SUSAN HALLAM AND

EVANGELOS HIMONIDES

THE
POWER
OF MUSIC
An Exploration of the Evidence
THE POWER OF MUSIC
 The Power of Music

An Exploration of the Evidence

Susan Hallam and Evangelos Himonides

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© 2022 Susan Hallam and Evangelos Himonides

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 Contents

Author Biographies xiii

Susan Hallam xiii
Evangelos Himonides xiv
Preface xvii
1. Introduction 1
Music, Its Functions and Origins 2
Transfer of Learning 7
Methodological Issues 9
Ways of Engaging with Music and Varying Levels of
Commitment 11
Music Therapy 13
Interpreting the Research Findings 13
2. Music and Neuroscience 15
Neuroscientific Methods 17
Changes in the Brain following Musical Activity 18
Comparisons between Musicians’ and Non-Musicians’
Expertise 19
The Automation of Skills as Expertise Increases 25
Bimanual Motor Coordination 26
Multisensory Learning 29
Neurological Differences Relating to Genre and the
Instrument Played 30
Studies with Child Musicians and Non-Musicians 33
Genetic and Maturational Effects versus Training Effects 37
Intervention Studies 38
Overview 42
vi The Power of Music

3. Aural Perception and Language Skills 43

Explanations of the Relationships between Music
and Language 46
Comparisons between Musicians and Non-Musicians 55
Research with Children 62
Research with those with Auditory or Language Impairments 72
Overview 77
4. Literacy and Related Language Skills 79
Correlation Studies and Comparisons between Musicians
and Non-Musicians 80
Intervention Studies 83
Children Facing Challenges with Literacy Skills 90
Are Pitch or Rhythm Programmes More Effective in
Enhancing Literacy? 96
Reviews, Meta-Analyses and Conclusions 101
Spelling 102
Writing 103
Overview 105
5. Music, Spatial Reasoning and Mathematical Performance 107
Comparisons between Musicians and Non-Musicians, and
Correlation Studies 110
Musical Interventions and Spatial-Temporal Reasoning 114
The Relationships between Spatial Skills and Mathematics 119
The Relationships between Music, Spatial Skills
and Mathematics 122
Musical Engagement and Mathematical Performance 123
Overview 130
6. The Impact of Musical Engagement on Memory 133
Visual Memory 134
Research with Children 140
Verbal Memory 141
Research with Children 145
Working Memory 148
Research with Adults 149
 Contents  vii

Research with Children and Young People 154

Older Adults 159
Reviews and Meta-Analyses 167
Overview 169
7. Executive Functioning and Self-Regulation 171
Research with Adults 175
Research with Children 181
Research with Older People 190
Reviews of the Literature 194
Overview 197
8. Intellectual Development 199
Nature or Nurture 201
Correlational and Comparative Research with Adults 202
Correlation and Comparative Research with Children 206
Intervention Studies 210
Music and Emotional Intelligence 215
Studies with Older Adults 217
Reviews and Meta-Analyses 219
Overview 221
9. Musicians and Creativity 223
Neurological Studies of Creativity 225
Correlational and Comparative Research on Musicians 227
The Personality of Musicians and Creativity 230
Intervention Studies 232
Creativity in Later Life 234
Reviews and Meta-Analyses 235
Overview 235
10. General Attainment 237
Correlation and Comparative Studies 237
Large-Scale Research 241
Research with Disadvantaged Populations 247
Intervention Research 248
Reviews and Meta-Analyses 251
viii The Power of Music

Explanations for the Research Findings 253

Neurological Studies 254
Length of Engagement with Music 255
Type, Nature and Quality of Musical Training 256
The Role of Executive Functions in Attainment 257
Personality Factors 257
Motivation 258
Overview 259
11. Music and Studying 261
Listening to Music prior to Completing a Task 261
Background Music 269
The Nature of the Music 270
Preferred Music, Familiarity and Liking 276
Preference for Music of One’s Own Culture 279
The Nature of the Task To Be Completed 279
Background Music and Memory 279
Background Music and Attention 284
Reading Comprehension 286
Second-Language Learning 288
Background Music and English as a Second Language 289
Individual Differences 290
Musical Expertise 290
Gender 292
Personality 292
Background Music and Metacognition 294
The Impact of Background Music on Children’s Behaviour
and Task Performance 296
Background Music and Primary-School Children 297
Background Music and Older Students 300
Research with Children with Emotional and
Behavioural Difficulties, ADHD and Developmental
Difficulties 301
Children with Attention Deficit Hyperactivity Disorder and
Attention Deficit Disorder 301
Emotional and Behavioural Difficulties 303
 Contents  ix

Older Adults and those with Cognitive Impairment 304

Reviews and Meta-Analyses 307
Explaining the Impact of Background Music on Cognitive
Performance 309
An Explanatory Framework 316
Overview 317
12. Re-Engagement and Motivation 319
Motivation 319
Motivation Developed through Engagement with Music 322
Children and Young People Facing Challenging Life
Circumstances 325
El Sistema and Sistema-inspired Programmes 326
Raised Aspirations and Motivation for Learning 326
Self-Beliefs 331
School Attendance and Positive Attitudes towards School 332
Emotional and Behavioural Difficulties 333
Transferable Skills 334
Music Interventions Unrelated to El Sistema 334
School Attendance and Attitudes towards School 339
The Integration of Young People with Special Educational
Needs into Mainstream Education 340
School-Based Music Therapy Interventions for Children
with Emotional and Behavioural Difficulties 342
The Role of Rap and Hip Hop in Therapy in School Contexts 347
Music Programmes for Young Offenders 353
Music Programmes for Adult Offenders 361
Choirs 362
Projects Using Gamelan 363
Assorted Music Therapies 365
Overview 372
13. Personal, Social and Physical Development 375
Personal Development 375
Music and Identity 375
Music and Personality 377
x The Power of Music

Self-Beliefs 384
Self-Beliefs, Deprivation and Disaffection 387
Children with Special Educational Needs and Disabilities 389
Ensemble Participation 390
Musical Preferences and Self-Esteem 391
Social Development 392
Musical Ensembles and Teamwork 397
School Climate 400
Sistema Programmes 401
Prosocial Skills and Empathy 403
Interventions for Children with Special Educational Needs
and Disabilities 405
Physical Development 406
Music, Locomotor Performance and Coordinated Motor
Skills 408
Overview 410
14. Psychological Wellbeing 413
The Use of Music to Support Emotional Stability and
Manage Moods 418
Singing 425
Wellbeing in Young Children 430
Music and Wellbeing in School-Aged Participants 432
Music and Wellbeing in Adolescents and Young People 437
Actively Making Music 444
Music and Wellbeing in Adults 447
Participation in Musical Activities 449
Attendance at Music Festivals 451
Music and Wellbeing in the Older Generation 453
Music, Wellbeing and the COVID-19 Pandemic 465
The Impact of the Pandemic on Music Professionals 475
Overview 477
15. Music and Physical and Mental Health 479
The Role of Music in Psychological and Physical Health 480
Music, Stress and the Immune System 484
 Contents  xi

Active Music-Making and the Promotion of General Good

Health 486
Music, Health and the Older Generation 488
Music, Dementia and Care in the Home 497
Reviews of the Relationship between Music Therapy and
Dementia 499
Music, Public Health and Music on Prescription 501
The Role of Community Music and Creative Workshops 503
Music, Brain Plasticity and Movement 505
Breathing 509
Speech Impairment 510
Music in Hospital Settings 511
Music and Mental Health: Stress, Anxiety and Depression 519
Mental Health Care in Children, Adolescents and
Young People 523
Insomnia 525
Music, Trauma and Abuse 527
Severe Mental Ill-Health 538
Overview 549
16. Music, Inclusion and Social Cohesion 551
Music and Conflict 555
Music and Refugees 560
Social Inclusion 566
Overview 571
17. Music in Everyday Life 573
Music and Leisure 574
Listening to Music 576
Attending Live Musical Events 577
Actively Making Music 578
Socioeconomic Status 579
Music in the Arts 581
Listening to Support Everyday Activities 581
Music and Driving 582
Music at Work and to Accompany Mental Activity 583
xii The Power of Music

Music and Exercise 584

Music, Commerce and Consumption 585
The Economics of Music 588
Music and Non-Human Species 589
Overview 591
Reflections on an Exploration of the Evidence for the
Power of Music 593
Bibliography 597
Index 805
 Author Biographies

Susan Hallam
Professor Susan Hallam (MBE) studied the violin at the Royal Academy
of Music prior to becoming Principal 2nd violin in the BBC Midland Light
Orchestra and Deputy Leader of Orchestra da Camera. She studied for
her BA in psychology externally with London University and for her
MSc in the Psychology of Education and her PhD at the Institute of
Education, University of London. She is currently Emerita Professor
of Education and Music Psychology at University College London,
Institute of Education. She is a past editor of the Psychology of Music
and Music Performance Research. She has been Chair of the Education
Section of the British Psychological three times and is an Academician
of the Learned Societies for the Social Sciences. She has been awarded
lifelong honorary membership of the British Psychological Society and
the International Society for Music Education. In 2020 she was awarded
a Music & Drama Education Lifetime Achievement Award.
Her research interests in music include practising, performing, musical
ability, musical understanding and the wider impact of engagement with
music. She is the author of numerous books related to music including:
Instrumental Teaching: A Practical Guide to Better Teaching and Learning
(1998); The Power of Music (2001); Music Psychology in Education (2005);
Preparing for Success: A Practical Guide for Young Musicians (2012) (with
Helena Gaunt); Active Ageing with Music (2014) (with Andrea Creech,
Maria Varvarigou and Hilary McQueen); The Impact of Actively Making
Music on the Intellectual, Social and Personal Development of Children
and Young People: A Research Synthesis (2015); The Psychology of Music
(2018); and Contexts for Music Learning and Participation: Developing
and Sustaining Musical Possible Selves (with Andrea Creech and Maria
xiv The Power of Music

Varvarigou). She is editor of The Oxford Handbook of Psychology of Music

(2009, 2016) (with Ian Cross and Michael Thaut); Music Education in the
21st Century in the United Kingdom: Achievements, Analysis and Aspirations
(2010) (with Andrea Creech); and The Routledge International Handbook
of Music Psychology in Education and the Community (2021) (with Andrea
Creech and Donald Hodges).

Evangelos Himonides
Dr Evangelos Himonides held the University of London’s first ever
lectureship in music technology education and now holds the country’s
first ever Chair in Technology, Education, and Music. Evangelos works
at University College London, where he leads a number of courses and
supervises doctoral and post-doctoral research. At postgraduate level, he
has led and now serves the MA in Music Education programme at UCL,
with courses in ‘Music Technology in Education’ and ‘Choral Conducting,
Leadership and Communication’. At undergraduate level, Evangelos
developed UCL’s first ever music-related course in the Institution’s near
two-century history, which is called ‘Interactions of Music & Science’
and offered under the innovative Bachelors of Arts and Sciences (BASc)
programme. He is fellow of the RSA and Chartered Fellow (FBCS
CITP) of the British Computer Society. As a musician, technologist and
educator, Evangelos has had an ongoing career in experimental research
in the fields of Psychoacoustics, Music Perception, Music Cognition,
IT, Human-Computer Interaction, Special Needs, the Singing Voice &
Singing Development. Publications currently number over two hundred
in high-profile international journals, such as Frontiers of Psychology
and Cognitive Science, Psychology of Music, IJME, RSME, Journal of
Voice, Logopedics Phoniatrics Vocology. Evangelos has been working on
numerous funded research projects for leading UK Research Councils
such as the AHRC, ESRC, EPSRC, grant-making foundations/charities
such as The Paul Hamlyn Foundation, RNIB, the AmberTrust and the
Esmée Fairbairn Foundation, government agencies/departments (such
as DfES, QCA) and also the European Union.
Evangelos is associate editor for the Journal of Music, Technology
and Education (Intellect), associate editor of Frontiers in Psychology,
past associate editor for the Journal Logopedics Phoniatrics Vocology
 Author Biographies  xv

(Informa Healthcare), reviews editor for Psychology of Music (SAGE),

editor of the Society for Education and Music Psychology Research
(SEMPRE) Conference Series, and section editor for ‘technology’ for the
Oxford Handbook of Music Education. Evangelos has co-edited, with
Andrew King, two key volumes in Technology, Music and Education,
published by Routledge.
As a sound engineer and researcher, Evangelos has recorded in
numerous venues (including York Minster, St.Paul’s, RCM), with various
artists such as Derek Lee Ragin (Farinelli), Vanessa Mae (SONY BMG)
and Jarvis Cocker (Pulp) and for numerous media productions (for the
BBC, Ch5, Discovery Channel, RTL, CBS, PBS, History Channel).
Evangelos has developed the free online technologies for Sounds of
Intent, Inspire-Music and the Online Afghan Rubab Tutor. In his spare
time, Evangelos likes to record music, play guitar, and handcraft musical
instruments in order to raise funds for his charitable work.
 Preface

This book was written to provide an update to The Power of Music: A

Research Synthesis of the Impact of Actively Making Music on the Intellectual,
Social and Personal Development of Children and Young People (2015). As
the evidence was collated, it became clear that much more research
had been undertaken since the original book was produced and that
that research was focused on a much wider age range with particular
expansion in work with older age groups. It was therefore decided to
expand the book to include research across the lifespan covering a wider
range of issues, particularly those relating to health and wellbeing as
these have become more important in the research agenda in recent
years. The title referring to an exploration of the research was selected
to make it possible to take account of all kinds of research, from large-
scale population studies to single case studies, correlation studies,
experiments and evaluations of interventions with a focus on both
listening to and actively making or creating music. Some interventions
that have several different outcomes are mentioned in more than one
chapter. As there has been much controversy recently as to whether
music can have any impact, particularly on cognition, it was felt to be
important to include examples of individual research projects for the
reader to be able to draw their own conclusions about the impact of
music rather than relying on a summary, although an overview is
provided at the end of each chapter. This means that the book is not
always an easy read. Some of the research is extremely complex and
takes time to understand. It is hoped that, despite this, the reader will
be enabled to make an informed decision about the power of music in a
range of areas across the lifespan.
 1. Introduction

The speed of change in electronic media in the latter part of the 20th
century revolutionised access to and the use of music in people’s lives.
Music can be accessed in many ways, through radio, CDs, DVDs,
TV, tablets, SMART technologies, computers and phones, and can
be downloaded to enable the creation of personal playlists. This can
be achieved with very little effort, but this was not always the case.
Historically, people could only access music through participating in
religious or other social events. These changes have made it possible
for individuals to use music to manipulate their moods, arousal
levels and feelings, and create environments which may change the
way that other people feel and behave. Music can be used to aid
relaxation, overcome powerful emotions, generate moods appropriate
for carrying out routine activities, prepare for social activities or
stimulate concentration. In short, music can be used to promote
wellbeing. In young people, it supports the development of identity
and self-presentation. Alongside this, technological advances in
research techniques have increased our understanding of the way that
music can benefit the intellectual, social and personal development of
children and young people.
The chapters in this book explore the ways that music can benefit
children and young people, as well as the wellbeing and health of the
general population. This introductory section sets out what we know
about the functions and origins of music; the transfer of learning;
methodological issues; ways of engaging with music with varying levels
of commitment; music therapy; and issues related to the interpretation
of research findings.

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.01

2 The Power of Music

Music, Its Functions and Origins

There is evidence for engagement with music pre-homo-sapiens (Turk,
1997). A bone flute estimated to be about 50,000 years old has been
found in a Neanderthal burial site and this may have been predated by
singing. In China, bone flutes have been found dating back to 6000 BCE,
stone flutes from 1200 BCE, and a system of classification of instruments
according to the materials that they were made of from 500 BCE
(Zhenxiong et al., 1995). Such evidence of the early use of instruments
has been found in several cultures (Carterette and Kendall, 1999).
Despite the evidence of musical activity in early humans, there is no
consensus as to whether music has evolutionary significance, although
the arguments for its evolutionary role are strong. For instance, Miller
(2000) has argued that music exemplifies many of the classic criteria for
a complex human evolutionary adaptation, pointing out that no culture
has ever been without music (universality); musical development in
children is orderly; musicality is widespread, all adults can appreciate
music and remember tunes; we have a specialist memory for music;
specialised cortical mechanisms are involved; there are parallels in the
signals of other species—for example, birds, gibbons and whales—so
evolution may be convergent; and music can evoke strong emotions
which implies receptive as well as productive adaptations.
Considering the possible functions of music, Huron (2003) set out
the following theoretical positions:
• mate selection—music performance may have arisen as a
courtship behaviour;
• social cohesion—music may create or maintain social cohesion
through the promotion of group solidarity and altruism;
• group effort—music may contribute to the coordination of
group work;
• perceptual development—music may contribute towards the
more general development of sound perception;
• motor skill development—singing with movement and other
music-making provides opportunities to refine motor skills;
 1. Introduction  3

• conflict reduction—music may reduce interpersonal conflict

within groups through shared activities unlikely to provoke
argument or dispute;
• safe time passing—music may provide a way of passing time
which avoids engagement with possible dangerous situations;
• transgenerational communication—music may have originated
as a useful mnemonic device for passing on information from
generation to generation.

Those supporting a sexual selection theory—for example, Miller

(2000)—argue that male musical performance influences female choice
of mate. This might also apply to males’ choice of mate and could
explain why music becomes so important in adolescence. Other theories
propose that music has evolved from emotional or impassioned speech,
or indeed was an imitation of bird song (Cross, 2003, 2009, 2016; Huron,
2003). Some have suggested that music evolved through the mother-
child relationship—in particular, soothing and comforting behaviour,
which developed into lullabies. This is supported by evidence that
systems for processing sound develop while the foetus is still in the
womb and are fully operational for processing music at birth (Gaston,
1968; Parncutt, 2009). Dissanayake (1988) further suggests that the
musicality of mother-infant interaction might lay the foundations for a
grammar of the emotions.
There is considerable support for the role of music in promoting
social cohesion. For instance, Sloboda (1985) speculates that music-
making is rewarding because participating in it generates social
bonding and cultural coherence. This is supported by the role of music
in a wide range of ceremonies (Roederer, 1984). It has survival value in
that synchronising the moods of many individuals can support them
in collectively taking action to strengthen their means of defending
themselves from attack (Dowling and Harwood, 1986). Moving
together rhythmically may reinforce this process (Kogan, 1997). This
approach suggests that music reinforces groupishness—the formation
and maintenance of group identity—as well as collective thinking,
synchronisation and catharsis (the collective expression and experience
of emotion; Brown, 1991). This is supported by Weinstein and colleagues
(2016), who demonstrated that small- and large-scale bonding could
4 The Power of Music

occur in choirs of 20 to 80 people and larger groups of over 200. These

findings corroborate evolutionary accounts which emphasise the role
of music in the social bonding of large groups which other primates are
not able to manage.
Cross (2003), drawing on the work of Smith and Szathmary (1995)
and Mithen (1996), suggests that the appearance of homo sapiens is
marked by the emergence of a flexible cross-domain cognitive capacity
which:

‘is uniquely fitted to have played a significant role in facilitating the

acquisition and maintenance of the skill of being a member of a culture—
of interacting socially with others—as well as providing a vehicle for
integrating our domain-specific competences so as to endow us with the
multi-purpose and adaptive cognitive capacities which make us human’
(2003: 52).

This intrinsically transposable aboutness of music (2003: 51) allows

its many meanings to change from situation to situation. This may be
exploited in infancy and childhood as a means of forming connections
and interrelations between different domains—social, biological and
mechanical. Musical activity may simultaneously be about movement,
mood, emotion and mastery embodied in sound, affording the
opportunity to explore cross–domain mappings.
Not all authors agree that music has evolutionary purpose. Some
suggest that music, along with the other arts, has no evolutionary
significance and no practical function (Barrow, 1995; Pinker, 1997;
Sperber, 1996). Music is condemned as an evolutionary parasite. Pinker
(1997) argues that music is bound to the domain of language, auditory
scene analysis, habitat selection, emotion and motor control, and merely
exploits the capacities that have evolved to subserve these areas. Music
is an evolutionary by-product of the emergence of other capacities that
have direct adaptive value. It exists simply because of the pleasure that
it affords; its basis is purely hedonic.
In the 21st century, music has a multiplicity of functions which operate
at several levels: that of the individual, the social group and society
in general (Radocy and Boyle, 1988; Gregory, 1997). Merriam (1964)
recognises ten major musical functions: emotional expression, aesthetic
enjoyment, entertainment, communication, symbolic representation,
physical response, enforcing conformity to social norms, validation of
 1. Introduction  5

social institutions and religious rituals, contributions to the continuity

and stability of culture, and contributions to the integration of society.
There is extensive evidence of the key role that music plays in the
lives of individuals (Sloboda et al., 2009). Music can generate feelings
of wellbeing, can facilitate working through difficult emotions, and is
frequently linked to spirituality (Juslin and Sloboda, 2001). It is widely
used for exploring and regulating emotions and moods (Juslin and
Laukka, 2004; North et al., 2004; Saarikallio, 2011; Shifriss & Bodner,
2014) and can be effective in inducing positive affective states (North
et al., 2004), achieving desirable moods (Vastfjall, 2002) and also for
coping with negative moods and emotions (Miranda and Claes, 2009;
Shifriss & Bodner, 2014). The most common activity for mood regulation
is listening to music (Saarikallio and Erkkilä, 2007). Even adolescents
who play an instrument report that the best activity for mood regulation
is listening to music alone (Saarikallio, 2006). In adolescence, music
makes a major contribution to the development of self-identity. It
plays an important role in teenagers’ lives and they spend many hours
listening to it (Bonneville-Roussy et al., 2013; Bosacki and O’Neill, 2013;
Greasley and Lamont, 2011). Teenagers listen to music to pass time,
alleviate boredom, relieve tension and distract themselves from worries
(North et al., 2000; Tarrant et al., 2000; Zillman and Gan, 1997). Music
is seen as a source of support when they are feeling troubled or lonely,
acting as a mood regulator and helping to maintain a sense of belonging
and community (Schwartz and Fouts, 2003; Zillman and Gan, 1997). It
is also used in relation to impression management needs. By engaging
in social comparisons, adolescents are able to portray their own peer
groups more positively than other groups in their network and are thus
able to sustain positive self-evaluations. Music facilitates this process
(Tarrant et al., 2000).
At the individual level, music has also been seen as a vehicle for
emotional expression, conveying ideas and emotions which might be
difficult to communicate in ordinary verbal interchanges. Music elicits
physical responses, can aid relaxation or stimulate activity, and is
particularly effective in changing moods (Thayer, 1996). Listening to
music provides opportunities to experience aesthetic enjoyment and be
entertained, while making music can be seen as a source of reward and
intellectual stimulation, providing interesting and challenging activities
6 The Power of Music

at the rehearsal stage, and opportunities to demonstrate expertise and

musicianship in performance which, if successful, can lead to enhanced
self-esteem.
In small groups, music is a means of communication. Making
music is a social activity in that creating, interpreting, performing
and hearing music all depend on shared social meanings. Music can
serve to provide shared experiences and understandings which assist
in binding together social groups, supporting their identities. This is
apparent in its use in children’s games and also in adolescence, where
music becomes one of the central aspects of young people’s chosen
youth culture. Music is also used in work contexts. It can facilitate
the appropriate level of stimulation for mental or physical activity
and may also serve to ensure that individuals literally work in time
together. Emotional expression can also be important at the group
level, for instance, in protest songs. It provides a means of expressing
feelings towards subjects which are taboo or where there are inhibitions
regarding the expression of emotions—for example, love, and not only
romantic love but the love of God or a country, school or institution.
Music fosters prosocial behaviour, a shared sense of success, physical
coordination, shared attention, shared motivation and group identity
(Weinstein et al., 2016). It creates and strengthens social bonds
amongst interacting group members through endorphins, which
are released during synchronised exertive movements in singing or
playing together and are involved in social bonding across primate
species (Tarr, Launay and Dunbar, 2014).
In society as a whole, music provides a means of symbolic
representation for ideas and behaviours. It can represent the state,
patriotism, religion, bravery, heroism or rebellion. It can encourage
conformity to social norms through songs or alternatively may incite
challenges to those social norms. It provides validation of social
institutions and religious rituals and plays a major part in ceremonial
occasions including weddings, military functions, funerals and sporting
events. Music also contributes towards the continuity and stability of
culture, as individuals respond in similar ways to the music of their own
culture, while the social nature of musical activity invites and encourages
individuals to participate in group activities, reducing social isolation.
 1. Introduction  7

The power of music is reflected in the way that there have been—and
continue to be—attempts to exert control over it. In Nazi Germany, music
was carefully selected for use at mass rallies to generate appropriate
patriotic emotions. In the USSR, the music of Shostakovich was censored
by the Soviet government. During the Cultural Revolution in China,
Western music was denounced as decadent and forbidden. In Iran,
when Ayatollah Khomeini was in power, tight restrictions were placed
on particular types of music. In white-dominated South Africa, centres
of African music were demolished, while musicians living in exile
continued to influence the attitudes of the world against the prevailing
political system through their music. In the Western world, criticism
of hard rock music by the establishment and its purported effects have
been well documented (Martin and Segrave, 1988). Music also reflects
the values, attitudes and characteristics of a society. For instance, Weber
(1958) suggests that the Western classical tradition reflects a drive to
rationalise and understand the environment. Technological advances
impact on the way that music-making develops, as does the extent of
contact with—and influence of—other musical cultures (Nettl, 1975),
and the development of musical literacy. The latter extends what can
be passed onto future generations, while oral cultures restrict what can
be remembered (Sloboda, 1985).

Transfer of Learning
The transfer of learning from one domain to another depends on
similarities between the processes involved. Transfer between tasks is
a function of the degree to which the tasks share cognitive processes.
Transfer can be near or far, and is stronger and more likely to occur
if it is near. Salomon and Perkins (1989) refer to low and high road
transfer. Low road transfer depends on automated skills and is
relatively spontaneous and automatic—for instance, in processing
music and language, or using the same skills to read different pieces
of music or text. High road transfer requires reflection and conscious
processing—for instance, adopting similar skills in solving different
kinds of problems.
8 The Power of Music

Some musical skills, near and low road, are more likely to transfer
than others—for instance, those relating to the perceptual processing of
sound, timing, pitch, timbre and rule-governed grouping information,
fine motor skills, emotional sensitivity, conceptions of relationships
between written materials and sound, reading music and text, and
memorisation of extended information, music and text (Norton et
al., 2005; Schellenberg, 2003). Far transfer may occur in relation to
the impact of making music on intelligence and attainment. High
road transfer may also occur in relation to the skills acquired through
learning to play a musical instrument—for instance, being able to
recognise personal strengths and weaknesses, being aware of a range of
possible strategies (task-related and personal) relating to motivation,
concentration, monitoring progress and evaluating outcomes.
Throughout this book, the ways that transfer can occur in relation
to skills developed through active engagement with music—and the
ways these skills may impact on intellectual, social and personal skills—
will be explored. The impact of music on wellbeing and health will
also be considered, with particular reference to the impact of music on
emotions. Consideration will be given to the extent to which learning to
control emotions through music can support the development of more
general change in behaviour.
Research exploring the impact of music on cognitive skills has a
long history, going back to the 1970s. However, there was a surge of
interest following the discovery of the so-called Mozart effect, where
20 minutes of listening to Mozart was claimed to enhance intelligence
(Rauscher et al. 1993; 1995). This was later discredited by a range of
studies (Cabanac et al., 2013; Hallam, 2001; Schellenberg and Hallam,
2005), which suggested that music could change arousal levels which, in
turn, affected performance on cognitive tests. Since then, much research
has been undertaken to explore whether active engagement with music
can enhance cognitive ability. For reviews, see (for example) Benz et
al. (2016); Bugos (2019); Hallam (2015); Holmes (in press); Jaschke et
al. (2013); Miendlarzewska and Trost (2014); Moreno (2009); Rauscher
(2009); and Schellenberg (2016). This research will be explored in detail
later in this book.
 1. Introduction  9

Methodological Issues
Research exploring the ways in which active engagement with music
has an impact beyond the development of musical skills has been
undertaken within a number of disciplines adopting different research
paradigms. The designs and methods adopted vary widely, as do the
sample sizes.
Much early research considering the impact of engaging with music
on other skills was based on correlation studies undertaken with
professional or young musicians with varying levels of expertise. This
has been criticised on the basis that showing a relationship between
musical skills and other skills does not demonstrate causality. This is
particularly the case with neuroscientific studies (Schellenberg, 2019).
Some research has compared the performance of groups identified as
musicians or non-musicians. This research has been—and continues to
be—useful in highlighting possible areas of transfer. What it is unable to
do is identify the direction of causality, although studies using multiple
regression analyses are able to take into account possible confounding
factors.
Experimental studies, where the outcomes of musical interventions
are compared with those where there is no musical intervention or an
alternative intervention, offer the possibility of establishing causality.
Such studies vary in the length of the intervention, the range of
measures adopted to measure outcomes, the age of the participants,
and the nature of the activity of the control or alternative intervention
group. In an ideal scientific study, participants are randomly assigned
to intervention and control groups. In longitudinal research, where
follow-up may be weeks or months later, it can be difficult to sustain
participation and there is a high likelihood of dropout. This is reduced
if participants self-select the activity that they wish to undertake, but
this then constitutes a confounding factor, as those selecting a musical
activity may share particular characteristics—for instance, high levels
of intelligence or particular personality characteristics. The context of
musical interventions and their natures are also critical in determining
impact. Different outcomes might be expected in relation to whole-class
general music lessons or individual instrumental lessons. The quality
of the teaching and the relationships between learners and teachers are
10 The Power of Music

also likely to be important. The extent of variability in research design

and implementation tends to produce conflicting evidence. Qualitative
research, including interviews, focus groups, and ethnographic/case
studies, is able to provide insights into the perceptions of participants
and the contexts within which music may have a wider impact. However,
it has been criticised as being too subjective. All of these methods of
undertaking research have the potential to enhance our understanding
of the nature of transfer of musical expertise to other domains and
skills—albeit in different ways.
Systematic reviews are typically used to appraise, summarise, and
communicate the results and implications of large bodies of research,
such as that relating to the transfer of musical skills to other domains.
They can help in overcoming bias, which may be associated with single
research projects and the lack of generalisability in studies conducted
with one type of population. Systematic reviews aim to rigorously
identify and evaluate research, and provide objective interpretation
and replicable conclusions. Systematic reviews may include a meta-
analysis—a specific statistical strategy for assembling the results
of several studies to provide a single estimate of the size of impact.
Meta-analyses draw on existing experimental research, using complex
statistical analysis to reanalyse data to assess the impact of interventions
across many studies. They adopt different criteria for the studies
selected for inclusion. Greater numbers of criteria which studies need
to meet in order to be included lead to the exclusion of more research.
Perhaps because of this, meta-analyses frequently produce conflicting
outcomes. Those adopting meta-analytic approaches are very critical of
research which does not adopt the strict methodological requirements of
randomised controlled trials, where individuals are randomly allocated
to groups. They also argue that control groups should participate in
alternative interventions rather than no intervention. Meta-analyses
have been severely criticised. For instance, Ansdell and DeNora (2014)
argue that too much important information is lost when music is forced
into before–after, yes–no grids of variables and outcome assessments.
An inclusive research strategy was adopted in accessing the literature
to be included in this book. Academic databases relevant to neuroscience,
psychology, education and music were searched, in addition to web-
based searches to locate relevant grey literature. Analysis of located
 1. Introduction  11

documents frequently led to further relevant material. The following

chapters will synthesise the findings from a wide range of studies, to
further develop our understanding of whether the skills gained through
actively participating in making music can transfer to other skills and,
if so, what circumstances might support this. The book also examines
the evidence relating to listening and making music, and its impact on
wellbeing and health. Each chapter synthesises the research findings
from all of the studies, focusing on one aspect of transfer or impact, and
drawing conclusions as appropriate.

Ways of Engaging with Music and Varying Levels of

Commitment
People can actively make music or listen to it, although both means of
engagement require listening. Listening to music or speech requires
the processing of an enormous amount of information rapidly without
conscious awareness (Blakemore and Frith, 2000). An idealised view
of musical listening is that it is a focused activity undertaken solely
for the purpose of deepening understanding and appreciation of the
music. In practice, most listening takes place alongside other activities,
including those relating to travel, studying and physical activity,
including relaxation and taking exercise (Sloboda et al., 2009). Like
these activities, listening does not necessarily preclude listening with
full attention (Herbert, 2012). Listening can have benefits in terms of its
impact on mood, emotions and arousal levels.
Actively making music can take many forms, from informal
interactions in the home between children and parents to formal
instrumental lessons. Recently, there has been greater recognition of
the importance of informal learning, both for the acquisition of musical
skills and creativity and for the personal and social benefits which may
emerge (Hallam et al., 2016; 2017). Formal music tuition in schools
may include whole-class teaching of instruments, ensemble work, or
focus on singing, the theory of music, listening or the history of music.
Those singing or learning to play an instrument through individual
tuition may also join ensembles out of school, which increases their time
commitment to music alongside any individual practice that they may
undertake. Any intellectual, personal or social benefits emerging from
12 The Power of Music

active engagement with music will depend on the type of activity, the
level of commitment of the learner and the quality of the teaching, both
musically and in terms of the rapport between teachers and learners. The
role of individual preferences, context and the diversity in how different
people interact with music need to be taken into account when carrying
out research and interpreting findings. This is frequently not the case.
Many studies do not assess whether the participants have actually
learned any musical skills. It is frequently assumed that participation
alone will ensure that musical skills have been acquired. If they have
not, then there is no reasonable prospect of transfer to other skill areas.
The level of commitment to music is another important factor
in the possible impact of music in people’s lives. Music constitutes a
leisure activity for many people, either through listening to or making
music. For some, singing or playing is a serious leisure activity, while
for others it is merely recreational. Similarly, listening is (for some) a
hobby to which they devote considerable time and energy, while for
others it constitutes casual engagement. Those who attend live music
performances tend to have a higher level of musical experience and rate
music as more important in their lives than non-attenders. Attending a
live music event suggests a greater level of commitment than listening
to recorded music. The main reasons for attending live events include
hearing a particular artist or style, learning about new music, affirming
or challenging existing musical tastes, and personal and social reasons,
such as engaging in social interaction and being part of a community
(Pitts and Burland, 2013; Pitts and Spencer, 2008).
For some amateur musicians, music shares many characteristics
with the work of professional musicians—it can be seen as an extremely
serious leisure activity, while others see it merely as a hobby they
engage with for personal amusement (Gates, 1991). Reported reasons
for participation in active music-making include a love of music, the
desire to develop skills and respond to challenges, and opportunities to
meet with like-minded others. Musical activities also provide pleasure,
relaxation and an opportunity for self-expression (Cooper, 2001; Taylor
and Hallam, 2008). Taylor (2010) argues that amateur musicians seek
affirmation, validation and verification of their musical selves as part
of a community of practice in a similar manner to their professional
counterparts. However, for amateurs this is less well defined and they
 1. Introduction  13

strive to attain a group affiliation based on a cultural ideal of musical

competence (Taylor, 2010). Rewarding membership of a community
of practice can develop through group lessons (Wristen, 2006), where
mastering new repertoire in the company of others can facilitate the
enhancement of self-confidence (Coffman and Adamek, 1999; 2001).
Despite the many differences in forms and levels of engagement,
music can have a considerable impact on subjective wellbeing. Wellbeing
can be enhanced through listening while undertaking other tasks, or
through using music to change moods and emotions. However, music
does not always have positive effects. It can cause distress when it is not
to the liking of a listener and is out of their control.

