Program harmonizes treatment at Prisma Health Children’s Hospital – Midlands
South Carolina’s first children’s hospital might also be its most innovative. Prisma Health Children’s Hospital – Midlands recently opened the state’s first pediatric rehabilitation unit – adding to the more than 30 subspecialties that provide care during over 150,000 children’s visits each year.
Prisma also continues to evolve its existing services. The Music Therapy Program began as a part-time initiative not long after the Midlands Children’s Hospital was established in 1994. Becca Kelly arrived on the scene more than two decades ago, and the music therapist is now the Team Lead in the Child Life Department, which houses the music therapy program.
As the demand for services continued to grow, Kelly was joined by two more therapists, including Janelle Mitchell, who launched the hospital’s Music Therapy Internship Program. It took two years and lots of paperwork to meet the numerous certification requirements, but the team welcomed their first intern in 2023.
“Like many other types of health therapy, music therapy has very strict criteria for entering into the profession,” Mitchell says. “You need to have a degree in music therapy from an approved program, become board-certified through the Certification Board of Music Therapists, and complete a six-month internship.”
Mitchell discovered the field when she was a member of her high school band in Florida. Her assistant band director showed the clarinet player an article about a device known as PAL (Pacifier Activated Lullaby) that – when administered by a music therapist – could reinforce effective non-nutritive sucking for premature infants through operant conditioning.
Mitchell knew she had found her calling, and she attended Florida State University to study music therapy with PAL’s inventor, Robert O. Lawton Distinguished Professor Jayne Standley. After completing her internship, passing the board certification exam, and gaining private practice experience for several years, Mitchell landed at Prisma Health’s Children’s Hospital-Midlands in 2019.
She was determined to establish an internship program and procure a PAL for their Neonatal Intensive Care Unit – the region’s only Level III NICU. Mitchell successfully secured a PAL device for their NICU earlier this year after detailing its merits in a grant application. “Working in the NICU is the reason I started in the music therapy field, and I continue to grow more passionate about it,” Mitchell says.
Working closely with nurses, physicians, and other therapists, Mitchell provides care for patients as young as 28 weeks gestation – an age at which most infants can respond to auditory stimuli. She keeps an eye on various monitors to see how she can help patients improve their vital signs (e.g., increase oxygenation, lower heart rate) through music therapy (often in conjunction with touch and other therapeutic methods).
“I have seen a patient go from oxygen levels in the low 80s to nearly 100 percent in response to positive auditory stimulation of singing with appropriate tempo, decibel level, and vocal range for premature infants,” Mitchell says. “It is so rewarding to see them learn how to self-regulate and to witness music assist with maintaining vitals in a healthy range.”
The team also works with parents – educating them on the best ways to sing and safely use sound machines and other devices to help their children’s neurological development. This training begins as soon as the babies are old enough to engage in kangaroo care with their parents, which works even better when music is added to the mix.
Every part of the music therapy program is collaborative – from working with patients to parents to other clinical services. Referrals often result from interdisciplinary healthcare meetings, or treatment can come about spontaneously when a clinician, parent, or patient sees Mitchell walking down the hall with her guitar.
It’s all about healing – whatever that looks like. A recent request from the pediatric sedation unit introduced Mitchell to an elementary school-aged girl with autism. Sedation services are a common and critical need for children’s hospitals because they enable kids to receive much-needed healthcare procedures and music therapy can help with decreasing anxiety during these procedures. Child life specialists work closely with clinicians, patients, and families to help them receive care, and music therapists are often called upon to provide their services.
“This little girl was having difficulty adjusting to the hospital environment and self-regulating before the procedure,” Mitchell says. “I brought in a keyboard, and she immediately began playing songs by ear and was able to settle in more. It’s an important component of treatment that helps normalize an unfamiliar experience that is happening in a new environment.”
The music therapists are often seen pushing entire carts of instruments among the various medical units at Prisma Health’s Children’s Hospital. From drums to guitars, they offer an array of options to children – using their extensive training and real-time feedback to engage patients in the cancer and blood disorder unit, surgical recovery, and beyond.
A patient in the hospital’s newly opened rehabilitation unit had experienced a significant trauma injury and needed intensive therapy. Working with the occupational and physical therapists, Mitchell addressed goals to improve his balance, core strength, and motor skills – all by pulling out a xylophone.
“He was sitting up and displayed difficulties using both hands at the same time,” she recalls. “We tried shakers and other instruments, but it was the xylophone that really got his attention. He used one hand to hold the base and the other to use the mallet. It was a great moment.”
These strategic interventions improve physical functioning while increasing endurance and motivation. The collaborations result in practical gains while participating in a fun environment. Sometimes the patients are making the music, sometimes it’s the therapists, but often, it’s both.
“We are therapists who use music as a medium for helping patients achieve non-music goals,” Mitchell says. “We vary our methods based on the patient and the healthcare goals, whether that’s rehabilitation, pain management, neurodevelopment, reducing anxiety, or any number of other areas.”
Adopting the field’s emphasis on patient-preferred music, Mitchell follows their lead. Whether it’s Broadway or Taylor Swift, much of this involves singing their favorite songs. She’s even known to rap. Versatility is the key, and Prisma’s innovative music therapists have it in spades.