18 OCTOBER/NOVEMBER 2001 by Midori Koga with Frederick Tims y grandfather was eighty-eight years old when he performed his first solo violin recital to celebrate his birthday. He had lived a full and extremely busy life to that point: He had lived through both World Wars, raised a family of four through difficult times and risen through the business ranks to retire at age 65 as president of a prominent electronics com- pany in Tokyo. His had been a stressful life with heavy responsibilities.
Transcript
18 OCTOBER/NOVEMBER 2001
by Midori Koga with Frederick Tims
y grandfather was eighty-eight
years old when he performed his first solo
violin recital to celebrate his birthday. He
had lived a full and extremely busy life to
that point: He had lived through both
World Wars, raised a family of four
through difficult times and risen through
the business ranks to retire at age 65 as
president of a prominent electronics com-
pany in Tokyo. His had been a stressful
life with heavy responsibilities.
In his sixties he had struggled withhealth problems that affected his workand his sense of well-being. It was notuntil he was almost 80 that he decided tobegin violin lessons once again; he hadstudied briefly in his youth but hadn’tplayed in more than fifty years. He beganpracticing one hour each morning,another in the afternoon and scheduledlessons with his teacher once a week. Ashe became more comfortable with hisinstrument, he joined a string quartetgroup—that was when he seemed to com-pletely fall in love with music making. Hefelt challenged by the other members ofthe ensemble, and he progressed at aneven faster rate than before. More impor-tantly, he became inspired with his music,and the excitement seemed to pervadeother parts of his life.
In Japan, the eighty-eighth birthday ofa man’s life is considered a milestone. Asmy grandfather approached this impor-tant event, he decided to present his firstconcert to celebrate the special day insteadof hosting the traditional party. At theconcert there was not a dry eye in the hall.Those close to him had become aware ofthe impact music making had on thequality of his daily life, but on that day itwas unmistakable to everyone present. Heplayed as a child plays, wholeheartedly,joyfully and with pure abandon.
Sadly, he passed away seven monthsafter this event. His family and closefriends were deeply affected by the factthat this man was able to participate inmusic and enjoy living through his strongspirit and love for music until the lastdays of his life. The group environmentprovided by the other quartet memberswas an ideal balance of enjoyment, sup-port and challenge, where he was encour-aged to grow and learn. As he used to say,“This is keeping me young! I wake up
each morning happy to know that I haveso much to learn today.”
Stories such as this are told in privatestudios, community music schools, musictherapy clinics and senior centersthroughout the world. While there alwayshas been this kind of anecdotal evidencethat active participation in music makinghas tremendous emotional and physicalhealth benefits, it was not until recentlythat researchers began specific studies inthis area. The Music Making andWellness Project was designed as a studyto look at the quality of life and the phys-ical and mental health benefits of activeparticipation in music making for healthyAmericans over age 65.
The ResearchersIn 1995, Frederick Tims of the
Michigan State University (MSU) MusicTherapy Department assembled a multi-disciplinary team of researchers. JoiningTims were specialists from the AgingInstitute of the University of SouthFlorida; Department of Psychiatry andBehavioral Science at the University ofMiami School of Medicine; KarolinskaMedical Institute, Stockholm Sweden;and from the Music TherapyDepartments of Appalachian StateUniversity, Western Michigan Universityand the University of Kansas. During thecourse of the study, I was invited to jointhe team, as a member of MSU’s PianoPedagogy Department. My role was toreview the lesson curriculum, design sup-plemental rhythm, movement and listen-ing activities, and help train the teachers.
Many members of the same team pre-viously had participated in another highlysuccessful study from 1993–1995, measuring the effects of music making onthe biology and behavior of Alzheimer’spatients.1 The results were significant, andthe team reasoned that there were most
likely equally positive benefits for healthyolder Americans participating in regularmusic making activities. It was at thispoint that we set out in search of anappropriate study environment.
The EnvironmentFletcher Music Centers of Clearwater,
Florida, is a unique company offering free,lifetime music lessons to seniors purchas-ing organs from any of their stores. Afteropening his first music center in 1975,Robert Fletcher began receiving lettersfrom seniors participating in the lessonprogram. In those letters, students wrote oftheir gratitude to the company and teach-ers, telling stories of how much healthierthey felt, both physically and emotionally,as a result of the organ lessons.
