Music From the Very Beginning—A Neuroscience-Based Framework for Music as Therapy for Preterm Infants and Their Parents

Abstract

Human and animal studies demonstrate that early auditory experiences influence brain development. The findings are particularly crucial following preterm birth as the plasticity of auditory regions, and cortex development are heavily dependent on the quality of auditory stimulation. Brain maturation in preterm infants may be affected among other things by the overwhelming auditory environment of the neonatal intensive care unit (NICU). Conversely, auditory deprivation, (e.g., the lack of the regular intrauterine rhythms of the maternal heartbeat and the maternal voice) may also have an impact on brain maturation. Therefore, a nurturing enrichment of the auditory environment for preterm infants is warranted. Creative music therapy (CMT) addresses these demands by offering infant-directed singing in lullaby-style that is continually adapted to the neonate’s needs. The therapeutic approach is tailored to the individual developmental stage, entrained to the breathing rhythm, and adapted to the subtle expressions of the newborn. Not only the therapist and the neonate but also the parents play a role in CMT. In this article, we describe how to apply music therapy in a neonatal intensive care environment to support very preterm infants and their families. We speculate that the enriched musical experience may promote brain development and we critically discuss the available evidence in support of our assumption.

Feasibility of Live-Performed Music Therapy for Extremely and Very Preterm Infants in a Tertiary NICU

“…Studies on music in preterm infants report that music may enhance formation and maturation of structural brain networks involved in cognition and emotion regulation ( 20 , 21 ). It is therefore hypothesized that early auditory experiences are associated with structural brain development ( 10 ). In music therapy, the music therapist tailors the musical intervention to specifically meet the needs of the individual infant at that particular moment.…”

“…Therefore, extremely preterm infants may benefit from music therapy, which could be most beneficial if started as early as possible. Research suggest that using music based interventions synchronously to neural development supports brain development through auditory priming and lies at the core of neural plasticity ( 10 , 11 ). Stimulating the developing neural circuitry with carefully selected and tailored musical notes supports synaptogenesis and connectivity early on ( 10 ).…”

“…Research suggest that using music based interventions synchronously to neural development supports brain development through auditory priming and lies at the core of neural plasticity ( 10 , 11 ). Stimulating the developing neural circuitry with carefully selected and tailored musical notes supports synaptogenesis and connectivity early on ( 10 ). Moreover, music reinforces positive behavioral adjustment after stressful events for preterm infants ( 11 ).…”

Clinical Practice Protocol of Creative Music Therapy for Preterm Infants and Their Parents in the Neonatal Intensive Care Unit

“…We may speculate that the enriched musical and socio-emotional experience in CMT may promote brain development, notably functional and structural connectivity, as well as emotional and cognitive development 74 . Rigorously designed trials are required to evaluate short and longitudinal effects of music therapy on brain development in preterm infants and psychosocial adaption.…”

Selective Attention and Inhibitory Control of Attention Are Correlated With Music Audiation

“…Even before birth we are often presented with music in our environment and this has an impact on children's development. Indeed, research indicates that early auditory experiences influence human development at different levels, especially since the fetus experiences sounds in an emotional, multimodal and vibro-acoustic manner during development (Haslbeck and Bassler, 2018). For example, neuroscientific research shows that music not only affects the development of our brain (e.g., limbic and paralimbic structures) but also enhances psychological and physiological health (Koelsch, 2010(Koelsch, , 2014.…”