Music Therapy
In addition to the listening to and making of music undertaken by
the population as a whole, music has been used therapeutically. The
role of music in health and healing has been recognised for more than
30,000 years. It is referred to in the Bible and the historical writings of
ancient civilisations in Egypt, China, India, Greece and Rome. Music
therapy can provide positive psychological, physiological, cognitive and
emotional benefits to patients, and has done since its development as a
profession in the United States following the two world wars. Music was
used to relieve the perception of pain of those with severe injuries, and
medical staff noted the benefits to health and wellbeing. Since then, it has
developed considerably to encompass music-making with individuals
and groups, work in hospitals and planned listening to support those
with mental health issues. Since the increased availability of music,
individuals have been able to use music therapeutically to manage their
own moods and emotions (DeNora, 2000; 2007).

Interpreting the Research Findings

There is now an extensive body of research exploring the wider benefits
of music. In interpreting these findings, it is important to be judicious in
suggesting what they may mean for policy and practice (Linnavalli et al.,
2018). Currently it is not possible to say with any great confidence that
any particular musical intervention will lead to any specific outcome—be
14 The Power of Music

it intellectual, personal or social—although it is clear that making music

can support the development of a wide range of skills and have an
impact on creativity. Making music is generally pleasurable, providing
a rewarding experience and a sense of achievement for participants,
although there are exceptions to this. Its frequent social context also
leads to a sense of belonging and it can be engaged with throughout
the lifespan. It is clearly worth continuing to try to understand the
circumstances under which music is beneficial, and for whom.
 2. Music and Neuroscience

Music has played an important role in neuroscience, enhancing our

understanding of the brain and how it functions. The human brain
contains approximately 100 billion neurons, many of which are active
simultaneously as we process information. Neurons communicate
with each other through nerve impulses, which allow information
to be processed and analysed. Each neuron has axons and dendrites,
both of which transmit nerve impulses. Axons pass nerve impulses
away from the cell body, dendrites towards the cell body. Each neuron
has approximately a thousand connections with other neurons. When
we learn, there are changes in the growth of axons, dendrites and
the number of synapses connecting neurons—a process known as
‘synaptogenesis’. When an event is important enough or is repeated
sufficiently often, synapses and neurons fire repeatedly, indicating that
this event is worth remembering (Fields, 2005). In this way, changes in
the efficacy of existing connections are made. As learning continues and
particular activities are engaged with over time, myelination takes place.
This involves an increase in the coating of the axon of each neuron,
which improves insulation and makes the established connections more
efficient. Effectively, the neurons become wired together. This enables
better connections within specific brain regions, and also improves the
functioning of broader neuronal pathways connecting separate brain
regions, which are needed for many human activities (sensory, cognitive
and motor). Pruning also occurs, a process which reduces the number
of synaptic connections, enabling fine-tuning of functioning. Through
combinations of these processes, which occur over different timescales,
the cerebral cortex self-organises in response to external stimuli and
the individual’s learning activities (Pantev et al., 2003). Overall, the
evidence from neuroscience suggests that each individual has a specific

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.02

16 The Power of Music

learning biography, which is reflected in the way the brain processes

information (Altenmuller, 2003: 349).
The brain has three main parts: the cerebrum, cerebellum and
brainstem. The cerebrum is the largest part of the brain; the cerebellum
is located under the cerebrum, while the brain stem acts as a relay
centre, connecting the cerebrum and cerebellum to the spinal cord. The
cerebrum is divided into two halves: the right and left hemispheres.
They are connected by the corpus callosum, which transmits messages
from one side of the brain to the other. Each hemisphere controls the
opposite side of the body, but not all functions of the hemispheres are
shared. Generally, the left hemisphere controls speech, comprehension,
and mathematical and literacy functions, while the right hemisphere
controls creativity, spatial ability, artistic and musical skills. For most
people, the left hemisphere is dominant for hand use and language.
The brain is also separated into the frontal, temporal, occipital and
parietal lobes. The frontal lobe is associated with executive functions
and motor performance, while the temporal lobe is associated with the
retention of short- and long-term memories and processing sensory
input, including auditory information and language comprehension.
The visual processing centre is the occipital lobe, while the parietal lobe
is associated with sensory skills.
Music has played an important role in neuroscience, facilitating the
study of neural plasticity, as training in music is complex and multimodal,
and musicians and those aspiring to become musicians spend many
hours practising and are committed to engagement with music over
long periods of time (Pantev and Herholz, 2011). Making music
draws on many brain functions, including those related to perception,
action, cognition, emotion, learning and memory. It has therefore been
an ideal tool to show how the human brain works and how different
brain functions interact. The findings from the neuroscientific study
of musicians have led to greater understanding of cortical plasticity
(Barrett et al., 2013; Dalla Bella, 2016; Habib and Besson, 2009; Herholz
and Zatorre, 2012; Jäncke, 2009; Merrett et al., 2013; Münte et al., 2002;
Rauschecker, 2001; Strait and Kraus, 2014; Wan and Schlaug, 2010;
Zatorre and McGill, 2005).
 2. Music and Neuroscience  17

Neuroscientific Methods
Recently, technology has changed the way that neuroscience has
been able to study the brain. Previously it largely relied on studying
individuals suffering from damage to the brain, exploring how the
damage affected particular behaviours. Common assessment techniques
which are adopted now include:
Electroencephalography (EEG), which measures electrical activity
generated by the synchronised activity of thousands of neurons,
allowing the detection of activity within particular cortical areas, even
at subsecond timescales. EEG measures event-related potential (ERP).
An event-related potential (ERP) is the measured brain response that
is the direct result of a specific sensory, cognitive or motor event. It is
any stereotyped electrophysiological response to a stimulus. Evoked
potentials and induced potentials are subtypes of ERPs. Other types of
ERP include:
• Frequency-following response (FFR) is an evoked potential
generated by periodic or nearly periodic auditory stimuli.
As part of the auditory brainstem response, the FFR reflects
sustained neural activity integrated over a population of
neural elements.
• Gamma-band activity (GBA) comprises an EEG frequency
range, from 30 to 200 Hz, and is distributed widely
throughout cerebral structures. GBA participates in various
cerebral functions, such as perception, attention, memory,
consciousness, synaptic plasticity and motor control.
• Early left anterior negativity (ELAN) is an event-related
potential in electroencephalography (EEG), or a component
of brain activity that occurs in response to certain kinds of
stimuli. It is characterised by a negative wave that peaks at
around 200 milliseconds or less after the onset of a stimulus,
and most often occurs in response to linguistic stimuli that
violate word category or phrase structure rules.
• Early right anterior negativity (ERAN) is a potential in
electroencephalography, or a component of brain activity that
occurs in response to a certain kind of stimulus.
18 The Power of Music

• Mismatch negativity (MMN) is an element of an event-

related potential to an odd stimulus in a sequence of stimuli.
It is most frequently studied in relation to auditory or visual
stimuli. In the case of auditory stimuli, the MMN occurs after
an infrequent change in a repetitive sequence of sounds. It
is usually evoked by either a change in frequency, intensity,
duration, or real or apparent spatial locus of origin.
• Magnetic resonance imaging (MRI) is a type of scan that uses
strong magnetic fields and radio waves to produce detailed
images of the inside of the brain.
• Voxel based morphometry (VBM) is a technique using MRI
that allows investigation of focal differences in brain anatomy,
using parametric mapping. The brain images are smoothed
so that each voxel represents the average of itself and its
surrounding areas.
• Functional magnetic resonance imaging (fMRI) is a brain-
scanning technique that measures blood flow in the brain
when a person performs a task. fMRI works on the premise
that neurons in the brain which are the most active during a
task use the most energy. A haemodynamic response allows
the rapid delivery of blood to active neuronal tissues.
• Magnetoencephalography (MEG) is a functional neuroimaging
technique for mapping brain activity by recording magnetic
fields produced by electrical currents occurring naturally in
the brain, using very sensitive magnetometers.
• Transcranial magnetic stimulation is a non-invasive procedure
that uses magnetic fields to stimulate nerve cells in the brain.

Changes in the Brain following Musical Activity

As individuals engage with different musical activities over long periods
of time, permanent changes occur in the brain. These changes reflect
what has been learned and how it has been learned. They also influence
the extent to which developed skills transfer elsewhere. Extensive active
engagement with music induces cortical reorganisation, producing
 2. Music and Neuroscience  19

functional changes in how the brain processes information. If this

occurs early in development, the alterations may become hardwired
and produce permanent changes in the way information is processed
(Schlaug et al., 1995a; 1995b). Indeed, there is evidence that Western
classical musicians have increased neuronal representation specific for
the processing of the tones of the musical scale (Pantev et al., 2003). The
largest cortical representations are in musicians who have been playing
their instruments for the longest period of time. Overall, the evidence
suggests that active engagement with music has a significant impact on
brain structure and function (Merrett et al., 2013; Norton et al., 2005).
Playing a musical instrument also seems to speed up brain maturation.
For instance, Hudziak and colleagues (2014) found more rapid cortical
thickness maturation in areas implicated in motor planning and
coordination, visuospatial ability, and emotion and impulse regulation
following musical training.

Comparisons between Musicians’ and Non-Musicians’

Expertise
A long-standing strand of research has explored the differences between
the brains of musicians and non-musicians and those with different
levels of musical expertise. The first (now seminal) studies provided
evidence of larger auditory and somatosensory cortical areas in adult
musicians compared with non-musicians (Pantev et al., 1998; Elbert et al.,
1995). Recent criticism of this approach has drawn attention to the lack
of clarity in classifying musicians and non-musicians. Musicians vary
widely in their areas of expertise and the levels that they achieve, while
so-called non-musicians may be very experienced listeners. Despite
these issues, this strand of research has enhanced our understanding
of the differences which emerge in the brain related to musical training,
starting in childhood or adulthood through to professional levels of
expertise (Herholz and Zatorre, 2012; Huotilainen and Tervaniemi,
2018; Munte et al., 2002; Tervaniemi, 2009).
Certain pieces of research exploring the differences between
musicians and non-musicians, or the functional changes due to
musical training, have highlighted the differences in very basic cortical
and subcortical processing—for instance, the response latencies and
20 The Power of Music

amplitudes of responses to random, musical or language sounds.

Musicians demonstrate higher fidelity of brain stem responses in
conveying temporal and frequency information present in the sounds
that they are exposed to (Wong et al., 2007). This fidelity increases
quickly over a period of a year when children are actively engaged in
making music (Skoe and Kraus, 2013).
The differences between musicians and non-musicians are in
evidence at different levels of the auditory pathway, from the brainstem
(Kraus and Chandrasekaran, 2010; Strait and Kraus, 2014) through to
the primary auditory regions (Bermudez et al., 2009; Gaser and Schlaug,
2003) and subsequently to higher levels of auditory processing. Low‐
level neural enhancements are likely to have a considerable impact on
higher-level processing because the ability of the cochlea and the brain
stem to replicate the content of a sound, and to deliver it accurately to
higher-level cortical processes, forms the basis of all sound processing.
This, in turn, leads to better performance in listening to speech embedded
in noise or hearing masked sounds (Strait et al., 2010; Strait and Kraus,
2011a; 2011b; Slater et al., 2015). Overall, trained musicians have greater
volume and cortical thickness in the auditory cortex regions, which are
most likely to be responsible for fine pitch categorisation, discrimination
and temporal processing. There are structural differences at the level of
the primary auditory cortex and auditory association areas (Schlaug,
2009). For example, Gaab and Schlaug (2003) compared brain activation
patterns between musicians and non-musicians while they performed
a pitch memory task. Both groups showed bilateral activation of the
superior temporal, supramarginal, posterior middle and inferior frontal
gyrus, and superior parietal lobe. However, the musicians showed more
right temporal and supramarginal gyrus activation, while the non-
musicians had more right primary and left secondary auditory cortex
activation. Since the performance of both groups was matched, these
results suggest that the processing differences are related to musical
training. Non-musicians may rely more on brain regions important for
pitch discrimination, while musicians may prefer to use brain regions
specialising in short-term memory and recall to approach pitch memory
tasks.
Schneider and colleagues (2002) used magnetoencephalography
to compare the processing of pure tones in the auditory cortex of 12
 2. Music and Neuroscience  21

non-musicians, 12 professional musicians and 13 amateur musicians.

They found neurophysiological and anatomical differences between
the groups. The activity evoked in the primary auditory cortex after
stimulus onset in the professional musicians was 102% larger than in the
non-musicians, and the grey-matter volume of the anteromedial portion
of Heschl’s gyrus was 130% larger.
Koelsch and colleagues (2002) compared event-related brain
potentials in response to harmonically inappropriate chords in musical
experts and novices. Such chords elicited an early right anterior negativity
(ERAN), which was larger for musical experts than for novices,
probably because the experts had more specific musical expectancies
than the novices. When chords were presented with a deviant timbre,
they elicited a mismatch negativity. This did not differ across the groups,
indicating that the larger ERAN in the expert musicians was not due to
a general enhanced auditory sensitivity, but to specific changes in the
brain related to the processing of harmony, learned through experience
with music.
Also focusing on aural processing, Shahin and colleagues (2003)
investigated whether the neuroplastic components of auditory evoked
potentials were enhanced in musicians in relation to their musical
training histories. Highly skilled violinists and pianists and non-
musicians listened to violin tones, piano tones and pure tones, the latter
of which was matched in fundamental frequency to the musical tones.
Compared with non-musicians, both musician groups evidenced larger
responses to the three types of tonal stimuli. These results suggest that
the tuning properties of neurons are modified in the auditory cortex in
relation to the extent of acoustic musical training.
Similarly, Tervaniemi and colleagues (2006) compared the neural
and behavioural sound encoding of non-musicians and amateur band
musicians. They explored auditory event-related potentials to changes
in basic acoustic features, frequency, duration, location, intensity, gap
and abstract features, melodic contour and interval size. There were
statistically significant differences in response to location changes but
not to other feature changes. This suggests that, when compared with
non-musicians, even amateur musicians have neural sound processing
advantages if the acoustic information is relevant to their musical
genre.
22 The Power of Music

Non-musicians seem to need more neuronal resources for processing

auditory information, relative to musicians. This is evidenced by
stronger activation of primary auditory regions. For instance, Besson,
Faïta and Requin (1994) presented musicians and non-musicians with
short musical phrases that were either selected from the classical musical
repertoire or composed for the experiment. The phrases terminated
either in a congruous or harmonically, melodically or rhythmically
incongruous note. The brain waves produced by these endnotes differed
greatly between musicians and non-musicians, and also as a function
of the participant’s familiarity with the melodies and the type of
incongruity. The findings additionally showed that the musicians were
faster than the non-musicians in detecting the incongruities.
Functional magnetic resonance imaging scans (fMRI scans) have
been used to study grey and white matter in the brain. Grey matter
contains most of the brain’s neuronal cell bodies and includes regions of
the brain involving muscle control and sensory perception—for instance,
sight, hearing, memory, emotions, speech, decision-making and self-
control. Structural differences in the grey matter of several cortical areas,
including the motor, somatosensory and auditory areas, have been
observed between musicians and non-musicians. Luders, Gaser, Jancke
and Schlaug (2004), using a voxel-by-voxel morphometric technique,
found grey-matter volume differences in motor, auditory and visual-
spatial brain regions when comparing professional keyboard players
with a matched group of amateur musicians and non-musicians. These
differences are related to cortical folding, indicating a greater cortical
surface or longer distances between the cortical areas of, for example,
fingers. This suggests that a larger patch of cortical surface is reserved
for finger control in musicians than in non-musicians.
Similarly, Groussard and colleagues (2014) compared the brains of
non-musicians and amateur musicians, the latter playing an instrument
for up to 26 years. Musical training led to greater grey-matter volume in
different brain areas in the musicians. The changes appeared gradually
in the left hippocampus and right middle and superior frontal regions,
but later included the right insula, supplementary motor area, left
superior temporal and posterior cingulate area. Together, these regions
are implicated in many functions including verbal memories, bodily
awareness, emotional experiences, control of movement, language,
 2. Music and Neuroscience  23

memory and impulse control. To ensure that the findings were linked
with musical training and not normal brain maturation, the researchers
controlled for age and educational level.
There are indications that musicians exhibit increased grey-matter
volume in the inferior frontal gyrus when compared to non-musicians
(Sluming et al., 2002). Voxel-based morphometry and stereological
analyses were applied to high-resolution three-dimensional magnetic
resonance images in 26 male orchestral musicians and 26 non-musicians
who were matched for sex, handedness and intelligence. The wide
age range of the participants, from 26 to 66, enabled the researchers
to undertake a secondary analysis of age-related effects. The findings
revealed increased grey matter in Broca’s area in the left inferior frontal
gyrus in the musicians. Overall, there was a significant age-related
volume reduction for only the non-musicians in the cerebral hemispheres
and dorsolateral prefrontal cortex subfields bilaterally, as well as in the
grey-matter density in the left inferior frontal gyrus. There was a positive
relationship between years of playing and the volume of grey matter in
musicians who were under 50 years old. The authors suggested that
orchestral musical performance promoted user-dependent retention,
and possibly the expansion of grey matter involving Broca’s area.
Similarly, James and colleagues (2014) used optimised voxel-based
morphometry to perform grey-matter density analyses on 59 age-, sex-
and intelligence-matched young adults with three distinct, progressive
levels of musical training intensity or expertise. The findings showed a
functional difference between areas exhibiting increase versus decrease
of grey matter as a function of musical expertise. Grey-matter density
increased with expertise in areas known for their involvement in higher
order cognitive processing, such as those concerned with executive
function, working memory and auditory processing. In contrast, grey-
matter density decreased with expertise in areas related to sensorimotor
function. This decrease may have reflected high levels of automatisation
of motor skills in those with greater expertise. A multiple regression
analysis showed that grey-matter density predicted accuracy in
detecting fine-grained incongruities in tonal music.
Changes in white matter have also been observed in the brains of
musicians. White matter is composed of the nerve fibres, axons, which
connect nerve cells and which are covered by myelin, an insulating layer
24 The Power of Music

that forms around nerves, consisting of protein and fatty substances.

It is this which gives the white matter its colour. Myelin speeds up
the communication between cells. Musicians have greater anisotropy,
a phenomenon varying in magnitude according to the direction of
measurement, which suggests that they either have a larger number
of fibres or greater myelination or both. Such findings have been
observed in corticocortical connections, where neurons in one cortical
area communicate with neurons in other cortical areas, but also in
corticomuscular connections, where neurons communicate with muscles
(Bengtsson, Nagy and Skare et al., 2005). Some research has shown that
musicians have greater amounts of substances in their brains related
to neuronal metabolism. The brain relies almost entirely on circulating
glucose rather than storing energy as glycogen. The majority of this
glucose is used to maintain synaptic function and the resting potential
of neurons. When there is an increase in these substances, it suggests
more active use of, for example, auditory cortical areas (Aydin et al.,
2005).
Musicians have a larger corpus callosum than non-musicians
(Schlaug et al., 1995a). This phenomenon is particularly evident in
male musicians (Lee et al., 2003). Greater midsagittal size of the corpus
callosum has also been found (Lee et al., 2003; Oztürk et al., 2002;
Schlaug et al., 1995). Musicians have more and/or thicker neuronal
tracts between the left and right motor and somatosensory areas. These
structural differences may relate to a range of functional differences
between musicians and non-musicians (Fauvel et al., 2014). The amount
of musical practice is also associated with greater integrity of the
corticospinal pathway (Bengtsson et al., 2005).
Individuals with absolute pitch—the ability to categorise tones
into pitch classes without reference to other sounds—have been the
focus of some pieces of research. For instance, Loui and colleagues
(2012) showed that those possessing absolute pitch had increased
functional activation during music listening, as well as increased
degrees, clustering and local efficiency of functional correlations, with
the difference being highest around the left superior temporal gyrus.
Similarly, Loui and colleagues (2011) observed hyperconnectivity in
bilateral superior temporal lobe structures linked to having absolute
pitch. Furthermore, the volume of tracts connecting the left superior
 2. Music and Neuroscience  25

temporal gyrus to the left middle temporal gyrus predicted absolute

pitch performance. Using in vivo magnetic resonance morphometry,
Schlaug and colleagues (1995a) measured the anatomical asymmetry
of the planum temporale. Musicians with absolute pitch revealed
stronger leftward planum temporale asymmetry than non-musicians
or musicians without absolute pitch. These results indicate that having
absolute pitch is associated with increased leftward asymmetry of the
cortex subserving music-related functions. Similarly, Bermudez and
colleagues (2009) used multiple methods to compare 71 musicians,
27 with absolute pitch, with 64 non-musicians. They found functional
evidence which indicated the importance of a frontotemporal network
of areas, which were heavily relied upon in the performance of musical
tasks. There was a difference between the musicians and those with
absolute pitch in that there was a significantly thinner cortex in a
number of areas—including the posterior dorsal frontal cortices—that
have been previously implicated in the performance of tasks involving
absolute pitch.

The Automation of Skills as Expertise Increases

As musicians’ expertise develops, many of their skills become
automated. This means that neurological differences between musicians
and non-musicians become harder to interpret, since some tasks reveal
less neural activity in musicians because of their automatisation (Jancke
et al., 2000), while others show more brain activity (Kleber et al., 2010;
Nikjeh et al., 2008; 2009). Simple motor tasks tend to become automated
while complex tasks, even those related to auditory processing, may
require more neurological resources (Gaab and Schlaug, 2003).
In a review, Zatorre and colleagues (2012) pointed out that, while
brain imaging had identified structural changes in grey and white
matter that occurred with learning, ascribing imaging measures to
underlying cellular and molecular events was challenging. Perceptual
or motor systems with extended representation in the brain as a result
of musical training may process information more efficiently, using
fewer neuronal resources, than less specialised systems. Enhanced
efficiency might be manifest in lower blood flow demands in skilled
musicians as compared to non-musicians when performing complex
26 The Power of Music

motor sequences. Functional neuroimaging studies do not always

present findings consistent with observed anatomical differences.
Musicians can exhibit either lower or more localised activation in the
primary motor cortex than non-musicians, and more variable levels
of activation in motor association regions (such as the premotor and
supplementary motor areas). Such inconsistencies may reflect higher
order cognitive processes—for example, tonal processing, working
memory and syntax—that are required for performance. This may lead
to increased density in associated brain regions. Other processes (for
instance, sensorimotor functions and basic motor control) are likely to be
automated, requiring fewer resources and less brain volume (James et al.,
2014). This may also explain inconsistencies between visible structural
changes and increased or decreased activation in musicians in primary
auditory and motor regions. Using event-related potentials, Trainor and
colleagues (1999) compared the responses of adult musicians and non-
musicians to infrequent changes to the last note of a five-note melody,
which either altered the contour or the interval. The findings suggested
that contour processing was more basic, while interval processing was
more affected by experience. This, again, indicates that it is not always
obvious whether training is associated with increased or decreased
activation in underlying brain regions.

Bimanual Motor Coordination

Pianists have provided a particular focus for research exploring
bimanual motor coordination. Automatisation of these processes
means that training is not systematically associated with increased
brain volume. For example, a decrease in striatal volume is observed in
skilled pianists as a function of greater efficiency in motor performance
(Granert et al., 2011). Haslinger and colleagues (2004) compared
professional pianists with musically naïve participants as they carried
out in‐phase, mirror and anti‐phase, parallel bimanual sequential finger
movements during functional magnetic resonance imaging. The tasks
included the performance of two different kinds of externally paced
bimanual finger tapping, involving the index to little finger of both
hands. In one condition, participants had to carry out parallel finger
movements starting either with the index finger of the right and the
 2. Music and Neuroscience  27

little finger of the left hand, or vice versa. The task then consisted of
continuous, bidirectional finger movements sequentially involving the
index, middle, ring and little finger of one hand versus little, ring, middle
and index finger of the other hand. The second task demanded the
performance of mirror-like finger tapping. The corresponding fingers of
both hands, index–index, middle–middle, ring–ring, little–little always
had to be moved simultaneously in bidirectional, sequential order. A
resting condition without finger movements served as a control. These
tasks correspond to bimanually playing scales, which constitutes part
of pianists’ regular practice routines. Musicians and non-musicians
showed significantly different functional activation patterns, suggesting
increased efficiency of cortical and subcortical systems for bimanual
movement control. This may be fundamental to achieving high‐level
motor skills, allowing the musician to focus on the artistic aspects of
musical performance.
Similarly, Krings and colleagues (2000) performed functional
magnetic resonance imaging with professional piano players and non-
musicians during an overtrained complex finger movement task, using a
blood oxygenation level dependent echo-planar gradient echo sequence.
Participants performed a complex finger opposition paradigm using
the right hand, with self-paced light touches of a thumb pad to a finger
pad without looking at the hand. The order of tapping was 5-4-3-5-4-
2-5-3-2-4-3-2, omitting one subsequent finger in each run. The pattern
was repeated. During rest periods, participants were asked to relax.
The task was practised before the scanning session to avoid learning
effects during the scan. Activation clusters were seen in the primary
motor cortex, supplementary motor area, premotor cortex and superior
parietal lobule. There were significant differences in the extent of cerebral
activation between the groups, with pianists having a smaller number
of activated voxels. This suggested that long-term motor practice led to
a different cortical activation pattern in pianists. They needed to recruit
fewer neurons to complete the same movements.
Using self-paced bimanual and unimanual tapping tasks which
reflect typical movements made in playing the piano, Jäncke and
colleagues (2000) measured haemodynamic responses, applying
functional magnetic resonance imaging in two professional piano
players and two carefully matched non-musician participants. The
28 The Power of Music

primary and secondary motor areas were activated to a much lesser

degree in professional pianists than in non-musicians, suggesting that
the long-lasting extensive hand-skill training of the pianists led to
greater efficiency. This was reflected in the smaller number of active
neurons needed to perform given finger movements. Similarly, Meister
and colleagues (2005) compared pianists and non-musicians as they
performed simple and complex movement sequences on a keyboard
with the right hand. In non-musicians, complex motor sequences showed
higher fMRI activations of the presupplementary motor area and the
rostral part of the dorsal premotor cortex compared to simple motor
sequences, whereas the musicians showed no differential activations.
This suggested that a higher level of visuomotor integration was required
in a complex task in non-musicians, whereas the musicians employed
the rostral premotor network during both tasks. Neural plasticity, as a
result of long-term practice, mainly occurs in caudal motor areas, but
the slowly evolving changes during motor-skill learning may extend
to adjacent areas, leading to more effective motor representations in
pianists.
Also focusing on a complex right-handed finger tapping task, Hund-
Georgiadis and von Cramon (1999) investigated blood-flow-related
magnetic resonance signal changes and the time course underlying
short-term motor learning in ten piano players and 23 non-musicians. A
functional learning profile, based on regional blood oxygenation level,
was assessed. All participants achieved significant increases in tapping
frequency during the 35-minute training session while in the scanner, but
the pianists performed significantly better than the non-musicians and
showed increasing activation in the contralateral primary motor cortex
throughout motor learning. Concurrently, involvement of secondary
motor areas—such as the bilateral supplementary motor, premotor and
cerebellar areas—diminished relative to the non-musicians throughout
the training session. Extended activation of primary and secondary
motor areas in the initial training stage during the first seven to 14
minutes, as well as rapid attenuation, were the main functional patterns
underlying short-term learning in the non-musician group. Attenuation
was particularly marked in the primary motor cortices as compared
with the pianists. When the tapping sequence was performed with the
left hand, transfer effects of motor learning were evident in both groups.
 2. Music and Neuroscience  29

Involvement of all relevant motor components was smaller than after

initial training with the right hand. This suggests that the involvement
of primary and secondary motor cortices in motor learning is dependent
on experience.
Using similarly complex unimanual and bimanual finger tasks,
Koeneke and colleagues (2004) studied cerebellar hemodynamic
responses in highly skilled keyboard players and non-musician
participants. Both groups showed strong haemodynamic responses in
the cerebellum during task conditions. However, non-musicians showed
generally stronger haemodynamic responses in the cerebellum than
the keyboard players, suggesting that long-term motor practice leads
to different cortical activation patterns. The same movements required
less neuronal activity. Palomar-García and colleagues (2017) found
reduced connectivity between the motor areas that control both hands in
musicians compared with non-musicians. This was particularly evident
in those whose instruments required bimanual coordination. The effects
were mediated by the number of hours of practice.

Multisensory Learning
Structural differences in the brains of musicians and non-musicians
extend beyond the auditory pathway and motor circuitries to the parietal
regions. These regions seem to be involved in multisensory encoding
and integration. Music performance is one of the most complex and
demanding cognitive challenges that human beings undertake. It
requires precise timing of a number of hierarchically organised actions,
as well as precise control over pitch interval production, implemented
variably depending on the instrument involved (Zatorre et al., 2007).
Structural differences due to musical training extend to motor and
sensorimotor cortices, to premotor and supplementary motor regions,
and involve subcortical structures such as the basal ganglia and the
cerebellum. This neuronal circuitry is engaged in motor control and
fine motor planning—for example, finger movement—during musical
engagement, as well as in motor learning (Schmidt and Lee, 2011).
Musicians have stronger connectivity between the right auditory cortex
and the right ventral premotor cortex than non-musicians. The longer
the period of time playing an instrument, the stronger the connection
30 The Power of Music

(Palomar-Garcia et al., 2017). Lahav and colleagues (2007) used

functional magnetic resonance imaging to explore whether the human
action-recognition system responded to sounds found in a complex
sequence of newly acquired actions. They chose a piece of music as a
model set of acoustically presentable actions and trained non-musicians
to play it by ear. They then monitored brain activity in participants while
they listened to the newly learned piece. Although they listened to the
music without making any movements, activation was found bilaterally
in the frontoparietal motor-related network, consistent with neural
circuits which have been associated with action observations and may
constitute a human mirror neuron system. Presentation of the practised
notes in a different order activated the network to a much lesser degree,
whereas listening to equally familiar but motorically unknown music
did not activate this network. These findings suggest that there is a
hearing–doing system that is highly dependent on the individual’s
motor repertoire and that this network is established rapidly, with
Broca’s area as its hub.

Neurological Differences Relating to Genre and the

Instrument Played
Neural changes are specific to the particular musical activities undertaken
(Munte et al., 2003). Functional auditory responses are strongest in the
areas reflecting each musician’s instrument, demonstrating timbral
specificity related to their training (Pantev et al., 2001). The processing
of pitch in classical string players, who have to create different pitches
with no guidance from frets, is characterised by longer surveillance
and more frontally distributed event-related brain potentials attention.
Drummers whose focus is rhythm generate more complex memory traces
of the temporal organisation of musical sequences, while conductors
demonstrate greater surveillance of auditory space as they listen to and
balance the sounds of the various instruments in the ensemble that they
are conducting (Munte et al., 2003).
Compared with non-musicians, string players have greater
somatosensory representations of finger activity, the amount of increase
depending on the age of starting to play (Pantev et al., 2003). Pianists,
violinists and non-musicians are differentiated by the particular form
 2. Music and Neuroscience  31

and shape of the motor cortex, violinists and pianists both needing to
be able to move their fingers quickly (Bangert and Schlaug, 2006), while
trumpet players have greater functional activation in the cerebellum
(which coordinates voluntary movements), the dominant sensorimotor
cortex and the left auditory cortex (Gebel et al., 2013). This may
be because trumpet players need to be sensitive to the relationship
between their embouchure and minute sequential differences in sound.
In relation to players of wind instruments, Choi and colleagues (2015)
found significant changes in cortical thickness in lip-tongue related
areas and resting-state neuronal networks, and differential activation
in the precentral gyrus and supplementary motor areas in comparison
with non-musicians.
The functional reorganisation of the motor cortex reflects differential
usage between instrumentalists. When comparing the regions containing
the hand representations of pianists and violinists, large anatomical
differences in the precentral gyrus have been revealed (Bangert and
Schlaug, 2006). String players require highly developed fine motor skills,
particularly in the left hand, while keyboard players require highly
trained fine motor skills in both hands, but particularly the right hand,
which frequently supports melody and has more challenging technical
passages than the left-hand accompaniment. Most keyboard performers
exhibit a configuration known as the ‘Omega sign’ in the left more
than the right hemisphere, whilst most string players show this only
on the right. The prominence of this sign is related to the age at which
musicians began to play an instrument and the cumulative amount of
time they spent practising. Greater cortical representations of fingers in
violinists’ left hands, as compared with right hands, have been found
using magnetoencephalography (Elbert et al., 1995).
Instrument-specific neuroplasticity extends to perception. Timbre-
specific neuronal responses are observable in different groups of
instrumentalists. For example, string and trumpet players reveal
stronger evoked cortical responses when presented with the sound of
their respective instrument (Pantev et al., 2001). This is particularly
evident in the right auditory cortex (Shahin et al., 2003). Musicians
also display increased gamma-band activity induced by the sound of
their own instrument as compared to other instruments (Shahin et al.,
2008). These findings are supported by functional imaging evidence
32 The Power of Music

from violinists and flautists (Margulis et al., 2009), which suggests that
instrument-specific plasticity is not restricted to the primary auditory
cortex but forms a network including association and auditory-motor
integration areas. Such experience-specific plasticity has been shown at
the level of the brainstem (Strait et al., 2012).
Some research has explored whether the style or genre of music
might shape auditory processing. Tervaniemi and colleagues (2016)
studied the auditory profiles of classical, jazz and rock musicians,
with particular reference to genre-specific sensitivity to musical sound
features. The participants watched a silent video and were instructed
to ignore the sounds. The researchers recorded the accuracy of neural
encoding of the melody. All groups showed a cortical index of deviance
discrimination, but the strength of the responses varied. Automatic
brain responses were selectively enhanced to deviance in tuning in
classical musicians, timing in classical and jazz musicians, transposition
in jazz musicians, and melody contour in jazz and rock musicians. The
jazz players had larger mismatch negativity (MMN) amplitude than
all other experimental groups across the six different sound examples,
indicating a greater overall sensitivity to auditory outliers. Enhanced
processing of pitch and the sliding up to pitches were only found in jazz
musicians. A more frontal MMN to pitch and location (compared to the
other deviations) was observed in jazz musicians, and left lateralization
of the MMN to timbre in classical musicians. Overall, the characteristics
of the particular styles or genres of music learned influence a musician’s
perceptual skills and the brain’s processing of them.
Training, listening experiences, musical styles and genre all shape
musicians’ brains (Vuust et al., 2012). Folk musicians exhibit early right
anterior negativity in inferofrontal brain regions in response to chords
which deviate from the conventions of Western music, indicating
differences in their expertise compared with non-musicians (Brattico et
al., 2013). Musical expertise in more than one music culture can modify
chord processing by enhancing responses to ambivalent or incongruous
chords.
Focusing on communication between musicians, Vuust and
colleagues (2005) explored how jazz musicians exchanged non-
verbal cues when they played together. The musicians received and
interpreted cues when performance departed from a regular pattern
 2. Music and Neuroscience  33

of rhythm, suggesting that they enjoyed a highly developed sensitivity

to subtle rhythmic deviations. Pre-attentive brain responses—recorded
with magnetoencephalography to rhythmic incongruence—were
left-lateralized in expert jazz musicians and right-lateralized in non-
musicians, suggesting functional adaptation of the brain to a task of
communication, similar to that required for learning language.

