Chapter 2, Part 1
“What do you think about doing a study on this?” asked Karl.
Karl was attending my African and Latin group drumming classes where I’d been telling the group about my experiences drumming for Stacey and other kids with developmental disabilities. Everyone was intrigued by the idea of using drumming for children with developmental disabilities, especially given the children were not asked to play the drum and only listened as I played. Karl, as it turned out, was the staff psychologist in a school district that contained what was considered one of the most progressive autism programs in the state.
“I think you have something here”, he said, “Maybe we could do the study at my school. It has a great autism program and the director is progressive. I’ll help you write a proposal and submit it. If we’re lucky we can do it this year yet.”
“That sounds exciting, but I don’t know how do write this type of proposal”, I confessed. “What does it need to look like?”
Up until this point, I had written articles about therapeutic rhythm-making, but nothing along the lines of what I would need for a study proposal. Karl went on to describe the key points of a research proposal and I went to work on a first draft.
As I was writing the proposal we hit a snag.
“You need a name,” Karl said.
“A what?” I asked.
“A name. For your therapy” he replied.
“What do you mean? This isn’t really a therapy yet. It’s an idea. An experiment.”
“I know, but the school board will want to it be more concrete. You can’t just call it drum therapy. How about something more clinical?”
“Okay, let’s see… AIT stands for Auditory Integration Training. That’s a mouthful,” I said, thinking out loud. ” And it sounds clinical and serious.”
AIT was an auditory therapy that was popular for autism in the early 1990’s. I was aware of it mainly because my client Stacy had gone through AIT several times. Her mother was well-versed in the process and had explained it in detail to me. Stacy’s mother was also a friend of the researcher conducting what would end up being the largest study done on an auditory intervention for autism.
It was the knowledge of AIT, along with my experiences with my drumming teacher Lloyd, that got me thinking that maybe I could be able to help with the condition.
So with AIT’s name as kind of model, Karl and I brainstormed.
“What is the drumming doing?” asked Karl.
“Well, I think it’s entraining the brain to a calm state,” I answered.
“Entrainment is a fancy word for synchronizing”, I explained. “There has been speculation that repetitive drumming can make the brain pulse in synch with the tempo.” I was referring to a study I had just heard about that documented what researchers had been speculating for a couple of decades. In this study, repetitive drumming at four-beats-per-second induced a corresponding four-beat-per-second theta wave in the listener’s brain. This discovery also fit with a series of studies done where rhythmic pulsations, in the form of binaural beats, were shown to induce a similar effect. This effect is often referred to as brainwave entrainment.
“Okay, you use rhythm to entrain”, surmised Karl. “How about calling it rhythm entrainment therapy? He paused and thought. “Not therapy. Intervention. Yeah, intervention. That’s better.”
“Rhythm Entrainment Intervention,” I pondered. “I like it. But I think it should be Rhythmic Entrainment Intervention, because the other entrainment approaches use beat frequencies. This sounds more precise.”
“Rhythmic Entrainment Intervention… REI. I like it”, Karl said thoughtfully.
So, we had a name. We had a study design and a protocol. Now what we needed was approval to do this in Karl’s school.
Schools are notoriously non-receptive to experimental programs, especially where kids were concerned. First we needed tentative approval from the program director and buy-in from the teachers. Then we would need consent from all the parents. From there, I was told, it would be on to the school board for approval. I was skeptical that we could do it.
“I’ll take this to the director and I let you know what else we need”, Karl said as he took the proposal.
The idea of a study intrigued me. I had been working with a lot of kids like Stacey over the previous year or so and had documented everything: The rhythms, responses and effects of various recordings. This study would be another step into trying to understand whether drumming had a place and whether specific rhythmic structures were useful for autism.
My teacher Lloyd had played for kids with issues similar to the kids I was playing for with autism. And I had watched Lloyd produce some pretty dramatic effects, especially with calming. I, too, had facilitated some great changes in anxiety along with improvements in other symptom areas; so I felt that this study may help me better understand the effects of the drumming, especially by collaborating with other people who had much more experience with this condition than I had.
