Sometimes when 13-year-old Rayna Neff sees her music therapist, Brianna McCulloch, she gets so excited that she can’t get her words out.
Rayna was born with Smith-Lemli-Opitz Syndrome, a rare disease that appears in just one out of 50,000-60,000 people. The syndrome, which prevents the body from making cholesterol, has also caused Rayna to be on the moderate to severe spectrum for autism. Her body cannot make cholesterol.
“It really affects her brain,” said her mom, Nicole Neff. “Her neurons do not fire properly. It causes intellectual disability.”
Rayna is at the developmental level of a toddler. She is so happy when she sees her therapist that the words won’t come. But McCulloch knows how to help.
“All Brianna has to do is prompt her with one of her songs and Rayna will tap her legs to the rhythm and that regulates her speed of speech,” Neff explained. “And she is able to say what she is excited about. Brianna really has that special touch with her.”
McCulloch, who runs the Vacaville Music Therapy center on Vacaville Parkway across from Kaiser, is a board-certified music therapy teacher. She got her undergraduate degree in music therapy at The Master’s University in Southern California and her master’s degree at the University of Miami.
Her first teaching experience was a six-month clinical internship at the Veterans Home of California in Yountville in 2013. She then started practicing music therapy as a branch of the Young Artists Conservatory of Music in Vacaville. She worked there in 2014 and 2015.
“At that point, Young Artists Conservatory, while an amazing organization, for some of my students and clients with autism it was a little bit overwhelming because it was very loud (with other students practicing),” said McCulloch.
So in 2015, she moved into the Shine Therapy Center, run by speech therapist Dr. Danielle Shahan.
“We had a mutual client,” recalled McCulloch. “As a music therapist, I was trained to work with clients who were using a picture exchange communication system (PECS). But I wanted to make sure that I was using the right protocol, so I asked if I could observe a session of hers with him. And so we had this amazing collaboration and we both come to therapy from the same perspective in terms of really looking at how kids typically develop and play-based and making therapy fun.”
The following year the center moved to its current location, where it offers speech therapy, occupational therapy, physical therapy, music therapy and behavior therapy through a program called Behavior Matters.
“We have this amazing interdisciplinary team at our fingertips and we have several kids who receive therapies from all three companies (speech, music, behavior),” said McCulloch. “And even if we don’t necessarily have a client in common, it’s so great because if I’m working with a client with a speech therapy goal and running into a roadblock, I have a speech therapy team right there at my center. So we collaborate with one another.”
Music therapy is the evidence-based use of music to achieve individual goals in the areas of communication, cognition, motor, sensory, social and behavioral development.
For example, a nonverbal, 3-year-old boy with a new autism diagnosis listens as each child in the group has the opportunity to sing goodbye. The music therapist leaves a musical space for him to fill in the blank. He utters his first intentional words: “bye-bye.”
Or a little boy with Down syndrome is struggling to pronounce his own name. On his first day, in the
context of a song with his name paired with a melody, he repeatedly sings his name.
“One of my favorite collaborations that I’ve done, is when Shine’s occupational therapist was teaching one of our mutual clients a unique method for tying shoes,” said McCulloch. “She came to me and said, ‘Do you think you could put this in a song so the kid could remember the steps for shoe-tying?’ So we did that and it was an amazing thing to watch this little girl. She was able to learn to tie her shoes while singing this song that she really liked and it helped cue the steps for tying shoes.”
McCulloch and her other staff person, therapist Annie Meulemans, also serve adults with developmental disabilities. But the day programs where she normally conducts those classes have been closed due to COVID. So she has recorded music programs that she sends to the centers and also has arranged for Zoom musical sessions.
“It’s been really different,” she said, “but I’ve been really impressed with how everyone is making the pivot and it’s been going really well.”
It is not as easy for children, especially the younger ones, to pivot. Meulemans has started a Zoom class for teens, who are generally better able to learn through Zoom.
“Most folks are really eager to get back into doing in person, especially individuals with special needs who already have challenges in terms of attention and executive function,” said McCulloch. “Zoom can be a real challenge.”
Zoom does not work at all for Rayna, who has had an especially difficult time adjusting to the ramifications of COVID.
“She doesn’t understand why she can’t go to school full-time,” said Neff. “She participates in Team Dixon where they do year-round activities. She misses her friends on her team. So with being cooped up at home, she has had a lot more aggressive behaviors, a lot more yelling and screaming and harder to calm down from her tantrums, especially with having to be on Zoom. She does not understand Zoom and can’t learn via the computer. So that’s been really rough.”
But Rayna eagerly looks forward to visiting McCulloch for her two 30-minute sessions a week.
“Rayna loves Brianna,” said Neff. “She has developed a rapport with her. She has been working with her for the past seven years. It’s really helped her improve her communication skills, her social interaction. When Brianna helps Rayna, she is lit up, she is so excited to see her, she asks for her all the time. They have a good bond and she has helped her come such a long way.”
Rayna also receives occupational, speech and behavior therapy at the center. Music therapy is fun, but it is also a science.
“We are using the elements of music, whether it is the rhythm, the melody, the form, or the words themselves in a song,” explained McCulloch. “We’re using those things to stimulate different parts of the brain. And we know exactly what part of the brain we can stimulate with different elements of music… This is where it differs from music education. In music education, you are looking to produce a musician, someone who can play an instrument in a certain way. In music therapy, we are looking for these other skills to be gained using music as our tool.”