Studies with Child Musicians and Non-Musicians

There has been considerable research focusing on the structural and
functional changes which occur in children’s brains as a result of
engagement with music. Enhancement of brain responses to musical
sounds can occur early in development. Four-month-old infants
exposed to melodies played on either guitar or marimba for just over
two hours over the course of a week exhibited MMN selectively to
the sound to which they had been exposed (Trainor et al., 2011). The
effects of musical training during development extended to brainstem
responses when processing speech in noise (Strait et al., 2013). Trainor
and colleagues (2012) studied six-month-old Western infants, who were
randomly assigned to six months of either an active participatory music
class or a class in which they experienced music passively while playing.
Active music participation resulted in earlier enculturation to Western
tonal pitch structure, larger and/or earlier brain responses to musical
tones, and a more positive social trajectory. Neural‐level changes also
occur in children participating in musical playschool activities designed
to develop a love for music through active engagement with making
music, singing and musical instruments. Putkinen and colleagues (2013)
explored the relationship between informal musical activities at home
and electrophysiological indices of neural auditory change detection
in two- to three-year‐old children. Auditory event‐related potentials
were recorded in a multi‐feature paradigm that included frequency,
duration, intensity, direction, gap deviants and attention‐catching novel
sounds. Correlations were calculated between these responses and
the amount of musical activity at home reported by the parents. The
neurological findings implied that there was heightened sensitivity to
temporal acoustic changes, more mature auditory change detection and
34 The Power of Music

less distractibility in children when there were more informal musical

activities in their home environment.
One strand of research has focused on the effects of training with
the Suzuki method, where children learn to play by ear and through
imitation. The method is implemented rigorously wherever it is adopted,
which makes it easier to make comparisons between studies. One study
with four- to six-year-old children revealed changes in auditory evoked
responses to a violin and a noise stimulus. The musically trained group
showed faster responses to violin sounds than the non-musician group
(Fujioka et al., 2006). These changes were accompanied by enhanced
performance on a musical task and improved working memory in
a non-musical task. Another study adopting the Suzuki method
tracked and recorded brainwave patterns. The research included adult
professional violinists, amateur pianists and four- and five-year-old
children studying the piano. Measures were taken before the children
commenced music lessons and one year later. The adult musicians
showed robust enhancement of induced gamma-band activity specific
to their musical instrument, with the strongest effects in the professional
violinists. Induced gamma-band responses are associated with attention,
expectation, memory retrieval and the integration of top-down,
bottom-up and multisensory processes. The children receiving piano
lessons exhibited increased power of induced gamma-band activity for
piano tones with one year of training, while children not taking lessons
showed no effect (Shahin et al., 2004; 2008).

In a similar study, Trainor and colleagues (2009) found larger

induced gamma-band responses in five-year-old children learning to
play instruments. Responses to musical sounds were larger in adult
musicians than in non-musicians, and developed in children after one
year of musical training (but not in children of the same age who were
not engaged in music lessons). Trainor and colleagues concluded that
musical training affected oscillatory networks in the brain which are
associated with executive functions, which in turn can enhance learning
and performance in several cognitive domains.
Standard musical training has been linked to greater mismatch
negativity responses to melodic and rhythmic modulations in children
between 11 and 13 years of age who have received musical training
(Putkinen et al., 2014), while structural changes in the brain have been
 2. Music and Neuroscience  35

found in relation to reading musical notation. Bergman and colleagues

(2014) undertook a longitudinal study with 352 children and young
people between the ages of six and 25, carrying out neuroimaging
investigations with 64 participants on two or three occasions, two years
apart. Those playing an instrument had larger grey-matter volume in
the temporo-occipital and insular cortex areas, previously reported to
be related to reading musical notation.
Structural differences in grey and white matter have also been found
in children who engage in music, particularly during early childhood,
compared with those who do not (Groussard et al., 2014; Habibi et al.,
2018; Huotilainen and Tervaniemi, 2018; Pantev and Herholz, 2011).
Schlaug and colleagues (2009) found that after just over two years of
musical training, five- to seven-year-old children who were committed
to music practice showed increased size of the anterior part of the corpus
callosum. Similarly, Hudziak and colleagues (2014) assessed the extent
to which playing a musical instrument was associated with cortical
thickness development among healthy children and young people.
Over a two-year period, 232 young people aged six to 18 underwent
MRI scanning and behavioural testing. While there was no association
between cortical thickness and years playing a musical instrument,
a later follow-up showed that music training was associated with an
increased rate of cortical thickness maturation in areas implicated in
motor planning and coordination. Similarly, Habibi and colleagues
(2018) investigated the effects of music training on children’s brains,
comparing children engaged with musical training and others involved
in either sport or no regular after-school activity. Two years after
training, the children in the music group showed brain changes related
to enhanced auditory processing skills.
A different approach was adopted by Hyde and colleagues (2009).
They tested two groups of children who had no prior formal musical
training. The instrumental group consisted of 15 children aged six
years old who had weekly half-hour private keyboard lessons and who
continued lessons for 15 months. The comparison group consisted of
16 children who were almost six years old, who did not receive any
instrumental music training but participated in a weekly 40-minute
group music class in school consisting of singing and playing with
drums and bells. The children underwent a magnetic resonance
36 The Power of Music

imaging (MRI) scan twice, at the beginning of the research and again 15
months later. The second scan showed that the children learning to play
instruments had areas of greater relative voxel size, within the motor
areas, the corpus callosum and the right primary auditory region (in
contrast to the comparison group). Overall, the study demonstrated
regional structural brain plasticity in the developing brain that occurred
with only 15 months of instrumental musical training in early childhood.
The study demonstrated that the type of musical training is important in
the transfer of musical skills (Hyde et al., 2009).
In a cross-sectional study, Ellis and colleagues (2012) explored
the impact of age-related maturation and training using functional
magnetic resonance imaging (fMRI) and linear regression techniques.
The participants, aged five to 33, had a range of hours of musical
practice from none to 21,000. Age-related effects common to melodic
and rhythmic discrimination were present in three left hemisphere
regions: the temporofrontal junction, the ventral premotor cortex,
and the inferior part of the intraparietal sulcus—regions involved in
actively attending to auditory rhythms, sensorimotor integration, and
working memory transformations of pitch and rhythmic patterns.
In contrast, training-related effects were localised to the posterior
portion of the left superior temporal gyrus/planum temporale, an area
implicated in spectrotemporal pattern-matching and auditory–motor
coordinating transformations. A single cluster in the right superior
temporal gyrus showed significantly greater activation during melodic
as opposed to rhythmic discrimination. In a second study (Ellis et al.,
2013) using the same sample, an fMRI study explored how relative
hemispheric asymmetries in music processing, making same or different
discriminations, were shaped by musical training as assessed by
cumulative hours of instrumental practice. A peak in the supramarginal
gyrus was characterised by a leftward asymmetry in partial correlation
with participants’ cumulative hours of practice, controlling for age and
task performance. The findings suggested a direct link between the
amount of time spent practising an instrument and the importance of
this region in auditory working memory.
Starting musical training before seven years of age seems to have a
particularly strong effect in stimulating brain changes (Barrett et al.,
2013; Penhune, 2011; Zatorre, 2013). Structural differences in the corpus
 2. Music and Neuroscience  37

callosum between musicians and non-musicians—and the extent of

hand representations in the motor cortex—are greater for musicians
who begin training before seven years of age (Amunts et al., 1997; Elbert
et al., 1995; Schlaug et al., 1995a; 1995b). Early training is also associated
with greater auditory cortex and brain-stem responses to tones (Pantev
et al., 1998; Wong et al., 2007). This is confirmed even when the amount
of training is controlled for (Bailey and Penhune, 2010; Watanabe et al.,
2007). Musicians who begin their training when they are very young
display better sensorimotor synchronisation skills when compared with
those starting at ages older than seven. This difference is underpinned
by brain connectivity in terms of white matter and structural differences
in terms of grey matter (Bailey and Penhune, 2012; Bailey et al., 2014;
Steele et al., 2013).

Genetic and Maturational Effects versus

Training Effects
Overall, cross-sectional studies suggest that there are structural and
functional differences in the brains of musicians and non-musicians,
and that engagement with music leads to behavioural changes which
are underpinned by changes in the primary and secondary auditory and
motor cortices, as well as in sensorimotor and multimodal integration
areas. The age of starting engagement with music and the intensity
or duration of that engagement may account for the extent of brain
differences, suggesting that there may be a causal link between musical
training and changes in the brain. However, the observed differences
could be caused by existing predispositions or genetic factors. At
the extreme end, these include those with difficulties in processing
sound (for instance, those who are tone deaf or suffer from congenital
amusia);Dalla Bella et al., 2011; Kirnarskaya, 2009; Peretz and Hyde,
2003; Williamson and Stewart, 2013) and at the other extreme those who
exhibit exceptional skills—for instance, prodigies or musical savants
(McPherson and Lehmann, 2018; Simonton, 2017). Individual anatomical
and functional properties of the brain, or genetic predispositions for
learning, might impact on the learning of musical skills (Zatorre, 2013).
These might explain discrepant findings in neuroplasticity and have
implications for research, which needs to take account of individual
38 The Power of Music

differences (Foster and Zatorre, 2010; Golestani et al., 2011; Merrett et

al., 2013). There are also issues relating to maturational effects which
are not always addressed, although there are exceptions to this (Ellis et
al., 2012; 2013).
To summarise, studies which compare the brains of musicians
and non-musicians can show neurological differences structurally
and functionally between the two groups. The age at which musical
engagement begins and its intensity or duration can account for some
differences, but cannot demonstrate a causal link. Differences might
be accounted for by genetic factors or predispositions. Longitudinal or
short-term intervention studies can address these issues.

Intervention Studies
Short-term intervention studies can demonstrate causality. For instance,
Chen and colleagues (2012) used fMRI to investigate the formation
of auditory-motor associations while participants with no previous
musical training learned to play a melody. Listening to melodies before
and after training activated the superior temporal gyrus bilaterally, but
neural activity in this region was significantly reduced on the right
when participants listened to the trained melody. Learning to play a
melody involves acquiring conditional associations between key presses
and their corresponding musical pitches, and is related to activity in
the dorsal premotor area of the superior frontal gyrus. When playing
melodies and random sequences, activity in the left dorsal premotor
cortex was reduced in the latter compared to the early phase of training.
Learning to play the melody was also associated with reduced neural
activity in the left ventral premotor cortex. Participants with the highest
performance scores for learning the melody showed more reduced
neural activity in the left dorsal premotor area and the ventral premotor
cortex. Overall, these findings demonstrated that auditory-motor
learning is related to a reduction in neural activity in the brain regions
of the dorsal auditory action stream, which suggests increased efficiency
in the neural processing of a learned stimulus.
There is evidence that the brain responds relatively quickly to new
activities. Measuring event-related potentials (ERPs), Bangert and
colleagues (2001) found that audio-motor coupling occurred following
 2. Music and Neuroscience  39

a 20-minute piano lesson. In another study, eight-year-old children with

just eight weeks of musical training differed from controls in cortical
ERPs (Moreno and Besson, 2006), while music training for 25 minutes
over a seven-week period led to changes in electroencephalogram (EEG)
frequencies associated with enhanced cognitive processing (Flohr et al.,
2000).
Transcranial magnetic stimulation (TMS) has also revealed changes
in hand cortical representation resulting from short-term training of
novel fine motor skills (Pascual-Leone et al., 1995). Cortical motor areas
were tracked targeting the contralateral long finger flexor and extensor
muscles in participants learning a one-handed, five-finger exercise on
the piano. In a second experiment, the researchers studied the different
effects of mental and physical practice of the same five-finger exercise
on the modulation of the cortical motor areas, targeting the muscles
involved in the task. Over the course of five days, as participants learned
the one-handed exercise in two-hour daily practice sessions, the cortical
motor areas targeting the long finger flexor and extensor muscles
enlarged, and their activation threshold decreased. Such changes were
limited to the cortical representation of the hand used in the exercise.
The research also studied the effect of increased hand use, without the
requirement to learn the five-finger exercise, in participants who played
the piano for two hours each day using only the right hand. In these
participants, the changes in cortical motor outputs were similar but
significantly less prominent than for those who learned the new skill.
Similarly, Lappe and colleagues (2008) reported ERP changes in
young adults after two weeks of music training. Later, Lappe and
colleagues (2011) divided non-musicians into two groups and provided
them with two weeks of musical training. In the sensorimotor group,
training consisted of learning to play a musical sequence on the piano.
In the other group, the non-musicians detected errors in performances
after listening to the stimuli played by other participants. Following
the sensorimotor training, participants showed enhanced detection
of incorrect pitch or timing, as compared to listening. This difference
was accompanied by a larger brain response to pitch and duration
deviations, indicating greater enhancement of musical representation
in the auditory cortex fostered by sensorimotor training. Similar
results showing greater benefits of auditory-visual multimodal
40 The Power of Music

training (as compared to unimodal training) have also been reported

(Paraskevopoulos et al., 2012).
To summarise, short-term changes in behaviour and brain activity
can be observed as a result of a brief period of musically related training.
Sensorimotor and multimodal training, typical of learning to play a
musical instrument, are more efficient in engendering neuroplastic
changes than unimodal training. This effect is likely to be underpinned
by brain changes occurring between auditory, motor and sensorimotor
integration regions involving both feed-forward mechanisms capable of
predicting the outcome of motor activity and feedback mechanisms for
monitoring performance (Herholz and Zatorre, 2012).
Practice can lead to dramatic improvements in the discrimination
of auditory stimuli. Carcagno and Plack (2011) investigated changes
in the frequency following response (FFR) after a period of pitch
discrimination training. Twenty-seven adult listeners were trained for
ten hours on a pitch discrimination task using one of three complex tone
stimuli: a static pitch contour, a rising pitch contour or a falling pitch
contour. Behavioural measures of pitch discrimination and FFRs for all
the stimuli were taken before and after the training phase for participants,
as well as for an untrained comparison group. Those receiving training
showed significant improvements in pitch discrimination as compared
to the comparison group for all trained stimuli. These findings indicate
that even relatively low-level processes in the mature auditory system
are subject to experience-related change. Similarly, Bosnyak and
colleagues (2004) found change in the functional brain attributes used
for discriminating small changes in pure tones, measured by EEG in
non-musicians after training over 15 sessions. Menning and colleagues
(2000) used sequences of pure and deviant tones to train participants’
discrimination skills over a three-week period. Participants had to detect
deviant tones, differing by progressively smaller frequency shifts from
the standard stimulus. Frequency discrimination improved rapidly in
the first week and was followed by small but constant improvements
thereafter. The results suggested a reorganisation of the cortical
representation for the trained frequencies.
Schulte and colleagues (2002) designed a melody perception
experiment—involving eight harmonic complex tones of missing
fundamental frequencies—to study short-term neuronal plasticity of
 2. Music and Neuroscience  41

the auditory cortex. The fundamental frequencies of the complex tones

followed the beginning of the virtual melody of the tune Frère Jacques.
The harmonics of the complex tones were chosen so that the spectral
melody had an inverse contour when compared with the virtual one.
After a baseline measurement, participants were exposed repeatedly
to the experimental stimuli for one hour a day. All reported a sudden
change in the perceived melody, indicating possible reorganisation
of the cortical processes involved in the virtual pitch formation. After
this switch in perception, a second measurement was taken. Cortical
sources of the evoked gamma-band activity were significantly stronger
and located more medially after the switch in perception. The results
revealed that the primary auditory cortices were involved in the process
of virtual pitch perception, and that their function was modifiable by
laboratory manipulation.
Adopting a different approach, Loui and colleagues (2009) explored
brain activity occurring when participants learned a new musical system.
Participants listened to different combinations of tones from a previously
unheard system of pitches based on the Bohlen-Pierce scale, with chord
progressions that form 3:1 ratios in frequency, which is different from
the 2:1 frequency ratios found in existing musical systems. Event-
related brain potentials elicited by improbable sounds in the new music
system emerged over a one-hour period. The findings demonstrated
that humans use a generalised probability-based perceptual learning
mechanism to process novel sound patterns in music.
Functional neuroimaging yields results which are less consistent and
more difficult to interpret. Pitch-related learning tasks are associated
with either decreased (Jäncke et al., 2001; Zatorre et al., 2012) or
increased activation (Gaab et al., 2006) of the auditory regions. Similar
discrepancies are observed following short-term sensorimotor training:
for instance, piano-like instrumental learning. Here, listening to melodies
before and after training was associated with either increased activation
of action observation regions (for instance, the premotor region, Broca’s
area and the inferior parietal region; Lahav et al., 2007), or decreased
activation of the dorsal auditory action pathway (Chen et al., 2012).
These findings reflect those encountered in cross-sectional studies, where
musical training manifests itself in increased or decreased activation. In
certain circumstances, learning seems to improve efficiency in encoding
or processing information, thus requiring less neuronal resources.
42 The Power of Music

The ways that we learn are reflected in specific brain activity. In

an intervention study, students aged 13 to 15 were taught to judge
symmetrically structured musical phrases as balanced or unbalanced
using traditional instructions about the differences, including verbal
explanations, visual aids, notation, verbal rules and playing of musical
examples, or participating in musical experiences including singing,
playing, improvising or performing examples from the musical literature.
Comparisons between the two groups revealed activity in different brain
areas (Altenmuller et al., 1997). Similarly, Tervaniemi and colleagues
(2001) have shown that musicians who play by ear and improvise may
learn to process complex musical information differently to and more
accurately than classically trained musicians, leading to corresponding
differences in auditory neural responses. It seems that the way musical
skills are acquired has a direct influence on brain development.

Overview
The evidence from neurological studies relating to engagement with
music suggests that the human brain has remarkable plasticity and
changes in response to training or the demands of the environment.
Active engagement with making music provides a rich aural and
sensorimotor experience which can shape the structure and functions
of the human brain. As the skills needed to become an expert musician
are acquired, an association between fine motor movements and specific
sound patterns is developed, which is based on real-time multisensory
feedback. This creates changes in the brain which are in evidence when
comparisons are made between non-musicians and musicians involved
in different musical activities. These changes are found in children and
adults after a few months of musical training. As musicians become
more expert, interpreting the findings from neurological studies
becomes more complex, because of the way that many aural and motor
skills become automated, thus requiring less neural activity. Despite
these challenges, it is clear that music has made a major contribution to
our understanding of plasticity in the brain, as well as demonstrating
the role of learning in developing expertise (albeit in interaction with
existing genetic predispositions).
 3. Aural Perception and
Language Skills

Language and music are unique human forms of communication. In

everyday life, we utilise complex linguistic systems to process sound
in the environment (Kraus and Slater, 2016). The environment is full
of events where it is necessary to segregate sounds into streams where
several sound sources are present at the same time (Bregman, 1994)
and it is necessary to differentiate between those which are relevant and
those which are irrelevant.
Being able to process sound has high survival value, and hearing
is the first sense to develop. The foetus in the womb can respond to
sound as early as 19 weeks into pregnancy (Moon and Fifer, 2000;
Graven and Browne, 2016). Learning the melodies, timbres and
rhythms of the music and language of an individual’s culture begins in
the mother’s womb during the third trimester of development. At this
point, the foetus can discriminate the speech of their mother from that
of a stranger, and the speech of their native language from a non-native
language (Kisilevsky et al., 2003; Kisilevsky and Hains, 2009). Foetuses
also respond differently to music and speech (Kisilevsky et al., 2004;
Granier-Deferre et al., 2011).
The impact of prenatal auditory experience can be observed among
newborns when infants show a strong preference for their mother’s
voice over the voice of another female (DeCasper and Fifer, 1980; Cooper
and Aslin, 1989), their mother’s language over a foreign language
(Moon et al., 1993; 2012), and specific passages of speech (DeCasper
and Spence, 1986) or music (Hepper, 1991) which were presented to
them during the final weeks of pregnancy. Some have proposed that this
early recognition of music and speech has evolved as a cross-cultural
adaptation to support mother-infant interactions (Huron, 2001; Tarr et
al., 2014; Freeman, 2000; Fritz et al., 2009; Gregory and Varney, 1996).

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.03

44 The Power of Music

Advances in technology—for instance, magnetoencephalography—

have been used to record foetal and neonatal cognitive functions by non-
invasively recording the magnetic fields produced by active neurons in
the brain. During the later weeks of pregnancy and the first months
of life, the cognitive capabilities related to the recognition of emotion
and language acquisition develop rapidly. The newborn can process
emotional information and speech sounds which form the basis of
the child’s development in relation to social tasks and native language
(Huotilainen, 2010).
Early interactions between adults and infants include the use of
infant-directed forms of language and music which are preferred by
infants; Trainor (1996; 1989) refers to this infant-directed speech as a type
of musical speech, while Koelsc and Masataka (1999) and Fernand and
Siebel (2005) suggest that the early developing brain processes language
as a type of music. It has been proposed that singing develops directly
out of motherese (infant-directed speech consisting of exaggerations,
elevated pitch, slow repetitions and melodic elaborations of ordinary
vocal communication; Dissanayake, 2004; Falk, 2004; Mahdhaoui et al.,
2009; Saint-Georges et al., 2013). Motherese and singing have simple
melodic arches which are cognitively easier to process than words.
Both are therefore able to support mother-infant communication and
language development while newborns are at a relatively early stage of
neurological development (Bouissac, 2004).
Infants prefer singing to speech. For instance, Nakata and Trehub
(2004) studied six-month-old infants who were presented with extended
audio-visual recordings of their mother’s infant-directed speech or
singing. Cumulative visual fixation and initial fixation on the mother’s
image lasted longer for maternal singing than for maternal speech.
Furthermore, movement reduction, which tends to indicate intense
engagement, accompanied visual fixation more frequently for maternal
singing than for maternal speech. The repetitiveness of maternal singing
may promote moderate arousal levels which sustain infant attention, in
contrast to the greater variability of speech, which may result in cycles of
heightened arousal, gaze aversion and re-engagement. The regular pulse
of music may also enhance emotional coordination between mother
and infant. Bosseler and colleagues (2016) found that the exaggerated
pitch contours of infant-directed speech resulted in differences in brain
 3. Aural Perception and Language Skills  45

activity linked to online statistical learning in sleeping newborns.

Karzon (1985) found that young infants could discriminate three-
syllable sequences when the suprasegmental characteristics typical of
infant-directed speech emphasised the middle syllable. This pattern of
results suggests that the exaggerated suprasegmentals of infant-directed
speech may function as a perceptual catalyst, facilitating discrimination
by focusing the infant’s attention on a distinctive syllable within a series
of polysyllabic sequences.
Learning to comprehend and communicate through language places
heavy demands on the auditory system. Understanding the stress
patterns of a child’s native language helps him or her to segregate
continuous streams of syllables into words. This ability is present
from birth (Mampe et al., 2009). The neonatal brain stores auditory
experiences of speech and music as memory traces (Partanen et al.,
2013a; 2013b). Exposure to music before birth has an impact on the
brain, which helps the newborn to make sense of a range of sounds and
auditory scenes immediately after birth. The newborn needs to learn
the phonemes of his or her native language quickly and effectively so
that he or she can construct a map of them in the first year of life (Kuhl,
2004). This is crucial for the development of language skills.
To function effectively, the auditory system requires high- and low-
level cognitive skills. In humans, the process begins in the cochlea,
where information about the acoustic characteristics of particular
sounds is presented. This information is then subject to time and
frequency processes, subsequently progressing to higher levels in the
auditory system. High-level cognitive skills are required to make sense
of auditory information. These skills include memory, attention and
predictive processes. Such processes are vital in speech perception; for
instance, being able to segregate sounds into streams when listening to
speech within noise, the perception of music, and learning native and
other languages. As we saw in Chapter 2, there is a large body of evidence
that active engagement with music in childhood produces structural
changes in the brain and its functioning—changes which are related to
the processing of sound (Elbert et al., 1995; Huotilainen and Tervaniemi,
2018; Hutchinson et al., 2003; Pantev et al., 2001; 2003; Pascual-Leone,
2001; Schlaug et al., 1995a; 1995b). How easily individuals are able to
process sound depends on their prior experiences with it (Krishnan et
46 The Power of Music

al., 2005; Krizman et al., 2012; White-Schwoch et al., 2013). Knowledge

related to auditory processing is acquired through exposure to particular
environments and is applied automatically whenever an individual
listens to music or speech (Bigand and Poulin-Carronnat, 2006). This
process begins in the womb and continues throughout infancy.
Research on aural processing and its relationship with language has
taken several forms beyond that undertaken in neuroscience. Some has
considered the relationships between language and music in terms of
processing but also skill levels. Another strand of research has focused
on aural perception—including comparisons of musicians with non-
musicians, adults and children—while some research has considered
how music might help those with difficulties in processing sound. The
following sections will consider these issues.

Explanations of the Relationships between Music

and Language
Language and music share many characteristics, including the use of the
auditory domain as the input path and the organisation of perceptual
elements into structured sequences (Patel, 2003). Understanding the
relationship between musical training and speech perception has proved
challenging. Early work focused on hemispheric specialisation. For
example, Bever and Chiarello (1974) suggested that language was based
in the left hemisphere and music in the right. In the 1990s, technological
developments in neuroimaging revealed partial neural overlap between
the two domains (Patel, 2008), although clinical studies of those with
brain damage revealed separate deficits in music and language (Peretz
and Coltheart, 2003). Despite this, there is evidence of common brain
regions for processing music and language (Herdener et al., 2014; Koelsch
et al., 2002) but this does not necessarily imply that there is shared
processing circuitry, as the findings of such research are open to different
interpretations (Kunert and Slevc, 2015). However, research focusing
specifically on shared neural circuitry has indicated neural overlap for
the processing of speech and music (Besson et al., 2011; Bidelman et
al., 2013; Bugaj and Brenner, 2011; Chandrasekaran et al., 2009; Degé
and Schwarzer, 2011; Gordon et al., 2014; Kraus and Chandrasekaran,
2010; Kraus and White-Schwoch, 2016; Overy, 2003; Patel and Iversen,
 3. Aural Perception and Language Skills  47

2007; Rogalsky et al., 2011; Sammler et al., 2007; Schulze et al., 2011;
Tallal and Gaab, 2006; Wong et al., 2007). Despite this, the extent and
nature of the overlap continues to be hotly debated (Norman-Haignere
et al., 2015; Patel, 2016; Peretz et al., 2015). One area of controversy is
whether the brain networks involved are separate or whether the neural
resources are shared (Kunert and Slevc, 2015; Norman-Haignere et al.,
2015; Peretz et al., 2015). A further issue is that the ease with which
shared processes operate depends on the individual’s prior experiences
with sound, including music (Bigand and Poulin-Carronnat, 2006;
Elmer et al., 2014; Krishnan et al., 2005; Krizman et al., 2012; Patel, 2016;
White-Schwoch et al., 2013). The strongest evidence for neural overlap
and cross-domain experience-dependent plasticity is in the brainstem,
followed by the auditory cortex. The evidence and the potential for
overlap becomes less apparent as the mechanisms involved in music
and speech perception become more specialised and distinct at higher
levels of processing (Ogg and Slevc, 2019).
The relationship between language and musical abilities might be
explained in terms of signal processing in the dorsal auditory stream,
which is domain-general. This suggests that there is overlap between
the perceptual processing of linguistic (Kotz and Schmidt-Kassow,
2015; Kotz and Schwartze, 2010), musical, affective and prosodic
sensory information (Fruhholz, Trost and Kotz, 2016). The dorsal circuit
integrates auditory and motor processes, providing a neural mechanism
for speech development, articulation, articulatory sequences and the
encoding of new vocabulary, phonological short-term memory and the
feed-forward function (Buchsbaum et al., 2005; Hickok and Poeppel,
2007). The putamen also plays a pivotal role in human motor cortico-
basal ganglia thalamo-cortical circuitry, but is also involved in the
perception of beats involving local gamma-band oscillations (Merchant
et al., 2015). This circuit is involved not only in sequential and temporal
processing, but also in rhythmic behaviours such as music and dance,
where audition plays a crucial role. The circuit is usually involved in
the control of voluntary skeletomotor movements, and includes the
supplementary motor cortex and the putamen as the fundamental
cortical and neostriatal nodes, respectively.
Two theoretical positions—Hickok and Poeppel’s (2000; 2007)
neuroanatomical model and Patel’s OPERA hypothesis—have
48 The Power of Music

underpinned much research. Hickok and Poeppel (2000; 2007) argue

that progress in understanding the nature and extent of overlap has
been limited because of the failure to consider the effects of different
tasks when mapping speech-related processing systems. They outline
a dual-stream model of speech processing in which a ventral stream
processes speech signals for comprehension, and a dorsal stream maps
acoustic speech signals to frontal-lobe articulatory networks. The model
assumes that the ventral stream is largely bilaterally organised, while
the dorsal stream is strongly left-hemisphere dominant. The OPERA
model proposed by Patel (2011) includes overlap in subcortical and
cortical networks but adds precision (the music must place higher
demands on the networks than language); emotions (the music must
elicit strong positive emotions); repetition (the musical activity must
be repeated frequently); and must be associated with attention. The
model suggests that there is anatomical overlap of the neural areas
that process acoustic features in both speech and music, but that music
requires greater precision than speech and places higher demands on
overlapping neural areas. It also suggests that musical training requires
repetition so that the neural areas are continually activated which, in
turn, leads to enhanced attention.
In early life, speech and music processing have been shown to rely
on overlapping neural substrates (Kotilahti et al., 2010; McMullen
and Saffran, 2004; Perani et al., 2011). Brandt and colleagues (2012)
have argued that, without the ability to hear musically, it would not
be possible to acquire language. They suggest that music serves as a
scaffold to learn speech, supported by the mother’s use of motherese as
she interacts with her child (Fernald, 1989).
Musical and language processes might have similar developmental
underpinnings in infants and children but be modularised in adults. As
newborns do not understand syntax and the meaning of words, they
focus on the acoustic features of voices and the prosodic features of
language (rhythm, speed, pitch and relative emphasis). The processing
systems may become differentiated as they become more familiar with
speech and cognitive maturation occurs (Koelsch and Siebel, 2005).
Koelsch (2011) suggests that there is an emergent modularity. Speech
and music processing both depend on perceptual categorisation. In
speech, the focus is primarily on timbral contrasts, while in music the
 3. Aural Perception and Language Skills  49

focus is on distinguishing differences in pitch. The sounds of vowels

and sound frequencies are spread along continua. Acquiring musical
and language skills requires individuals to learn to separate the sounds
in each continuum into separate vowels or pitches. In addition, it must
also be possible to separate variation within a category—for instance,
sound variation produced by different speakers from variation that
constitutes a change of category. Patel (2008) suggests that these
challenges are likely solved by a shared system. If there is a shared
sound-category learning mechanism, it would suggest comparable
individual differences in language and musical abilities. Some support
for this comes from research with individuals classed as ‘tune deaf
which has shown that poor musical performance tends to be associated
with deficits in processing speech sounds’ (Jones et al., 2009).
There may be a sensitive period for musical training. Support for this
comes from findings that musicians who begin training early show better
task performance and greater changes in auditory and motor regions
of the brain than those who start later in childhood (Bengtsson et al.,
2005; Elbert et al., 1995; Gaser and Schlaug, 2003a; Koeneke et al., 2004;
Penhune, 2011; Schneider et al., 2002). Those who have absolute pitch—
the ability to identify or produce musical pitch without recourse to any
reference tones—offer further support as, typically, those with absolute
pitch begin training before the age of six, with almost no examples of
absolute pitch in those commencing musical activity after nine years of
age (Baharloo et al., 1998). However, auditory learning and plasticity
remain possible after sensitive periods (Strait et al., 2010). During a
sensitive period, learning is largely a bottom-up process that is triggered
by exposure to auditory input, and is optimised because underlying
neural circuits are still developing and are extremely sensitive to input
received. Following a sensitive period, learning is largely a top-down
process that depends on attention to enhance the salience of features in
order to encode them. The process involves changing the structure and
efficiency of pre-existing circuits to optimise processing. Music training
may support the developmental trajectory of top-down control over
speech processing (Strait et al., 2014; White et al., 2013).
The most recent research approaches draw on the clinical evidence
of music-related deficits in neurologically impaired individuals,
while also exploring the processing of music in healthy people,
50 The Power of Music

using neurocomparative music and language research (Sammell and

Elmer, 2020). Particular areas of interest have been the role of general
attention (Perruchet and Poulin-Charronnat, 2013), rhythm, neuronal
entrainment, predictive coding and cognitive control (Slevc and Okada,
2015). For instance, Sammell and Elmer (2020) suggest that temporal
attention can be influenced by external rhythmic auditory stimulation
and that this benefits language processing, including the processing of
syntax and speech production. Such research starts from the proposition
that speech and music have similar acoustic (Reybrouck and Podlipniak,
2019; Tsai and Li, 2019) structural features (Boll-Avetisyan et al., 2020;
Daikoku, 2018; Fotidzis et al., 2018; Lagrois et al., 2019; Lee et al, 2019;
Myers et al., 2019; Silva et al., 2019; Snijders et al, 2020).
Processing systems for language and music share the challenge of
extracting a small number of categories that are meaningful from a flow
of acoustically variable signals. The analysis skills used in language
processing, phonological distinctions, blending and segmentation
of sounds are similar to the skills necessary for the perception of
rhythmic (Lamb and Gregory 1993; Lipscomb et al., 2008), harmonic
and melodic discrimination (Anvari et al., 2002; Barwick et al., 1989;
Lamb and Gregory, 1993). The processing of timing cues is emerging as
particularly important in leading to better segmenting of the sounds of
speech and quicker recognition of distinctive units of spoken language
(Kraus and Chandrasekaran, 2010; Overy, 2003; Tallal and Gaab, 2006).
Reybrouck and Podlipniak (2019) argue that some sound features
and their common preconceptual affective meanings may reflect joint
evolutionary roots of music and language that continue to the present
day—for instance, musical expressivity and speech prosody. Recent
neurophysiological models assume that speech and music processing,
as well as the role of rhythm in language development, are based on
the synchronisation of internal neuronal oscillations with temporally
regular stimuli (Goswami, 2019; Lakatos, et al., 2019; Large et al., 2015;
Poeppel and Assaneo, 2020). For instance, Lakatos and colleagues (2019)
argue that rhythms are a fundamental and defining feature of neuronal
activity in humans. Rhythmic brain activity interacts in complex ways
with rhythms in the internal and external environment, through the
phenomenon of neuronal entrainment. This has been proposed as
having a role in many sensory and cognitive processes. Auditory senses
 3. Aural Perception and Language Skills  51

