016). A 2001 study found that most
children with speech and language impairments also have a diagnosis of
developmental coordination disorder, defined as movement difficulties out of
proportion with general development and intelligence (Hill, 2001). SLI frequently
presents in parallel with motor co-ordination deficits, with this co-occurrence present
in ninety per cent of patients during one study (Corriveau, 2009). Aligned with this, it
has also been noted that children with speech and language impairments have
difficulties with auditory cues to the rhythmic timing of language (Corriveau, 2009).
People with developmental dyslexia also exhibit these same neurological
impairments in timing cognition (Thomson, 2006).
In 2009 a study was carried out to explore possible links between motor and auditory
rhythmic timing issues in children with speech and language impairments. The
results confirm “that at least part of the comorbidity between language and motor
impairment found in some children with SLI results from a rhythmic processing
deficit.” (Corriveau, 2009) So how can rhythmic auditory stimulation be employed in
the treatment of children with speech and language impairments? One methodology
is rhythmic speech cueing, which seeks to improve fluency, pause time, articulatory
rate and intelligibility of speech. This therapy seeks to improve speech performance
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by patients reading and talking whilst also tapping in time with an auditory rhythm.
However for this treatment to function properly the patient is required to exhibit
rhythm entrainment ability, if audio-motor entrainment is impaired rhythmic speech
cueing will not be effective (Mainka, 2016). A different approach was employed in an
experiment conducted to ascertain how rhythmic auditory stimulation influences
syntactic processing in children with developmental language disorders. During tests,
children with and without SLIs and dyslexia listened to regular and irregular rhythm
patterns, they were then shown grammatically correct and incorrect written
sentences, and were subsequently asked to make grammatical judgements on what
they had read. It was proposed that external timing cues help to synchronize internal
and external oscillators and thus “allows orienting attention over time and allows
developing expectations about the temporal occurrence of a next event, which then
facilitates processing of events at expected time points and facilitates segmentation
and structural, temporal integration.” (Przybylski, 2013: 122) Data collected from this
study did confirm the expectation that the application of rhythmic auditory stimulation
improved syntactic performance. Interestingly, it also discovered the control group
who presented with no SLI or dyslexia also benefited, “As speech is inherently tied to
time and requires temporal processing and cognitive sequencing, this modulation of
temporal attention benefits both the healthy and impaired brain.” (Przybylski, 2013:
128) In relation to the treatment of speech and language impairments, it seems
“Vocal learning requires a tight coupling between auditory input and motor output in
order to match vocal production to a desired model.” (Patel, 2006: 101) Thus
practicing therapeutic exercises under the influence of rhythmic auditory stimulation
is deemed to be beneficial as it helps to integrate auditory, motor and language
neurological processing, with one neurologic music therapist stating, “rhythm can be
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extremely useful for promoting speech production and anticipation of response.”
(LaGasse, 2016: 199)
The neurological basis of music and language are closely linked, with neuroimaging
studies suggesting that “neural circuitries established for language may have been
recycled during evolution for musicality, or vice versa that musicality served as a
springboard for language emergence”. (Peretz, 2015: 1) There is much evidence to
suggest that there exists substantial neural overlap between speech and language
processing, and that this sharing is crucial in explaining transfer effects between
music and language, meaning that in evolutionary terms “musicality may have
preceded language, and language may build on the natural disposition for
musicality.” (Peretz, 2015: 1) Linked to this theory of language, musicality and
neurological evolution, research has been carried out to establish if there is a link
between rhythmic motor entrainment and vocal mimicry across species (Schachner,
2009). This study tested the hypothesis that entrainment evolved as a by-product of
vocal mimicry, with the prediction that only vocal mimicking animals have the ability
to physically synchronise with an auditory pulse, to entrain. Vocal mimics in the
animal kingdom are humans, songbirds, parrots, humming-birds, cetaceans, seals,
elephants, and bats. After conducting tests with live animals and scrutinising video
footage, the researchers concluded that indeed, “Only vocal mimicking species
showed evidence of entrainment.” (Schachner, 2009: 834) In anatomical terms, birds
appear to have evolved this ability due to evolutionary modifications in the basal
ganglia region of the brain, the same area that is proven to be influential in human
beat perception and entrainment, and the same area that is deficient in Parkinson’s
disease sufferers. Neurobiological research indicates that vocal learning is
associated with the basal ganglia as it plays a key role in mediating between auditory
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input and motor output during learning (Doupe, 2005). As Professor of Psychology
Aniurddh Patel puts it “Importantly, the basal ganglia are involved in motor control
and sequencing meaning that a brain structure involved in perceptually keeping the
beat is also involved in the coordination of patterned movement.” (Patel, 2006: 101)
Analysing the results of all these tests in unison reveals that auditory beat perception
and entrainment are essential neurological requirements for language and movement
development and control. If the parts of the brain that influence these abilities are
functionally deficient then problems with motor coordination and language use can
ensue.