“It became clear to me that we weren’tsimply selling organs and providing freemusic lessons,” says Fletcher. “I began tosuspect that we were providing peoplewith health, happiness and long life.”
The philosophy and goals of the com-pany and its CEO were well matchedwith those of the Music Making andWellness Project researchers. The FletcherMusic Center proved to be the ideal “real-world” setting for the study.
The DesignThe study was projected over a five-
year time span with three phases.Phase I: Phase I was a preliminary trial
from January 1996 to September 1997.In this phase, eighty students of varyinglevels from Fletcher Music Centers wereinvited to become subjects of the study.In the beginning, all students completedwritten wellness inventory tests to assessgeneral physical health and self-perception of their mental states. Thedata were collected over fifty weeks; eachten-week period, students completed atake-home psychological assessment that
AMERICAN MUSIC TEACHER 19
“Since we have learned together relaxation and breathing
exercises, my anxiety has dropped many levels. So much so,
the other night I played for some friends. Even though
I told them to stay in another room, before you knew it,
they were all around me singing and having
a good time. They were so excited about my playing
and the progression I have made.”
Midori Koga isassistant professorof piano and direc-tor of piano peda-gogy at MichiganState University.She holds graduatedegrees from theUniversity of Michigan and theMozarteum Hochschule für Musik inSalzburg, Austria.
20 OCTOBER/NOVEMBER 2001
included questions pertaining to generalhealth, sense of control, perceived stress,depression, loneliness, coping strategiesand social support. Blood tests also weretaken every ten weeks. During this timeperiod students participated in weeklygroup organ/musicianship classes and alsowere invited to meet for private help ses-sions and lessons with their teachers.
Phase II: While the results of Phase Iwere encouraging, the researchers con-cluded that a few changes in samplingstrategy in Phase II would clarify anytrends in the gathered data. In Phase II,from October 1997 to September 1998,the number of subjects was increased to100. The experimental group comprisedfifty adults participating in organ lessons;fifty other adults from the same demo-graphic profile who did not participate inorgan lessons were the control group.Both groups were asked to complete iden-tical psychological surveys and take thesame blood tests. The lesson period wasdecreased to twenty weeks during the win-ter months only, to avoid losing partici-pants to the annual migration “north”during the hot and humid summermonths in Florida. Blood work and written psychological surveys were takenat three points—approximately every tenweeks.
Phase III: The final phase was theanalysis and interpretation of the varioustests and the publication and dissemina-tion of the study results.
The Lesson ProgramThe study’s success relied heavily on the
lesson program’s strength, the teachers andthe music center’s environment. Theorgan curriculum, which had an established history of successful results,originally was designed by Joan Manero,keyboard consultant to Fletcher MusicCenters. The curriculum was appropriatefor students with little or no musicalbackground and based primarily on anaural approach. Notation was introducedfurther along in the curriculum but wasnot a main focus of the lessons. The les-sons were weekly, fifty-minute sessions ina group setting of up to fifteen students.The students also were encouraged to goto the center for private tutorials through-out the week for extra help. Many of thestudents also enjoyed joining other classesduring the week for a repetition of thematerial and interaction with other stu-dents. The lessons incorporated the fol-lowing components:
Music Therapy Wellness ActivitiesThese exercises, designed by Alicia Ann
Clair, Ph.D., professor of music therapy atthe University of Kansas, were introducedat the beginning of every class. Studentswere encouraged to experience the activi-ties as a group, then take them home forcontinual use during the week. Exercisesincluded special deep breathing, stretchingand visualization/imagery activitiesdesigned to promote relaxation in the
mind as well as the body. Many studentscommented that they practiced the exercis-es at home and found them to be extreme-ly helpful for relaxation and a general senseof well-being in all areas of their lives.
Listening, Singing and MovementImmersion in musical experiences
through listening, singing and movementactivities was another key component ofthe lessons. As the students entered theclassroom, they often were treated to liveperformances of their favorite popular,folk, patriotic or hymn melodies. Thesepieces often were ones they currently werelearning or would be learning in the nearfuture. Singing familiar tunes was also anintegral part of the lesson and one inwhich all students were able to participatesuccessfully from the beginning. Singingand knowing the songs prior to playingthem ensured the students internalized themain rhythmic and melodic conceptsbefore attempting the technical aspects ofplaying keyboard instruments. The students were able to play the melodiesmuch more naturally and beautifully whenthey had already heard, sung and feltthem. One of the most difficult skills tomaster, especially for these students enter-ing music lessons later in life, was develop-ing a strong sense of rhythmic pulse. Byworking with rhythmic skills away fromthe keyboard, students were able to devel-op a stronger sense of pulse and were moresuccessful and confident as they played.Students were encouraged to feel the pulsethrough the use of their large motor skillsby swaying, tapping, clapping, chantingand conducting to the music. Many stu-dents also commented on how much theyenjoyed the feeling of freedom as theymade music with their entire bodies.