are faced with many rhythmic inputs. Entrainment couples rhythmic

brain activity to external and internal rhythmic events, serving fine-
grained routing and modulation of external and internal signals across
multiple spatial and temporal hierarchies. Lakatos and colleagues (2019)
propose a theoretical framework, explaining how neuronal entrainment
dynamically structures information from incoming neuronal, bodily
and environmental sources. For instance, Doelling and Poeppel, (2015)
suggest that the brain exploits the temporal regularities in music to
accurately parse individual notes from the sound stream using lower
frequencies or entrainment, and in higher frequencies to generate
temporal and content-based predictions of subsequent musical events
associated with predictive models.
One strand of research has focused on the patterning of strong
and weak syllables or beats that make up rhythm, pulse and prosodic
stress (Breen et al., 2019; Frey et al., 2019; Myers et al., 2019; Richards
and Goswami, 2019; Snijders et al., 2020). The rhythmic patterning of
both speech and music has been proposed to draw on domain-general
abilities which are required to perceive and process the temporal
features of sound (Jones, 2019; Kotz et al., 2018). Richards and Goswami
(2019) explain that prosody, particularly the hierarchical structuring of
stressed and unstressed syllables, provides reliable cues to the syntactic
structure of speech (Selkirk, 1984) and may therefore facilitate the
acquisition of syntactic language organisation (Cumming et al., 2015).
Early disturbances of this rhythm-syntax interface may hinder normal
language acquisition, leading to developmental language disorders.
Richards and Goswami suggest that basic processing of rhythmic
prosodic cues may provide a key foundation for the scaffolding of
higher aspects of language during development.
A further strand of research has focused on the common auditory
processing of temporal regularities (Boll-Avetisyan et al., 2020; Fotidzia
et al., 2018; Lagrois et al, 2019; Reybrouck and Podlipniak, 2019). These
are thought to promote higher-level linguistic functions (Breen et al.,
2019; Frey et al., 2019; Fotidzis et al., 2018: Richards and Goswami,
2019; Rossi et al., 2020; Snijders et al., 2020), possibly through neuronal
entrainment (Myers et al., 2019). For instance, Lagrois and colleagues
(2019) found that so-called ‘beat deaf individuals’, those who have
beat-finding deficits in music, showed deficits in synchronising tapping
52 The Power of Music

with speech rhythm, and more generally, in regular tapping without

external rhythms. This pattern of deficits may arise from a basic
deficiency in timekeeping mechanisms that affects rhythm perception
across domains. Similarly, Boll-Avetisyan and colleagues (2020) used
multiple regression analyses and found that musical rhythm perception
abilities predicted rhythmic grouping preferences in speech in adults
with and without dyslexia, while Fotidzis and colleagues (2018) found
that musical rhythmic skills predicted children’s neural sensitivity
to mismatches between the speech rhythm of a written word and an
auditory rhythm. A further strand of research has explored top-down
modulations of common auditory processes by domain-general cognitive
and motor functions in both perception and production (Christiner and
Reiterer, 2018; Daikoku, 2018; Lee et al., 2019). For instance, Jung and
colleagues (2015) demonstrated that rhythmic expectancy is crucial
to the interaction of processing musical and linguistic syntax, while
Silva and colleagues (2019) demonstrated top-down adjustment of
music and language perception through behavioural modelling. They
found that listeners placed break patterns in ambiguous speech-song
stimuli differently, depending on whether they believed that they were
listening to speech prosody or contemporary music. Similarly, Tsai and
Li (2019) found that the strength with which an ambiguous stimulus
was perceived as song rather than speech depended not only on the
acoustics of the stimulus itself, but also on the sound category of the
preceding stimulus, while Mathias and colleagues (2019) showed that
pianists gradually anticipated the sounds of their actions during music
production, similar to the mechanisms of auditory feedback control
during speech production (Hickok, 2012; Palmer and Pfordresher, 2003).
Overall, this research suggests that the listening context, the listener’s
own motor plans and statistical and domain-specific expectations may
influence the top-down anticipation and perception of acoustic features
in speech and music.
Myers and colleagues (2019) summarise the current state of
knowledge about neuronal entrainment in speech envelope tracking,
reflecting quasi-regular amplitude fluctuations over time. Speech
envelope tracking is neural and occurs simultaneously at multiple time
scales corresponding to the rates of phonemes, syllables and phrases
(Giraud and Poeppel, 2012; Gross et al., 2013). They argue that the
 3. Aural Perception and Language Skills  53

slowest rate, corresponding to prosodic stress and rhythmic pacing in

the delta range, constitutes a particularly strong source of neuronal
entrainment which is crucial for normal language development.
Jung and colleagues (2015) demonstrated that rhythmic expectancy
is crucial to the interaction of processing musical and linguistic
syntax, supporting the incorporation of dynamic models of attentional
entrainment into existing theories, which have proposed a sharing of
neural resources between syntax processing in music and language
(Patel, 2003), and a dynamic attention network that governs general
temporal processing (Large and Jones, 1999). Their findings suggest
that the interaction of music and language syntax processing depends
on rhythmic expectancy, supporting emerging theories of music and
language syntax processing with dynamic models of attentional
entrainment.
Some research has examined domain-general top-down modulations
of music and language from the perspective of perception and
production, focusing on the continuous interaction between bottom-up
and top-down processes in line with significant trends in predictive
coding (Erickson and Thiessen, 2015). For instance, Koelsch and
colleagues (2019) suggest that music perception is an active act of
listening. When listening to music, we constantly generate plausible
hypotheses about what could happen next. Actively attending to music
resolves uncertainty. Within the predictive coding framework, Koelsch
and colleagues (2019) present a formulation of precision filtering and
attentional selection, which explains why some lower-level auditory—
and even higher-level syntactic—music processes elicited by irregular
events are relatively exempt from top-down predictive processes.
They provide evidence for the attentional selection of salient auditory
features, which suggests that listening is a more active process than
traditionally conceived in models of perception. To examine predictive
mechanisms in music, Fogel and colleagues (2015) presented listeners
with the beginning of a novel tonal melody of five to nine notes and
asked them to sing the note they expected to come next. Half of the
melodies had an underlying harmonic structure designed to constrain
expectations for the next note, based on an implied authentic cadence
within the melody. Each authentic cadence melody was matched to a
non-cadential melody in terms of length, rhythm and melodic contour,
54 The Power of Music

but differing in implied harmonic structure. On average, participants

showed much greater consistency in the notes sung following authentic
versus non-cadential melodies, although there was significant variation
in consistency for both melodies, suggesting that individual differences
were important.
Examining perceived relationships between perceptions of speech
and song through the speech-to-song illusion, Margulis and colleagues
(2015) presented native-English-speaking participants with brief
spoken utterances that were repeated ten times. The speech-to-song
illusion occurs when a brief phrase is repeated several times and then
begins to be perceived as song. The illusion exposes a border between
the perception of language and the perception of music. The phrases
used were either drawn from languages that were relatively difficult for
a native English speaker to pronounce, or languages that were relatively
easy for a native English speaker to pronounce. Participants rated the
utterances before and after the repetitions on a five-point Likert-like
scale as ranging from sounds exactly like speech to sounds exactly
like singing. The speech-to-song illusion occurred more readily if the
utterance was spoken in a language difficult for a native English speaker
to pronounce. This suggests that speech circuitry was more likely to
capture native and easy-to-pronounce languages, and more reluctant to
relinquish them to perceived songs across repetitions.
Some research has explored the processing benefits of rhythmically
highly regular stimuli such as songs. For instance, Rossi and colleagues
(2020) investigated whether meaning was extracted from spoken and
sung sentences in a similar way. Participants listened to semantically
correct and incorrect sentences while performing a correctness
judgement task. Neural mechanisms were assessed with several
methods. The combined results indicated similar semantic processing
in speech and song.
The findings of the effects of general rhythmic processing skills on
higher-order linguistic abilities are currently being investigated in the
context of first language acquisition (Ladányi et al., 2020). Christiner
and Reiterer (2018) found that links between musical aptitude, phonetic
language abilities, and imitation of foreign speech in pre-school children
were mediated by domain-general working memory resources. While
this does not preclude auditory perceptual connections between music
 3. Aural Perception and Language Skills  55

and language, the findings suggest that there may be more complex
interactions which have not yet been identified.
Miles and colleagues (2016) suggest that two different aspects of
music and language depend on the same two memory systems. One
brain system, based in the temporal lobes, helps humans memorise
information in both language and music—for example, words and
meanings in language, and familiar melodies in music. The other system,
based in the frontal lobes, helps humans unconsciously learn and use
the rules that underlie both language and music, such as the rules of
syntax in sentences, and the rules of harmony in music. The findings
suggest that one set of brain structures underlies rules in both language
and music, but also that a different brain system underlies memorised
information in both domains.
Over time, the research exploring the relationship between music
and language has progressed from exploring the mapping of music and
language functions in the brain to trying to understand the mechanisms
involved. Much further investigation is required before there is a
clear understanding of this. Future research needs to take account of
individual differences and the nature of the tasks studied, as neural
overlap might be task-dependent. Differences in listening tasks may
limit the extent to which any clear conclusions can be drawn about the
underlying neurobiology of music and speech.

Comparisons between Musicians and Non-Musicians

Altenmüller (2003) proposed that cortical activation during music
processing reflects the individual’s auditory learning biography (their
personal musical experiences accumulated over time). He suggests
that the complexity of neural networks is enhanced depending on
the complexity of auditory information experienced. Musical training
leads to the development of mental representations of music, which
may involve different cerebral substrates to those required for other
types of aural processing. These representations can take several forms,
including auditory, sensory motor, symbolic or visual. This means that,
to process the same level of auditory information, professional musicians
use larger and more complex neural networks when compared with
non-musicians.
56 The Power of Music

A considerable body of research has developed which has focused on

making comparisons between sound processing in musicians and non-
musicians. In such research, musicians tend to be identified in terms
of playing an instrument or being involved in formal singing activities.
Non-musicians are defined as not engaging in music-making in these
ways, although they may engage with music in other ways. Despite
the crudity of this distinction, much research has been undertaken on
this basis, with participants of all ages, from children to seniors. This
research has demonstrated that musicians have enhanced abilities to
process pitch and temporal sound information (Chobert et al., 2011;
2014; Kishon-Rabin et al., 2001; Kraus and Chandrasekaran, 2010; Magne
et al., 2006; Marques et al, 2007; Micheyl et al., 2006; Moreno et al., 2009;
Schon et al., 2004; Strait et al., 2010; Tervaniemi et al, 1997; van Zuijen
et al., 2005; Zendel and Alain, 2009). They have improved performance
on a range of listening skills (Hyde et al., 2009; Pantev et al., 2001; Patel
and Iverson, 2007; Tallal and Gaab, 2006). They have enhanced auditory
attention (Strait and Kraus, 2011; Strait et al., 2014), better processing
of the metric structure of words when they are presented in sentences
(Marie et al., 2011b) and better discrimination and identification of
moraic units of timing and other language features (Sadakata and
Sekiayama, 2011). Musicians can classify voiced sounds, vowels, more
easily and quickly than non-musicians (Bidelman et al., 2014), and have
advantages in relation to the processing of linguistic syntax (Fiveash
and Pammer, 2014) and in making judgements about grammar (Patston
and Tippett, 2011). They are better able to distinguish rapidly changing
sounds (Gaab et al., 2005), harmonic differences (Corrigall and Trainor,
2009; Musacchia et al., 2008; Zendel and Alain, 2009), temporal novelty
(Herdener et al., 2014) and tonal variations in non-native speech sounds
(Chandrasekaran et al., 2009; Cooper and Wang, 2010; Kühnis et al.,
2013; Marques et al, 2007; Martinez-Montes et al., 2013; Perfors and Ong,
2012; Wong et al., 2007; Wong and Perrachione, 2007; Yang et al., 2014).
They can perceive speech better than those without training when it is
accompanied by noise (Parbery-Clark et al., 2009a; 2009b; 2011), and
can identify syllables presented when spectral information is degraded
(Elmer et al., 2012), identify whether sentences in a foreign language
which is tone based are the same or different (Marie et al., 2011a; 2011b)
and predict the ability to perceive and produce subtle phonetic contrasts
 3. Aural Perception and Language Skills  57

in a second language (Slevc & Miyake, 2006). They are also better than
non-musicians at the perception and processing of vocally expressed
emotion (Bhatara et al., 2011; Lima & Castro, 2011; Strait et al., 2009;
Thompson et al., 2004).
At the subcortical level musicians demonstrate more robust and
quicker auditory brainstem responses to music (Lee et al., 2009) and
speech (Bidelman et al., 2009; Bidelman & Krishnan 2010). For instance,
Musacchia and colleagues (2007) demonstrated that musicians,
compared to non-musicians, had earlier and larger auditory and
audiovisual brainstem responses to speech and music stimuli. The
strength of the brainstem response was related to the number of years
of musical practice. Similarly, Wong and colleagues (2007) examined
brainstem encoding of linguistic pitch and found that musicians show
more robust and faithful encoding compared with non-musicians. The
extent of subcortical consonant discrimination in noise perception is also
enhanced in musicians (Parbery-Clark et al., 2012). Finally, musicians
have an increased neural capacity for the perception and processing of
vocally expressed emotion (Strait et al., 2009a; 2009b) and have high-
functioning peripheral auditory systems. The quality of aural encoding
is related to the amount of musical training (Wong et al., 2007) and also
the nature of instrumental requirements.
As was demonstrated in Chapter 2, there are subtle differences
between musicians in their aural processing, depending on the
instrument that they play. For instance, Rauscher and Hinton (2011) used
four discrimination tasks with adults aged 16–63—musicians and non-
musicians—and found that auditory discrimination was better in the
musicians. This was particularly true of the string players as compared
with percussionists, probably as a consequence of the many years of
subtle tonal discrimination required to play a stringed instrument. The
findings demonstrated that expertise in playing a musical instrument
selectively improved discrimination thresholds corresponding to the
skills emphasised by training on that instrument. Similarly, Brattico and
colleagues (2013) established that responses to sound are modulated
by expertise in more than one music culture, as is typical of Finnish folk
musicians, while Tervaniemi and colleagues (2006) found that amateur
musicians still had advantages over non-musicians in their neural and
behavioural sound encoding accuracy. In a later study, Tervaniemi
58 The Power of Music

and colleagues (2016) found that classical, jazz, and rock musicians
exhibited automatic brain responses which were selectively enhanced
to deviants in tuning, classical musicians, timing, classical and jazz
musicians, transposition, jazz musicians, and melody contour, jazz and
rock musicians. Another study found different brain responses to six
types of music featured by classical, jazz, rock and pop musicians and
non-musicians. Jazz and classical musicians scored higher in a musical
aptitude test than band musicians and non-musicians, especially with
regards to tonal abilities. Jazz musicians had a greater overall sensitivity
to auditory outliers, processing of pitch and sliding up to pitches (Vuust
et al., 2012).
Greater left-hemisphere lateralisation has been shown in musicians in
comparison with non-musicians when they are presented with musical
stimuli (Bever and Chiarello, 1974; Hirshkowitz et al., 1978; Besson et
al., 1994; Schlaug et al., 1995a). This is consistent with more efficient
verbal processes. This asymmetry has been proposed to potentially be
related to language and pitch processing skills. Ohnishi and colleagues
(2001) assessed cortical activation during a passive listening task and
also found greater activation of the planum temporale and the left
dorso-lateral prefrontal cortex in musicians than in non-musicians.
The authors also found a negative correlation between the degree of
activation in the left planum temporale and the age of commencement
of musical training. Non-musicians demonstrated right dominant
secondary auditory areas during the same task. Further, the degree of
activation in the left posterior dorsolateral prefrontal cortex and the left
planum temporale correlated significantly with absolute pitch ability.
Fujioka and colleagues (2006) also observed a greater left-hemisphere
lateralisation in four- to six-year-old children who received music lessons
over the period of a year when listening to violin tones, as compared
with children receiving no music lessons.
The auditory expertise gained over years of music training finetunes
the auditory system (Strait and Kraus, 2011a; 2011b) strengthening
the neurobiological and cognitive underpinnings of speech and
music processing including enhancing neural responses to changes in
pitch, duration, intensity and voice onset time. Musicians’ enhanced
perceptual skills play a role in enhancing language skills (Bever and
Chiarello, 2009; Gaab et al., 2005; Hutka et al., 2015; Jakobsob et al., 2003;
 3. Aural Perception and Language Skills  59

Strait et al., 2014; Tallal and Gaab, 2006; Zatorre and Belin, 2001; Zattore
et al., 2002). This increased sensitivity and attention to speech seems
to be supported, in part, by right-hemisphere processing (Jantzen et
al., 2014). Musicians’ pitch expertise appears to extend from music to
the language context with no significant differences between domains
(Alexander et al., 2005; Bidelman et al., 2011; Delogu et al., 2010; Lee
and Hung, 2008; Marie et al., 2011; Mom and Zuo, 2012; Weidema et
al., 2016). Musicians are also better at recognising vocally expressed
emotion. For instance, Pinheiro and colleagues (2015) investigated
the effects of musical training on event-related potential correlates of
emotional prosody processing. Fourteen musicians and fourteen non-
musicians listened to 228 sentences with neutral semantic content,
differing in prosody: one third with neutral, one third with happy and
one third with angry intonation, with intelligible semantic content and
unintelligible semantic content. The findings suggested that auditory
expertise can have an impact on different stages of vocal emotional
processing.
Fujioka and colleagues (2004) found that people with no formal
music education processed both contour and interval information in
the auditory cortex automatically. They designed stimuli to examine
contour and interval information separately. In the contour condition,
there were eight different standard melodies, each consisting of five
notes, all ascending in pitch. The corresponding deviant melodies
were altered to descend on their final note. The interval condition used
one five-note standard melody transposed to eight keys from trial to
trial, and on deviant trials the last note was raised by one whole tone
without changing the pitch contour. There was also a control condition,
in which a standard tone and a deviant tone were presented. The results
suggested that musical training enhanced the ability to automatically
register abstract changes in the relative pitch structure of melodies.
Language and music depend on rules and memorised representations.
Miranda and Ullman (2007) examined the neural bases of these aspects
of music with an event-related potential study of note violations in
melodies. Rule-only violations consisted of out-of-key deviant notes
that violated tonal harmony rules in unfamiliar melodies. Memory-
only violations consisted of in-key deviant notes in familiar well-known
melodies. These notes followed musical rules but deviated from the
60 The Power of Music

actual melodies. Finally, out-of-key notes in familiar well-known

melodies constituted violations of both rules and memory. All three
conditions were presented to healthy young adults: half were musicians
and half non-musicians. The results revealed a double dissociation,
independent of musical training, between rules and memory. Both rule
violation conditions, but not the memory-only violations, elicited an
early, somewhat right-lateralised anterior central negativity consistent
with previous studies of rule violations in music, and analogous to the
early left-lateralised anterior negativities elicited by rule violations in
language. In contrast, both memory violation conditions, but not the
rule-only violation, elicited a posterior negativity, a component that
depends, at least in part, on the processing of representations stored in
long-term memory, both in language and in other domains. The results
suggest that the neurocognitive rule memory dissociation extends from
language to music, further strengthening the similarities between the
two domains.
Harding and colleagues (2019) recorded the EEG of 28 participants
with a range of musical training, who listened to melodies and sentences
with identical rhythmic structure. The results showed that participants
with only a few years of musical training had a comparable cortical
response to music and speech rhythm. However, the cortical response
to music rhythm increased with years of musical training, while the
response to speech rhythm did not, leading to an overall greater cortical
response to music rhythm across all participants. It seems as if task
demands shape asymmetric cortical tracking across domains.
Focusing on sound discrimination, Parbery-Clark and colleagues
(2012) established that musicians have an increased ability to detect small
differences between sounds. They showed that this conferred advantages
in the subcortical differentiation of closely related speech sounds (for
example, /ba/ and /ga/), distinguishable only by their harmonic spectra.
By measuring the degree to which subcortical response timing differed
for the speech syllables /ba/, /da/ and /ga/ in adult musicians and
non-musicians, they showed that musicians demonstrated enhanced
subcortical discrimination of closely related speech sounds. Further, the
extent of subcortical consonant discrimination correlated with speech
in noise perception. Similarly, Ott and colleagues (2011) determined
whether musical expertise led to an altered neurophysiological
 3. Aural Perception and Language Skills  61

processing of subsegmental information available in speech signals.

They analysed neurophysiological responses to voiced and unvoiced
consonant-vowel syllables and noise-analogues in 26 German-speaking
adult musicians and non-musicians. The findings showed that musicians
processed unvoiced stimuli, irrespective of whether these were speech
or non-speech stimuli, differently to non-musicians. Zuk and colleagues
(2013) examined the perceptual acuity of musicians to the acoustic
components of speech necessary for intra-phonemic discrimination of
synthetic syllables. Musicians and non-musicians were compared on
discrimination thresholds of three synthetic speech syllable continua
that varied in their spectral and temporal discrimination demands.
Musicians demonstrated superior discrimination only for syllables that
required resolution of temporal cues. In addition, performance on the
temporal syllable continua positively correlated with the length and
intensity of musical training.
Musicians are also better at processing intervals than non-musicians.
Comparisons between eleven musicians aged 21-33 and ten non-
musicians aged 19-29 years who were required to detect infrequent
changes to the last note of a five-note melody—which either altered the
contour or the interval up or down—showed that contour processing
was more basic and less affected by musical experience (Trainor et al.,
1999).
The benefits of musical training have been shown to continue
throughout the lifespan. Bidelman and Alain (2015) showed that
musical training can offset the decline in auditory brain processing that
frequently accompanies normal ageing. They recorded brainstem and
cortical neuroelectric responses in older adults as they classified speech
sound along an acoustic phonetic continuum. Those who had only
had modest musical training had higher temporal precision in speech-
evoked responses and were better at differentiating phonetic categories.
Even limited musical training can preserve robust speech recognition
late in life.
As considered in Chapter 2, comparisons between musicians and non-
musicians cannot demonstrate causality. Differences in aural processing
could be present at birth or appear at any stage of development due to
genetic programming, while differences in language skills could have
62 The Power of Music

developed through diversity in educational opportunities or home

circumstances.
However, the fact that most enhancements are greater the longer the
period of training suggests that musical experience is the cause (Ho et
al., 2003; Lee and Noppeney, 2015; Musacchia et al., 2008; Norton et al.,
2005; Pantev et al., 1998; Seither-Preisler et al., 2014; Strait and Kraus,
2014; Wong et al., 2007), although the nature of the particular musical
activities may be important, as may the intensity and commitment to
engagement with music. The issue of causality can best be resolved by
intervention studies. These usually take place in research with children.

Research with Children

There have been reports of the benefits of music for language
development, extending from early years through childhood (Tierney
and Kraus, 2013; White et al., 2013) in addition to benefits for auditory
skill development, including auditory discrimination and attention
(Putkinen et al., 2013) and language skills including pitch perception
(Linnavalli et al., 2018; Nan et al., 2018; Yang et al., 2014).
One strand of research has focused on infants and preschool children.
For instance, Zhao and colleagues (2016) examined the effects of a
laboratory-based intervention on music and speech processing in nine-
month-old infants who were exposed to music in triple time (a waltz) in a
social context. Infants, with the aid of caregivers, tapped out the musical
beats with maracas, or their feet, and were bounced in synchronisation
to the musical beats. The intervention incorporated key characteristics
of typical infant music classes to maximise learning. It was multimodal,
social, and offered repetitive experiences. A control group experienced
similar multimodal, social, repetitive play, but without music. Following
the intervention, the infants’ neural processing of temporal structure
was tested using tones in triple time and speech with foreign syllable
structures. After 12 sessions, the infants’ neural responses to temporal
structure violations in music and speech were assessed. Compared
with infants in the control group, the infants exposed to the music
intervention improved their detection and prediction of auditory
patterns, demonstrating enhanced temporal structure processing in
music and speech, musical pitch and the processing of timing. The
intervention enhanced the infants’ ability to extract temporal structure
 3. Aural Perception and Language Skills  63

information and to predict future events in time, a skill affecting both

music and speech processing.
Similarly, Trainor and colleagues (2012) reported neural‐level changes
in six-month-old infants randomised to engage in active participatory
music classes for six months or a class in which they experienced music
passively while playing. Active music participation resulted in earlier
enculturation to Western tonal pitch structure, larger and/or earlier brain
responses to musical tones, and a more positive social trajectory. Also
working with six-month-old infants, Gerry and colleagues (2012) found
that random assignment to six months of active participatory musical
experience accelerated the acquisition of culture-specific knowledge of
Western tonality, in comparison to a similar level of passive exposure
to music. The infants assigned to the active musical experience showed
superior development of prelinguistic communicative gestures and
social behaviour compared to infants assigned to the passive musical
experience. The findings showed that infants can engage in meaningful
musical training when appropriate pedagogical approaches are used,
and that active musical participation in infancy both enhances culture-
specific musical acquisition and impacts the development of social and
communication skills.
Another comparable study is that of Snijders and colleagues (2020),
who investigated whether infants could learn words from ecologically
valid children’s songs. Forty Dutch-learning ten-month-olds participated
in the research to explore whether infants could segment repeated target
words embedded in songs during familiarisation, and subsequently
recognise those words in continuous speech in a test phase. The infants
participated in both song and speech sessions. The findings showed
that 10-month-old infants could indeed segment words embedded in
songs. Working with children participating in Head Start provision,
Yazejian and colleagues (2009) evaluated the effects of a supplementary
preschool classroom music and movement curriculum on language
skills. The participating children made greater gains in communication
skills than children in a comparison group, although there were no
differences in receptive language or phonological awareness.
A study with children aged two to three by Putkinen and colleagues
(2013) found a relationship between informal musical activities with
parents at home and auditory event-related potentials linked to sound
64 The Power of Music

discrimination and attention. They showed that children with higher

levels of musical activity had heightened sensitivity to temporal
acoustic changes, more mature auditory change detection, and less
distractibility. The children in the research who also attended a music-
focused playschool until the age of four or six displayed more rapid
development of neural responses than those who gave up the activity.
A related cross-sectional study showed enhanced control over auditory
novelty processing in musically trained school-aged children and
adolescents (Putkinen et al., 2015).
Similarly, the Soundplay project in the UK worked with children
aged two to four years old, using a combination of methods including
observation, music, language tracker tools, interviews and written
reports compiled by early years practitioners, parents and workshop
leaders. They found that, after participating in the project, children
who had been identified as being at risk of developmental delay
achieved higher than average development in language skills (Pitts,
2016). In Australia, Williams and colleagues (2015) investigated parent-
child home music activities in a sample of 3031 Australian children
participating in a national longitudinal study. The frequency of shared
home music activities was reported by parents when children were
two to three years old and a range of social, emotional and cognitive
outcomes were measured by parent and teacher report and direct testing
two years later (when the children were four to five years old). A series
of regression analyses found that the frequency of shared home music
activities had a small significant association with children’s vocabulary,
numeracy, attentional and emotional regulation, and prosocial skills.
Taken together, these studies provide causal evidence of the role of music
training and less formal musical activities in shaping the development
of important neural auditory skills in young children.
We can also consider studies looking at older children: Trainor and
colleagues (2003) found that four-year-olds who had received Suzuki
training had a better developed auditory cortex and were better able to
discriminate between sounds. Fujioka and colleagues (2006) recorded
auditory evoked responses to a violin tone and a noise-burst stimulus
in four- to six-year-old children in four repeated measurements over a
one-year period using magnetoencephalography, and found that the
children who had participated in music lessons throughout the year
 3. Aural Perception and Language Skills  65

showed a clear musical training effect in response to the violin stimuli,

when compared with the untrained children. Similarly, Shahin and
colleagues (2004) measured auditory evoked potentials in response to
piano, violin and pure tones twice in a group of four- to five-year-old
children enrolled in either Suzuki music lessons or non-music controls.
Where children were learning to play an instrument—piano or violin—
auditory evoked potentials observed for the instrument played were
comparable to those of children who were not musically trained and
approximately three years older in chronological age, suggesting that
the neocortical synaptic matrix is shaped by an accumulation of specific
auditory experiences, and that this process is accelerated in those who
have musical training. The children playing the piano also exhibited
increased power of induced timbre-specific gamma-band activity for
piano tones with one year of training in comparison with non-musicians
(Shahin et al., 2008).
Using event-related potential and behavioural measures in a
longitudinal design, Nan and colleagues (2018) showed that musical
training conferred advantages in speech-sound processing in 74
Mandarin-speaking children aged four to five years old, who were
pseudo-randomly assigned to piano training, reading training or a
no-contact control group. Six months of piano training improved
general auditory word discrimination, as well as word discrimination
based on vowels, compared with a control group. Although the
reading group yielded similar trends, the piano group demonstrated
unique advantages in comparison with the reading and control groups
in consonant-based word discrimination and in enhanced positive
mismatch responses to lexical tone and musical pitch changes. The
improved word discrimination based on consonants correlated with
enhancements in musical pitch among the children in the piano group.
The results suggested strengthened common sound processing across
domains as an important mechanism underlying the beneficial impact
of musical training on language processing.
Some research has focused on the development of musical skills
and auditory discrimination in school-aged children (Elbert et al., 1995;
Hutchinson et al., 2003; Pantev et al., 2001; 2003; Pascual-Leone, 2001;
Schlaug et al., 1995a; 1995b). This has provided evidence that musical
training enhances auditory processing in children who, prior to training,
66 The Power of Music

exhibited no pre-existing differences (Chobert et al., 2014; François et

al., 2013; Kraus et al., 2014b; Moreno et al., 2009; 2011; Norton et al.,
2005; Tierney et al., 2013). Making music has been shown to strengthen
children’s auditory encoding of speech (Chobert et al., 2014; Magne
et al., 2006; Strait et al., 2011a; 2011b; 2013; Tierney et al., 2013) and
auditory discrimination and attention (Chobert et al., 2011; Koelsch et
al., 2003; Moreno et al., 2009; Putkinen et al., 2013), as well as leading
to structural changes in auditory cortical areas in the brain (Hyde et al.,
2009; Seither-Preisler et al., 2014).
For instance, Hyde and colleagues (2009) tested two groups of
children who had no prior formal musical training. The instrumental
group consisted of 15 children aged six years old who had weekly
half-hour private keyboard lessons over a period of 15 months. The
control group of 16 children, who were almost six years old, did not
receive any instrumental music training, but participated in a weekly
40-minute group music class in school, consisting of singing and
playing with drums and bells. Structural brain changes in motor and
auditory areas, of critical importance for instrumental music training,
were correlated with behavioural improvements on motor and auditory
musical tests. Children who played and practised a musical instrument
showed greater improvements in motor ability and in auditory melodic
and rhythmic discrimination skills. Changes in the right auditory area
underlay improved melodic and rhythmic discrimination. Similarly,
Putkinen and colleagues (2014) conducted a longitudinal study of more
than 120 school-aged children and showed that children who received
formal musical training displayed enhanced development in neural
responses related to pre-attentive neural sound discrimination and
auditory attention. The musically trained children also showed superior
performance in tests of executive functions.
Huotilainen and Tervaniemi (2018) investigated longitudinal brain
development in children starting a musical hobby. At age seven, when
most of the children in the music group had just started their training
or were about to start, there were no group differences in the brain
responses compared with children of the same age starting other hobbies.
Two years later and beyond, enhanced auditory brain responses had
developed in the music group, while no such development was observed
in the brain responses of the control group. In a later study, Putkinen
 3. Aural Perception and Language Skills  67

and colleagues (2020) studied nine- to fifteen-year-old children who

had or had not participated in musical training. Using auditory event-
related potentials, they showed that the musically trained children
demonstrated enhanced sound encoding.
Not all of the intervention studies with music have shown positive
outcomes. For instance, working with seven- and eight-year-old
Spanish children who were learning to speak English as a second
language, Fonseca-Mora and colleagues (2015) showed that all of those
participating in a phonological training program benefited from that
training, but additional musical support had no clear benefits.
Strait and colleagues (2012) explored the encoding of speech in quiet
and noisy backgrounds in musically trained and non-trained children.
Thirty-one children with normal hearing between the ages of seven and
thirteen participated. Those classified as musicians had received private
instrumental training from at least the age of five, and had practised
consistently for at least four years. The musically trained children
outperformed the non-musicians on speech-in-noise perception overall
and demonstrated less auditory brainstem response degradation with
the addition of background noise than non-musicians. Perceptual,
speech-in-noise, cognitive, auditory working memory and attention
performance correlated with the extent of the musicians’ musical
training. Similarly, Slater and colleagues (2015) followed a cohort of
eight- to nine-year-old school children for two years, assessing their
ability to perceive speech in noise before and after musical training.
After an initial assessment, participants were randomly assigned to
one of two groups. One group began music training immediately and
completed two years of training, while the second group waited a year
and then received one year of music training. The research showed that
speech-in-noise perception improved after two years of group music
training.
Several studies have compared the impact of music versus painting
or equivalent visual stimulation. In an early study, Moreno and Besson
(2006) tested whether eight weeks of musical training affected the
ability of eight-year-old children to detect pitch changes in language.
Twenty non-musician children listened to linguistic phrases that
ended with prosodically congruous words, or with weak or strong
pitch incongruities. Reaction times, error rates and event-related brain
68 The Power of Music

potentials were recorded for the final words. For both groups, the weak
incongruity was the most difficult to detect, but performance was not
significantly different between groups. However, the amplitude of a
late positive component was largest in response to strong incongruities,
and was reduced after training only in the music group. These results
suggest that a relatively short exposure to pitch processing in music
exerted some influence on pitch processing in language.
In a later longitudinal study, Moreno and colleagues (2008; 2009)
studied event-related potentials in 32 eight-year-old non-musician
children over nine months, while they performed tasks designed to
test the hypothesis that musical training improves pitch processing in
music and speech. Following initial testing, the children were pseudo-
randomly assigned to music or to painting training for six months, and
were tested again after training using the same tests. After musical—but
not painting—training, children showed enhanced reading and pitch
discrimination abilities in speech. The results revealed positive transfer
from music to speech, showing that short periods of training can have
strong consequences on the functional organisation of children’s brains.
A further study (Moreno et al., 2011a) researched 64 children, half
of whom received visual art training and the other half music training.
To undertake the training, two computerised training programmes were
developed and administered. The training programmes had the same
learning goals, graphics and design, duration, number of breaks and
number of teaching staff. The only difference was the content of the
training. The music curriculum was based on a combination of motor,
perceptual and cognitive tasks, and included training in rhythm, pitch,
melody, voice and basic musical concepts. The training relied primarily
on listening activities. The curriculum in visual art emphasised the
development of visuospatial skills relating to concepts such as shape,
colour, line, dimension and perspective. The children engaged in the
training programmes in two daily sessions of one hour each, five days a
week, for four weeks. The programmes were projected onto a classroom
wall and conducted in groups, led by a teacher. The findings showed
that training in music listening skills transferred to verbal ability. After
the music training, the children exhibited enhanced performance on
vocabulary knowledge. There was no significant increase in verbal or
 3. Aural Perception and Language Skills  69

spatial skills following visual art training, although there was a trend
towards improvement in spatial skills.
Similarly, Chobert and colleagues (2014) randomly assigned non-
musician children to music or painting training and recorded neural
responses to syllables that differed in vowel frequency, vowel duration
and voice onset time. This was done three times: before training, after
six months and after twelve months. While no cross-group differences
were found before training, enhanced pre-attentive processing of
syllabic duration and voice onset time was found after twelve months
of training in the music group only. These results suggest that active
musical training can lead to improvements in aural processing. Similarly,
over a period of two years, François and colleagues (2013) assigned
eight-year-old children, matched for cognitive abilities, sex, age, grade
at school and socioeconomic status, to music or painting lessons. Prior
to the study, the two groups of children performed similarly on a test
where they had to identify whether three syllable nonsense words were
present within a five-minute-long string of syllables. After one year of
training, the music group performed better than the painting group in
speech segmentation skills, with the difference increasing over the two-
year period.
Another strand of research has considered the impact of second
language training versus music training in enhancing aural processing.
For instance, in a comparative study of the impact of second language
learning (French) and musical training, Moreno and colleagues (2015)
recorded event-related potentials for French vowels and musical notes in
36 four- to six-year-old children. The children demonstrated improved
processing of relevant trained sounds, and an increased capacity to
suppress irrelevant, untrained sounds. After one year, training-induced
brain changes persisted, hemispheric changes appeared and there was
increased EEG complexity at coarse temporal scales during music and
French vowel tasks in widely distributed cortical regions. These findings
showed that musical training increased diversity of brain network
states, which supported domain-specific music skill acquisition and
music-to-language transfer effects. Similarly, Carpentier and colleagues
(2016) conducted a 28-day longitudinal study of monolingual English
speaking four- to six-year-old children randomly selected to receive
daily music or French language training. Children completed passive
70 The Power of Music

EEG music-note and French-vowel auditory detection tasks before and

after training. Comparison of pre-training with post-training showed
that musical training was associated with increased EEG complexity at
coarse temporal scales during music and French vowel tasks in widely
distributed cortical regions. The findings demonstrated that musical
training increased the diversity of brain network states to support
domain-specific music skill acquisition and music-to-language transfer
effects.
Further evidence for the benefits of musical training on language
comes from Yang and colleagues (2014), who examined whether
children’s experience of music training related to language skills in
Chinese (their first language), English (their second language) and
their performance on a musical achievement test. Seventy-seven children
who had received formal musical training out of school, beginning
in semester three, were categorised as musicians, and the remaining
173 children were classed as non-musicians. The children’s musical
skills over the 11 semesters of the study improved when they received
training, and their performance in their second language (English) was
also enhanced, although performance in their first language was not.
In a correlational study, Milovanov and colleagues (2008) explored
the relationship between musical aptitude and second-language
pronunciation skills in school-aged children. Children with good
linguistic skills had better musical skills than children with less accurate
linguistic skills. ERP data showed that children with good linguistic
skills showed more pronounced sound-change evoked activation with
music stimuli than children with less accurate linguistic skills. These
findings implied that musical and linguistic skills could partly be based
on shared neural mechanisms. In a regression study, Swaminathan and
Schellenberg (2020) used a sample of six- to nine-year-old children to
test the links between musical expertise and language ability, speech
perception and grammar. The analyses revealed that language abilities
had significant partial associations with musical ability but not with
music training. Further, rhythm discrimination was a better predictor
of language skills than melody discrimination. The authors concluded
that links between music and language arise primarily from pre-existing
factors and not from formal training in music.
 3. Aural Perception and Language Skills  71

Music training can alter the course of auditory development as

late as adolescence. Tierney and colleagues (2015) investigated the
effects of in-school music training versus another in-school training
programme not focusing on the development of auditory skills. They
tested adolescents on neural responses to sound and language skills
before they entered high school, pre-training, and again three years
later. They showed that in-school music training begun in high school
prolonged the stability of subcortical sound processing and accelerated
the maturation of cortical auditory responses. Phonological processing
improved in both the music training and active control groups, but the
enhancement was greater in adolescents who underwent music training.
Not all of the research supports the proposition that singing supports
speech development. For example, Snijders and colleagues (2020) found
that ten-month-old infants were able to segment words in children’s
songs—but they performed equally well at segmenting infant-directed
speech. Similarly, Rossi and colleagues (2020) found no differences
between speech and songs in a study on semantic processing in healthy
adults.
Taken together, these data suggest that the presentation of verbal
material as song may not be sufficient to enhance vocabulary learning
or language comprehension in healthy individuals.

