Neurologic Music Therapy Breakdown: MACT

Our last post regarding Neurologic Music Therapy (NMT) gave a list of definitions for each of the techniques. Now it's time to get to the nitty gritty. What is this and how can it help? We will be breaking down each NMT technique in an individual post to help our families better understand how and why we do what we do! First on our list is one of our therapist's favorites— Musical Attention Control Training or MACT.

Musical Attention Control Training: MACT

What is MACT?

MACT involves structured active or receptive musical exercises, using pre-composed performance or improvisation, in which musical elements cue different musical responses to practice sustained, selective, divided, and alternating attention functions (Thaut 2003).

You could say MACT is the use of musical experiences and/or musical elements to practice specific types of attention.

MACT falls under the cognitive category of NMT. Cognition is the process of acquiring knowledge and being able to process and understand the gained information. Attention is a key component of cognition.

Keyword... Attention

The biggest factor in MACT is the focus on attention. In this NMT technique, five different types of attention can be addressed.

Focused: Focused attention is when an individual can maintain attention to one task without becoming distracted by external stimuli.

Sitting in a lecture for the entire duration without becoming distracted is one instance where focused attention occurs. 

Sustained: Sustained attention is when an individual selects to focus on one stimulus for an extended period. 

An example of sustained attention in day-to-day life could be what you're doing now, reading an article!

Selective: Selective attention is being able to complete a task while filtering out and ignoring unnecessary stimuli.

A real-life example of this is being able to have a conversation in a crowded room.

Alternating: Alternating attention is being able to switch between tasks; to stop one task to complete another then return to the initial task.

An example of this might be doing homework, having to stop to eat dinner, then returning to complete your homework.

Divided: Divided attention is when you are focused on multiple stimuli at once, more commonly referred to as multitasking.

An example of this would be singing along to a song while driving, or writing down notes while a teacher is talking.

What does this look like in Music Therapy?

As Music Therapists, we tailor each intervention and session to individual clients so no two sessions will look the same. The overall concept, however, remains. MACT interventions could involve instruments, recorded music, live music, or any number of combinations. This all rests on what the client needs. Any number of receptive or active music interventions could be used.

Your classroom or workplace can have endless extra stimuli that you have to filter out to focus. You may have to ignore someone tapping a pencil or typing loudly on their keyboard. In Music Therapy, we can utilize instruments to help in this area.  A favorite for focused attention is a little game called “distractor.” This intervention works well with groups. Each group member would have a drum and play the same rhythm together. One group member will be the “distracter” and will attempt to disrupt the other group members by playing a random rhythm on their drum. The goal for the rest of the group is to not get tripped up by the heckler! 

Being able to focus on a task for a longer duration can be difficult. You may need to read a chapter of a book for school or take a test. In Music Therapy, we can work on extending a client’s time for attending to tasks. For example, a stop-and-go intervention where the client and therapist are playing different instruments. The therapist could play the guitar and have two separate melodies. One of the melodies would indicate for the client to play their instrument while the other would be the signal to stop. Thus the client has to sustain attention to stop and start at the correct time, even when the signal is coming from the same instrument.

When a lot of things are going on around us it can be difficult to pay attention to what we need to. Selective attention can be needed in a variety of instances. You could be in the lunchroom at school trying to talk to a friend but with so many other conversations going on around you it’s too hard. Or you could be giving a presentation and your friend is making silly faces in the crowd. In Music Therapy, we can help build clients' skills in this area! For example, the therapist and client can be playing different instruments simultaneously. The therapist will establish a brief melody/rhythm that indicates to the client to play faster. This same motif can be played a second time indicating to play slower. The motif would be hidden within all of the other sounds. The client would have to discern when the motif is played in order to alter their playing speed.

Alternating attention is hard for anyone in day-to-day life. You start one task and get sidetracked by another! In Music Therapy, we can work on this through a multitude of activities. One example would be having to separate tasks set up in the room. This could be a puzzle along with a handbell song. For example, the therapist would establish two separate melodies or rhythms that would then be associated with either of the activities. When the therapist plays the musical indicator for the puzzle the client would work on that until the therapist plays the indicator for the handbells song. This would go back and forth until both activities have been completed.

Some people can multitask like a pro while others can have difficulty focusing when multiple stimuli are happening at once. In Music Therapy, we can work on divided attention with clients in many ways. One example of this is having the client and therapist play a rhythm together on a drum while simultaneously holding a conversation. This will engage the client auditorily, mentally, and physically. 

How does Music Therapy make this work?

Receptive and active music experiences share patterns of brain activity in several neurologic locations including the brainstem, bilateral frontal lobes, and cerebral cortex. Music engages both sides of the brain. The overlap between both hemispheres will help the attention skills learned in Music Therapy to transfer to other situations. Music in itself is a mentally engaging and rewarding stimulus. As Music Therapists, we have the advantage of music on our side. Music gives us an “in” with clients, and since Music Therapy doesn’t feel like work, it is therapy wrapped in a package of fun. 

MACT is one of the twenty Neurologic Music Therapy techniques we utilize at Musical Bridges Music Therapy. Join us as we explore the other NMT techniques!