Scott is a pseudonym.
Scott began music therapy at the age of five, following a referral to support his expressive language, attention, emotional understanding and fine motor development. He had a diagnosis of Global Developmental Delay, epilepsy and a heart abnormality, and was attending a large mainstream primary school.
At the time, Scott found it very difficult to remain in one place or engage with an activity for more than a few minutes. He was often withdrawn from the main classroom, and when I first began collecting him for his weekly music therapy session, it was not unusual for us to manage little more than a brief hello song before he wanted to leave. Staff were finding it difficult to help him remain settled and engaged.
One thing that stood out was that, when I collected him, Scott was often sitting quietly in the corner of his classroom playing with small dolls and toys. His family had also shared that he loved music and would often sing along beautifully to songs in the car. These observations offered a possible way in.
Rather than asking him to leave his preferred play behind, I began inviting his dolls and toys into the sessions with him. We sang hello to Scott, and then to his dolls. Gradually, the dolls became part of the structure and familiarity of our time together. Over weeks and months, Scott began staying for longer, and play became a way for him to communicate, explore stories and express experiences that were difficult to put into words.
Music was introduced gently alongside this play. I would improvise songs about what was happening in the dolls’ stories, matching the music to the characters’ feelings and experiences. We also incorporated the school’s Zones of Regulation framework, helping Scott connect emotions with words, sounds and familiar concepts.
Progress was gradual and required considerable repetition, consistency and patience. Over time, school staff noticed that Scott was beginning to communicate his needs more clearly before becoming distressed, and that he was often calmer and easier to settle following periods of disregulation. At home, his family noticed that he was increasingly able to describe how he felt using words such as “tired”, “hungry”, “sad”, “happy” and “lots of energy”.
These changes were particularly meaningful because they gave Scott a way to communicate what was happening for him before his feelings became overwhelming. Music therapy offered a space where emotions could be explored safely, repeatedly and in a way that made sense to him.
When Scott later moved schools, the music therapy relationship provided a familiar and consistent point of connection during a significant transition. Although the change initially felt unsettling for him, he was able to use the dolls and stories to act out and process what was happening, and gradually settled into the new environment.
As the years progressed, his play became increasingly complex. He explored stories involving disappointment, embarrassment, grief, feeling unheard and loss, as well as excitement and joy. When he experienced the death of a grandparent, the dolls and improvised music provided a way for him to explore and express some of the feelings surrounding this.
His stories also reflected his rich imagination and love of fairy tales and Disney. In the earlier years, stories would often end with characters dying or the “evil” side winning. Over time, these narratives became more varied and increasingly hopeful. Music allowed us to stay with his stories without needing to direct or correct them, while gently offering opportunities for different endings and possibilities.
By the time Scott was discharged from music therapy, shortly before his tenth birthday, he was able to engage in a 45 minute session, making music, sustaining shared attention and narrating increasingly elaborate stories. We could spend an entire session singing a story together through call and response, with Scott leading the narrative and cueing the next part of the musical exchange.
What began with a child who could barely remain in the room for a few minutes developed into a sustained musical and imaginative dialogue. The progress was not simply about sitting still or completing tasks; it was about Scott finding ways to communicate, understand his emotions, process experiences and build relationships.
For Scott, music therapy became a place where he could be understood through his own interests and ways of communicating - and, over time, where those ways of communicating could grow.
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