Children from Deprived Backgrounds

Some research has focused on children who have been perceived as ‘at
risk’ because of their deprived backgrounds. For instance, Kraus and
colleagues (2014) used a randomised controlled trial to investigate
whether community music participation could induce a change in
auditory processing in children from deprived backgrounds. The
programme provided free music instruction to children who were
considered to be at risk. The participants were 44 children with a mean
age of eight years, living in gang reduction zones in Los Angeles. The
children were randomly assigned to participate in or defer musical
participation for one year. Participants attended music classes twice
weekly for three to ten months. Students began in music appreciation
classes, where they learned pitch-matching and rhythm skills, musical
styles and notation, and basic vocal performance and recorder playing.
72 The Power of Music

Students then progressed to instrumental instruction. Students

were given their own instruments and participated in group-based
instrumental classes for four hours per week. The children who were
more committed to the music intervention, who attended more and
participated to a greater extent in the classroom activities, developed
stronger brain encoding of speech than those who were less engaged.
The children who completed two years of music training had a
stronger neurophysiological distinction of stop consonants and neural
mechanisms linked to reading and language skills. One year of training
was sufficient to elicit changes in nervous system functions. Greater
amounts of instrumental music training were associated with larger
gains in neural processing. The research showed that participation
reinforced literacy skills and enhanced the neural encoding of speech
cues—important for reading—and the perception of speech in noisy
backgrounds (Kraus et al., 2014a; 2014b; Kraus and Strait, 2015; Slater
et al., 2014).
Similarly, in an El-Sistema-inspired project, Habibi and colleagues
(2016), as part of an ongoing five-year longitudinal study, investigated
the effects of a music training programme on the auditory development
of children, over the course of two years, beginning at age six to seven.
The children in the music group were compared with two groups of
children from the same socioeconomic background, one involved in
sports training and the other not involved in any systematic training.
Prior to participating, children who began training in music did not
differ from those in the comparison groups in any of the assessed
measures. After two years, the children in the music group, but not in
the comparison groups, showed an enhanced ability to detect changes in
tonal environment, and an accelerated maturity of auditory processing
as measured by cortical auditory evoked potentials to musical notes.

Research with those with Auditory or

Language Impairments
When the auditory system does not have full acoustic input, as in the
case of hearing deficits or congenital deafness, the development of skills
related to audition is damaged. Working with deaf children, Rochette
and colleagues (2014) compared the auditory perception, auditory
 3. Aural Perception and Language Skills  73

cognition and phonetic discrimination of 14 profoundly deaf children

who completed weekly music lessons between the ages of eighteen
months and four years, and 14 deaf children who did not receive musical
instruction. The trained children showed better performance in auditory
scene analysis, auditory working memory and phonetic discrimination
tasks. Multiple regression analysis showed that success on these tasks
was at least partly driven by music lessons.
While cochlear implants can support hearing, they cannot deliver
complete auditory information to the cochlea. The input is small and
distorted, and has an impact on communication skills. However, children
who receive a cochlear implant by 12 months of age demonstrate normal
language growth rates and achieve age-appropriate receptive language
scores three years after the implant. Later implants lead to significant
language delay, evident three years after the implant. The development
of speech follows a similar pattern to that of normal hearing children,
but is delayed (Leigh et al., 2013). Some research has explored whether
musical interventions can help these children. For instance, Torppa
and colleagues (2014a) assessed word and sentence stress perception,
discrimination of fundamental frequency, intensity and duration, and
forward digit-span twice over a period of 16 months. Twenty-one early-
implanted children and age-matched normal-hearing children aged four
to 13 years participated. Children with cochlear implants who had been
exposed to music improved with age in word stress perception, intensity
discrimination and digit-span. Their performance was equivalent to the
natural-hearing children, while later-implanted children performed less
well. Overall, the findings suggested that music was a valuable tool for
the rehabilitation of implanted children.
A further study (Torppa et al., 2014b) researched the interplay
between singing and cortical processing of music in children with
cochlear implants. The findings showed an augmented development of
neural networks for attention, and more accurate neural discrimination
associated with singing. In addition, Torppa and colleagues concluded
that musical playschool also supported learning with other children,
as it offered more efficient use of mirror neurons, especially as the
children with cochlear implants participated alongside their normal-
hearing peers. The emotional and social aspects of the group in musical
74 The Power of Music

playschool may also impact on learning outcomes, through the provision

of a positive and inspiring environment.
Similarly, Good and colleagues (2017) studied 18 children with
cochlear implants aged six to 15, who received either six months of
individualised piano lessons or six months of individualised painting
lessons. Measures of music perception and emotional speech prosody
perception were obtained pre-, mid- and post-training. Music training
led to improved performance on tasks requiring the discrimination
of melodic contour and rhythm, incidental memory for melodies and
emotional speech prosody perception. Art training did not lead to
the same improvements. Good and colleagues concluded that music
training may be an effective supplementary technique for supporting
auditory rehabilitation following cochlear implantation.
Children born very premature have an increased likelihood of
sensory, cognitive and motor deficits. Mikkola and colleagues (2007)
used neurocognitive tests with very pre-term children at one and five
years old and suggested that they may have altered primary auditory
processing. They suggested that the early auditory environment within
the intensive care unit and during later hospitalisation might play a role
in the decreased auditory, attention and learning skills of prematurely
born infants. To ameliorate such deficits, Virtala and Partanen (2018)
developed interventions focusing on music. They found that music-
making and parental singing promoted infants’ early language
development and auditory neural processing.
There is some evidence that aphasia can be rehabilitated through
music. Sparks and colleagues (1974) used melodic intonation therapy,
which involves sung intonation of propositional sentences in such a way
that the intoned pattern is similar to the natural prosodic pattern of the
sentence when it is spoken. Eight severely, but not globally, impaired
right-handed aphasic subjects with left hemisphere damage (resulting
from cerebrovascular accidents) participated. Each patient acted as their
own control. The participants had shown no improvement in verbal
expression for at least six months, during which time they had received
other language therapy. Recovery of some appropriate propositional
language occurred for six of the eight patients as a result of melodic
intonation therapy.
 3. Aural Perception and Language Skills  75

It has also been argued that music may aid the development of
listening skills and support children with learning difficulties (Hirt-
Mannheimer, 1995; Humpal and Wolf, 2007; Wolf, 1992). Music has
helped children with developmental disabilities (Mendelson et al.,
2016) and those with particularly low reading levels (Cogo-Moreira et
al, 2013).
Infants of dyslexic parents show some minor differences in auditory
processing compared with infants of parents without dyslexia. These
can be observed in infancy using neurological measures. In a review of
research on auditory processing deficits in individuals with dyslexia,
Hämäläinen and colleagues (2013) showed that measures of frequency,
rise time and duration discrimination, as well as amplitude modulation
and frequency modulation detection, are most often impaired. It may be
that infants with dyslexic parents and children with symptoms of dyslexia
might benefit from training of their auditory systems to overcome the
possible differences in auditory processing early in life. Indeed, musical
interventions have been found to be successful in helping children
with dyslexia overcome some of these difficulties (Flaugnacco et al.,
2015). Children who show delayed language development at three and
four years of age are at risk of dyslexia, although many children who
eventually are diagnosed as dyslexic have perfectly normal language
development. However, early language difficulties and a diagnosis of
language impairment in childhood is predictive of reading disabilities
in the later school years, and during adolescence and adulthood.
Atypical entrainment to rhythmic prosodic cues due to deficits
in fine-grained auditory perception may constitute a risk for the
development of speech and language disorders (Goswami, 2011;
Ladányi, et al., 2020). If this is the case, then increasing the regularity
of stimuli, or strengthening individual rhythmic abilities with the aim
of improving neuronal entrainment, may enhance development. Some
research has suggested that song could be used for improving speech
processing in individuals with language processing deficits, including
dyslexia (Vanden Bosch et al., 2020) as music-based training effects in
dyslexia have already been demonstrated. Enhancing the auditory skills
of children with dyslexia can be achieved by attendance at musical play
school (Overy, 2000; Overy, 2003).
76 The Power of Music

Children with developmental language disorders have been shown to

be impaired not only in language processing (including syntax), but also
in rhythm and metre perception. Sammler and Elmer (2020) suggest that
there may be a role for rhythm-based processing in language processing
and acquisition. Frey and colleagues, in a longitudinal study using EEG,
demonstrated that six months of music training positively influenced
the pre-attentive processing of voice onset time in speech in children
with developmental difficulties, while Przybylski and colleagues (2013)
tested the influence of external rhythmic auditory stimulation on syntax
processing in children with specific language impairment and dyslexia.
Children listened to either regular or irregular musical prime sequences,
followed by blocks of grammatically correct and incorrect sentences.
They were required to perform grammar judgements for each auditorily
presented sentence. Performance of all children, including controls, was
better after regular prime sequences than after irregular prime sequences.
The benefit of the regular prime was stronger for children with specific
language impairment than for dyslexic children. The results suggest that
rhythmic structures, even in non-verbal materials, may boost linguistic
structure processing. Regular music therapy can also help children with
Rett syndrome, a genetic brain disorder associated with problems with
language and coordination. It can improve receptive language, and
verbal and nonverbal communication (Chou et al., 2019).
Music-making—whether playing an instrument or singing—is
a multimodal activity that involves the integration of auditory and
sensorimotor processes. The ability to sing in humans is evident from
infancy and does not depend on formal vocal training, although it can be
enhanced by training. Wan and colleagues (2010) reviewed the evidence
on the therapeutic effects of singing, and how it might potentially
ameliorate some of the speech deficits associated with conditions such
as stuttering, Parkinson’s disease, acquired brain lesions and autism.
Singing may help children who stutter by reducing stress and using
melodic architecture to help in the formation of longer verbal phrases
(Clements-Cortès, 2012; Wan et al., 2010).
 3. Aural Perception and Language Skills  77

Overview
The previous sections and recent reviews (Benz et al., 2016; Engel et al.,
2019; Hallam, 2015; 2017; Hämäläinen et al., 2013; Jäncke, 2012; Patel,
2008; Sammler and Elmer, 2020; Wan et al., 2010; White et al., 2013)
provide considerable and compelling evidence that musical training
sharpens the brain’s early encoding of sound, leading to enhanced
performance on a range of listening and aural processing skills. Active
engagement with music in childhood produces structural changes in the
brain related to the processing of sound, which can develop over quite
short periods of time. Making music supports the development of aural
processing systems, which facilitate the encoding and identification of
speech sounds and patterns which, in turn, enhance language skills.
The earlier that active participation takes place, the greater the length of
participation, the level of commitment and its intensity, and the greater
the impact. Musical experience and training also enhance emotional
perception and a range of cognitive skills. The benefits of musical
engagement occur without the conscious awareness of the participants
and have been demonstrated with a range of different groups across the
lifespan. Despite this, it is not possible to say with any certainty which
musical activities are the most beneficial. For young children, informal
music-making in the home and more formal activities in playschools
have both been found to be effective. Later, school music education can
have an impact, as can instrumental tuition. The particular instrument
played and the genre engaged with lead to very specific neural and
behavioural changes.
Overall, enhancing auditory cognition requires sufficient training,
high levels of personal motivation, rewarding musical experiences,
supportive learning environments and a range of high-quality formal
and informal learning experiences. The most effective learning
approaches will depend on the age and individual characteristics of the
learner. The identification of optimal musical interventions is important
to enable the further development of conceptual understanding and
the enhancement of aural processing, as well as the amelioration of
problems with aural processing and language.
 4. Literacy and Related
Language Skills

Literacy is generally defined as the ability to read and write, but more
broadly has been considered as the ability to identify, understand,
interpret, create, communicate and compute, using printed and written
materials in a variety of contexts. This chapter will focus on how active
engagement with music may support literacy, with a particular emphasis
on reading and the skills required to become a competent reader. It will
also consider research on writing and spelling.
The evidence for an association between music training, musical
skills and reading skills is typically explained by near-transfer theories.
Reading requires the development of decoding and comprehension
skills. Comprehension requires basic word-decoding skills, as well as
higher-level cognitive processes such as memory and attention (Sesma et
al., 2009). Active engagement with making music may have a differential
impact on decoding and comprehension. Decoding is the ability to apply
knowledge of letter-sound relationships, including knowledge of letter
patterns, to enable the correct pronunciation of unfamiliar words. It is
strongly associated with auditory skills (Ahissar et al., 2000). In order
to be able to decode written material, readers have to be aware of the
sounds related to the written word, i.e. phonics. Phonological awareness
is an important precursor to early reading (Bradley and Bryant, 1983).
Children need to develop phonological awareness to begin to be able to
translate written text into sound. Phonological awareness is the ability
to analyse and manipulate language on two levels. At the word level,
phonological awareness refers to the ability to manipulate and analyse
larger phonological units (for instance, rhyming and blending words).
At the phoneme level, phonological ability refers to the ability to analyse
and manipulate individual sound units (phonemes) within a word. It

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.04

80 The Power of Music

has repeatedly been shown that phonological awareness is an important

predictor of later reading ability (Pratt and Brady, 1988; Bruck, 1992).
Successful decoding occurs when a learner uses knowledge of letter-
sound relationships to accurately read a word.

Correlation Studies and Comparisons between

Musicians and Non-Musicians
One strand of research on the role of music in the development of
literacy skills has focused on comparing musicians with non-musicians.
A second strand has examined the relationship between musical skills
and literacy.
Comparisons between musicians and non-musicians have
revealed that musicians exhibit advantages in making judgements
about grammar (Patston and Tippett, 2011), are better at correctly
pronouncing irregularly spelled words (Jakobson et al., 2008; Stoesz
et al., 2007), and remembering lyrics (Kilgour et al., 2000), novel
words (Dittinger et al., 2016) and short excerpts of speech (Cohen
et al., 2011). They have a larger vocabulary (Forgeard et al., 2008a)
and in one study showed enhanced comprehension of complicated
passages of text (Thompson et al., 2012). Those who have had musical
training demonstrate enhanced speech perception on a wide range
of different tasks. For instance, they can perceive speech better than
those without training when it is accompanied by noise (Parbery-
Clark et al., 2009a; 2009b; 2011), can identify syllables presented when
spectral information is degraded (Elmer et al., 2012), identify whether
sentences in a foreign tone-based language are the same or different
(Marie et al., 2011a; 2011b), and predict the ability to perceive and
produce subtle phonetic contrasts in a second language (Slevc and
Miyake, 2006). They are also better at phoneme perception (Kuhnis et
al., 2013). Children with four years of music lessons, aged nine, have
been found to be more accurate and fast in accurately discriminating
syllables that varied in duration and frequency than those not having
lessons (Chobert et al., 2011). Cross-sectional studies have shown that
preschool and school-aged children and adults with musical experience
are able to make stronger distinctions between speech syllables than
non-music students (Kraus and Nicol, 2014; Parberry-Clark et al., 2012;
 4. Literacy and Related Language Skills  81

Strait and Kraus, 2014; Zuk et al., 2013). Having musical skills also
enhances the ability to interpret affective speech rhythms (Thompson
et al., 2004); eight-year-olds with musical training outperform those
with no training on music and language tasks (Magne et al., 2006).
In research with 250 Chinese elementary-school children, Yang and
colleagues (2014) examined the relationship between long-term
music training and students’ development of first language, second
language and mathematics. The musician children outperformed non-
musicians on musical achievement and second language development.
Although music training appeared to be correlated with the children’s
final academic development of first and second languages and
mathematics, it did not independently contribute to the development
of first language or mathematical skills.
Correlation studies are able to identify if there are relationships
between musical skills and various skills related to literacy, including
verbal and auditory working memory. Studies with preschool children,
aged four to five years, have found relationships between musical skills,
phonological awareness and reading development (Anvari et al., 2002).
There is a positive relationship between phonological awareness and
musical ability in preschoolers, children aged five to six, and older
children (Lamb & Gregory, 1993; Milovanov et al., 2008; Milovanov and
Tervaniemi, 2011; Peynircioğlu et al., 2002), while Loui and colleagues
(2011) worked with children aged seven to nine years old and showed a
significant positive correlation between pitch perception and production,
and phonemic awareness. There are also relationships between the
development of auditory skills in early childhood and informal musical
activities (Putkinen et al., 2013a).
Moderate relationships have also been found between tonal
memory and reading age (Barwick et al., 1989), while the magnitude
of neural responses to speech harmonics is correlated with reading
ability (Banai et al., 2009). Schellenberg (2006) found that length of
music training predicted measures of reading even after controlling
for intelligence, while Chandrasekaran and Kraus (2010) linked
poor reading ability with deficiencies in processing essential sound
elements. Corrigall and Trainor (2011), examining the association
between length of music training and reading ability in 46 six to
nine-year-old children enrolled in music lessons, found that length
82 The Power of Music

of training correlated significantly with reading comprehension but

was not associated with word decoding scores. The length of music
training was robustly associated with reading comprehension, even
after age, socioeconomic status, auditory perception, word decoding,
general intelligence and the number of hours spent reading each week
were taken into account. There is a relationship between individuals
who are tone deaf and phonological processing, word discrimination
and syllable segmentation (Jones et al., 2009).
Swaminathan and colleagues in a series of studies (2017; 2018; 2019)
explored a range of relationships between music and other skills. In 2017,
they reported that the relationship between music training and reading
in adults was facilitated by general cognitive—rather than auditory—
skills. In 2018, also working with adults, they assessed reading ability,
comprehension and speed, music-perception skills, melody and rhythm,
general cognitive ability, non-verbal intelligence, short-term memory,
working memory, family income and parents’ education, and found that
reading ability was associated positively with music training, English as
a native language and general cognitive ability. The association between
reading and music training was significant after socioeconomic status,
native language and music perception skills were controlled for, but
when general cognitive abilities were held constant, there was no longer
an association between reading and music training. These findings
suggest that the association between reading ability and music training
is a consequence of general cognitive abilities. In 2019, an association
between rhythm aptitude and speech perception was found in a sample
of six- to nine-year-old children. Musical training was associated
positively with performance on a grammar test, musical ability, IQ,
openness and age. Regression analyses revealed that language abilities
had significant partial associations with musical ability and IQ but not
with music training. Rhythm discrimination was a better predictor of
language skills than melody discrimination. Musical ability predicted
language ability independently of IQ.
Not all correlational studies have shown a positive relationship
between music and literacy skills. Establishing the main and subsidiary
beats in a musical selection has not been found to be a significant predictor
of reading in third- and fourth-grade students (Chamberlain, 2003),
while Hartas (2011) found no relationship between parent-reported
 4. Literacy and Related Language Skills  83

frequency of singing songs and rhymes or playing music at three years

and teacher-rated performance on literacy. The strongest relationships
with children’s learning outcomes were between family income and
mother’s educational level.

Intervention Studies
Learning to read requires word decoding skills These skills are
strongly associated with auditory skills. The auditory analysis skills
used in language processing, phonological distinctions, blending
and segmentation of sounds are similar to the skills necessary for the
perception of rhythmic (Lamb and Gregory, 1993; Lipscomb et al., 2008),
harmonic and melodic discrimination (Anvari et al., 2002; Barwick
et al., 1989; Lamb and Gregory, 1993). Learning to become an expert
reader involves dynamic cross-modal processes, beginning with the
mapping of letters and sounds, culminating in skilled reading, which
involves the simultaneous processing of phrases, sentences and larger
multiple sources of information from the text and their integration
with contextually relevant background information from the reader’s
own experiences (Gellert and Elbro, 2017; Perfetti and Stafura, 2014).
The dynamic and multiplex process of reading has been argued to be
similar to the entrainment seen in musical ensembles, where individuals
segregate and integrate concurrent streams of information (Ragert et al.,
2014). Reading requires integrative attending and activates an amodal
interface, where internal and external goals and experiences intersect.
A range of intervention studies have explored the impact of active
engagement with music on phonological awareness and reading skills.
Research findings, which attempts to demonstrate causality between
musical engagement, phonological awareness and reading, have been
mixed. Arts-enriched programmes that include music have led to
improvements in school readiness in relation to receptive vocabulary
(Brown et al., 2010) and literacy (Phillips et al., 2010) when compared to
non-arts programmes. In a school-based arts programme which included
music, Gardiner and colleagues (1996) showed that children with a
lower score on literacy at baseline achieved similar scores on reading
tests after one year of visual arts and music training, as compared to
controls.
84 The Power of Music

Some research has focused on the impact of music on sound

processing, as it relates to phonemic awareness. In a study of preschool
children’s informal musical activities at home, Politimou and colleagues
(2020) found systematic associations between rhythm perception/
production and phonological awareness, while melody perception was
related to the acquisition of grammar. Similarly, Eccles and colleagues
(2020) evaluated the effect of varying durations of music instruction
over a single academic year on the phonological awareness and early
literacy of young children aged five to seven, compared with children
who only received class music. The children with greater exposure
to music showed greater improvement in phonological awareness.
Douglas and Willats (1994) found that group training involving singing
and the use of percussive instruments improved decoding.
Good and colleagues (2002) worked with kindergarten children who
participated in a weekly music intervention lasting 30 minutes which
consisted of singing, body percussion activity, movement, instrument
playing, singing and the use of graphic notation. On completion of the
programme, the music group exhibited significantly higher phoneme
segmentation fluency as compared with controls. Similarly, Degé and
Schwarzer (2011) showed that preschool children who were randomly
assigned to intensive training in music (ten minutes each day for five days
each week, for twenty weeks) showed improvements in phonological
awareness that were identical to changes in other children who received
lessons in perceiving and segmenting speech sounds. A control group
who received sports training showed no improvement.
Also working with kindergarten children, Moritz and colleagues
(2013) explored whether musical activity could support the acquisition
of reading skills before formal reading instruction began. They found
that rhythm skill was related to phonological segmentation skills at the
beginning of kindergarten, and that children who received more music
training during kindergarten showed a wider range of phonological
awareness skills at the end of kindergarten than children with less
training. Furthermore, kindergartners’ rhythmic ability was strongly
related to their phonological awareness and basic word identification
skills in second grade. Schon (2014) has also shown that phonological
awareness can be influenced by several months of rhythmic training
which, in turn, improves reading skills. In a preschool setting, Elliot
 4. Literacy and Related Language Skills  85

and Mikulas (2014) investigated the effectiveness of an integrated

music curriculum on language and literacy skills in a year-long study,
which employed a pre- and post-treatment design with a control group.
Students in the treatment group received instruction using an integrated
music curriculum as part of their preschool instruction. The findings
showed that the students in the treatment group had significantly
greater gains in language and literacy, with an effect size of 0.24. In a
similar study, Vidal and colleagues (2020) tested 44 children aged three
to four years old with a phonological awareness test, prior to and after
an intervention period lasting a full school year with weekly music or
visual arts classes. Following the interventions, both groups improved,
but the music class students outperformed those in the visual art classes,
showing larger differences before and after the intervention.
Working in a community setting, Linnavalli and colleagues (2018)
studied whether a low-cost, weekly music playschool provided for five-
to six-year-old children would have an impact on linguistic abilities.
Sixty-six children were tested four times over two school years on
phonemic processing, vocabulary, perceptual reasoning and inhibitory
control. The children attending music playschool were compared to
their peers who were attending dance lessons or not attending either
activity. Attendance at music playschool significantly improved the
development of children’s phoneme processing and vocabulary skills.
In a series of studies, Rauscher and colleagues (Rauscher, 2009;
Rauscher & Hinton, 2011) explored whether children receiving Suzuki
violin instruction performed better on phonemic awareness tasks than
control groups. Seventy-five musically naive five-year-olds participated.
Lessons were provided for 45 minutes per week for 16 weeks. Prior to
instruction, there were no differences in the children’s performance on a
reading test, but following the intervention the children receiving music
lessons scored significantly higher on letter-word calling and phonemic
awareness than the other groups.
Adopting a training programme which included a range of activities,
Gromko (2005) studied five- to seven-year-old children who received
four months of music instruction for 30 minutes once a week. The
instruction included active music-making with movement emphasising
a steady beat, rhythm and pitch, as well as the association of sounds
with symbols. The children who received the music instruction showed
86 The Power of Music

significantly greater gains in phonemic awareness when compared

to a control group. Learning to discriminate differences between
tonal and rhythmic patterns and to associate their perceptions with
visual symbols seemed to transfer to improved phonemic awareness.
Similarly, Welch and colleagues (2012) evaluated the impact of a music
programme which linked literacy activities with a range of musical
activities including chanting, clapping, copying and composing
rhythms, and improvising using rhymes and alliterative or unusual
vocabulary. Children participating in the musical activities showed on
average 8.4 months of reading improvement compared with 1.8 months
for those in the control group. In a later study, Welch and colleagues
(2020) evaluated a six-month specialist singing project undertaken with
young disadvantaged children in London, where professional singers
provided focused mentoring—relating to a specialised programme of
singing and vocal activities—to generalist primary-school teachers.
The mentored classroom-based singing activities resulted in significant
improvements in children’s singing, changes in reading and aspects
of executive function related to inhibition and phonological working
memory.
Using painting as a comparison activity, Moreno and colleagues
(2009) conducted a longitudinal study with 32 non-musician children
over nine months. Following the first testing sessions, non-musician
children were pseudo-randomly assigned to music or to painting
training for six months and were tested again after training using the
same tests. After musical—but not painting—training, children showed
enhanced performance in reading. In a further study of eight-year-old-
who were assigned pseudo randomly to six months of music or painting
tuition, the children in the music group showed larger pre- to post-test
improvement in reading irregularly spelled words (Moreno et al., 2009).
A further study with pseudo-random assignment of four- to six-year-
olds to four weeks of daily, computer-controlled lessons in listening to
music or visual arts, children in the music group had larger pre- to post-
test increases in vocabulary (Moreno et al., 2011a; 2011b). The music
group also showed greater improvement on a task that required them
to match arbitrary symbols with words, a skill that is a prerequisite for
learning to read (Moreno et al., 2011b). Similarly, Chobert and colleagues
(2011; 2014) conducted a longitudinal study over two school years
 4. Literacy and Related Language Skills  87

with non-musician children randomly assigned to music or painting

training. Neurological responses to syllables that differed in vowel
frequency, vowel duration and voice onset time were recorded three
times over the course of the study. The results highlighted the influence
of musical training on the development of phonological representations
in normally developing children. Also using painting as a comparison
activity, François and colleagues (2013) assigned children, matched in
terms of cognitive abilities, sex, age, grade at school and socioeconomic
status, to music or painting lessons for a two-year period. Before the start
of the study, the two groups of children performed similarly on a test
where they had to identify whether three-syllable nonsense words were
present in a five-minute string of syllables. After one year of training,
the music group performed better than the painting group, with the
difference increasing over the two-year period.
Nan and colleagues (2018) studied 74 Mandarin-speaking children
aged four to five years old who were pseudo-randomly assigned to piano
training, reading training or a no-contact control group. Six months of
piano training improved behavioural auditory word discrimination in
general, as well as word discrimination based on vowels, when compared
with controls. The group receiving reading training yielded similar
trends; however, the piano group demonstrated unique advantages over
the reading and control groups in consonant-based word discrimination.
All three groups improved on general cognitive measures, including
tests of IQ, working memory and attention. Focusing on adolescents,
Tierney and colleagues (2015) investigated the effects of in-school music
training, versus a school training programme that did not focus on
the development of auditory skills. Participants were tested on neural
responses to sound and language skills before they entered high school,
before the training and again three years later. In-school music training
begun at secondary school prolonged the stability of subcortical sound
processing and accelerated maturation of cortical auditory responses.
Phonological processing improved in the music training and control
groups, but the impact was greater in the adolescents who underwent
music training.
In an interesting study which directly related rhythm to reading,
Lipscomb and colleagues (2008) provided a form of reading rhythm
training to children in third grade who participated in four sessions
88 The Power of Music

each week for 12 weeks, where they read lists of words at varying tempi.
This led to a dramatic improvement in reading fluency.
Children from low socioeconomic backgrounds tend to fall
progressively further behind their higher income peers over the course
of their academic careers. Music interventions have been proposed as a
way to help low-income children to improve their academic attainment.
Some research has pursued this line of enquiry. For instance, Register and
colleagues (2004) examined the effects of a music therapy programme
designed to teach reading skills versus a television programme designed
to support literacy skills on the early literacy of kindergarten children
aged five to seven years from low socioeconomic backgrounds. Each
class was assigned to one of four treatment conditions: music only, video
only, music and video or a control group with no activity. Children’s
literacy was assessed using standardised tests and teacher assessment.
The ‘music and video’ and ‘music only’ groups achieved the highest
increase in the mean scores of four out of seven literacy subtests. The
‘video’ group scored significantly better on phonemic segmentation
than the other groups. Strong correlations were found between letter-
naming and initial sound-fluency tests. However, children were more
off-task in the video condition than the music condition. Children in the
‘music’ and ‘video’ enrichment groups showed gains in four out of the
eight tests used to measure progress. Slater and colleagues (2014) used
a controlled, longitudinal design to assess the impact of group music
instruction on English reading ability in 42 low-income Spanish-English
bilingual children aged six to nine in Los Angeles. After one year,
children who received music training retained their age-normal level
of reading performance, while a matched control group’s performance
deteriorated, consistent with expected declines in this population. While
the extent of change was modest, the outcomes nonetheless showed that
music can help to counteract the negative effects of low socioeconomic
status on children’s literacy development. In a similar study, Barbaroux
and colleagues (2019) studied the impact of a classical music training
programme, Démos, on the cognitive development of children from
low socioeconomic backgrounds. The children were presented with
standardised tests before the start of the programme, and again after 18
months of music training. The findings showed that the Démos music
training improved reading precision.
 4. Literacy and Related Language Skills  89

Not all of the research has found a positive impact of musical training
on literacy (Bowles, 2003; Kemmerer, 2003; Lu, 1986; Montgomery,
1997). Some findings have been difficult to interpret. For instance,
Rauscher (2014) provided at-risk preschool children with weekly
piano instruction, computer instruction or no instruction for two years.
No effects were found in relation to verbal, memory or reading tests.
Similarly, Piro and Ortiz (2009) focused on the way that learning the
piano might impact on the development of vocabulary and verbal
sequencing in second-grade children. Forty-six children who had
studied the piano for three consecutive years participated, with 57
children acting as controls. At the end of the study, the music learning
group had significantly better vocabulary and verbal sequencing scores.
However, they had already been playing the piano for two years with no
initial differences in reading between their skills and those of the control
group. These findings are difficult to interpret. The authors suggested
that no enhancement had occurred because effects may take a long time
to appear, because the age of tuition was important, or because the
summer holidays immediately prior to testing may have lowered initial
scores. The tuition itself may also have changed over time.
Lukács and Honbolygó (2019) evaluated the transfer effect of
general elementary-school music education on the development of
linguistic abilities. The relationship between specific musical auditory
skills, phonological awareness and reading was investigated in 30
second-grade children who either attended a class with an intensive
music curriculum or a class with a regular curriculum. The findings
indicated no significant differences between the children experiencing
intensive music education or the normal curriculum. Overall, one year
of Kodály-based classroom music education was not sufficient to yield
improvement in musical and linguistic abilities, although phoneme
deletion accuracy was associated with tonal memory, suggested by a
similar quasi-experimental pre- and post-test design with measurements
taken across a period of two years. Kempert and colleagues (2016)
tested the effects of two interventions: a consecutive combination of
musical and phonological training, and phonological training alone. The
participants were 424 German-speaking children aged four to five years
old. The findings demonstrated a positive relationship between musical
abilities and phonological awareness. While the phonological training
90 The Power of Music

produced positive effects, adding musical training did not contribute

significantly to the development of phonological awareness. This may
have been because of differences in the initial level of phonological
awareness of the participants.
Overall, there may be a range of reasons for the differences in the
research findings. The types of training adopted differ and there may be
differences in the quality of their delivery. There is a large age range in the
participating children’s ages and they are likely to be at different stages
in their developing literacy, although experimental designs are able to
take account of this to some extent. The development of phonological
skills may be important early on in the process of developing literacy
skills and these may be enhanced with shorter periods of musical
engagement, whereas longer training may be needed to influence
decoding and ultimately understanding.

