Aug. 27, 2006
 
Reaching Adult Autism Patients Through Music
 
By Kay Miller
Minneapolis – St. Paul Star Tribune
 

Kenny Bujarski stums the guitar while Teacher Jenifer Josephson sings along during their morning music class. (SHNS photo by Tom Wallace / Minneapolis St. Paul Star Tribune)

Kenny Bujarski, 43, has had a rough week emotionally and lies curled up on a couch, covered head to toe with a heavy yellow blanket. LaShauna White, 27, rocks frantically, lamenting, "We're not doing beads." Danny Genest, 41, keeps asking for his electric fan and reaching over to hug the head of aide Gail Spartz.
 
They barely notice when MacPhail Center for Music's Jenifer Josephson enters the room, toting large bags filled with drums, CDs, bean bags, colorful scarves and an electric guitar. She's been coming to Opportunity Partners' Karlins Center in Plymouth, Minn., since October to teach a weekly music therapy class for adults with autism.
 
Music therapy has long been used to treat autism. What is different here is that MacPhail designed "Music to Our Ears" specifically for people ages 21 to 43 who have moderate to severe autism.
 
"Look what I brought, Kenny. You got all your stars and earned the electric guitar!" Josephson says.
 

Lauren Dodge is rewarded with applause by teacher Jenifer Josephson. Dodge is one of six autistic adults in the music therapy class. (SHNS photo by Tom Wallace / Minneapolis St. Paul Star Tribune)

Bujarski moans but doesn't sit up. Josephson could prod. Instead, she tries to see the world as he does -- as a chaotic, confusing, dangerous place. When he feels overwhelmed, Bujarski hits himself on the head. He spends about 80 percent of his time alone in a room, by choice.
 
"It's huge that he chose to come to music therapy today," said Susan Fries, manager of Karlins, one of Minnesota's only employment-focused day training and rehabilitation programs for adults with autism spectrum disorders.
 
Every day is different. Today Bujarski is difficult to reach. But he will be the star of the class in two weeks, earning stars for cooperating, playing instruments and singing along. After accumulating 20 stars, he gets to pick a reward. His favorites are the electric guitar and drum set.
 
All of these autistic clients love music.
 
"We don't stop with one or two methods and say, 'Oh, this isn't working,' " Fries said." We continue until we find a way that works for that individual. Every day we're looking for new connections."
 
Making up for lost time
 

Most of the six autistic adults in the music therapy class at Karlins have been written off elsewhere when their progress stalled. But McPhail music therapist Jenifer Josephson has found ways of reaching people through and by tuning into their inner worlds. Adam Gilbert rocks hard in the big leather rocker in the music room. (SHNS photo by Tom Wallace / Minneapolis St. Paul Star Tribune)

It's Thursday morning and six music therapy clients gather in Karlins' carpeted "fish room," with its blue underwater mural brimming with sea creatures that glow in black light. Clients sit on the sofa, in rockers or cushy recliners designed to help them cope with sensory overload. "You get to be class leader today," Josephson tells Bujarski. "Who gets to start the welcome song?" she asks, coaxing him to name a classmate. He doesn't answer.
 
"Me, me!" says Corbin Leih, 22, waving her hand.
 
Both Leih and her friend, Lauren Dodge, 21, are beneficiaries of early educational intervention and graduated from a special education program. As a result, they are more socially adept and willing to interact with other people than are their older classmates, Fries said. They're also more likely to use words to get what they want, instead of disruptive behavior.
 
Autism is a spectrum disorder that encompasses a wide range of severity, behavior and cognitive abilities. But generally, people with autism are captive to their own inner worlds, Fries said. When they want something, they want it immediately. They find it hard to block out competing stimuli to focus on a single voice, idea or activity. Some respond by rocking or hitting themselves to express distress or refocus their thoughts.
 
All six clients in this class have significant challenges. When Danny Genest started at Karlins in 2000 he was so into his own world that it was as if he didn't even hear requests and required constant one-on-one attention. Nate Loher, 29, took an entire year to adjust to leaving home and starting at Karlins. Now he never misses an opportunity to choose an Eagles CD.
 
LaShauna White perseverates, meaning she repeats the same phrases over and over. But she has a beautiful voice. With encouragement, she sings lilting, inventive songs.
 
Leih has a seizure disorder that produces behaviors that mimic those associated with autism. Lately Leih has begun to ask for what she wants, instead of pointing.
 
Josephson holds the guitar, fingering chords as Leih strums the strings. In a clear, lyrical voice, Josephson sings as Leih mimics a word here or there. Through music therapy these clients are learning to take turns, follow directions, use words to get what they want, express emotion in socially acceptable ways and interact with others. That includes the daunting task of calling peers by name.
 
Josephson has learned that she can tease Loher and be firm with Dodge. But the more options she gives Bujarski, the less likely he is to hit himself in frustration. When she asks him to pass out drums to classmates, she reminds him, "You can say, 'No, thank you.' "
 
A muffled "No, thank you" comes through the blanket. "Way to go, Kenny!" Josephson says, quietly setting the drum where he can reach it. Bujarski can't resist. Soon he is thumping rhythms in time with his classmates.
 
E-I-E-I-O doesn't feel like work
 
"Music is processed in both the right and left hemispheres of the brain," Josephson said. So it can bridge damaged or impaired areas of the brain. Music is fun. It's empowering. Everyone can be successful at singing, playing a drum, unfurling a parachute or simply choosing a CD. So Josephson can work on the same goals that an occupational or physical therapist might without it feeling like work to clients.
 
Halfway through class, Bujarski sits up and asks for Simon & Garfunkel's "Hazy Shade of Winter." It is a turning point. Soon he's standing, insisting that Josephson "put on a 45!"
 
And when Josephson asks how he feels now, Bujarski blurts an emphatic "FINE!"
 
The black light goes on, the school of fish on the wall glows and Lauren Dodge grins for all she's worth.
 
Distributed by Scripps Howard News Service, www.scrippsnews.com.