Documenting case experiences and playing one-on-one were very satisfying for me for my own curiosity, but I really didn’t have much sense of what I should do with my music beyond this. However, I made a conscious effort to follow whatever path formed in front of me. This study could be an interesting one, I thought. One in which, I was sure, I would learn a lot. And I was all about learning more without any real expectation of where it would lead me (a trait that has been my guiding principle throughout my entire career).
After only a week Karl called and said, “We got it.”
“Got what?” I asked.
“Approval. Carrie, the program director, looked over the study proposal and felt it was worth doing. We presented it to the teachers and they’re all behind it. We’re now waiting for the last of the parental consent forms to come back. I figure you can start playing for the kids on Monday.”
“Wow,” I said. I really wasn’t expecting this to happen, and so quickly. “Okay I’ll see you first thing Monday morning.”
Now I was nervous. I had played for quite a few people up to this point, but a study? In a school? I was a drummer, not a researcher, at least not this kind of research. Up until this point research was something I did by myself for my own interest. Now I had a school involved in my weird idea.
I mean, drumming. To help kids with autism. How strange is that?
A quiet suburb outside of St. Paul, Minnesota. 7:30am Monday March 7, 1994.
It was unseasonably warm, which was a good thing because the top on my convertible was leaking and the heat in my old Volkswagen was never very good. Still, after a forty-minute drive I arrived chilled, my hands stiff. This won’t do, I thought. I have to be limber to be able to play for these kids.
This was my first day of a pivotal study that would forever change my life and the nature of my work. I was at the elementary school where we were going to track the calming effects of drumming on 16 children with autism ages 6-12. This school housed one of the most progressive autism programs in the state, and perhaps the country.
“We received 16 parental consent forms back for the kids,” described Karl when I met with him and the autism program director, Carrie. “That’s about half of the kids in the four classrooms. The kids range in age from 6 to 12, though most are between 8 and 11.”
He handed me the forms and gave me a brief overview of each kid’s issues.
“They are all so different,” I said, showing my lack of knowledge of the many manifestations of symptoms, abilities, and behaviors of children on the autism spectrum. “Some can talk, some can’t. Some are anxious, some are withdrawn. Some have seizures, some don’t.” I said, beginning to feel overwhelmed.
Could I actually do this? I wondered. Could my drumming have a noticeable positive impact on the kids? Sure, I had great success with Stacey and some other kids with similar issues, but the range of issues presented in these kids was astounding. I was feeling out of my depth. Who was I to think that my playing on a drum would help with a condition that professionals have been struggling with for decades and that even the multi-billion-dollar-a-year pharmaceutical industry was having limited results in being able to help?
Karl could tell I was freaking out. So he tried to calm me by putting the study back in perspective.
“Just focus on the calming,” advised Karl. “Try not to worry about having any dramatic effects. Just do what you did with Stacey and let whatever happen, happen. I’ll be in the room with you the entire time.”
I took a few breaths and we went to meet the teachers and aids. The introduction to the staff went well. Everyone was interested in seeing if the kids could be calmed. Anxiety and anxiety-based behaviors were the most significant and disruptive events during the day. So much of the teachers’ and aids’ time and energy went to managing these behaviors that very little learning actually happened. Anything that could have a calming effect on their students, I was told, was a welcome addition to their classrooms.
The vast resources that went into managing anxiety and anxiety-based behaviors is the reason that the most accepted therapy for autism centers on managing behaviors. ABA (Applied Behavioral Analysis) and other behavior-related approaches focus on re-directing behaviors through repetition, rote responses to stimulus, and an often arcane system of rewards and (sometimes) punishments. Behavioral therapies are time-consuming and labor-intensive – therefore expensive – and offer limited results unless implemented perfectly. A good behavioral therapist, working one-on-one with a client for 40+ hours a week, has to have the patience of a saint and the stamina of a marathon runner.
If this study could offer any observable improvement in calm, it could make the kids more at ease and receptive, potentially opening a door for learning and internalizing well-implemented behavioral approaches. Of course, thinking this way made me anxious again. It’s a good thing that at this point I was asked to perform a little of the type of drumming I would be doing. The staff wanted to get a sense of what my drumming was about. Up until now, no one but Karl had actually heard me play.