Children Facing Challenges with Literacy Skills

One strand of research has focused on children with difficulties in
reading. The evidence for the importance of rhythmic training is
especially strong for poor or dyslexic readers (Overy, 2000; 2003; Tallal
et al., 1993; Thomson, 1993). Huss and colleagues (2011) have shown
that dyslexics have lower performance than normal-achieving readers
on tasks involving musical metrical structure. This is supported by a
range of studies showing that children with dyslexia have difficulties
with keeping a beat (Corriveau et al., 2007; Corriveau and Goswami,
2009; Goswami et al., 2002; Tierney & Kraus, 2013b; Wolff et al., 1990).
While children with dyslexia have impaired rhythmic processing skills,
especially for rhythm production, they have normal pitch-processing
skills (Overy, 2000; 2003; Overy et al., 2003).
Musical interventions emphasising the development of rhythmic
skills seem to have the greatest impact for children facing challenges
with literacy. For instance, working with children in kindergarten,
Bolduc (2009) compared the effects of two music programmes. One
programme employed musical activities to increase interest in reading
and writing in those with special educational needs, while the other
was primarily designed to enhance musical abilities. The programme
that focused on enhancing reading and writing was more effective in
 4. Literacy and Related Language Skills  91

enhancing phonological awareness than the one designed to enhance

musical abilities. Similarly, Standley and Hughes (1997) evaluated
the effects of music sessions designed to enhance the pre-reading and
writing skills of 24 children, aged four to five, who were enrolled in early
intervention programmes or programmes for children with particular
needs.
The intervention lasted for just over seven weeks and included
two 30-minute music lessons per week for a total of fifteen lessons.
In the autumn, musical activities were designed to teach writing
skills and, in the spring, reading skills. Children receiving the normal
kindergarten curriculum without music involvement acted as controls.
All participants were tested before and after the intervention. The
findings demonstrated that music significantly enhanced print concepts
and the pre-writing skills of the children. Replicating this work, Register
and colleagues (2001) studied 50 children aged four to five years old
enrolled in early intervention programmes or programmes for children
with particular needs. The intervention and control group both received
two 30-minute music sessions each week for an entire school year. The
differentiating factors were the structure and components of the musical
activities. The autumn sessions for the experimental group were focused
on writing skills while the sessions in the spring taught reading and
literacy concepts. Music sessions for the control group were based
purely on thematic material, which was determined by the classroom
teacher with the purposeful exclusion of all pre-literacy concepts. All
participants were tested at the beginning and end of the programme.
The findings demonstrated that the music sessions significantly
enhanced both groups’ abilities to learn pre-writing and print concepts,
but the experimental group showed significantly higher results on
logo identification and a word recognition test after the intervention.
Working with older children, aged six to eight, Nicholson (1972)
studied the impact of a music intervention on children categorised as
slow learners. After music training, the experimental group exhibited
significantly higher reading performance, scoring in the 88th percentile
versus the 72nd percentile. After an additional year of musical training,
the reading scores of the experimental group were still superior to those
of the control group.
92 The Power of Music

Drawing on a theoretical framework which emphasised pulse as the

underlying organisational feature common to music and language, Long
and Hallam (2012) investigated the impact of an intervention on children
aged eight to ten years old. The rhythm-based music intervention
involved an entrainment strategy in which groups of children rapidly
developed music-notation reading skills while synchronising stamping,
clapping and chanting actions in time with a musical accompaniment
for ten minutes each week. The intervention groups received the
rhythm-based music intervention for ten minutes each week for six
weeks. The effects of the rhythmic training were assessed before and
after the intervention, and measured reading behaviour and rhythmic
performance. A control group was matched on reading comprehension
and rhythmic performance. There were statistically significant effects
on reading comprehension scores for those children with lower
attainment in reading, but not for normal-attaining children. This
research demonstrated that children with reading difficulties can
benefit from specific rhythmic musical training which was carried out
alongside their normal-attaining classmates. In a similar study, Long
(2014) recruited 15 children aged nine to ten who had been identified as
weak readers by their school. The intervention consisted of ten minutes
of rhythm-based exercises and was administered at the start of the
children’s usual weekly curriculum music lessons. The children’s school
music teacher was trained to deliver the intervention in two sessions,
with a gap of one week between them. Following participation in the
intervention, statistically significant gains occurred in the children’s
reading comprehension, reading accuracy and reading rate. An analysis
of reading fluency revealed significant gains in the prosodic features
of reading behaviour, including syllable division, grammatical structure
and phrase contours. The rhythmic training emphasised group
interaction, which also led to the children reporting positive changes
in their sense of wellbeing. This research showed that interventions
can be effective when delivered to a whole class by a class teacher. The
intervention required mental anticipation and inhibitory control by
participants, in order to lift one foot while striking the other against the
floor in synchrony with the strong beat of the musical accompaniment
and the actions of the other children. The entrainment activity applied
the theoretical modelling of normal anti-synchrony—as one foot comes
 4. Literacy and Related Language Skills  93

up, the other goes down (Clayton et al., 2005)—and a stable hierarchical
distribution of cognitive attention (Clayton et al., 2005; Jones, 1976;
Jones and Boltz, 1989; Jones and Yee, 1997). Overall, the children were
required to plan ahead, synchronise, monitor and integrate multi-
level physical coordination, which in turn required anticipatory and
inhibitory control, while keeping time with the musical accompaniment
and the other children. The teacher also modelled reading simple staff
notation and chanting the alphabet letter names of music notation
in a monotone, which was synchronised in time with stamping and
clapping actions. During the training, in addition to reading pitch,
the note durations were varied and rests were added. Following the
intervention, the children demonstrated statistically significant gains in
reading comprehension, accuracy and rate of reading. Comprehension
and rate of reading had large effect sizes, with a moderate effect size
for accuracy. The mean change in reading accuracy for the intervention
group was 1.83 in standardised scores and, for the control group, 0.45 in
standardised scores. The mean change in reading comprehension for the
intervention group was 5.82 in standardised scores and, for the control
group, 3.49 in standardised scores. There was no statistically significant
difference in rate of reading. Using the same music programme for
ten minutes each week over a ten-week period with groups of ten
children, 354 in total, who had lower-than-average reading scores in
the first year of secondary school (eleven- to twelve-years-old), Hallam
(2018) found that those randomly allocated to intervention groups
showed statistically greater improvement in reading accuracy and
comprehension than controls, but not in reading rate. The differences in
reading accuracy were equivalent to 1.38 in standardised scores and, for
reading comprehension, 2.33 in standardised scores. Similarly, Bonacina
and colleagues (2015) developed computer-assisted training, called
rhythmic reading training, where reading exercises were combined
with a rhythmic background. Participants took part in nine bi-weekly
individual sessions of 30 minutes. The intervention had a positive effect
on reading speed and accuracy, and significant effects were also found
for the reading speed of short and long pseudo-words, high-frequency
long words, and text reading accuracy.
Not all of the research has demonstrated overwhelmingly positive
effects of music interventions for those who find literacy challenging.
94 The Power of Music

For instance, Bhide and colleagues (2013) compared the effects of a

musical intervention for poor readers with a software intervention
based on rhyme training and phoneme-grapheme learning, and found
that both interventions had similar benefits for literacy, with large
effect sizes. Some music interventions have had very small effects. For
instance, working in Brazilian schools in an attempt to improve reading
skills, Cogo-Moreira and colleagues (2013) studied children aged eight
to ten with reading difficulties. Two hundred and thirty-five children
with reading difficulties in ten schools participated in a five-month,
randomised controlled trial in an impoverished zone within the city of
São Paulo, to test the effects of a music education intervention while
assessing reading skills and academic achievement during the school
year. Five schools were chosen randomly to incorporate music classes,
while five served as controls. Two different methods of analysis revealed
mixed results. Positive results were found for the rate of correct real
words read per minute and phonological awareness. There were also
improvements in Portuguese and mathematics throughout the school
year but, overall, the effects were relatively small.
Children with dyslexia have been studied over a number of years.
The core deficit underlying developmental dyslexia has been identified
as difficulties in dynamic and rapidly changing auditory information
processing, which contributes to the development of impaired
phonological representations for words. Overy (2003) argued that the
underlying causes of the language and literacy difficulties experienced
by dyslexic children are linked to deficits in timing, as they exhibit timing
difficulties in language, music, perception and cognition, as well as motor
control. Based on these ideas, Overy and colleagues (2003) designed a
programme which was administered to 15 dyslexic children aged seven
to eleven, and 11 control children, aged seven to ten. The children were
tested on musical aptitude and their scores were compared. The results
showed that the dyslexic group scored higher than the control group on
three tests of pitch skills, but lower than the control group on seven out
of nine tests of timing skills. Particular difficulties were noted on one of
the tests involving rapid temporal processing, in which a subgroup of
five of the dyslexic children was found to account for all of the significant
errors. There was also a correlation between spelling ability and the skill
of tapping out the rhythm of a song, both of which involve the skill
 4. Literacy and Related Language Skills  95

of syllable segmentation. These results suggest that timing presents a

particular difficulty for dyslexic children and that they may be helped
using targeted interventions.
Since this early research, a range of studies have considered issues
relating to dyslexia. Even short-term rhythm instruction has brought
about positive effects (Habibi et al, 2014). Seven—month-long training
has been shown to lead to an increase in phonological awareness and
reading skills (Flaugnacco et al., 2015). Habibi and colleagues (2016)
tested the efficacy of a specially designed cognitive music training
method which included a series of musical exercises involving (jointly
and simultaneously) the sensory, visual, auditory, somatosensory and
motor systems, with special emphasis on rhythmic perception and
production, in addition to intensive training on various features of
musical audition. Two separate studies were carried out—one in which
children with dyslexia received intensive musical exercises concentrated
over 18 hours during three consecutive days, and the other in which the
18 hours of musical training were spread over six weeks. Both studies
showed significant improvements in several untrained, linguistic and
non-linguistic variables. The first study yielded significant improvement
in categorical perception and the auditory perception of the temporal
components of speech. The second study revealed improvements
in auditory attention, phonological awareness, reading abilities and
repetition of pseudo-words. These benefits persisted for six weeks after
training. Flaugnacco and colleagues (2015) carried out a prospective,
multi-centre, open randomised controlled trial with children with
dyslexia aged eight to eleven, consisting of test, intervention and
re-test. After the intervention, the music group performed better than
the control group in tasks assessing rhythmic abilities, phonological
awareness and reading skills. The findings showed that music training
can modify reading and phonological abilities even when they are
severely impaired.
Thomson (2014) explored the perception of amplitude envelopes in
speech and non-speech, and the necessity of this skill for parsing the
sounds represented as letters in literacy in a group of school children
with dyslexia. A six-week rhythm-based intervention had positive
effects on phonological awareness and literacy equal to those of a control
intervention on phonemic awareness, while Frey and colleagues (2019)
96 The Power of Music

investigated whether six months of active music training was more

efficient than painting training in improving the pre-attentive processing
of phonological parameters based on durations that are often impaired
in children with developmental dyslexia. Comparisons were made with
a typically developing group of children matched on reading age. The
results showed a normalisation of the pre-attentive processing of voice
onset time in children with developmental dyslexia after music training,
but not after painting training. Working with adults, Boll-Avetisyan and
colleagues (2020) assessed the reading and musical abilities of dyslexics
and age-matched controls, and presented them with a rhythmic
grouping task. They listened to speech streams with syllables alternating
in intensity, duration or neither, and indicated whether they perceived
a strong-weak or weak-strong rhythm pattern. The findings showed
that the adults with dyslexia had lower musical rhythm abilities than
those without dyslexia. Lower musical rhythm ability was associated
with lower reading ability. However, speech grouping by adults with
dyslexia was not impaired when musical rhythm perception ability was
controlled for. Rhythmic grouping was predicted by musical rhythm
perception ability, irrespective of dyslexia. Overall, the results suggested
associations among musical rhythm perception ability, speech rhythm
perception and reading ability in adults with dyslexia. Cogo-Moreira
and colleagues (2012), in a review of research on dyslexia and music,
found no randomised controlled studies and argued that it was therefore
impossible to draw any conclusions.

Are Pitch or Rhythm Programmes More Effective in

Enhancing Literacy?
As researchers have explored the extent to which active engagement
with music may support the development of literacy skills, there has
been ongoing debate about the kind of interventions which may be the
most successful. Most musical programmes include pitch and rhythm
activities, but some research has focused on trying to assess whether
rhythm or melody is more important in supporting literacy skills. One
approach to considering this has been to examine the relative skills of
those with poor musical or literacy skills. For instance, Sun and colleagues
(2017) examined whether phonological impairments were evident in
 4. Literacy and Related Language Skills  97

individuals with poor music abilities. Twenty individuals with congenital

amusia and 20 matched controls were assessed on a pure tone-pitch
discrimination task, a rhythm discrimination task, and four phonological
tests. The amusic participants showed deficits in discriminating pitch
and rhythmic patterns that involved a regular beat. As a group, these
individuals performed similarly to controls on all of the phonological
tests but eight. Amusics with severe pitch impairment, as identified by
the pitch discrimination task, exhibited significantly worse performance
than other participants in phonological awareness. A regression analysis
indicated that pitch discrimination thresholds predicted phonological
awareness beyond that predicted by phonological short-term memory
and rhythm discrimination. In contrast, the rhythm discrimination task
did not predict phonological awareness beyond that predicted by pitch
discrimination thresholds, suggesting that accurate pitch discrimination
is critical for phonological processing. Patscheke and colleagues (2019)
also investigated the separate effects of training in rhythm and pitch on
phonological awareness in preschool children aged between four and
six years old. Participants were randomly assigned to either a non-music
training condition, a sports programme or a music training condition
which was either based on rhythm or pitch. All groups were trained
three times a week for twenty minutes per session over a period of 16
weeks. Phonological awareness was tested before and after the training
phase. Following training, only the pitch programme showed a positive
effect on phonological awareness concerning rhyming, blending and
segmenting. Lamb and Gregory (1993) also found that pitch perception
was associated with reading ability in five-year-olds after controlling
for non-verbal ability, while Barwick and colleagues found that pitch
perception was associated with reading ability in seven- to ten-year-
old reading-disabled children after controlling for general intelligence.
Similarly, Besson and colleagues (2007) examined pitch processing in
dyslexic children and found that they had difficulties discriminating
strong pitch changes that were easily discriminated by non-dyslexic
readers. Rautenberg (2013) studied the effects of musical training on
decoding skills in German-speaking primary school children and found
that rhythmical abilities were significantly correlated with decoding
skills, reading accuracy and reading prosody, while tonal skills were not
related to reading skills.
98 The Power of Music

As the research with children experiencing difficulties with literacy

has shown, programmes with a focus on rhythm have been particularly
effective in enhancing reading skills (Boll-Avetisyan et al., 2020; Fotidzis
et al., 2018; Hallam 2018; Long, 2014; Long and Hallam, 2012; Overy,
2003; Overy et al., 2003). There is a relationship between tests of
auditory-visual rhythmic pattern-matching and reading ability in eight-
and nine-year-olds (Rudnick et al., 1967; Sterrit and Rudnick, 1967),
while rhythmic skills may be a better predictor of reading ability than
pitch-based skills (Douglas and Willatts, 1994; Huss et al., 2011; Strait,
et al., 2011a; 2011b; Swaminathan and Schellenberg, 2020), although not
all of the research supports this.
Cultural factors play a role in how individuals perceive metrical
structure, including beat perception (Tierney and Kraus, 2013b) and
the perception of complex rhythms (Hannon and Trehub, 2005). The
human ability to perceive and entrain to a beat flexibly and accurately
is spontaneous and universal across cultures (Savage et al., 2015; Bégel
et al., 2017), although there is individual variability in sensorimotor
synchronisation, including the phenomenon known as beat deafness
(Nozaradan et al., 2016)—an individual’s inability to distinguish musical
rhythm or move in time to it. By nine months of age, the coordination of
rhythm and syllable structure is usually sufficiently supportive for the
infant to segment speech streams into syllables (Morgan and Saffran,
1995). Rhythmic movement may play a role in this process. While
many children naturally move in time to a beat, enculturation plays a
major role in this process (Repp and Su, 2013; Manning and Schutz,
2013). Jones and colleagues (2006) propose the pitch-time entrainment
theory, which argues that timing in the brain can be understood as a
response to regular or irregular rhythmical events. Children display
entertainment—the patterning of body processes and movements to the
rhythm of music—typically by four years of age (Trainor and Cirelli,
2015) but it takes longer to adjust to tempo. This does not usually occur
until seven to eight years of age (Kurgansky and Shupikova, 2011).
Reading ability and phonological awareness are related to a variety
of rhythmic abilities, including reproduction of rhythmic patterns
(Rautenberg, 2015), tempo reproduction (Moritz et al., 2013), tapping
to the beat of music (David et al., 2007), discrimination of stimuli based
on amplitude rise times (Goswami et al., 2011; Leong et al., 2011)
 4. Literacy and Related Language Skills  99

and temporal patterns (Overy, 2003; Strait et al., 2011). Furthermore,

children who have language-learning impairment tap more variably
to a beat (Corriveau and Goswami, 2009). Musical training improves
verbal ability (Moreno et al., 2011), speech segmentation (François
et al., 2013), sentence processing (Moreno et al., 2009) and syllable
processing (Chobert et al., 2014), while training in beat synchronisation
has been shown to improve reading fluency (Taub and Lazarus,
2012). Overall, it seems that rhythmic training may enhance learning
to read. Neurological evidence revealing a direct link between cortical
and behavioural measures of rhythmic entrainment supports this
(Nozaradan et al., 2016).
Tracking rhythm patterns seems to play a vital role in both music and
speech perception, both of which are important for acquiring reading
skills. Beat induction, where humans can derive a pulse from most music
even when it is not explicit, has been suggested to serve the development
of auditory scene analysis and language (Patel, 2008). In particular, the
supplementary motor area known to be involved in the articulation of
speech and the preparation of movement, is engaged when performing
music, imagining listening to music or imagining performing to
music (Herholz and Zatorre, 2012; Brown et al., 2015). It also plays
an important role in planning music during performance, in terms of
rhythm and melody sequencing (de Manzanö and Ullén, 2012). The
link between the basal ganglia and the supplementary motor area along
the dorsal route supports the finding that the ability to synchronise with
a beat is positively correlated with better pre-reading skills, such as the
segmenting of speech streams and better neural encoding of speech and
language (Carr et al., 2014; Tierney and Kraus, 2014; Kraus and Slater,
2016), better subcortical neural timing in adolescents (Tierney and
Kraus, 2013a) as well as better cognitive and linguistic skills (Tierney
and Kraus, 2013b). The integration of sensory and motor information
may provide a mechanism for predicting sequence timing (Large et al.,
2015), such as the processes that ensure smooth flow in a conversation.
Tierney and Kraus (2013c) propose that two theories—the temporal
sampling hypothesis and dynamic attending theory—suggest that
rhythm in music and the envelope of speech may be tracked biologically
through the same mechanism. The temporal sampling hypothesis
proposes a neural mechanism for the tracking of speech amplitude
100 The Power of Music

over time (Goswami, 2011) suggesting phase-locking of slow neural

oscillations in the delta and theta range. The mechanism selectively
samples low-frequency information in the amplitude envelope which
is crucial for the segmentation of speech sounds. Dynamic attending
theory proposes a similar set of neural oscillators that phase-lock and
resonate to the temporal structure of music, leading to an attentional
focus that changes in relation to the rhythmic structure of a piece of
music (Velasco and Large, 2011). Speech is inherently temporal, with
boundary lengthening and pauses enhancing the experience of language
as a temporal phenomenon (Moberget and Ivry, 2016). The metrical,
intonational and pitch components of grammar are experienced as
prosody (Ferreira and Karimi, 2015).
Some studies have reported the importance of both rhythmic and
pitch perception in the development of reading skills (Atterbury, 1985;
Forgeard et al., 2008). Atterbury (1985) found that reading-disabled
children aged seven to nine could discriminate rhythm patterns as well
as controls, but were poorer in rhythm performance and tonal memory
than normal-achieving readers. Anvari and colleagues (2002) studied
50 four- and 50 five-year-olds and found that both rhythm- and pitch-
perception skills predicted early reading performance in four-year-olds,
even after taking account of variance due to phonological awareness.
In five-year-olds, only pitch perception predicted early reading
performance, after accounting for phonological awareness. Tsang and
Conrad (2011) studied 69 children with and without formal music
training. The trained children out-performed the untrained children
on pitch discrimination, rhythm discrimination and phonological
skills, although the two groups performed the same on tests of word
identification, timbre discrimination and receptive vocabulary. Jones
and colleagues (2006) have shown that pattern structure, particularly
initial patterns of pitch and time, involving small pitch intervals is
important and that listeners rely heavily on global pitch structure and
rhythm for language processing.
There are a range of possible reasons for the differing outcomes of
the research, including the different methods used to assess reading,
the nature of the musical interventions, whether they support the
development of pitch, melodic or rhythmic skills, and the prior musical
and literacy experiences of the participants. Where musical activities
 4. Literacy and Related Language Skills  101

involve learning to read notation, there may be direct transfer to reading

text. Singing has also been proposed as one possible way in which
musical activity improves literacy, as it involves reading predictable text,
segmenting words into syllables so that lyrics can be matched to music,
or recognising patterns (Butzlaff, 2000; Forgeard et al., 2008). Other
possible explanations for the impact of musical training on reading
performance relate to changes in concentration and motivation that aid
children in focusing for long periods of time, helping them to persevere
(Butzlaff, 2000).

Reviews, Meta-Analyses and Conclusions

There have been a number of reviews of the research considering
the relationship between musical engagement and literacy. Taken
together, they indicate that there are a number of similarities between
learning to read text and music. The auditory analysis skills used in
language processing, phonological distinctions, and the blending and
segmentation of sounds are similar to the skills necessary for music
perception of rhythmic and melodic discrimination. The five sub-skills
underlying reading acquisition—phonological awareness, speech in
noise perception, rhythm perception, auditory working memory and
the ability to learn sound patterns—are linked to music experience.
Temporal attention can be influenced by rhythm, which benefits syntax
processing and speech production. Music and written text both require
the reading of notation from left to right, and the conversion of notation
into specific sounds. The reviews agree that music education can
contribute to literacy development in all children, including those who
find the development of literacy skills challenging (Bolduc, 2008; Bugaj
and Brenner, 2011; Sammler and Elmer, 2020; Schön and Tillman, 2015;
Tierney and Kraus, 2013a).
Rolka and Silverman (2015) carried out a systematic review analysing
research on music and dyslexia. Twenty-three studies were included.
Some focused on the challenges of studying music—in particular,
problems with reading notation—although most explored how music
could be used to improve literacy skills, or to test for neural processing
of auditory information, offering the potential to inform early diagnosis.
The findings from the review revealed that music training was seen as
102 The Power of Music

a remediation tool to improve literacy skills for children with dyslexia,

although the specific type of music support to achieve predictable
outcomes require further investigation.
Meta-analyses have had mixed results. Butzlaff (2000) carried out two
meta-analyses; the first included 29 studies examining the correlation
between music instruction and reading performance, and the second
six intervention studies. The first demonstrated a significant, positive
relationship between music instruction and performance on reading
tests; the second yielded no reliable effects. In contrast, Standley (2008)
in an analysis of 30 experimental studies found a strong overall effect,
while the meta-analysis of Gordon and colleagues (2015), based on 13
studies, found that music training led to gains in phonological awareness
skills, while transfer effects for rhyming skills became stronger with
increased hours of training. No significant transfer effect emerged for
reading fluency measures.
To conclude, taken together, the evidence set out in this chapter,
along with research reviews and meta-analyses, suggests that active
engagement with music can have a positive effect on children’s literacy.
A variety of musical activities appears to contribute to these benefits,
although the exact nature of those which are most effective remains to
be established. Differences in the outcomes of the research may depend
on its rigour, the age and general life experiences of the participants,
the assessment measures used and their reliability and validity, and the
nature and quality of the musical instruction.

Spelling
There has been much less focus on the impact of active engagement with
music on spelling compared with reading. In an early study, Douglas
and Willatts (1994), working with seven- and eight-year-olds, found
positive correlations among tests of pitch and rhythmic aptitude, and
vocabulary, reading and spelling. When vocabulary scores were taken
into account, the association between rhythm and spelling abilities
remained, but those between pitch aptitude and spelling disappeared,
suggesting the importance of rhythm in relation to spelling. Overy
(2003) found a positive effect of music lessons on spelling performance,
with children with poor spelling skills benefiting the most, while Hille
 4. Literacy and Related Language Skills  103

and colleagues (2011) tested 194 boys who were in Grade 3 (aged
eight to nine) in Germany, just over half of whom had learned to play
a musical instrument. The boys who played an instrument showed
better performance in spelling, an effect which occurred independently
of intelligence test scores (there being only a weak correlation between
spelling mistakes and non-verbal measures of intelligence). Examination
of data from those who performed poorly on spelling showed that those
who played an instrument were under-represented. Only 27 percent of
boys in the lowest quartile played an instrument, whereas 61 percent of
boys in the highest quartiles were active musicians. Singing in a choir
or taking part in a course entitled First Experiences With Music was
not associated with spelling performance, suggesting that it was the
skills developed through playing an instrument which had the potential
for transfer. Currently, there is insufficient research on the relationship
between actively engaging in musical activities and spelling skills for us
to draw any firm conclusions.

Writing
As with spelling, little attention has been paid to the influence of active
engagement with music on writing. An exception was a study where
children from economically disadvantaged homes participated in
instruction which focused on the concepts of print, singing activities and
writing. The children in the experimental group showed enhanced print
concepts and pre-writing skills (Standley and Hughes, 1997). Register
and colleagues (2001) replicated the study of Standley and Hughes
(1997), evaluating the effects of a music intervention using a curriculum
designed to enhance the pre-reading and writing skills of 25 children
aged four to five who were enrolled in early intervention programmes
and a programme for children with exceptional needs. Intervention
and control groups received two 30-minute music sessions each week
for an entire school year. The autumn sessions for the experimental
group were focused on writing skills, while the spring sessions taught
reading and book concepts. Music sessions for the control group were
based on thematic material, as determined by the classroom teacher,
with purposeful exclusion of all pre-literacy concepts. All participants
were pre-tested at the beginning of the school year and post-tested
104 The Power of Music

before the school year ended. The findings showed that music sessions
significantly enhanced both groups’ abilities to learn pre-writing and
print concepts, although the experimental group showed statistically
significantly higher results on logo identification and word recognition
following the intervention.
Some research has focused on whether learning to play a musical
instrument can enhance the development of fine motor skills, which may
contribute towards the development of handwriting. Neuroscientific
studies have shown changes in the cortical representation of fingers
during intensive keyboard practice sessions over periods as short as five
days and as long as two weeks (Pascual-Leone, 2001).
Orsmond and Miller (1999) compared the fine motor abilities
of children who participated in two years of piano instruction and
those who had never received formal music training. A significant
improvement in fine motor skills was found only for the children who
received the piano lessons, and a significant difference in the speed of
response was found between the two groups at the end of the two years
of instruction. The innumerable opportunities to assess, refine and time
their motor responses to specific stimuli during musical practice, and the
availability of constant evaluative feedback (sound) may allow musicians
to improve the accuracy and speed of perceiving and responding to
relevant stimuli. Similarly, Costa-Giomi (2005a) compared the fine
motor abilities of children from low-income families who participated
in two years of piano instruction and those who had not received
formal music training. A significant improvement in fine motor skills
was found for the children receiving the lessons. The children in the
experimental group were supplied with acoustic pianos and practised,
on average, for up to three-and-a-half hours weekly (Costa-Giomi,
2005b). The motor proficiency of the two groups was comparable at the
start of the project (Costa-Giomi, 1999). The findings suggested that the
improvement in motor proficiency was mainly caused by differences
in a speed subtest which required children to react quickly to catch a
rod that was sliding down against a wall. Scores in tasks that measured
hand-eye coordination and dexterity were not affected by the lessons.
Costa-Giomi concluded that music performance requires accurate and
quick motor reaction to visual, aural and kinesthetic stimuli, which
improves accuracy and speed in perceiving and responding to stimuli.
 4. Literacy and Related Language Skills  105

To conclude, while there is relatively little evidence, it appears that

learning to play a musical instrument contributes to the development of
fine motor skills, which may support the development of handwriting.

Overview
Taken together, the evidence suggests that active engagement with
music can have a positive effect on children’s literacy. The enhancement
of aural skills improves phonological awareness, which supports the
decoding of written material into sound, while rhythmic activities, in
particular, seem to support reading skills—particularly for those who
are experiencing difficulties with literacy. There is too little evidence to
draw any conclusions relating to the role of learning to play a musical
instrument on spelling or handwriting.
 5. Music, Spatial Reasoning and
Mathematical Performance

Historically, there has long been interest in the relationship between

acquired musical skills and performance in mathematics. It has
been assumed that there is a strong connection between music and
mathematics, as many musicians play from notation and are constantly
required to adopt quasi-mathematical processes to subdivide beats and
turn rhythmic notation into sound. More recently, there has been interest
in the relationship between music and spatial-temporal reasoning,
which contributes to some areas of mathematical understanding.
Spatial-temporal reasoning is the ability to transform mental images
in the absence of a physical model (Rauscher et al., 1997; Shaw, 2000).
It involves the ability to manipulate and understand complex shapes
through mental imagery, as the individual develops and evaluates
patterns which change in space and time. Cooper (2000) viewed spatial-
temporal reasoning as an abstract model of cognition consisting of several
elements, including pattern-seeking, recognition, retention and recall;
visualising imagery; perceiving figures as wholes; generating a whole
image from a fragment; grasping the whole of a problem; understanding
spatial relationships from multi-perspectives and among internal
movement of parts; maintaining orientation within space; and mentally
manipulating shapes within two- or three-dimensional space. The key
features used in spatial-temporal reasoning include the transforming
and relating of mental images in space and time, the use of symmetries
to compare physical and mental images, and temporal sequencing
(Grandin et al., 1998). These skills are high-level mathematical abilities
which are useful in learning proportional reasoning (Grandin et al.,
1998; Shaw, 2000) and induce advanced understanding of mathematical
concepts such as fractions, proportions, symmetry and other arithmetic

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.05

108 The Power of Music

operations (Tran et al., 2012). Developing spatial-temporal thinking

may also be related to geometrical skills.
Early mathematical skills tend to be one of two types: number
knowledge or number operation (Griffin, 2004). The latter is linked
with the formulation of mental number lines, which enable children
to understand magnitudes, relations between them and arithmetic
operations (Jordan et al., 2008; Gunderson, 2012). Mental number
lines are linked with spatial-temporal reasoning. The development of a
mental number line is fundamental for mathematical understanding and
facilitates performance, especially in arithmetic (Ramani and Siegler,
2008; Booth and Siegler, 2008; Van Nes and Doorman, 2011; Gunderson
et al., 2012). Spatial skills have also been linked with spatial structuring,
which is important in determining quantities, as well as comparing and
calculating them (Butterworth, 1999; Mulligan and Mitchelmore, 2009).
Undertaking such tasks early in development occurs unitarily. This
takes time and can also lead to errors. Most children gradually learn to
organise objects in ways that enable them to count more accurately and
efficiently. This helps them to understand the decimal system. Spatial
awareness contributes to the development of patterning, while the
temporal element might be used in structuring and strategy choice.
Explanations for the relationship between music and spatial-temporal
reasoning have been sought in neuroscience. Two main approaches
have developed. The first concerns connectivity, and proposes that the
processing of music and spatial tasks is underpinned by overlap in brain
functions (Fiske, 1996). In contrast, near-transfer theory suggests that
music and spatial-temporal reasoning share some processes, and the
development of one leads to the development of the other (Rauscher,
2009; Schellenberg, 2004). Explanations for the links between music and
spatial-temporal reasoning relate to connectionism—the development
of neural connections (Sporns, 2011)—and modular theory, which
is related to near-transfer (Jordan-DeCarbo and Nelson, 2002). The
connectivity proposal has been supported by Shaw (2000), who
suggested that musical and spatial processing overlap in the brain and,
as a result of these cortical connections, the development of certain kinds
of musical and spatial abilities (especially spatial-temporal abilities) is
intertwined. Near-transfer suggests that several kinds of thinking are
required in order to learn and make music. Both are multi-dimensional
 5. Music, Spatial Reasoning and Mathematical Performance  109

processes. A range of spatial skills might be improved because of the

practice required in making music (Jordan-DeCarbo and Nelson, 2002).
Particular interest in the relationship between music and spatial
reasoning skills developed following a study by Rauscher and colleagues
(1993), who claimed that after listening to Mozart’s ‘Sonata for Two
Pianos (K448)’ for ten minutes, adult participants showed significantly
better spatial reasoning skills than after periods of listening to relaxation
instructions designed to lower blood pressure, or listening to silence.
The mean spatial reasoning scores were eight and nine points higher
after listening to the music than in the other two conditions. However,
the effect only lasted for ten to fifteen minutes. Early attempts to replicate
the phenomenon were unsuccessful (Chabris, 1999; Steele et al., 1999).
Using a logical rather than spatial reasoning task, Newman and
colleagues (1995) tested 114 students before and after listening to either
eight minutes of Mozart’s music, relaxation instructions or silence, and
found that all participants showed a practice effect with no particular
enhancement in the music group. Similarly, Rideout and Laubach (1996)
tested four female and four male undergraduates on two equivalent
spatial tests, following either the presentation of Mozart’s ‘Sonata for Two
Pianos in D Major’ or a non-musical activity. EEG was recorded during,
at baseline and at two task performance periods. Correlations were
generated between task performance and EEG variables. Performance
improved significantly following the presentation of the music. In a
later study, Rideout and colleagues (1998) studied 16 participants who
showed reliable improvement on a paper-folding and cutting task after
listening to Mozart’s ‘Sonata for Two Pianos in D Major’. The enhanced
performance was also noted for 16 other participants after listening to a
contemporary musical selection with similar musical characteristics. In
both cases, the control procedure included ten minutes of listening to a
relaxation tape. Similarly, Wilson and Brown (1997) examined the effect
of Mozart’s music on 22 college undergraduates who had listened to a
selection of Mozart’s music. Each participant performed a pencil and
paper maze task after a ten-minute presentation of each of three listening
conditions: a piano concerto by Mozart, repetitive relaxation music and
silence. Limited support for the previously obtained enhancing effect of
listening to Mozart’s music was revealed in measures of performance
accuracy on this spatial task, whereas no effect was found for either the
110 The Power of Music

number of maze recursions or the overall quality of maze solutions.

Hetland (2000b) carried out two meta-analyses and found that music
significantly enhanced performance on a variety of spatial tasks, but that
music other than Mozart also enhanced spatial-temporal performance
over a short period of time.
Some research has explored the so-called Mozart effect on children.
For instance, as part of the BBC programme Tomorrow’s World, a
replication of Rauscher’s study was undertaken with over 6,000 ten- and
eleven-year-old children (Hallam, 2001). They were tested after they
listened simultaneously to either contemporary pop music by Blur or
Oasis, the same piece of music by Mozart that was used in Raucher’s
study, or a talk given about experiments. After being assigned at
random to one of the three listening experiences, each child completed
two tests of spatial abilities. No statistically significant differences were
found between the performance of the three groups on the two tests of
spatial reasoning. A reanalysis of the data using a different statistical
approach by Schellenberg and Hallam (2006) showed that performance
on one of the tests—square completion—did not differ as a function of
the listening experience, but performance on the paper-folding test was
superior for children who listened to the popular music compared to the
other two groups. This was interpreted in terms of the arousing effects
of the popular music, which the children also enjoyed, leading to an
increase in their motivation.
This mixed, although mainly negative, evidence relating to the
Mozart effect led to research focusing on the role of music when it was
played alongside the completion of a range of different intellectual
tasks. The impact of background music is considered in more depth in
Chapter 11.