AMERICAN MUSIC TEACHER 21
Stylistically Appropriate RepertoireAccording to research on the topic of
“Musical Preferences of the Elderly,”2 seniorsare clear about their repertoire likes and dis-likes. We found that the students enrolled inthis program responded most positively tothe familiar—patriotic, hymn and popularsongs from their youth. Playing familiar andwell-loved melodies proved to be a strongmotivational factor in the learning process.It was also important to take the vocal rangeof the students into consideration since,throughout the program, they often wereencouraged to sing. In general, the range forwomen was from F3 to C5, calculated fromthe bass of a piano keyboard; the range formen was one octave lower.
Ensemble PerformancesWhile students often were reluctant to
perform solo for their friends and col-leagues, they were more than willing tomake music together in ensemble. Theclassrooms held up to five or six organs,allowing some students to play, others tosing and still others to provide a rhythmicbackground using rhythm instruments orsimply clapping or tapping.
In this way, the rewards of makingmusic together were immediate, and students could participate in the perform-ance in a welcoming, comfortable environment.
Positive Working EnvironmentWhile learning music was the focal
point and purpose of these lessons, char-acteristics of a positive working environ-ment were evident.
The promise of social interaction inmany cases was what initially may havebrought the students to the classes.Students may have not yet become awareof, or understood the value of, musicmaking and the power it had to make animpact on their physical, mental andemotional well-being. Many participantssaid they first started taking the classeswhen invited by friends or neighbors.
Other students also noted that the bal-ance between a supportive, stress-free envi-ronment and one that was educationallychallenging and stimulating was veryimportant. Owe Ronstrom, in a paperentitled “I’m Old and I’m Proud!”3,admonishes society for treating matureadults as anything less than the wise, intel-ligent and capable people they are.
Participating in many of the classes, Iimmediately became aware of the cama-raderie and supportive nature of theinteraction between the students andteachers. This was an environment wherestudents felt safe to try new experiences.
A model in the classroom, whichworked particularly well, was for teachersto aim for less lecture and encouragemore active participation from the stu-dents. Students commented on howmuch easier it was to understand newconcepts when allowed to immediatelyexperiment with the ideas. An introduc-tion of a new rhythmic note value, forexample, was clearly understood whenpreceded by a few rhythmic movementactivities in which students could feel thepulse and hear the length of the note.When students were then shown the sym-bol for the note value, there was immedi-ate recognition.
Those of us who have ever had theopportunity to make music through singingor performing on an instrument know howrewarding and moving such an experiencecan be. While many of these students wereworking at a beginning level, they wereappreciative of being able to make music ina personal and meaningful way.
Students of this particular demographyalso preferred to have a sense of controlover their learning environment. The les-son curriculum utilized in this study wasdivided into relatively short units of tenlessons each. Students were permitted tochoose to either repeat the unit or proceedto the next level. Many students preferredto repeat a unit, citing they enjoyed
playing the same repertoire again withoutany pressure. They would move to the nextlevel when they felt ready. The flexibility ofthe curriculum was important to them.
Research ResultsFrom the beginning this project was
about people and making an impactthrough making music. If you could haveseen the smiles, heard the laughter,singing and music making, and felt theenergy and warmth in the music class-rooms, you would have felt, as we did, theproject was successful. As an added bonus,the positive research results corroboratedthe testimonials of the students.
Decreased anxiety was demonstrated byscores on the Mental Health Inventory,4 astandardized test administered to studentsat the beginning of each research period,ten weeks later and at the end of twentyweeks of lessons.
Anxiety dropped considerably from thebeginning of the lesson sessions to mid-point, with a slight but insignificant
22 OCTOBER/NOVEMBER 2001
increase toward the end of the study.While there was bound to be some fluc-tuation in participants’ anxiety levels,those participating in the music lessonsgenerally showed lower anxiety levels thanthose who did not take lessons.
