Knight Ridder Newspapers

TALLAHASSEE, Fla. – Lightly plucking guitar strings as if they were silken threads, Judy Nguyen sings softly to a baby who seems, in his swaddling, about as big as a Betsy Wetsy. Baby Joseph Mariner is 36 weeks old, still a month shy of full-term but on this day already 24 days out of the womb in Tallahassee Memorial Hospital’s neonatal intensive care unit.

“Three green and speckled frogs sitting on a speckled log …” Nguyen (pronounced “win”) sings, turning a child’s humorous ditty into a sound that flows like liquid over the baby while his mom Lisette Mariner’s right index finger caresses his forehead.

Mariner next touches the peach-soft cheeks. With his eyes shut tight, Joseph turns up the corners of his mouth to suggest a smile.

When unexpectedly born, Joseph Mariner weighed 4 pounds 10 ounces – not awfully underweight but still tiny.

His neurological system was too immature to work properly, and he was given a feeding tube since he couldn’t suck or swallow. He also had a concern-causing incident of apnea, when he quit breathing, although he had no other complications.

Because he was born seven weeks early but didn’t have a lot of special medical needs, Baby Joseph met the criteria for this special music therapy – the only clinical music therapy program in the nation for premature babies developed by Jayne Standley of Florida State University.

Florida State University has “the only degree-granting music therapy program in the country that runs a medical program,” says Standley, named in October the 2005-06 Lawton Professor, the highest award given by the faculty.

A music therapy major who played the French horn at Florida State University in the 1960s, Standley joined the university’s staff in 1976. Ten years later, Congress passed the Education of the Handicapped Act, which gave states money to develop early intervention services for newborns and infants.

Standley was working with prekindergarten children at the time, “but we noticed that many of them had been preemies,” she says. So she backed down the age scale because “the number of preemies was increasing and early intervention was the best prevention” of later developmental problems.

About the same time, her Florida State University mentor, Clifford Masden, asked whether infants prefer to listen to music or their mothers’ voices. She didn’t know. So, she rigged Velcro attachments to babies’ feet so that moving one foot turned on recorded music, moving the other got mother’s voice. She tested babies from one to eight months.

“The thing that shocked us was that all the babies learned to use the switches in 2 1/2 minutes,” she said.

The youngest infants preferred the mother’s voice; the older infants liked the lullabies.

“So I was sitting in medical meetings where babies were discussed whose medical problems were OK but who hadn’t learned to nipple feed,” Standley said. “I wondered: How do you teach a baby to suck? And I wondered if music could reinforce sucking and teach feeding.”

She was off and running, training undergraduate and graduate students – her students provide music therapy at Florida Hospital in Orlando and Children’s Hospital in St. Petersburg, Fla., and elsewhere – and launching follow-up research on children who have benefited from music.

“It is cutting-edge for music therapy,” says Al Bumanis, a spokesman for the American Music Therapy Association.

At Tallahassee Memorial, Florida State University and the hospital jointly run the music therapy program for preemies like Joseph: children who need to be taught to suck, swallow and breath, to remain calm in the over-stimulation of the neonatal intensive care unit (NICU) and to bond with mother. The program has been taking shape over six years and Standley estimates her “graduates” number in the hundreds.

In NICU settings, where preemies are hooked to wires in artificially lighted plastic boxes, babies must be taught how not to be over-stimulated, says Nguyen, director of Tallahassee Memorial Hospital’s music therapy program and former student of Standley’s. One way to do this is to combine music, soft touch and rocking: music to soothe; touch to reduce the alarm triggered by a touch when over-sensitive nerves are so near thin skin; rocking gently to calm and help develop inner-ear balance.

Music is understood even by fetuses, who will reduce their heart rate, move or kick in response to music. And mothers singing to babies is universal.

“Mothers sing two song types,” says Shannon de l’Etoile director of the University of Miami’s music therapy program. “They sing lullabies, which relax infants and help calm them, and they play songs to arouse and stimulate them.

“The human brain is hard-wired to interpret music and it is meaningful for newborns,” de l’Etoile says.

Singing also teaches babies about speech patterns, such as inflection, accent and timing. “It’s a critical aspect of development,” de l’Etoile explains.

In fact, her research has shown that music elicits more attention from a baby than that oft-heard spoken language, baby-talk.

Standley devised a way for babies to be “rewarded” with music. She developed a computer-rigged and patented pacifier that triggers lullabies in the key of C at 65 decibels. The more the baby sucks the pacifier, the more frequently they hear music, and the more they suck. The pacifier has been patented.

Dr. Ed Bell of Iowa Hospitals, neonatologist and previous Head of Neonatology at the University of Iowa Hospitals and Clinics, called Standley’s pacifier “very clever.”

“At the very least, it seems like an interesting research tool. It makes sense to use it in a clinical setting.”

Even when milk is not the reward, sucking is vital to an infant’s development, studies show. It releases hormones in the gastrointestinal tract that promotes growth and development and helps deliver oxygen into the body, including the brain. Baby Mariner’s apnea probably was from a lack of oxygen, Nguyen said.

During the last trimester before birth, the fetus is developing at a nearly unbelievable rate, producing 250,000 neurons per minute, Standley says in her book “Music Therapy With Premature Infants” (The American Music Therapy Association, $60). “That’s all the neurons a human will get in a lifetime.”

If these neurons aren’t given jobs, they’re discarded. So stimulation is vital.

Neurological development occurs from the head down and from the center of the body out. That’s why mom Lisette Mariner, 37, stroked her son from the head to the cheek, then the neck, then tummy, legs and feet. She also traced her finger over her son’s chest, out to one arm, then another.

If a baby doesn’t like the music, Nguyen says, he will show one of three signs, or all three: he’ll raise a “halt” hand, palm out; he’ll turn red in the face; he’ll cry.

“When we see these, we stop. Then when he’s OK, we’ll start again,” she says.

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