Comparisons between Musicians and Non-Musicians,

and Correlation Studies
One strand of research has compared the performance of musicians
with non-musicians on spatial-temporal reasoning tasks, while a
further strand has compared performance on mathematical tasks.
Neuroscientific research into brain structures has confirmed that the
areas of the brain where spatial reasoning occurs are more pronounced in
 5. Music, Spatial Reasoning and Mathematical Performance  111

adult musicians, and that the processing of music and spatial-temporal

tasks activates similar neural structures. Sluming and colleagues (2002)
found that musicians achieved better results than controls on a line
orientation test and were better in finding the middle of a line (Patston
et al., 2006). Skills used in these two tasks may be related to the ability to
manipulate the mental number line. Taking account of the importance of
the concept of mental number line for the development of mathematical
thinking, it is possible that active engagement with music enhances this
process (Siegler and Booth, 2005; Ramani and Siegler, 2008).
There is considerable evidence from research with professional
musicians or those training to become professional musicians that they
have better spatial-temporal reasoning abilities than non-musicians,
including mental rotation. Pietsch and Jansen (2012) compared students
of music, sports and education, and demonstrated better performance
on mental rotation tasks among the first two groups, while Sluming
and colleagues (2007) found that members of orchestras outperformed
controls in mental rotation tasks. They suggested that this was linked
with more pronounced development of Broca’s area in the brains of the
musicians, while Mark (2002) showed that the areas of the brain which
are activated whilst performing music and spatial-temporal tasks are
proximate.
Musicians are better at a range of visuospatial search tasks. Patston
and Tippett (2011) administered a language comprehension task and
a visuospatial search task to 36 expert musicians and 36 matched non-
musicians in conditions of silence and correct or incorrect piano music
playing in the background. Musicians performed more poorly on the
language comprehension task in the presence of the background music
compared to silence, but there was no effect of background music on
the musicians’ performance on the visuospatial task. In contrast, the
performance of non-musicians was not affected by the music on either
task. This suggests that, when musicians process music, they recruit a
network that overlaps with the network used in language processing.
Musicians have better reaction times to selective and divided visual
attention tasks (Rodrigues et al., 2013). They are better at matching
a set of coloured blocks to a visual image (Stoesz et al., 2007), have
better memory for line drawings (Jakobson et al., 2008), and are more
accurate when asked to mark the centre of a horizontal line (Patston
112 The Power of Music

et al., 2006) and when asked to judge the orientation of a line (Patston
et al., 2007). These findings might be particularly important in linking
music with mathematics, as the ability to visualise a horizontal line and
localise a middle and proportional distance on it is closely related to the
notion of the mental line used for a variety of mathematical operations
(Gunderson et al., 2012). However, Helmbold and colleagues (2005)
compared 70 adult musicians and 70 non-musicians matched for age,
sex and level of education on their performance on different aspects of
primary mental abilities including verbal comprehension, word fluency,
space, flexibility of closure, perceptual speed, reasoning, number and
memory—they found no significant differences except for flexibility of
closure and perceptual speed, where the musicians performed reliably
better than non-musicians.
Pannenborg and Pannenborg (1915) compared individuals with
varying degrees of musical talent and found only a slightly higher
level of mathematical ability in those with high levels of musical
ability. In contrast, Haecker and Ziehen (1922) administered a self-
report questionnaire via the internet to 227 musical and 72 unmusical
male participants, who were doctoral-level members of the American
Mathematical Association or the Modern Language Association. The
questionnaire assessed musicality, music perception, music memory and
musicianship, music performance and music creation. The mathematics
group did not exhibit higher levels of either musicality or musicianship.
The mathematicians reporting high-level music performance ability
did not report significantly greater musicality than did the literature or
language scholars. Similarly, Haimson and colleagues (2011a; 2011b)
recruited participants from the online membership of the American
Mathematical Society and the Modern Language Association and
presented them with a questionnaire assessing skills in musicality and
musicianship. Members of both groups reported relatively low levels
of musicality with no statistically significant differences between them.
Revesz (1954) also found that reported levels of interest or aptitude for
mathematics in musicians were low.
Vaughn (2000) meta-analysed studies comparing mathematics
achievement in students with and without self-selected music study, and
only reported a very small positive association between mathematics
and musical engagement. Working with fourth-grade children, Haley
 5. Music, Spatial Reasoning and Mathematical Performance  113

(2001) investigated the effects of participating in an instrumental music

programme, band or orchestra on their academic achievement. The
children were placed into three groups. The first consisted of children
who had studied an instrument prior to the introduction of band
and orchestra in fourth grade, the second consisted of children just
beginning to study an instrument and the third consisted of children
with no experience of instrumental instruction. The findings showed
that students who had studied an instrument prior to fourth grade had
higher scores in mathematics achievement than did students in the
other groups.
Comparing performance in reading and mathematics in two schools
with different levels of music education, one with an outstanding
music programme and the other with no music programme, Deere
(2010) carried out a survey. Students experiencing high-quality music
education had higher Tennessee Comprehensive Assessment Program
(TCAP) reading and mathematics scores in the fourth grade. There was
also a high correlation between music education and TCAP scores in
reading and mathematics. In the eighth grade, where musical education
was of high quality, students also reported higher TCAP reading and
mathematics scores.
In a study with young children, Williams and colleagues (2015)
investigated parent-child home music activities in a sample of 3031
Australian children participating in Growing Up in Australia: The
Longitudinal Study of Australian Children. Frequency of shared home music
activities was reported by parents when children were two to three years
old. A range of social, emotional and cognitive outcomes were assessed
by parent and teacher report and direct testing two years later, when
the children were four to five years old. A series of regression analyses
found that frequency of shared home music activities had a small
significant partial association with measures of children’s numeracy.
The findings suggested that there may be a role for parent-child home
music activities in supporting children’s mathematical development.
Catterall and colleagues (2000), using the NELS:88 data, studied
low socioeconomic status students who exhibited high mathematics
proficiency in twelfth grade and found that 33 percent were involved
in instrumental music compared with 15 percent who were not
involved. Miksza (2010) extended this research, examining the potential
114 The Power of Music

relationship between participation in high-school music ensembles

and extra musical educational outcomes, including achievement in
mathematics, using data from the Education Longitudinal Study of
2002. The sample of 12,160 students was representative of white and
minority high-school students from 603 rural, suburban and urban
schools across the United States. The students who belonged to school
music ensembles had higher scores in standardised mathematics tests.
The study controlled for socioeconomic status but not mathematical
performance prior to any music training. Similarly, Bergee and
Weingarten (2020) used multi-level mixed modelling to test the
extent to which students’ music achievement scores were related to
their reading and mathematics achievement scores. Of the four levels
examined—individual students, classrooms, schools and districts—
only individuals and districts accounted for a significant portion of the
total variance in achievement scores. There was a strong relationship
between music scores and reading/mathematics achievement. In
higher education, Barroso and colleagues (2019) aimed to identify the
cognitive and affective factors related to mathematics and music theory
that best explained undergraduate music theory achievement. The
findings suggested that mathematic scores and music theory confidence
were important predictors of grades in undergraduate music theory
examinations.

Musical Interventions and Spatial-Temporal Reasoning

While the research comparing musicians and non-musicians, and that
showing relationships between music, spatial-temporal reasoning
and mathematics is important, it is not able to demonstrate causality.
To demonstrate causality, it is necessary to carry out experimental
intervention studies where the impact of musical engagement is
compared with the impact of other activities or no activity. Rhythm
may be particularly important, as infants engage in significantly more
rhythmic movement to music and other rhythmically regular sounds
than to speech, and also to some extent exhibit tempo flexibility (Zentner
and Eerola, 2010).
General music instruction—including singing, movement and
playing percussion instruments—has been shown to assist four- to
 5. Music, Spatial Reasoning and Mathematical Performance  115

six-year-old children in the development of spatial ability (Bilhartz et

al., 1999). Zafranas (2004) studied 61 kindergarten children who
received two piano or keyboard lessons weekly during one school
year. Following piano or keyboard instruction, participants improved
significantly in hand movement, gestalt closure, triangles, spatial
memory and arithmetic, but not in matrix analogies. Similarly, Gromko
and Poorman (1998) investigated the effect of music training on 15
preschoolers’ performance on subtests of the Wechsler Preschool and
Primary Intelligence Scale. For the three-year-olds in the study, this
musically intellectually stimulating environment resulted in an increase
in the ability to perform spatial-temporal tasks.
Rauscher and colleagues (1997) assigned 78 students from three
preschools to music, computer or no instruction groups. The instruction
groups received training in one of the following: piano or keyboard
(either individually or coupled with group singing lessons), group
singing lessons only or computer instruction. The children were pre- and
post-tested using one spatial-temporal reasoning task, object assembly,
and three spatial recognition tasks (geometric design, block design
and animal pegs). There were no differences between groups in pre-
test scores, but after instruction the children in the piano group scored
significantly higher on the spatial reasoning task compared to children
in the other conditions. There were no differences amongst the groups
on the spatial recognition tasks. The computer group, singing and
no-instruction groups did not improve significantly over time on any of
the tests. Later studies (Rauscher, 2002; Rauscher and Zupan, 2000)—
which were undertaken over three years with upper-middle-income
children who were provided with eight months of weekly 40-minute
keyboard instruction in groups of eight to ten beginning in either
kindergarten, aged five, or first grade, aged six—scored higher on two
spatial-temporal tasks, puzzle-solving and block-building compared to
children who did not receive music instruction. No enhancement was
found for a pictorial memory task. However, these effects were not
maintained when music instruction was terminated, although when
lessons resumed in second grade the same children’s scores increased
again, surpassing the levels that they had reached before the lessons
were terminated. The children who received instruction over a period
of three years scored higher on the spatial-temporal tasks compared
116 The Power of Music

to children who had not received instruction. While the scores of the
keyboard group improved every year, although not significantly, after
kindergarten the scores of children who began instruction in the second
grade did not improve, suggesting that it was important that the training
began early. Rauscher and La Mieux (2003) also reported that children
who received keyboard lessons, singing training or rhythmic instruction
scored higher than controls on spatial reasoning tasks. Further studies
examined the effects of musical instruction on spatial-temporal
reasoning in middle-income elementary-school children (Rauscher and
Hinton, 2011). Two groups—a music group and an animated reading
group—received 40 minutes of lessons in groups of eight to ten for nine
months. At the end of the study, the children who received the keyboard
lessons scored significantly higher on spatial-temporal reasoning tasks
than those who received the animated reading lessons, although the
improvement for the keyboard group was only for the girls.
Working with elementary-school students, Johnson and Davis (2016)
investigated the effects of a programme combining musical ensembles
in residence with regular classroom music instruction on students’
auditory discrimination and spatial intelligence. In combination with
regular, sequential general music classes, participants in the programme
received two half-hour lessons each week from musical ensembles in
residence, lasting for four consecutive years. The chamber ensembles
provided aural models for reinforcing fundamental concepts. Data
were collected from a stratified, random sample of students in grades
two and four to five receiving the experimental programme, and from
demographically similar comparison schools which did not receive
any regular music instruction. A total of 684 elementary students
participated in the study. Children participating in the programme
with the chamber music ensembles showed consistent and statistically
significantly greater scores in both auditory discrimination and spatial
intelligence measures.
Holmes and Hallam (2017) examined the potential of active music-
making to improve mathematics achievement in primary-school pupils.
In a quasi-experimental design, 60 children aged five or six participated
in the music programme, while the same number of pupils from parallel
classes made up two control groups. Lessons contained a variety of
musical, predominantly rhythmical activities, based on popular nursery
 5. Music, Spatial Reasoning and Mathematical Performance  117

rhymes. Spatial-temporal skills were tested at the beginning and the

end of the study. Throughout the intervention, pupils were assessed
on musical skills, as well as general and specific mathematical skills.
A strong relationship between musical and spatial-temporal skills
was found in both age groups. The younger group scored higher than
their peers on a picture test and a puzzle test. The results for the older
children were also higher for the music group in both spatial-temporal
tests. Some enhancement in mathematics in the intervention group
was found, although there was no significant contribution of spatial-
temporal abilities to general mathematics achievement.
One strand of research has focused on preschool children from
deprived backgrounds participating in Head Start programmes
(Rauscher, 2003, Rauscher et al., 2005). In the first study, 87 Head
Start children were randomly assigned to one of three groups—piano,
computer or no instruction—for 48 weeks over two years. At the
end of the intervention, the children who received music instruction
scored significantly higher than control groups on visual and auditory
tasks that required spatial and temporal skills. Performance on an
arithmetic task also improved following music instruction. A second
study focused on whether different types of music instruction had
different effects. Over 100 Head Start children of mixed ethnicity were
assigned randomly to one of four conditions: piano, singing, rhythm
or no instruction. All of the children in the music groups received
weekly individual instruction for a period of 48 weeks over two years.
The data from the three music groups replicated the data from the first
study. The children in the music groups scored significantly higher at
post-test on tasks requiring spatial and temporal skills. The rhythm
group scored significantly higher than the piano and singing groups
on temporal and arithmetic tasks. A third study was conducted to
determine whether the effects endured after instruction stopped. The
scores of the Head Start children who received lessons in the first and
second studies were compared with three groups of grade-matched
children participating in Head Start who did not receive music
instruction, at-risk children not involved in Head Start, and middle-
income children who did not receive music instruction. The children
who had received music instruction in the first study continued to
score higher than all of the other groups of children, with the exception
118 The Power of Music

of the age-matched middle-income children, on three of the four tests

two years after instruction had ended. The data from the children who
participated in the second study when they progressed to kindergarten
showed that the singing, piano and rhythm groups scored higher than
the Head Start and at-risk children on five of the tests. In addition, the
rhythm group scored higher than the singing and piano groups on an
arithmetic subtest, and scored significantly higher than the middle-
income children on the temporal, arithmetic, mathematical reasoning
and numeracy tasks. These findings suggest that rhythm instruction
has the strongest impact on a range of mathematically related tasks.
Rauscher and Hinton (2011) summarised the results from several
of these studies and showed that music groups had higher scores
on arithmetic and spatial abilities following musical interventions,
although they were equivalent initially (Rauscher, 2014).
Several research projects have been undertaken within the context
of the El Sistema approach to musical engagement, a structured
extracurricular orchestral programme. For instance, Osborne and
colleagues (2015) studied pupils from a low-income neighbourhood
participating in El Sistema and showed that they had greater improvement
in spatial reasoning, verbal and mathematical skills than comparison
groups. Further evidence for music being responsible for enhanced
spatial reasoning in at-risk children comes from an Israeli study, in
which a two-year music training intervention of two to three hours per
week was introduced in some after-school centres for at-risk children,
but not in other centres (Portowitz et al., 2007). Children participating
in the intervention showed larger improvements in remembering and
reproducing a complex line drawing.
The most effective music interventions for enhancing spatial
temporal reasoning in all children seem to be based on rhythm
(Hetland, 2000a; Holmes, 2017; Holmes and Hallam, 2017; Rauscher
and Le Mieux, 2003). Children in the early years of primary school
seem to benefit the most from such interventions (Costa-Giomi, 2004;
2013; Graziano et al., 1999; Holmes, 2017; Holmes and Hallam, 2017;
Rauscher, 2002, Rauscher and La Mieux, 2003; Rauscher and Zupan,
2000; Schellenberg, 2004). The optimal length of interventions that is
required for there to be a sustainable impact has not been conclusively
established. Rauscher and Zupan (2002) showed improvement in
 5. Music, Spatial Reasoning and Mathematical Performance  119

spatial-temporal skills which continued throughout a four-year

programme, whilst Rauscher (2000) suggested that there was a need
for programmes to last for at least two years to achieve lasting change.
The underpinnings of such accelerated progression in disadvantaged
and other pupils are not yet clear, and these enhancements might
be mediated by the development of general cognitive abilities. It is
also possible that these programmes raise participants’ motivation,
self-efficacy, and perseverance. Overall, the majority of studies have
shown that spatial-temporal skills can be improved by musical
training. Interestingly, when other related cognitive abilities have
been assessed—for instance, pictorial memory (Rauscher and Zupan,
2000), spatial recognition (Rauscher 1994; 1997), and number recall
(Rauscher and La Mieux, 2003)—there has been no significant
improvement related to musical engagement.
Not all of the research has shown an impact of music on spatial
reasoning. For instance, Hanson (2003) investigated the effects of a
sequenced Kodály literacy-based music programme on the spatial
reasoning skills of kindergarten students. Fifty-four kindergarten
children participated. One group of children received Kodály music
instruction, a second group computer instruction and a third group no
intervention. The programme lasted for seven months. Spatial-temporal
reasoning, spatial reasoning and a nonspatial measure were assessed.
The analysis revealed no statistically significant differences in pre-, post-
or gain scores for any of the measures.

The Relationships between Spatial Skills

and Mathematics
Children engage with arithmetic long before they experience formal
mathematics education. Some number processing is present prior to the
development of language. Preschool children understand estimation
and comparison of quantities often before they can count or use number
terminology. They have a sense of ordinality (Kaufmann, 2008) and use
and develop strategies and procedures in solving problems (Bisanz et
al., 2005). Very young children can discriminate between small groups of
items containing different numbers of objects. Understanding increasing
quantity by adding objects and decreasing quantity by removing them
120 The Power of Music

depends on observing ordinal relations among numbers (Bisanz et

al., 2005). This skill is related to addition and develops earlier than
subtraction. Children gradually develop greater accuracy until they can
provide exact solutions to arithmetic problems. This is usually achieved
by four to five years old. They also begin to develop rules and concepts
that inform and constrain their growing ability to manipulate numbers
(Bisanz et al., 2005). Krajewski and Schneider (2009) developed a three-
phase model of this process: basic numeric skills, quantity number
concepts and number relationships. At the third level, visual-spatial
skills play a vital role, while non-verbal representations of magnitudes
are essential for problem-solving (Rasmussen and Bisanz, 2005). This
model supports a strong relationship between spatial skills (Cheng and
Mix, 2014), the visual–spatial components of working memory and the
development of mathematical abilities.
Alternatively, Spelke (2008) proposes a broader model which
outlines three main systems which support young children’s
mathematical learning: a system for representing small exact numbers
of objects, up to three; a system for representing large approximate
numerical magnitudes—for example, about 20—and a system for
representing geometric properties and relationships. Each system is
malleable and relatively independent in young children, but as basic
concepts and mathematical operations develop, children learn to
connect the three systems. Linking representations of numbers with
representations of space helps in creating mental number lines, which
are central to understanding relationships between numbers and
calculations.
Spatial structuring is essential for many mathematical activities
of a numerical or geometrical nature. Van Nes and de Lange (2007)
propose that the ability to imagine a spatial structure relates to a specific
magnitude, and to mentally manipulate it helps in understanding
quantities and the process of counting and also speeds up that
process. Van Nes and Dorman (2011) describe the mathematical skills
which rely on spatial structures as composing and decomposing of
quantities; counting and grouping; part-whole knowledge in addition,
multiplication and division; comparing a number of objects; patterning;
building a construction of blocks; ordering, generalising and classifying;
 5. Music, Spatial Reasoning and Mathematical Performance  121

and more sophisticated mathematical operations; for instance, algebra,

proving, predicting, and mental rotation of structures.
Booth and Siegler (2008) examined whether the quality of numerical
magnitude representations of first-grade children with a mean age of
7.2 years was correlated with, predictive of and causally related to their
learning of arithmetic. The children’s pre-test numerical magnitude
representations were correlated with their pre-test arithmetic knowledge,
and were predictive of their learning of answers to unfamiliar arithmetic
problems. The relation to learning to solve unfamiliar problems
remained after controlling for prior arithmetic knowledge, short-term
memory for numbers and mathematics achievement test scores. In
addition, presenting randomly chosen children with accurate visual
representations of the magnitudes of addends and sums improved
their learning of the answers to problems. Representations of numerical
magnitude are both correlationally and causally related to arithmetic
learning. These abilities are engaged not only in geometry, but also in
number sense, comparing and calculating quantities, and effectively
using strategies to solve problems.
Similarly, Gunderson and colleagues (2012), using two longitudinal
data sets, found that children’s spatial skills and mental transformation
ability, at the beginning of first and second grades, were a predictor
of improvement in linear number-line knowledge over the course of
the school year. Spatial skill at age five predicted performance on an
approximate symbolic calculation task at age eight. This relationship
was mediated by children’s linear number-line knowledge at age six.
Similarly, working with 760 preadolescent college students and high-
and low-ability college bound youths, Casey and colleagues (1995)
found that spatial skill (as measured by the Vandenberg Mental
Rotation Test) was highly related to success in mathematics. For all of
the female samples, mental rotation predicted mathematics aptitude
even when verbal aptitude scores were entered into the regression first.
For the male samples, the relationship varied as a function of the ability
of the sample. Overall, spatial skills are widely used in many levels of
mathematical thinking and their development is considered a strong
predictor of achievement in mathematics at primary school and other
stages of education.
122 The Power of Music

The Relationships between Music, Spatial Skills

and Mathematics
Another strand of research has studied the relationships between music,
spatial skills and mathematics. Understanding ratio enables children to
calculate fractions, divisions and proportions, while pattern recognition
is used in spatial-temporal tasks and in a broad variety of mathematical
tasks. Schlaug and colleagues (2005) suggested a link between these
skills and using rhythmic notation, while Gordon (1993) saw the
link as being through the processing of structures of sound. Geist
and colleagues (2012) argue that music is children’s first patterning
experience and helps engage them in mathematics even though they do
not recognise this.
Research has provided evidence for the relationships between music,
spatial-temporal reasoning and mathematics. For instance, McDonel
(2015) found strong correlations between musical aptitude, rhythm
achievement and scores in numeracy tests. However, the sample size
was very small, so the findings have to be interpreted cautiously. Spelke
(2008) compared performance in tasks measuring performance on the
three main systems supporting young children’s mathematical learning:
representing small exact numbers of objects, large approximate
numerical magnitudes, and representing geometric properties and
relationships in students aged five to seventeen with no music training,
with sports training, with training in other art forms and with music
training which was considered on three levels of intensity: moderate,
intense and highly intense. The first experiment, with children who
had low levels of music training, did not show that such instruction
enhanced any core mathematical skills. The second experiment included
students with mixed levels of music training. Here, the children with
intense music instruction outperformed the others in all tests related
to spatial awareness. In the third experiment, students with extensive
music training achieved higher scores in tests of sensitivity to geometry,
including a task which assessed children’s ability to relate numerical and
spatial magnitudes, and involved operations on a mental number line.
Researching these relationships is complex, because musical training
may be associated with some aspects of mathematics but not others. For
instance, Bahna-James (1991) found that high-school students’ music
 5. Music, Spatial Reasoning and Mathematical Performance  123

theory grades correlated with their grades in algebra, geometry and pre-
calculus, but not with grades on an advanced mathematics course on
logic. Similarly, Bahr and Christensen (2000) reported that performance
on a mathematics test and a musicianship rating scale correlated in
areas where music and mathematics shared structural overlap in pattern
recognition and symbol usage, but not for other areas of mathematics,
where there was no overlap. However, not all of the research supports
this. For instance, Helmbold and colleagues (2005) failed to demonstrate
any advantage for musicians in pattern recognition.
Holmes and Hallam (2017), working with primary-school children
showed correlations between music and only some, rather than all,
mathematical skills related to spatial reasoning, while changes in
mathematical skills reliant on memory were much smaller. This finding
suggests that the development of spatial skills may act as a moderator
between rhythmic instruction and attainment in mathematics.
There were correlations between spatial reasoning scores and music
performance. These were high for a picture test and a puzzle test score.
Correlations between music score, the two puzzle tests and various
mathematical performances showed strong correlations with some but
not all mathematical tests. The strongest correlations were with two-
and three-dimensional shapes. There were lower or no correlations with
addition, subtraction, counting and number recognition.
Cranmore and Tunks (2015) adopted a qualitative approach asking
24 high school students to share their direct experiences with music and
mathematics, as well as their perceptions of how the two fields were
related. Participants were divided into four groups based on school
music participation and level of achievement in mathematics. Most
of the students saw mathematics as a foundation for musical ability,
suggesting a different direction to most previous studies. Rhythm was
perceived to have the most connections with mathematics.

Musical Engagement and Mathematical Performance

Some studies have concentrated on the impact that learning music might
have on the development of specific cognitive skills which are considered
useful in acquiring mathematical understanding; for instance, notions
of proportions, fractions and patterns. Gardiner and colleagues (1996)
124 The Power of Music

showed that children participating in an arts programme—which

included seven months of supplementary music lessons with a lower
score on mathematics at baseline—outperformed controls in terms of
mathematics achievement. Those participating for the longest period of
time had the highest scores overall. As all of the groups participated
in music and other arts, it was not possible to conclude that it was the
music element that produced the effect.
Whitehead (2001) examined the effect of Orff Schulwerk music
instruction on the mathematical scores of middle- and high-school
students. Subjects were randomly placed into three groups: a full
treatment group which received music instruction for 50 minutes five
times each week, a limited treatment group which received 50 minutes
of instruction once a week and a no treatment group which received
no music instruction. After 20 weeks, the full treatment group showed
higher significant gains in mathematics than the other two groups. The
limited treatment group showed limited mathematics improvement and
the no treatment group showed the lowest gain.
Ribeiro and Santos (2017) aimed to verify the efficacy of non-
instrumental musical training on numerical cognition in children with
low achievement in mathematics. Using cluster analysis, they examined
whether children with low scores on numerical cognition would be
grouped in the same cluster pre- and post-musical training. Primary-
school children were divided into two groups according to their scores
on an arithmetic test. Testing with a battery of numerical cognition
tests revealed improvements for the children with low achievement in
mathematics, especially for number production capacity, compared to
normative data. The number of children with low scores in numerical
cognition decreased after the intervention.
Neville and colleagues (2008) examined the differences in results
between four groups of preschoolers who received music training;
attention training; no training and general teaching delivered in a small
group; and no training and general teaching in a large class. Music
instruction was delivered daily and included listening to music, making
music, moving to music and singing. The intervention lasted for eight
weeks. A statistically significant change was recorded in numeracy and
visual cognition for the music group and the attention group. Children
from the music group performed especially well in verbal counting and
 5. Music, Spatial Reasoning and Mathematical Performance  125

estimating magnitudes. Similarly, Geoghegan and Mitchelmore (1996)

investigated the impact of a weekly early-childhood music programme
on the mathematics achievement of preschool children aged four to five.
The group of children involved in musical activities scored higher on a
mathematics achievement test than the control group, although home
musical background may have been a confounding factor. The children
who listened more frequently to adults singing and to their own music
collection at home performed better than other children.
Cheek and Smith (1999) examined whether the type of music training
was related to the mathematics achievement levels of eighth-grade
students. Data were collected from the Iowa Academic Achievement Tests
of Basic Skills and through a survey on participants’ music background,
including type of musical instrument, number of years of school music
lessons, number of years of private lessons and demographics. No
significant difference was found between the mathematics scores of
students who did and did not receive private music lessons. However,
students with two or more years of private lessons had a significantly
higher mean mathematics score than students with no private lessons.
Furthermore, students who had keyboard lessons had significantly
higher mathematics scores than students who had music lessons on
other instruments.
In an innovative study, Kvet (1985) investigated whether significant
differences existed in sixth-grade reading, language and mathematics
achievement between students who were excused from regular classroom
activities for the study of instrumental music and students not studying
instrumental music. Over 2000 sixth-grade students participated.
The analyses showed that there was no significant difference in sixth-
grade reading, language and mathematics achievement between those
who were excused from regular classroom activities for the study of
instrumental music and those not studying instrumental music.
Focusing on emotions related to mathematics as well as achievement,
An and colleagues (2014) studied 56 third-grade elementary students
in a pre-post-test control group design, which was utilised to examine
changes between two groups of participating students in mathematics
achievement and dispositions, including beliefs about success, attitude,
confidence, motivation and usefulness. The students in the music group
received music-mathematics integrated lessons, while the students
126 The Power of Music

in the control group received traditional lecture- and textbook-based

mathematics instruction. Analysis of the results demonstrated that,
despite statistically equivalent pre-test scores prior to the intervention,
after the intervention the music group students had statistically
significantly higher positive mathematics disposition scores than their
non-music-group peers. This suggests that there are advantages for
teachers in utilising music-themed activities as a context for offering
students the opportunity to learn mathematics in a challenging yet
enjoyable learning environment.
While the evidence for the impact of musical activity on mathematics
performance is mixed, some authors have proposed that there may be
a link between the use of fractions and proportions in rhythm, and
point out that the processing of these requires mathematic specific
skills (Shaw, 2000; Schlaug et al., 2005; Jones, 2011). For instance,
Courey and colleagues (2012) examined the effects of an academic
music intervention on conceptual understanding of music notation,
fraction symbols, fraction size and equivalency in third-graders from
a multicultural, mixed socioeconomic public-school setting. Sixty-
seven students were assigned in their class to their general education
mathematics programme or to academic music instruction for 45
minutes, twice a week for six weeks. The academic music students
used their conceptual understanding of music and fraction concepts
to inform their solutions to fraction computation problems. Statistical
analysis revealed significant differences between experimental and
comparison students’ music and fraction concepts, and fraction
computation following the intervention, with large effect sizes. Students
who began instruction with less fraction knowledge responded well to
the intervention and produced post-test scores similar to their higher
achieving peers. Similarly, Azaryahu and colleagues (2019) examined
the effect of two integrated intervention programs representing holistic
versus acoustic approaches to teaching fraction knowledge. Three
classes of fourth-grade children attended 12 lessons on fractions. One
class attended the MusiMath holistic programme focusing on rhythm
within the melody, while the second class attended the academic music
acoustic programme (Courey et al., 2012) which used rhythm only. The
third class of children received regular mathematical lessons on fractions.
Students in both music programmes learned to write musical notation
 5. Music, Spatial Reasoning and Mathematical Performance  127

and perform rhythmic patterns through clapping and drumming as part

of their fraction lessons. They worked toward adding musical notes to
produce a number fraction, and created addition–subtraction problems
with musical notes. The music programme used a 4/4 time signature
with crotchets, quavers and semiquavers. In the mathematics lessons,
the students learned the analogy between musical durations and half,
quarter and eighth fractions, but also practised other fractions. Music
and mathematics skills were assessed before, immediately following,
and three and six months after the intervention. The analysis indicated
that only the MusiMath group showed greater transfer to intervention
trained and untrained fractions than the comparison group. The
academic music group showed a positive trend on trained fractions.
Despite this, both music groups outperformed the comparison group
three and six months after the intervention on the trained fractions. Only
the MusiMath group demonstrated greater gains in untrained fractions.
Similarly, Hamilton and colleagues (2018) describe a pilot study which
aimed to determine whether understanding in mathematics, and
specifically, fractions, equivalence, ordinance and division improved
when music and musical rhythm were used in lessons. The preliminary
data suggested that students responded positively to this novel method
of teaching in terms of engagement but also test performance.
Focusing on piano keyboard skills, Johnson and Edelson (2003)
developed an activity for teaching children aspects of mathematics
through musical concepts, including the use of musical instruments
and musical symbols, to expand the concepts of serial order, fractions,
sorting, classification and ratios. They concluded that music had
the potential to assist in developing mathematical skills. Also using
piano keyboard lessons but combined with a video game, Graziano
and colleagues (1999) demonstrated that preschool children given six
months of piano keyboard lessons improved dramatically on spatial-
temporal reasoning, while children in appropriate control groups did
not improve. The researchers also developed a Spatia1 maths video game
which was designed to teach fractions and proportional mathematics. It
was extremely successful in a study involving 237 second-grade children,
aged six to eight years old. The children participating in the piano
keyboard training as well as the maths video game scored significantly
higher on proportional mathematics and fractions than children who
128 The Power of Music

experienced non-musical training along with the maths video game.

Lim and colleagues (2018) investigated future teachers’ experiences
and perceptions of using a virtual reality game for elementary maths
education. The virtual reality game was designed and developed to
integrate a musical activity, beat-making, into the learning of fractions.
The mathematics education students who participated perceived that
the concept of fractions was effectively represented via beat-making in
the virtual reality game.
Wentworth (2019) explored the effectiveness of an integrated
approach to music and mathematics in high school. Four lessons
were taught to an intervention and control class to determine how
mathematically motivated music instruction affected students’
understanding of operations of functions, composition of functions,
inverse functions, domain and range. A pre-post-test design was used
to determine the effect on achievement of the integrated lessons; a
questionnaire was also given out, to identify differences in students’
mathematical perceptions, self-efficacy and determination. The
intervention group demonstrated significantly greater gains overall.
Three major differences were identified between the groups—the
intervention group used function notation more frequently than the
control group; the control group demonstrated confusion between
composition of functions and inverse functions, while the intervention
group did not; and the intervention group showed more mathematical
work for the applications portion of the test than the control group. The
integrated instruction led to comparable and, in some cases, significantly
better mathematics outcomes than the control group, giving students an
increased willingness to work with mathematical applications both on
the post-test and moving forward.
Not all of the research has shown that music has a positive effect
on learning mathematics. For instance, Costa-Giomi (2004) worked
with nine- to ten-year-old children from low-income families, who were
involved over three years with weekly individual piano lessons. All of
the children who participated in the study were given an instrument so
that they could practise at home. Self-esteem and musical understanding
were enhanced for the music group, but their academic achievement in
mathematics and English was no different from a control group.
The quality of the musical input is crucial in any transfer of skills. This
was illustrated in a three-year study to explore whether group music
 5. Music, Spatial Reasoning and Mathematical Performance  129

instruction could improve the test scores of economically disadvantaged

elementary-school children (including almost 600 kindergarten to fifth-
grade students from four elementary schools). One school provided 30
minutes of keyboard lessons per week, another a 40-minute lesson every
six days, while the remaining two schools acted as controls. All lessons
were in groups of 20 to 25 pupils. Participants were pre-tested with two
subtests measuring verbal abilities, two measuring quantitative abilities
and one measuring spatial-temporal abilities. Tests were then repeated
at 9, 18 and 27 months. During the first two years of the study, there
were difficulties in the implementation of the music programme, and
it was only at the end of the study when the children had received one
year of high-quality tuition that there were any gains (Rauscher, 2005).
Similarly, Yang and colleagues (2014) examined the relationship
between long-term music training and child development based on
250 Chinese elementary-school students’ academic development of
first language, second language and mathematics. They found that
the musician children outperformed the non-musician children only
on musical achievement and second language development. Although
music training appeared to be correlated with children’s final academic
development of first- and second-language learning and mathematics,
it did not independently contribute to the development of the first
language, nor all mathematical skills. The authors argued that other
variables might be important; for example parents’ level of education.
Two experiments by Rickard and colleagues (2012) also revealed
inconclusive results. The first was based on an already existing music
programme for ten- to thirteen-year-olds. Comparing participation in
drama, art or music groups, there was some improvement in the music
group on a non-verbal IQ test but not in academic achievement. A second
musical intervention, provided externally over six months, included
playing music with percussion instruments, composing, improvising,
playing in a group, singing, active listening and analysis of a wide range
of styles. As the programme was introduced in a private school, all of
the students were of middle or high economic status. Three groups
participated in music, drama or an additional activity. Students from the
music group achieved better results in mathematics but this result was
also in evidence in the drama group. The authors argued that the age
of the children may have been a factor in the outcomes of the research.
130 The Power of Music

Cox and Stephens (2006) compared high-school students with

different numbers of music credits in relation to their mean mathematics
grade point averages, or their mean cumulative grade point averages.
Students were then separated into two groups based on the number of
music credits. Those who had earned at least two music credits per grade
level were placed into Group A. This included ninth-graders with two
or more music credits, tenth graders with four or more music credits,
eleventh graders with six or more music credits, and twelfth graders
with eight or more music credits. The remaining students were placed
into Group B. The group A students performed better than the group B
students but the differences were not statistically significant, although
there was a slight upward trend in grade point average as the number of
music credits increased. Lower grade point averages were non-existent
as music credits increased.