This is always the fun part for me. In instances like this I prefer to jump right into rhythms at my typical eight-beats-per-second pace rather than slowly speed up. This is partly for effect and partly because the sooner I can get the group to shift, the deeper I can take them in the few minutes I’m usually allotted for my demonstration.
Listeners always go through four distinct stages when they first experience me banging my drum. The first stage of listening to my REI drumming is disbelief, especially if listeners are expecting calm. Eight beats per second is fast. And the drum I play is fairly loud (I can make it painfully loud if I want to, though I don’t this day), so uninitiated listeners tend to get a little tense at first. This day was no exception. I actually saw some eyes go wide as I started playing. Several teachers looked over at Carrie, the program director, clearly wondering what this was about. Carrie, in turn, looked toward Karl, who just smiled and nodded in time to my playing.
After an initial shocker rhythm (yes, I can be provocative when I play – it makes people remember their experience), I settled into a calming groove based on the African afuche rhythm. This is a simple two-beat pattern that has a forward-driving feel similar in effect to a Mambo beat. Two-beats, by the way, are a two-quarter-note pulse, with me playing sixteenth notes. This means that there are 8 individual drumbeats in this pattern.
This simple groove brought up the second stage of listening to live REI drumming: Amusement. Some teachers smiled, some began to sway to the rhythm. I kept the two-beat pulse going until I saw most of the staff begin to relax and engage with me. Some of the same teachers who looked at the program director with concern now looked at her with what could be best described as, well, amusement. They were having fun but didn’t see how this was going to be calming for their students (or even themselves).
I began to morph my rhythm, turning this simple two-beat pattern into a complex arrangement of odd-meter variations that had no discernible beginning or end. Instead it appeared to be a stream-of-consciousness improvisation with no real goal. There was a goal, however. And that was to usher in the third stage of dealing with my REI drumming: Bemusement.
Now, nearly five minutes into my performance, I watched the gears in people’s minds clog and jam as they tried to understand what I was playing. This was especially the case with those trained in music. What I was playing could not be understood intellectually in the moment – it was too unpredictable and went by too fast to analyze – so confusion fell across people’s faces. At this point, I saw Carrie look at Karl, questioning her decision to let me be there. Karl nodded reassuringly at her.
I took this as my cue to help drive my bewildered listeners to the final stage of the REI drumming indoctrination: Surrender. Once the analytical mind surrenders and people stop “listening” and allow the drumming to waft over them, they let me take control of their brain. I’m just kidding (sorta). I’m not taking control in classic sense of leaving my listeners without a choice. I’m taking control in the sense they are open to allowing their brains shift.
REI drumming does require the listener’s brain to attempt to decipher the patterns I play. But REI also requires that the listener’s brain entrains (synchronizes) to the pulsations of the underlying patter of my rhythms. This can’t happen when people are trying to intellectually process what I’m playing. Many people will stop listening for understanding pretty quickly because they enjoy the feel of the music. Others, mostly people with musical training, will hold out until the constantly changing nature of my playing goes on long enough that they get tired of trying to count it out and make sense of what I’m doing.
Auditory driving research has shown that it can take a few minutes before the initiated brain synchronizes to the stimulus. This time can be shortened if I am able to break homeostasis. The brain wants to remain in its current state, but novelty and anticipation make the brain easier to influence. This is why I always start off with loud fast drumming – it shakes the listener and allows me to break homeostasis. Then I take my listeners on a journey from simple rhythms to progressively more complex rhythms until I have their brains engaged. This can happen in less than ten minutes.
I saw this shift take place as eyes drifted off of me and started to close or the swaying and tapping to the music stopped. This is my favorite part of my performances, because my listeners are with me, fully engaged with my drumming. And this is where I begin to see the calm. No longer were the staff looking over at Carrie or Karl with concern. Most weren’t really looking anywhere. They were just experiencing the drumming. I kept playing for a few minutes as I watched everyone settle more. Then I slowly faded out and stopped.
I sat quietly and didn’t say anything for a while. Partly because I wanted everyone to be with their experiences for a minute and partly because I was speechless (this often happens to me when I play). I was calm. I sat with a big smile on my face. I tried not to, but I couldn’t suppress it. I felt a deep sense of peace inside. I was finally ready to begin this study.