Test results also hint that vocal mimicry preceded entrainment in evolutionary terms,
with musicality and then language evolving and adapting upon these established
neurological pathways. Researching the evolutionary roots of human rhythmicity has
been the focus of scientific study involving primate rhythmic cognition. African great
apes (gorillas, chimpanzees and bonobos) have long been observed in the wild
drumming on their bodies and on resonant objects using their feet and hands (Fitch,
2015). However, this doesn’t in itself signify rhythmic entrainment; “sustained
patterns are not heard nor any attempt at group synchronisation.” (Merker, 2009: 6)
Test analysis seems to support the assertion that the last common ancestor of
humans and great apes had evolved neurologic rhythmic recognition some seven
million years ago in the forests of Africa; “Drumming is thus a clear candidate for a
homologous behavioural component of the entire African great ape clade, of which
humans are one member.” (Fitch, 2015: 6) However, great apes do not display vocal
mimicry, nor do they do they display beat perception synchronization. It could be that
because they missed this first evolutionary step of vocal mimicry, they have not
acquired entrainment, music or language and thus leave humans unique in primate
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behaviour.
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Autism Spectrum Disorder
“What a man danced, that was his tribe, his social custom, his religion.” (Ellis, 1983:
479)
Autism spectrum disorder is a pervasive developmental neurological dysfunction, and
being a spectrum, “there is not one way of being autistic.” (Berger, 2002: 26) It is
characterised as a neurologically atypical state, and is a lifelong condition. Key
features of ASD include ritualistic behaviours, internal preoccupation, speech deficits,
self-stimulation, intellectual dysfunction, sensory-integrative dysfunction,
communication deficits, and an inability to express normal affective relationships. A
core feature of ASD is an absence of Theory of mind. Theory of mind essentially
describes empathy; people with ASD lack an understanding that other people have
thoughts, beliefs, emotions and intentions.
All animals function via a mechanism of receiving sensory information, neurologically
processing that stimulus, then outputting action through the body. This process
happens through the stimulation of sensory neurons and motor neurons within the
brain. A key part in this process chain is called sensory integration, namely the
neurological action of organising uncoordinated sensory input, which in turn creates
useful, adaptive responses. It is every creature’s survival mechanism (Berger, 2002).
In people with ASD this mechanism of sensory integration is dysfunctional in a
variety of aspects, and that can lead to mental and physical impairments. It should be
noted that every individual possesses a unique neurological make-up, and sensory
integration abilities are thus individual. However, issues arise when the manifestation
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of sensory integration processing elicits atypical behavioural responses, especially in
a social context where norms of behaviour apply.
It appears that atypical behaviour stems from “erroneous sensory interpretations of
environmental and systemic conditions that thrust the Central Nervous System’s
sympathetic system into action from which the person cannot easily modulate.”
(Berger, 2012: 2) The central nervous system’s sympathetic system regulates a
person’s fight or flight responses to sensory input, in people with ASD this response
is continually primed resulting in elevated levels of anxiety. To test the efficiency of
rhythm based interventions on alleviating anxiety, a 2012 study monitored children
diagnosed with ASD carrying out a variety of repetitive motor tasks in synchrony with
a sixty beats per minute auditory rhythm, with repetition over an eight-week trial
period. All participants showed improvements to varying degrees with the report
concluding that “highly structured rhythmic interventions at a slow tempo can yield
levels of systemic pacing, motor planning, visual contact, attention, reduction of
anxiety and repetitive behaviours, and functional adaptation.” (Berger, 2012: 1)
Rhythmic auditory stimulation appears to help with sensory integration through a
mechanism of system pacing, and increasing the brains ability to predict events
present in a patterned, repetitive sequence thus decreasing anxiety. Professor of
neurology, Oliver Sacks, states in his book Musicophilia, that humans, when listening
to auditory rhythms, not only entrain with the beat but also respond by mentally
anticipating the rhythmic pattern (Sacks, 2007). We have an ability to mentally
internalize a pattern and thus begin to predict it’s unfolding through time. Displaying
an inability to recognize, internalize and produce a synchronized rhythmic pattern is
seen as a “manifestation of communication deficit.” (Pavlicevic, 1997: 42) And it has
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been posited that a display of disorganized rhythm and synchrony can be early signs
of ASD in children (Trevarthen, 2005).
