The Use of Percussion Instruments as a Therapeutic Tool in

School-Based Practice
Donald E. Walkovich, DHSc, MS, OTR/L; Barbara R. Walkovich, OTR/L;

Jennifer Conrad, MOT, OTR/L April 15, 2011 - Poster Session 2074

Introduction:
Occupational therapy practitioners use a variety of
therapeutic modalities to help children with autism to
develop appropriate social, play, and learning skills.
School-based therapy addresses the child’s need for
sensory regulation to promote appropriate learning
and attention to task. Research has shown that children
and adolescents with Autism Spectrum Disorder who
present with limitations in conventional forms of verbal
and non-verbal communication are found to respond
positively to occupational therapy intervention
involving the use of percussion instruments.
Autism treatment is rapidly evolving, and there is need
for expanded and improved treatment options.
Occupational Therapy practitioners continue to strive
to find ways in which they can assist children on the
autism spectrum to communicate and control their
environment for the purpose of improving their quality
of life.
Phase One:
Phase One of the project included training
of 18 occupational therapy practitioners in
“how to drum” by Jim Donovan, a
renowned percussionist, drum facilitator,
and former member of the band Rusted
Root. The practitioners were taught
percussion and rhythm techniques that
could be used easily regardless of musical
ability.
Practitioners then participated in round
table discussions regarding practical
application of this treatment technique for
occupational therapy in the school system.
Due to their size and weight, hand drums
were found to be impractical, so Sound
Shapes and Boom Whackers were the
percussive instruments of choice.

The reason rhythm is such a powerful tool for treating

these conditions is that it permeates the entire brain.
The human response to rhythm has been studied for
centuries and, according to Dolle, rhythm is
documented to have a far more influential effect upon
us than previously believed (Dolle, 2006). Michael
Winkleman of Arizona State University notes that,
“drumming synchronizes the frontal and lower areas of
the brain, integrating nonverbal information from
lower brain structures into the frontal cortex,
producing feelings of insight, understanding,
integration, certainty, conviction, and truth, which
surpass ordinary understandings and tend to persist
long after the experience, often providing foundational
Phase One:
insights for religious and cultural traditions”
(Winkleman, 2000).
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 Phase Two:
In Phase Two of the project, the
occupational therapy practitioners used
their newly learned skills as therapeutic
intervention to promote sensory regulation
and attention to task with children with
autism in public schools across the
Commonwealth of Pennsylvania. The use of
Sound Shapes and Boom Whackers were
found to be helpful as a preparatory activity
to achieve therapeutic goals. Rhythmic
drumming patterns were found to alert or
calm the sensory system, increase attention
to task, and improve non-verbal
communication.
A total of 41 children in grades Pre-K
through 8 and ages varying from 2 to 17
years with a diagnosis of Autism Spectrum
Disorder participated in this 12-week study
In alignment with statistics, the gender of
the participants were male dominated with
38 males to 3 females.
For each participant in the study, an initial
measure of attention-to-task was recorded.
Attention-to-task was also measured during
each therapy session utilizing a digital stop
watch. The participants utilized learned
percussion techniques while skillfully
observing each student to determine
changes in on task behavior. The results
were compared and contrasted against
student baseline data. The stop watch was
started when the child initiated the
presented tasks, and stopped if the child
oriented away from the task. The study was
outcome-based and the subjects, all with an
ASD diagnosis, acted as their own control.
The percentage change from the baseline
measure was then calculated for each
session.
Results:
Attention-to-task Percent Change
The following line chart shows the average
percentage change in attention-to-task
from the baseline by session. For example,
following session one, there was an average
change in attention-to-task behavior of
126.1% of the baseline percentage.
As expected and for various reasons, each
participant’s performance in the study was
not always consistent. There were
participants who had realized a significant
increase in attention-to-task in one session
and then fell below their baseline in the
very next session. Therefore given the
nature of the participants and the study,
each participant’s attention-to-task
measure by sessions was averaged to yield
a mean change from baseline. The results of
this analysis showed that participants in the
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study realized a statistically significant
average increase of 90.3 (p < 0.01) seconds
with a median of 74.15 seconds. This is an
average percentage change of 189.1%.
Conclusion:
The percussion instrument techniques
learned in Phase I of this project were
tested in a clinical trial to measure attention
to task results on school-aged children with
Autism Spectrum Disorders. The overall
result for all participants was an impressive
positive average percentage increase of
189.1% in attention to task.
This study indicates that the use of
percussion instruments may improve
attention to task for children with autism,
thereby promoting participation in
educational activities.
Percussion, when used as a clinical
intervention, positively impacts the length
of time a child with autism will sustain
attention to task.
Occupational therapists are justified in
giving consideration to the use of this
intervention as a preparatory activity in
occupational therapy treatment sessions.
References:
-Autism Speaks (2010) Retrieved December 14,
2010 from
http://www.autismspeaks.org/
-Boomwhackers at http://boomwhackers.com
-Dolle, S. (2006). Drum circles. Retrieved
August 31, 2007 from:
http://www.diaceph.com/DrumCircles
htm
-Drake, M. (2009). Drum therapy – therapeutic
effects of drumming. Retrieved March 16, 2009
from:
http://healing.about.com/od/drums/a/
drumtherapy.htm
-Friedman, R.L. (2000). The Healing Power of
the Drum. Reno, NV: White Cliffs
-Kaplan, R.S. and Steele, A.L. (2005). An analysis
of music therapy program goals and outcomes
for clients with diagnoses on the autism
spectrum. Journal of Music Therapy, 422-19.
-West Music at http://www.westmusic.com/
- Winkelman M, Shamanism: The Neural
Ecology of Consciousness and Healing.
Westport, Conn: Bergin & Garvey; 2000.
Contact Information:
Donald Walkovich – Saint Francis
University - dwalkovich@francis.edu
814-472-3899
Barbara Walkovich – Camco PT and OT
bwalkovich@atlanticbb.net
814-266-8833
Jennifer Conrad – Camco PT and OT
jconrad@camcoptot.com
814-266-8833