I went through the usual gauntlet of people thanking me for my playing and telling me their observations of their experiences, but I cut this short because I wanted to get to the testing room as quickly as I could in the hopes that I could remain in my own peaceful state.
I rushed to my room and set up my equipment while the kids arrived at school. Karl began the process of lining up which student will come at which time over the next two days. I would play for eight kids each day, recording the sessions and making notes, after each student leaves, of any thoughts and feelings I had as I played for them. Karl would keep the kids in the room and re-direct any behavior he saw as being disruptive to the process. He would also alert me to any potential problems he may see coming or that I may have unwittingly initiated. He would also take notes of his observations of each child’s reactions to my playing. From these recordings and our collective notes I would go back to my studio and make a custom drumming tape for each kid.
“Steven won’t be able to tolerate the drumming,” his teacher said to me as she brought him to the room. “He is much too sensitive to sounds to be in this tiny room when you play that loud drum,” she added, looking at Karl hoping, I think, for him to agree with her and let her take Steven away. Karl took Steven’s hand without a word and guided him to a chair across the room from me.
“I’ll play quietly and Karl will remove him if he is bothered,” I replied.
She nodded but looked at me and Karl with doubt and concern. Reluctantly, she left, but stood by the door. Karl gave her a reassuring look as he gently closed the door and settled in a chair next to Steven.
Our testing room was small, about eight feet square, with cinder block walls, a suspended acoustical tile ceiling and a linoleum floor. Typical mid-century industrial drab construction. The reflective walls and floor created a booming sound with the bass of the drum and the tiny space made volume a real issue if I wasn’t careful.
I was careful.
“Would you like me to play the drum for you, Steven?” I asked.
No response. He stood, left side facing me while looking at the wall and running his finger along the mortar line.
A scream erupted from outside of the room. Steven grabbed his ears and began to rock. His teacher, seeing this through the window of the door, started to enter but Karl waved her off and signaled me to start playing.
I tapped a slow bass tone, pushing my right palm into the center of the drum at a tempo in time to his rocking. He kept rocking and after a minutes dropped his hands from his ears. I continued this pattern for another minute or so and then added a quiet syncopation with my left hand in time to the bass tone. Simple at first, slowly growing in tempo and complexity. Steven turned my way.
I changed my rhythm to a faster triplet-based feel, one that often excited the children. I was looking to get him engaged with the rhythm, so I added some bass and slap tones and played a odd meter variation on a Brazilian naningo rhythm. This rhythm has a smooth half time triplet feel.
Steven made his way along the wall and toward me and, more importantly, my drum. Next, I added some bouncy fills to vary the rhythm. It took him a few minutes of moving along the wall, but soon he was standing right next to me when he stealthily moved his hand to the drum. He lightly touched the edge of the rim with his palm and let his fingers drape onto the head. He held it there as I kept playing this triple feel rhythm. He had a flat affect, showing no sign on his face of liking or disliking my playing as he stood touching the drum and it’s head.
He stood unmoving for several minutes, so I switched to a calmer rhythm, one that many children have sat or laid down to, in an effort to illicit a response.
Nothing. He continued to stand facing the wall with his hand on the drum. I switched to a bass-heavy rhythm, knowing that he would feel a strong sensation in his fingers.
He smiled and moved his hand further onto the drumhead. With his hands in the way it was getting difficult to play and Karl, noticing this, tried to distract Steven and pull his attention and hand away.
Steven pulled back from Karl, keeping his hand on the drum. He began rocking again. I moved my hands to the edge of the drum and played a light soft rhythm, partly to get my hands away from his so I could keep playing and partly because I wanted to keep him from getting anxious or reacting negatively to Karl’s redirection.
Karl was eventually able to redirect Steven and have him sit quietly next to him as I continued playing. Once Steven was sitting I increased the intensity and volume of my playing. Steven sat and listened. I kept building volume and rhythm speed. Steven sat quietly. Again, I raised the volume. Steven sat. With a volume that was high for the room and despite what I was told he could handle, Steven didn’t seem bothered. I dropped the drumming to a whisper. Steven looked my way.