Autism Spectrum Disorder is a developmental condition with many children on the
spectrum showing a difficulty in mimicry and action imitation (Ramachandran, 2011).
Imitation is key to typical child development; children learn form observing and
mentally integrating the actions of others, in readiness to perform that same action.
Coordinating ones own actions to another is called joint action, and linked with this is
joint attention, which allows for the sharing of a “perceptual common ground.”
(Sebanz, 2006: 70) Brain development through imitation enables humans to interact
in joint activity such as language communication, and to also perceive a common
reality. People who lack theory of mind, as in ASD, have difficulty in perceiving and
imitating the actions and intentions of others, and therefore joint attention and joint
action are problematic.
As humans we typically find synchronizing our actions comes naturally; when we
walk together, toil together, dance together. We seem to have an innate ability to
‘lock’ together in sound or movement. This ability is not unique to humans, it can be
found at work in the natural world. Where humans are unique is in using rhythmic
synchrony in social contexts, we are the only animals “known to feature tactus based
behavioural group synchrony as part of its ethogram, principally in the form of a
cross-culturally universal propensity to occasionally gather for rhythmic group singing
and dancing.” (Merker, 2009: 5)
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Our relationship with auditory rhythm develops during childhood; as infants we will
move to audible rhythms but not ‘stay in time’, between the ages of two and five we
begin to develop the ability to maintain a regular beat, and by age seven we can hold
a regular pulse, but mainly within the tempo ranges that resembles our own
‘spontaneous motor tempo’ (our natural movement speed). Adult-like rhythmic
abilities emerge around the age of nine (Large, 2015). An interesting observation is
that young children can find it difficult to follow an audible rhythmic pattern presented
by a machine but achieve better understanding when the action is part of a socially
engaging activity. This makes sense when it is considered that prior to the invention
of sound recording and reproduction technology, “every musical context involving
synchronized motor movements implied some form of social activity.” (Kirschner,
2009: 301) A shared intentionality combined with joint attention. In many existing
indigenous cultures, especially in sub-Saharan Africa, music is predominantly social
in nature. This means any societal gathering will feature heard rhythms and “the
prominence of the beat has a unifying effect for the group.” (Pavlicevic, 1997: 41)
Participating in rhythm based physical and social activity, such as group drumming,
offers people with ASD therapeutic possibilities in the areas of action and attention
focus, imitating, alleviation of anxiety, audio-motor entrainment and coordination,
sensory integration, social cognition and language skills. “When the body is
rhythmically organised, it appears that physiological responses become more
manageable.” (Berger, 2002: 114)
Much debate still surrounds the origins and neurological mechanisms at work in
Autism Spectrum Disorder, research is very much on-going and new approaches and
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theories are progressing and being debated. An area of considerable focus began
with the discovery of the mirror-neuron system in our brains. During neurological
research on primates in the early 1990s, a team of scientists at the University of
Parma documented how certain neurons in macaque brains fired not only whilst
undertaking a physical action, but also while watching another monkey perform the
same action (Ramachandran, 2011). Mirror neuron activity in human brains
automatically allows us to mentally experience another person’s emotions, intentions
and actions. The activity of mirror neurons ties in with the theory of mind; it is our
human ability to imitate on an innate, multi-sensory and highly sophisticated level that
creates empathy, entrainment and social intelligence. It has been hypothesized that it
is dysfunction in the mirror neuron system in people with ASD that is characterised
by a lack of theory of mind, and in addition a deficit of social cognition (Pineda,
2009). The resulting social interaction emanating through rhythmic entrainment can
provide a direction for rhythm-based interventions in ASD therapy. Group drumming
or group activities centered on rhythmic stimulation can bring an awareness of
shared action and intentionality.