The Profile of Mood States Depressionand Dejection Tests5 were used to measuremood levels. Both groups indicated simi-lar depression levels at the beginning ofthe study. While the levels of those whodid not take lessons rose significantly tothe midpoint with a slight decrease at theend, the levels of those taking lessons con-tinually declined throughout the study.
Lesson participants scored a decrease inperception of loneliness, with no reportedchange in external support from familyand other personal relationships. Sincethere was no actual increase in externalsupport in their personal lives, we con-cluded that it is highly possible their feel-ings of decreased loneliness stemmed fromtheir involvement with the music classes.
The blood tests of those taking lessonsindicated a 90% increase in levels of HumanGrowth Hormone (hGH), which normallydecreases at a rapid rate as one ages. HigherhGH levels increase energy and sexual func-tion, while causing fewer wrinkles and casesof osteoperosis. Those not taking lessons
showed very little change in hGH levels dur-ing the same time period.
Impact on PedagogyPrimarily, our field has focused on edu-
cating our youth, and this area will contin-ue to be an important focus for many.However, perhaps it is time to expand ourattention to include educating healthyadults. The population demographics arechanging dramatically. Currently, there arefifty-six million adults over age 55 in theUnited States, and experts believe this num-ber will increase to at least sixty six millionin the next five years. As the baby-boomergeneration reaches ages 55 and 60, we willcontinue to see an increase in the olderadult population. People are living longer,
healthier and more active lives than before.Many of these adults in their “golden
years” have always wanted to play musicbut have not had the opportunity to takelessons or thought it was too late. It is nottoo late! I saw this in the eyes of my grand-father, who began taking violin lessons inhis eighties and performed his first recitalat age 88. I also saw this in the eyes of theparticipants in the Music Making andWellness Project.
As teachers, we might ask ourselves ifwe are members of the health care profes-sion as well as the education profession.Perhaps this is not only an opportunityfor us, but also a responsibility.
AMTNOTES1. Kumar, A. M., F. Tims, D. G. Cruess,
M. T. Mintzer, G. Ironson, D. Loewenstein,R. Cattan, J. B. Fernandez, C. Eisdorfer andM. Kumar. “Music Therapy Increases SerumMelatonin Levels in Patients withAlzheimer’s Disease.” Alternative Therapies inHealth and Medicine, Vol. 5, No. 6, (Nov.1999), pp. 49–57.
2. Moore, Randall S., Myra J. Staumand Melissa Brotons. “MusicalPreferences of the Elderly: Repertoire,Vocal Ranges, Tempos, andAccompaniments for Singing.” Journal ofMusic Therapy, Vol. 29, No. 4, (Winter1992), pp. 236–252.
3. Ronstrom, Owe. “I’m Old and I’mProud!” The World of Music, Vol. 36, No. 3 (1994), pp. 5–27.
4. Ware, J. E. and D. C. Sherbourne.“The MOS 36-Item Short-Form HealthSurvey” (SF-36). Medical Care, Vol. 30(1992), pp. 473–481.
5. McNair, D. M., M. Lorr and L. F.Droppelman. “EITS Manual for theProfile of Mood States.” (San Diego:Educational and Industrial TestingService, 1971).
“I lost my husband a couple of years ago. I needed
a new challenge. When I go to Fletchers, I feel I am
among friends. I get off the couch. I have always
admired anyone who can play a musical instrument.
It may take me a long time to do this,
but I will do it eventually. Thank you for the
opportunity. I did this for myself!”
The Music Making and Wellness Research Team
In addition to Tims and Koga, the research team was made up of nationally andinternationally known experts in the fields of medicine, biochemistry, psychology,psychiatry, aging, music therapy and keyboard pedagogy.
Dr. Alicia ClairDirector of Music TherapyUniversity of Kansas
Dr. Donna CohenDirector of the Aging Institute and
Professor of Aging and Mental HealthUniversity of South Florida
Dr. Carl EisdorferChair, Department of Psychiatry and
Behavioral SciencesDirector of the Center for Adult
DevelopmentUniversity of Miami, School of Medicine
Dr. Adarsh KumarAssociate Professor of Psychiatry and
Behavioral SciencesUniversity of Miami, School of Medicine