Encouraged by his response, I lightly tapped the edge of the head at a barely audible volume. Steven watched my hand intently as I fingered some double tempo patterns.
With Steven watching my hands, I stopped and placed my hands on the drumhead. He watched my hands for a minute and then got up and came over to the drum. He put his hands on mine and stood in front of me, looking off into the distance at the wall. We stayed that way for a few minutes until Karl came over and gently guided Steven back to his classroom.
I was feeling pretty peaceful about now and enjoying the silence of the room when a tornado came in. Her name was Nina. She was a highly verbal, highly anxious 9 year-old with Asperger’s syndrome.
Asperger’s syndrome is a subset on the autism spectrum and is the form of autism that Stacey (Chapter 1) had. Nina was a lot like Stacey. She had a large vocabulary that she felt free to use, though most of what she said was not appropriate or sensical. With Karl on her heels, she burst in my room and walked directly to me.
I introduced myself to her, showed her my drum, and asked if she minded if I played for her. She said that she didn’t and then began vigorously beating the drum. So vigorously, in fact, that it was impossible for me to play at the same time. While I held the drum, I let her play for a few minutes until she seemed to settle a bit. She didn’t stop on her own, however, and required Karl to redirect her before I could play.
As I discovered, this experience was a good introduction to Nina’s overall personality and behavior. She, the school staff described, was an intense, uninhibited child. She was verbal and tended to perseverate on whatever came to mind. She talked almost constantly about anything and everything, much of it running together and making little sense. She was also highly anxious and sometimes aggressive to others. Her teachers noted that she was disruptive to the other students and they found it difficult to get her attention and keep her on task. It wasn’t uncommon to need to separate her from the other children and to work with her one-on-one to get her to attend to her schoolwork.
When I began playing, Karl was playing a hand game with her while she continued to talk. She paid no attention to my playing initially, but after a few minutes she focused her attention on me when I began playing a rhythm that I often found helpful for people who were anxious or engaging in self-stimulatory behaviors. This rhythm, one that I had just successfully played for Steven, was based on a Brazilian Naningo. This pattern starts in a 12/8 time signature with accents on the first (bass tone), third (bass tone), sixth (open tone), seventh (slap tone), tenth (open tone) and twelfth (open tone) beats and evolves into a 23/16 rhythm by dropping the last beat of the second measure. This rhythm then drops another 2 beats to repeat a 21/16 time signature pattern.
After settling into this 21/16 portion, Nina sat down in a chair next to Karl and watched me play. I continued this rhythm and some variations on it for several minutes during which time Nina became quiet and attentive to what I was doing. I played for another 6 minutes using a variety of similar rhythms while she stayed quiet and sat in her chair, watching me play.
When I ended, she remained quiet while Karl led her back to her classroom. Her teacher later reported that she was calm the rest of the morning, until lunchtime when she became agitated by the change from the quiet of the classroom to the commotion of the lunchroom. The rest of her day was similar to other days, with her teachers struggling to keep her from acting out and becoming disruptive to the other students.
Nina was followed by her opposite: Marcus. Marcus was a small, quiet 8 year-old. Where Nina was high activity, high anxiety, Marcus was non-verbal, and largely non-responsive. Karl led him in the room and he sat, or more accurately, melted into the chair.
Like with all the kids, I started by playing very quietly for Marcus. He sat motionless for the longest time until, when I was playing a bouncy rhythm in a 19/8 time signature, he got up and walked over to the drum. He put his hands on the side of the drum as I played. I then switched to a simple samba-like pattern consisting of two bass tones followed by two quiet open tones. This rhythm bounced along until I dropped a beat here and there to create a more syncopated samba type feel. With the heavy bass tone pattern, Marcus laid down and crawled under the drum. He positioned his stomach directly under the bottom of the drum.
I dropped the volume a little so as not to hurt Marcus’ ears but kept playing an abundance of bass tones. Marcus stayed on the floor for the rest of the time I played.
When I stopped Karl, picked Marcus up and took him back to his room. He came back with nine-year-old Sammy. She came into the room and didn’t say a word to me as I introduced myself. Karl had her sit next him and nodded at me to begin.