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Biological responses to drumming
At the 2016 British Science Festival, hosted in Swansea University, Dr. Daisy
Fancourt presented a lecture titled “Can music change our immune system?” During
this lecture she highlighted a recent research paper, “Effects of Group Drumming
Interventions on Anxiety, Depression, Social Resilience and Inflammatory Immune
Response among Mental Health Service Users.” (Fancourt, 2016) This research
tracked biological and physiological changes in individuals across ten weeks of
drumming in a social context, and cross-referenced any changes in relation to a non-
participatory group. This scientific study concluded “…that group drumming can
reduce depression and anxiety and improve social resilience in mental health service
users…changes in psychological profiles were found in parallel with reductions in
inflammatory response and a shift towards an anti-inflammatory immune profile”
(Fancourt, 2016: 10) The report concluded that further research is needed to
ascertain the underlying neurobiological mechanisms that influence these beneficial
changes. They had statistically proven a biological reaction to drumming in a social
context, but couldn’t conclude on the reasons.
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Conclusion
The mechanisms at work in some therapeutic applications of rhythmic auditory
stimulation are clearly understood because the condition is fully understood. In
Parkinson’s disease and Speech and language impairments the application of rhythm
during auditory-motor exercises can achieve predictable effects because the cause
of the dysfunction and the reasoning behind the therapy are transparent. However,
as in Autism Spectrum Disorder, the condition is not fully understood therefore some
therapeutic applications could be seen as conjecture; positive results can be noted
but the complex neurobiological interaction is not fully understood. Problems in
achieving predictable, qualitative results are further compounded in the area of ASD
due to the condition manifesting in unique, individualised behaviour. In the example
of altering immune system function, the effect can be clearly noted but the
physiological process is not understood, we haven’t deciphered the interaction. Some
of the therapeutic exercises described here involve listening to rhythm, and some
require playing rhythm. Further exploration may expose whether there are
fundamentally different physiological reactions in each instance, and if one mode is
favoured over another in targeting certain conditions.
Speech and language impairments and ASD are both classed as developmental
conditions, with Parkinson’s and immune system issues being acquired. This
distinction means sufferers have differences in terms of experience and therapy
expectations; in the developmental conditions there is no ‘before and after’ therefore
sufferers may have no concept of what changes are trying to be made. The situation
can be markedly opposite in people with acquired conditions, they have previous
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experience to lend context to their current abilities. Before applying any kind of
therapy it is essential to know what outcomes are trying to be achieved and how
realistic expectations are.
The uniqueness of human neurology manifests in a unique relationship with rhythm.
This research has explored our human relationship with rhythm, it has shown how
rhythm is a conduit through which we stimulate and regulate our senses, actions and
interactions. Rhythm is a universal language, a language we recognised as infants
being rocked in our mothers’ arms, and cognition of rhythm is a core feature of our
survival mechanism; a method by which we navigate and communicate with the
patterns present in our worlds. Our reactions and interactions with rhythm take place
in both the conscious and unconscious realms of perception. Our subconscious
relationship revolves around central nervous system pattern generators and beat
perception; our essential life support systems rely on rhythms as the most efficient
means of function. Our conscious, social reactions to rhythmic stimulation can be
observed in collective actions such as protest, dance and rituals. It is a unifying force
for social cohesion and cultural identity (Phillips-Silver, 2010). Rhythm use in a social
context affords an alternative means of communication and connectedness.
A core aspect of rhythmic entrainment is that it too occurs at both a conscious and
subconscious level, and it is a fundamental feature of being human. Indeed,
“rhythmic entrainment may hold one of the keys not only to the origins of music, but
to human nature itself.” (Merker, 2009: 114) This research has shown that rhythm is
an essential component of many developmental and physiological activities; during
movement, in language use and in social communication. Rhythm acts as an anchor
to which other actions can attach themselves, an anchor that our bodies and minds
require to achieve functioning levels of sensory integration.
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Images
Cover image: Intermediate magnification micrograph of the putamen
Creative Commons Attribution
Figure 1: Putamen
http://www.cmu.edu/news/stories/archives/2015/august/images/brain