She sat quietly as I started playing the drum. After just a few times through a basic calming rhythm, Sammy looked at me and smiled. Over the next ten minutes, I played a large variety of rhythms, from simple, calming rhythms to complex, intensely focused rhythms. Sammy never stopped smiling. She did seem to prefer open tones on the drum and rhythms with triplet feel (these types of rhythms tend to have an uplifting quality to them).
After I stopped playing and Sammy was taken back to her class, the teacher described that Sammy rarely talked, though she was able to express her needs and desires when prompted. She was also very socially withdrawn and difficult to engage, had poor eye contact, and poor motor control.
Next came Lucas, another eight-year-old. Lucas was similar in some ways to Nina in that he talked a lot, often not making much sense, and he could be aggressive to other children if he got over-stimulated. He differed from Nina in that he rarely initiated contact with other children in his class, preferring interact with his teacher and aid.
Lucas was told I would be playing a drum for him, so when he arrived he immediately approached me and asked me what kind of drum I was holding. I told him as I tapped it, then asked him if he’d like to play it a bit.
He touched the head as he tapped it with his fingers and talked and asked me a series of questions. The questions came fast as he tapped, with no space for me to answer. But he didn’t seem to want any answers. This pace continued for several minutes until Karl redirected him away from the drum. At that point Lucas shifted his one-way conversation to Karl and I started playing.
I played quietly at first with the hope that he’d stop talking and focus his attention on the drum. I began with a simple calming rhythm that is a variation on a 2-beat long Brazilian mambo beat.
As a side note, short rhythms such as the mambo, need to be varied for people on the developmental disability spectrum, otherwise they become annoying to the listener and defeat the purpose of calming.
In this instance, the variation I used created a rhythm in a time signature of 31/16 (the typical rhythm is in 2/4). Lucas shifted his attention to me, but continued talking as I played. After about ten minutes of playing various rhythms, I settled into to a more complex rhythm and Lucas stopped talking almost immediately. I played this rhythm and some variations for a couple of minutes before Lucas came up to me and asked me how long I was going to play. I took this as a cue to stop.
Next came Tom. Tom, like Steven, was extremely sound-sensitive. He was very anxious and often aggressive. He was also non-verbal, which tends to contribute to anxiety and aggressive behavior for many children due to their inability to express their needs. Unfortunately, Tom often hit others without provocation. This was a problem and his teacher was hopeful that the drumming would help calm him down. She was concerned, however, because of his extreme sensitivity to sound, that he wouldn’t do well with the rhythms. After my experience with Steven, I wasn’t so worried.
With Tom’s sound sensitivities in mind, I began by playing very quietly. Tom grabbed my hands and stopped me on several occasions, sometimes tapping the drum himself seemingly to get comfortable with it and its sound. After about 4 minutes, he sat down next to Karl and watched me as I played.
I played a large variety of rhythms over the next 12 minutes and observed that he seemed to prefer rhythms that had a flowing regularity to them. The more complex, chaotic rhythms appeared to make him tense up a bit, though at no point did he cover his ears or indicate in any way that we was bothered by the drumming, even though there where a few times where I played very loudly.
By the time I stopped playing, Tom was sitting next to Karl and vocalizing along with the drumming. I couldn’t hear him as I played, but Karl reported that Tom began vocalizing about 2 minutes before I stopped. In reviewing the session recording, I noticed that at that point in the session I had been playing a rhythm with repeating groupings of 5. Tom stopped vocalizing after a minute or so of when I stopped playing.
He was the last person I played for that day. I left the school feeling pretty satisfied with the childrens’ responses, hopeful that I could have a positive impact with this study. The next day I played for the rest of the children in the study and was again encouraged by their responses to the rhythms.
All the children were calmed and sometimes engaged by my drumming, which was a good start. But our goal was to see if listening to a recording of the drumming would elicit the same calm as my live playing. I spent the next week making each child their own cassette tape by playing rhythms I had mapped out from the live recordings and notes. Each tape would be twenty minutes long. The following Monday I brought everyone their tapes. It was like Christmas, at least for me, to hand out each tape.
Karl and I asked the teachers to play each child’s recording once a day, preferably turning it on at a time when the child was anxious, then track their response. We would do this for four weeks at which time I would come back and see how everyone was doing.