Overview
There have been a number of reviews of the impact of music on cognitive
skills, including spatial reasoning and mathematics. In relation to
spatial reasoning, Hetland (2000a) reviewed 15 studies and found a
strong and reliable relationship and concluded that music instruction
led to dramatic improvement in performance on spatial temporal
measures. She commented on the consistency of the effects and likened
them to differences of one inch in height or about 84 points on the SAT
(p. 221). She showed that the effects were likely to be stronger among
younger children, three to five years than those aged six to twelve
years. Similarly, Črnčec and colleagues (2006) reviewed the evidence
on the impact of music teaching on spatio-temporal reasoning skills
and found that there was a consistent effect, although improvements in
associated academic domains, such as arithmetic, had not been reliably
shown. More recent research( as reviewed above) generally supports a
positive role for music in developing spatial temporal reasoning skills,
the consistency of the findings suggesting a near transfer, automated
effect. Where spatial temporal skills are well developed the wider and
more appropriate the choice of strategies and the more efficient and
less erroneous mathematical operations. Rhythm-based instruction
seems to be the most conducive for the improvement of spatial temporal
 5. Music, Spatial Reasoning and Mathematical Performance  131

reasoning skills, followed by learning to play the piano. Singing leads to

smaller changes.
Focusing on the impact of engaging with music on a broader range
of academic skills and educational attainment, including mathematics,
Hodges and O’Connell (2007) suggest that a moderate position needs
to be taken. At one extreme, the data support the contention that
music improves academic performance, but at the other extreme there
is no basis for saying that music instruction has no effect on academic
achievement. Hodges and O’Connell argue that human learning is so
complex that any simplistic explanations must be rejected. They suggest
that some music experiences have a positive impact on academic
performance under certain circumstances. What is neglected is the
impact that an individual teacher can have. Excellent teachers who
are enthusiastic and who relate well to students may make a greater
difference to educational outcomes than particular methods used,
although if the overall quality of tuition is poor it can have a negative
impact. A more recent systematic review also suggests that the findings
are inconclusive and contradictory (Jaschke et al., 2013). Jaschke and
colleagues attribute this to differences in research design, the analytical
methods used, the nature of the musical interventions and differences
in neural activation during the processing of these tasks. Recent meta-
analyses have come to similar conclusions about the challenges faced by
research and some have concluded that overall, music does not have an
impact on children’s cognitive skills including mathematics (Sala and
Gobet, 2020).
To conclude, the evidence suggests that active engagement in musical
activities enhances a range of spatial processing skills, particularly in
young children. These skills may support the development of some
simple mathematical skills, mediated by line number knowledge, but
do not transfer to all mathematical skills. There remain many questions
about the type of training that may be effective, that involving rhythm
seems a likely candidate; how long training needs to be sustained,
the type of mathematical activities which may be most influenced by
musical activity, and the overall quality of the training on offer.
 6. The Impact of Musical
Engagement on Memory

Memory is the faculty of the brain by which data or information is

encoded, stored and retrieved when needed. There are several different
types of memory, which broadly fall into three groups: sensory memory,
short-term memory and long-term memory. Sensory memory is very
short, typically acting for less than half a second, and accurately retains
material for that time, acting as a buffer for stimuli received through the
five senses. Iconic memory refers to immediate visual memories, echoic
memory to auditory memories and haptic memory to the sense of
touch, while olfactory memories relate to smell and gustatory memories
to taste. Short-term memories are slightly longer than sensory memories
but still disappear after a few minutes. Short-term memory holds
information briefly until it is needed. The term ‘short-term memory’
is often used interchangeably with the term ‘working memory’. Short-
term memory is temporary and has limited capacity, as the information
being processed is either lost or entered into long-term memory.
Long-term memory is the brain’s system for storing, managing
and recalling information. It is complex and serves different functions.
Long-term memories include anything from an event that occurred five
minutes ago to something from 50 years ago. There are many different
forms of long-term memories. Sometimes they are conscious, requiring
us to actively think in order to recall them. Other memories are
unconscious and appear without an active attempt at recollection. The
most common forms of long-term memory are explicit memory (the
intentional recall of information), declarative memory (the retention
and recall of important facts, dates and information), episodic memory
(enabling memory of first-hand experiences in one’s life), semantic
memory (the storage of vocabulary, names and general knowledge),

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.06

134 The Power of Music

implicit memory (sometimes referred to as unconscious memory where

information from a moment in time cannot be specifically recalled),
procedural memory (memory for how to do things), auditory memory
(which helps to retain information based on the sounds an individual
has heard), visual spatial memory (which enables memory for spatial
objects and their manipulation), and working memory. The latter has
been more controversial than other forms of memory. Cowan (2014),
after reviewing the evidence, suggests that it is the retention of a small
amount of information in a readily accessible form which facilitates
planning, comprehension, reasoning and problem-solving. In the
research on the impact of making music on working memory, mention
is often made of executive control skills that are used to manage
information in working memory, and the cognitive processing of that
information. Overall, there continues to be debate about the actual
nature of working memory, although there is agreement that similar
research findings are obtained when specific test methods are adopted.
This chapter reports the findings from research on the impact of music
on visual memory, verbal memory and working memory, although, as
will be seen, much of the research explores several different aspects of
memory simultaneously.

Visual Memory
One strand of research has explored the impact of musical training on
visual cognition. Early work focused on memory for musical notation.
For instance, Sloboda (1976) demonstrated that musically trained adults
showed significantly greater capacity to maintain musical notation
in short-term memory than non-musicians. George and Coch (2011)
investigated the neural and behavioural aspects of visual memory
in college-aged, non-professional musicians and non-musicians.
Behaviourally, the musicians outperformed the non-musicians on
standardised subtests of visual memory. Event-related potentials were
recorded in standard visual paradigms, where participants responded
to infrequent deviant stimuli embedded in lists of standard stimuli.
Electrophysiologically, the musicians demonstrated faster updating of
working memory in the visual domain. These findings demonstrated
that long-term music training was related to improvements in visual
 6. The Impact of Musical Engagement on Memory  135

working memory. Similarly, Brochard and colleagues (2004) used a

neuropsychological task in which participants had to detect the position
of a target dot relative to vertical or horizontal reference lines which
flashed onto a screen. In the perception condition, the reference line
remained on the screen until the dot was displayed, while in the imagery
condition, the line disappeared before the target dot was presented,
requiring participants to keep a mental image of the reference line. In
both conditions, musicians had shorter reaction times compared to non-
musicians, suggesting that the musicians had enhanced visuospatial
abilities. The authors concluded that the enhanced performance of the
musicians resulted from their long-term reading of musical notation,
which requires fine-grained recognition of the positions of notes on
the stave and also efficient attentional processes. This explanation is
supported by Kopiez and Galley (2002), who suggested that patterns of
saccadic eye movements can be used as an indicator of mental processing
speed. The specific demands of reading musical notation, particularly
if it is begun at an early age, may modify the way visual information
is processed by the nervous system. Kopiez and Galley (2002) and
Gruhn and colleagues (2006) compared saccadic eye movements
during oculomotor tasks in adult musicians and non-musicians, and
reported more efficient oculomotor strategies in the musicians, which
they argued may be associated with complex visual processes involved
in the long-term practice of reading musical notation, alongside more
efficient attentional processes. Gruhn and colleagues (2006) point out
that there is some evidence (Biscaldi et al., 2000; Currie et al., 1991;
Kinsler and Carpenter, 1995; Sereno et al., 1995) that there is a strong
association between attention and saccadic eye movements. The control
of eye movements requires highly complex mental processes, involving
many cerebral areas (Tatler and Wade, 2003). All modalities of attention
have an impact on the oculomotor system (Kimmig, 1986).
Rodrigues and colleagues (2007) compared the performance of
musicians who were members of a symphony orchestra or symphonic
band with non-musicians, in tasks involving visual attention. They used
a multiple-choice reaction-time test which consisted of specific motor
responses to various luminous stimuli. The test was applied twice in
order to assess divided visual attention ability. The second time, it
was used alongside other continuously and randomly changing visual
136 The Power of Music

stimuli presented in video form. The participants were asked to respond

verbally to each change. The musicians showed a higher percentage of
correct responses when the test was applied alone, but not when the test
was applied together with other changing visual stimuli, although the
musicians showed shorter reaction times for verbal responses to stimuli
changes. The authors suggested that musicians may have augmented
divided visual attention ability compared to non-musicians, which
they ascribed to ensemble rehearsal. They argued that the professional
activities of musicians are characterised by constant demands of divided
visual attention, including dealing with several kinds of visual stimuli
simultaneously—for instance, the musical score, the conductor’s gestural
instructions and the body movements of other musicians—while also
playing their own instrument.
Patston and colleagues (2006) compared right-handed musicians
and non-musicians in a line bisection task, which entailed marking the
centre of 17 horizontal lines, varying in length from 10 to 26 cm, displayed
randomly on a page. Neurologically intact right-handers showed a
slight but reliable tendency to bisect about two percent to the left of the
centre on this task (Hausmann et al., 2002) a phenomenon attributed to
dominance of the right hemisphere for visuospatial attention (Oliveri
et al., 2004). In contrast, Patston and colleagues (2006) demonstrated
that musicians showed a slight rightward bias, while non-musicians
showed greater deviation to the left. The musicians also bisected the
lines more accurately and with fewer intermanual differences than the
non-musicians. The researchers suggested that musicians may develop
an increased ability for the left hemisphere to perform cognitive
functions that are typically right-hemisphere dominant, resulting in
more balanced spatial attention. In a later study, Patston and colleagues
(2007a) compared reaction times and accuracy between musicians and
non-musicians in response to stimuli presented to the left and right
of a vertical line. Both groups performed more accurately with the
left-sided stimuli, but the musicians were significantly more accurate
than non-musicians for the right-sided stimuli, and overall had faster
reaction times. This suggested a more balanced attentional capacity
in musicians, as well as enhanced visuomotor ability. They may also
have an advantage on line and dot tasks of the type used in this study
and that of Brochard and colleagues (2004), because they are familiar
 6. The Impact of Musical Engagement on Memory  137

with these components—they are similar to those required for reading

musical notation, although the placement of the lines vertically rather
than horizontally means that the tasks are not truly equivalent. Patston
and colleagues (2007b) also studied the lateralisation of visuospatial
attention using interhemispheric transfer time. Musicians and non-
musicians responded to stimuli presented to the left and right visual
fields while being submitted to electroencephalography. Non-musicians
showed significantly faster responses in the right to left direction than in
the opposite direction and a shorter latency in the left than in the right
hemisphere. In contrast, musicians exhibited no directional difference
between hemispheres and no hemispheric difference in latency,
indicating more bilateral neural connectivity. Patston and colleagues
concluded that the bimanual training of musicians facilitates additional
myelination that results in more balanced connections between the
hemispheres than normally found in those without musical training.
Stoesz and colleagues (2007) investigated visual processing of
local details in musicians and non-musicians, utilising disembedding
and constructional tasks. They used the group embedded figures test,
where a series of 25 complex figures is presented, each containing
one of nine targets hidden in the design. The task is to examine each
test figure and outline the hidden target as soon as it is identified. In
a second study, two tests were used: a block design subtest, which
requires the participant to replicate a geometric pattern presented on
a card using the top surfaces of several coloured blocks, and secondly
a task involving copying possible and impossible drawings of objects.
The musicians outperformed the non-musicians on the embedded
figures test, the block design subtest and the task of copying drawings
of physically impossible objects. These findings suggest enhanced visual
processing of local details. There was a correlation between the block
design scores and the accuracy scores for the impossible figures, but not
for the possible figures. Local processing ability did not correlate with
drawing ability per se. Stoesz and colleagues concluded that a relative
strength in local processing contributed to the superior performance of
the musicians on the drawing task. They suggested that the enhanced
visual processing of local details may reflect training-induced changes
in the frontoparietal system involved in controlling exploratory eye
movements and shifts in visual attention—skills that are important for
138 The Power of Music

reading musical notation (which requires the detailed analysis of visual

details).
Suárez and colleagues (2016) carried out a cross-sectional study
exploring the relationship between music training and visual working
memory in adult musicians and non-musicians. Twenty‐four musicians
and 30 non-musicians matched for age, gender, years of formal education
and verbal intelligence performed several working memory tasks. The
musicians outperformed the non-musicians in tasks related to visual
motor coordination, visual scanning ability, visual processing speed
and spatial memory. Similarly, Jakobson and colleagues (2008) studied
visual memory in pianists and non-musicians using a visual design
learning test, which required participants to try to learn and remember
a sequentially presented set of 15-line drawings of simple geometric
figures, each containing two elements (for example, a circle and a line).
Participants were asked to draw all the figures that they could remember,
after each of the five learning trials and after a delay. A test of delayed
recognition was also administered. The results suggested superior
visual memory in musicians, since they outperformed non-musicians
on the fourth and fifth learning trials and on the delayed recall and
delayed recognition tasks. After controlling for general intelligence, the
group difference on the delayed recall tasks persisted. The researchers
suggested that the observed relationship between visual memory and
musical training may be related to improvement in processes supporting
attention to visual details, to the increased skill of musicians at holding
and manipulating visual images in working memory—which confers
an advantage during the encoding process—or to superior use of high-
level, strategic memory processes.
Some research has focused on processing speed—for instance,
Bugos and Mostafa (2011) examined the effects of music instruction
on information processing speed. Using neuropsychological tests,
the paced auditory serial addition task and the trail-making test, they
examined the role of music on information processing speed in 14
musicians and 16 non-musicians. The musicians performed better on
both tests, suggesting that musical training has the capacity to enhance
the processing speed of auditory and visual content. Brain-imaging
studies have also suggested more efficient visual processes in musicians.
For instance, Platel and colleagues (1997) showed activation of an
 6. The Impact of Musical Engagement on Memory  139

associative visual area in musicians during a pitch-discrimination task,

while Schmithorst and Holland (2003) investigated the relationship
between musical practice and cerebral processing relating to melody
and harmony. The findings showed that musicians and non-musicians
used different neural networks to process these elements. In the
musicians, the inferior parietal areas were activated only during melody
and harmony perception. These have been identified as involved in
general visuospatial processing. In a study comparing male symphony
orchestra musicians with non-musicians, there was increased density
of grey matter in Broca’s area in the musicians—an area important for
spoken language and visuospatial localisation (Sluming et al., 2002).
More recently, Sluming and colleagues (2007) showed enhanced
performance on a visuospatial task by orchestral musicians, compared
to non-musicians. This was also associated with increased activation in
Broca’s area.
Not all of the research with adults has shown enhanced visual memory
in musicians. For instance, Cohen and colleagues (2011) showed that,
while musicians had superior auditory recognition memory for musical
and non-musical stimuli compared to non-musicians, this was not the
case for the visual domain. For both groups, memory for auditory
stimuli was inferior to memory for visual objects. Although considerable
musical training is associated with better musical and non-musical
auditory memory, this does not increase the ability to remember sounds
to the levels found with visual stimuli. This suggests a fundamental
capacity difference between auditory and visual recognition memory,
with a persistent advantage for the visual domain. Using a very different
task, Brandler and Rammsayer (2003) asked 35 adult musicians and
non-musicians to indicate, from memory, the location of buildings on
a city map that they had previously studied. There were no statistically
significant differences between the performance of the musicians and
non-musicians on this task. Chan and colleagues (1998) also found
no benefit of musical training in relation to a visual task where the
participants—60 female college students from the Chinese University
of Hong Kong—had to draw from memory ten simple figures that they
had been asked to memorise. Thirty of the participants had had at least
six years of training with a Western musical instrument before the age
of 12, while 30 had received no musical training. The participants were
140 The Power of Music

matched in terms of age, grade point average and years of education.

There were no statistically significant differences between the musicians
and non-musicians in the proportion of drawings that they were able to
create.

Research with Children

Another strand of research has focused on visual memory in children.
For instance, Degé and colleagues (2011b) tested the effect of a two-
year extended music curriculum on secondary school children’s visual
and auditory memory. The curriculum consisted of learning to play a
musical instrument, participating in an orchestra, auditory perception
and music theory training. Ten-year-old children who had just started
the programme and children without training were tested on visual and
aural memory at the start of the programme and two years later. Prior
to the training, there were no differences between the groups, but the
children participating in the musical training improved significantly
from time one to time two in visual and auditory memory, while the
children not receiving training did not. These effects were apparent
even when a range of confounding variables was taken into account,
including intelligence, socioeconomic status, extra-curricular schooling,
motivation to avoid work and musical aptitude.
It seems that musical training generally has a positive impact on
aural memory in children but this is not necessarily the case for visual
memory. Ho and colleagues (2003), working with a group of Chinese
children, showed that those with music training did not demonstrate
better visual memory than their non-musician counterparts. When the
performance of these children was followed up after a year, changes
in visual memory were not significantly different between the groups.
Similarly, Roden and colleagues (2012; 2014a) examined the effects of
a school-based instrumental training programme on the development
of visual memory skills in primary-school children. Participants either
took part in a music programme with weekly 45-minutef instrumental
lessons in small groups at school, or received extended natural science
training. A third group of children did not receive any additional
training. Each child completed visual memory tests three times over a
period of 18 months. No differences between groups were found in the
 6. The Impact of Musical Engagement on Memory  141

visual memory tests. Similarly, Rickard and colleagues (2010) explored

the effect of increasing the frequency and intensity of a classroom-based
instrumental training programme on visual memory across a two-year
period. Data from 142 participants aged eight to nine were analysed.
Eighty-two children were allocated to the intensive string-music
training programme; 68 acted as a control group and participated in
their usual music classes. The intensive music training had no effect on
visual memory, although an improvement in visual perceptual ability
was observed in the first year.
To conclude, there are a number of reasons why the evidence
relating to visual memory is inconsistent. First, there is no reason why
music, which essentially requires enhanced aural skills, should have any
impact on visual skills. Only if musicians are required to read musical
notation is it likely that there would be any impact on visual skills. As
some musicians play by ear, this is not always the case. Second, in the
research, visual memory has been assessed using different methods,
including reaction times and recall accuracy. Third, participants in some
studies (Chan et al., 1998; Ho et al., 2003) were Chinese. The Chinese
language is written in symbols rather than letters, which may have led
to experimental and control groups already being skilled in processing
complex visual signs. Fourth, the participants in the research were
of very different ages. Fifth, the levels of musical experience in those
classified as musicians varied, and sixth, the nature of the musical
training itself was different, particularly the extent to which it involved
learning to read musical notation.

Verbal Memory
Research has compared the performance of musicians with non-
musicians on a variety of verbal tasks. For instance, Parbery-Clark
and colleagues (2009a) investigated the effect of musical training
on identifying speech in noise, which is a complex task requiring the
integration of working memory and stream segregation, as well as
the detection of time-varying perceptual cues. Sixteen musicians and
15 non-musicians aged 19 to 31, all with normal hearing, participated.
The musicians outperformed the non-musicians on hearing speech in
challenging listening environments. In a second study, Parbery-Clark
142 The Power of Music

and colleagues (2009b) compared subcortical neurophysiological

responses to speech in quiet conditions and in noisy conditions,
for a group of highly trained musicians and non-musician controls.
Musicians were found to have a more robust subcortical representation
of the acoustic stimulus in the presence of noise. They demonstrated
faster neural timing, enhanced representation of speech harmonics and
less degraded response morphology in noise. Neural measures were
associated with better behavioural performance on a hearing-in-noise
test, in which musicians outperformed the non-musician controls. These
findings suggest that musical experience limits the negative effects of
competing background noise, thereby providing biological evidence for
musicians’ perceptual advantage for speech in noise.
Other studies have found similar results. For instance, Strait and
Kraus (2011b) assessed the impact of selective auditory attention on
cortical auditory evoked response variability in musicians and non-
musicians. The outcomes indicated strengthened brain networks for
selective auditory attention in musicians. Strait and colleagues (2010)
administered a standardised battery of perceptual and cognitive tests
to adult musicians and non-musicians. Tasks included those which
were either more or less susceptible to cognitive control—for instance,
backward versus simultaneous masking—and more or less dependent
on auditory or visual processing: for instance, auditory versus visual
attention. The findings indicated lower perceptual thresholds in
musicians specifically for auditory tasks that related to cognitive
abilities, such as backward masking and auditory attention. The
results suggested that long-term musical practice strengthens cognitive
functions and that these functions benefit auditory skills. Further, the
intensity of the enhancement of verbal memory and auditory attention
was related to the start of musical training and how long it lasted (Kraus
and Chandrasekaran, 2010).
Cohen and colleagues (2011) compared professional musicians
and music students with non-musicians on their verbal and visual
memory. The musicians were significantly better than non-musicians
at remembering familiar music, unfamiliar music, speech and
environmental sound clips, but there was no difference between the two
groups on their performance on tests of visual memory. Also working
with music students, Kilgour and colleagues (2000) studied whether
 6. The Impact of Musical Engagement on Memory  143

music training acted as a mediator for the recall of spoken and sung lyrics,
and whether the presentation rate of materials was important rather
than the inclusion of melody. In the first experiment, 78 undergraduates,
half with music training and half without, heard spoken or sung lyrics.
Recall for sung lyrics was superior to that for spoken lyrics for both
groups. In the second and third experiments, presentation rate was
manipulated so that the durations of the spoken and the sung materials
were equal. With presentation rate equated, there was no advantage for
sung over spoken lyrics. In all of the experiments, those participants
with music training outperformed those without training. Overall, the
results suggested that music training leads to enhanced memory for
verbal material. Similarly, working with 15 highly trained pianists and
21 non musicians, Jakobson and colleagues (2008) studied non-musical
perceptual and cognitive abilities. The musicians showed superior
immediate and delayed recall of word lists and greater use of a semantic
clustering strategy during initial list-learning than non-musicians. The
group differences in delayed free recall of words persisted even when
IQ was controlled for.
Brandler and Rammsayer (2003) tested the psychometric performance
of 35 adult musicians and non-musicians on different aspects of primary
mental abilities, verbal comprehension, word fluency, space, closure,
perceptual speed, reasoning, number and memory. The only statistically
significant differences were found in relation to verbal memory and
reasoning. Performance on verbal memory was reliably higher for the
musicians than for the non-musicians, but the non-musicians performed
significantly better on subscales of a culture-free intelligence test. This
supports the notion that long-term musical training exerts beneficial
effects on verbal memory. This is probably because it leads to changes in
cortical organisation.
In research exploring attention, Puschmann and colleagues (2019)
required participants with varying amounts of musical training to attend
to one of two speech streams while detecting rare target words. The
findings showed that the duration of musical training was associated
with a reduced distracting effect of competing speech on target detection
accuracy. More musical training was related to robust neural tracking
of both the speech stream to be attended to and the speech stream to
be ignored, up until the late cortical processing stages. The findings
144 The Power of Music

suggested that musically trained persons were able to use additional

information about a distracting verbal stream to limit interference by
competing speech.
One strand of research has compared musicians’ performance as
opposed to non-musicians’ performance in detecting pitch change
in spoken sentences in both native, French (Schön et al., 2004) and
unfamiliar (Portuguese—Marques et al., 2007) languages. Similarly,
Deguchi and colleagues (2012) studied the effects of familiarity of
intonational contour and the presence of meaningful context, using
behavioural and electrophysiological data from Italian musicians and
non-musicians. Performance was compared in a pitch incongruity
detection task using sentences in native, Italian and foreign (French)
languages and in jabberwocky, meaningless sentences formed by
pseudo-words. To examine whether these differences depended on
enhanced auditory sensitivity to pitch, the frequency discrimination
threshold for tones was obtained using a psychophysical procedure.
Musicians were more accurate than non-musicians at detecting small
pitch changes in all languages, showing a smaller response bias. Overall,
the findings confirmed musicians’ advantage in the detection of subtle
pitch changes, not only with tones but also with speech sentences, in
both native and unfamiliar languages. Such effects seemed to emerge
from more efficient pitch analysis acquired through musical training.
Enhancements of short-term memory related to music may also
support linguistic functions. Ludke and colleagues (2014) randomly
assigned 60 adult participants to one of three listen-and-repeat learning
conditions: speaking, rhythmic speaking or singing. Participants in the
singing condition showed superior overall performance on a collection
of Hungarian language tests after a 15-minute learning period, as
compared with participants in the speaking and rhythmic-speaking
conditions. These differences were not explained by age, gender, mood,
phonological working memory ability, or musical ability and training.
The researchers suggested that a ‘listen and sing’ learning method could
facilitate verbatim memory for phrases spoken in a foreign language.
The relationship between musical expertise and language processing
is well documented, but there is less evidence of language-to-music
effects. Bidelman and colleagues (2013) used a cross-sectional design
to compare the performance of musicians to that of tonal language
 6. The Impact of Musical Engagement on Memory  145

(Cantonese) speakers on tasks of auditory pitch acuity, music

perception and general cognitive ability, including fluid intelligence and
working memory. While musicians demonstrated superior performance
on all auditory measures, comparable perceptual enhancements were
observed for Cantonese participants, relative to English-speaking non-
musicians. These results suggest that tone language background is
associated with higher auditory perceptual performance for listening
to music. Musicians and Cantonese speakers also showed superior
working memory capacity relative to non-musician controls, suggesting
that in addition to basic perceptual enhancements, a background of
tonal languages and music training might also be associated with
enhanced general cognitive abilities. The findings support the notion
that tonal language speakers and musically trained individuals have
higher performance than English-speaking listeners in the perceptual
cognitive processing necessary for basic auditory—as well as complex
music—perception. These results illustrate bidirectional influences
between the domains of music and language.

Research with Children

Early work exploring the relationship between musical training and
verbal memory was carried out with Asian participants. For instance,
Chan and colleagues (1998) showed that learning to play a musical
instrument before the age of 12 enhanced the ability to remember
words. Participants with musical training could remember 17 percent
more verbal information than those without musical training. Music
training in childhood may therefore have long-term positive effects on
verbal memory. Ho and colleagues (2003) supported these findings in
a later study of 90 boys aged six to fifteen. Those with musical training
had significantly better verbal learning and retention abilities. Duration
of music training, learning to play an instrument and verbal learning
performance correlated positively, even after controlling for age and
education level. Those with musical training learned approximately 20
percent more words from a 16-word list. Their retention was also better
after 10- and 30-minute delays. A follow-up study compared children
from the same cohort who had just begun or continued their music
training for one year, and those who had given up playing. Children
146 The Power of Music

in the beginner and advanced training groups significantly increased

verbal learning and retention performance. This was not the case for
those who had discontinued training, although their verbal memory
performance remained stable at least nine months after ceasing to play
an instrument. Ho and colleagues concluded that music training seemed
to have long-term enhancing effects on verbal memory.
While these studies demonstrate a relationship between musical
training and verbal memory, they do not demonstrate causality. For
this, intervention studies are required. In further work with Chinese
participants, which focused on children aged four to five years old, Nan
and colleagues (2018) studied 74 Mandarin-speaking children who
were pseudo-randomly assigned to piano training, reading training
or a no-contact control group. Six months of piano training improved
behavioural auditory-word discrimination in general, as well as word
discrimination based on vowels, compared with controls. The reading
group yielded similar trends. However, the piano group demonstrated
unique advantages over the reading and control groups in consonant-
based word discrimination. All three groups improved on general
cognitive measures, including tests of IQ, working memory and attention.
In a typical intervention study, working with kindergarten children,
Hallberg and colleagues (2017) investigated the effects of instrumental
music instruction as opposed to no tuition. The children received five
hours of instrumental instruction for five weeks using the Suzuki
method and were tested on working memory efficiency, visuospatial
processing and controlled attention. The only statistically significant
difference between the two groups related to attentional control, which
was enhanced in those having instrumental music instruction. Rickard
and colleagues (2010) researched 142 children from nine primary
schools, 82 of whom (aged eight to nine) participated in an enhanced
school-based music programme. The remainder of the children acted
as controls and received standard class music lessons. The children
were tested three times within the first two years of the study, and in
the third year a subset of the control sample was tested again. Verbal
learning and immediate recall scores significantly increased after one
year of enhanced school-based music training. No such increase was
found in the control group. However, these advantages disappeared
in the second year, although in the second year of the study there was
 6. The Impact of Musical Engagement on Memory  147

significantly enhanced visual perception for the music training group.

Similarly, Roden and colleagues (2012) examined the effects of a school-
based instrumental training programme on the development of verbal
memory skills in primary-school children aged seven to eight years
old. Participants either took part in a music programme with weekly
45-minute sessions of instrumental lessons in small groups at school,
or received extended natural science training. A third group of children
did not receive any additional training. Each child completed verbal
memory tests three times over a period of 18 months. Children in the
music group showed greater improvements than children in the control
groups after controlling for their socioeconomic background, age and
IQ. Overall, the evidence suggested that children who have musical
training develop efficient memory strategies for verbal materials. This
is likely to be because playing music requires continued monitoring of
meaningful chunks of information. Individual notes are combined into
meaningful melodic phrases which have a quasi-syllabic structure, and
are based on temporal frameworks that have metric structures which are
parallel to stresses on syllables in language (Patel and Daniele, 2003).
This is supported by evidence that the auditory cortex is structurally and
functionally shaped through the individual’s experiences with sound
(Fritz et al., 2007). Fujioka and colleagues (2006) recorded auditory
evoked responses to a violin tone and a noise-burst stimulus from four-
to six-year-old children on four occasions over a one-year period, using
magnetoencephalography. Half of the children participated in music
lessons throughout the year, while the other half had no music lessons.
A clear musical training effect was expressed in a larger and earlier
peak in the left hemisphere in response to the violin sound in musically
trained children compared with untrained children. This transition
could be related to establishing a neural network associated with sound
categorisation and/or involuntary attention, which can be altered by
musical learning experiences.
Also working with primary-aged children, Piro and Ortiz (2009)
adopted a quasi-experimental approach to examining the effects of a
scaffolded music instruction programme on the vocabulary and verbal
sequencing skills of two cohorts of second-grade students. One group
of 46 children studied piano formally for a period of three consecutive
years as part of a comprehensive instructional intervention programme.
148 The Power of Music

The second group of 57 children had no exposure to music lessons,

either at school or through private study. The findings showed that
the experimental group had significantly better vocabulary and verbal
sequencing scores following the intervention than the control group. In
an interesting study, Brodsky and Sulkin (2011) focused on children’s
hand clapping and reported positive effects of a classroom hand-clapping
intervention on verbal memory. They examined whether children who
spontaneously engaged in hand-clapping song activity demonstrated
improved motor or cognitive abilities. The study also investigated the
outcome of a two-group, eight-week classroom intervention. The study
found that children who were more skilful at performing hand-clapping
songs were more efficient in first grade, while those in second grade who
spontaneously engaged in hand-clapping songs were advantaged in
bimanual coupling patterns, verbal memory and handwriting. Classroom
hand-clapping song training was more efficient than music appreciation
classes in developing non-musical skills among participating children.
Adopting an experimental design, Martens and colleagues (2011) focused
on the effect of musical experience on verbal memory in 38 individuals
with Williams syndrome, aged 6 to 59. Participants who had engaged in
formal music lessons scored significantly better on a verbal long-term
memory task when the stimuli were sung than when they were spoken
in comparison to those who did not have formal lessons, who showed no
benefit for either the sung or spoken conditions.

Working Memory
Working memory is the time- and capacity-limited storage of task-
relevant information, which generally requires mental manipulation,
flexible use or inhibition of distractors, or all of these. It is different
to short-term memory, as it requires mental manipulation of encoded
information or the inhibition of goal-irrelevant stimuli. From a
neuroscientific perspective, working memory also requires the integrity
of the medial-temporal lobe regions, whereas short-term memory does
not. In addition, there is strong evidence linking behavioural measures
of working memory to both localised and distributed patterns of
neural oscillations (Yurgil et al., 2020). Working memory is typically
studied using behavioural tasks that require the implementation of a
 6. The Impact of Musical Engagement on Memory  149

combination of stored information, manipulation of that information

and interference including the N-back (Ding et al., 2018), backward
digit-span (Clayton et al., 2016; George and Coch, 2011; Zuk et al., 2014),
reading span (D’Souza et al., 2018; Franklin et al., 2008) and operation
span tasks (D’Souza et al., 2018; Franklin et al., 2008). The N-back task
presents participants with a sequence of visual or auditory stimuli. The
participant then maintains the information while deciding whether each
subsequent stimulus item matches the stimulus that came a specific
number of letters previously (Owen et al., 2005). In the backward digit
span task, participants are presented with a series of digits, then asked
to report the sequence of digits in reverse order (Hester et al., 2004).
The central executive component of working memory has been argued
to play an important role in the performance of span tasks, particularly
backward span. Both forward and backward span tasks recruit the
central executive resources necessary for successful task performance
(Hester et al., 2004). For the reading span task, a number of sentences are
presented one sentence at a time. As the number of sentences increases,
so does the memory load required to perform the task. Where two
sentences are presented sequentially, after each sentence, the participant
writes the sentence verbatim and the last word of each sentence in
order (Daneman and Carpenter, 1980). Finally, the operation span task
requires participants to memorise a sequence of unrelated words while
simultaneously performing a series of mathematical operations. After
all of the operation word strings are presented, the participant writes all
of the words that were displayed in the order of presentation (Turner
and Engle, 1989). The reading span and the operation span require
participants to hold information while working on a secondary task,
which can cause interference. Each of these tasks fulfils the criteria of
maintenance and manipulation of information, which may occur with
differing levels of interference (Aben et al., 2012).

Research with Adults

Oechslin and colleagues (2013) used functional magnetic resonance
imaging with non-musicians and amateur and expert musicians, who
listened to a comprehensive set of specifically composed string quartets
with hierarchically manipulated endings. Two irregularities at musical
150 The Power of Music

closure were implemented, differing in salience but within the tonality of

the piece. Behavioural sensitivity scores of both transgressions perfectly
separated participants according to their level of musical expertise. The
functional brain imaging data showed compelling evidence for stepwise
modulation of brain responses by expertise level in a fronto-temporal
network hosting universal functions of working memory and attention.
Additional independent testing evidenced an advantage in visual
working memory for the professionals, which was predicted by musical
training intensity. Similarly, George and Coch (2011), using event-related
potentials and a standardised test of working memory, investigated
neural and behavioural aspects of working memory in college-aged,
non-professional musicians and non-musicians. Behaviourally, the
musicians outperformed the non-musicians on standardised subtests
of phonological and executive memory. Event-related potentials were
recorded in standard auditory oddball paradigms, where participants
responded to infrequent deviant stimuli embedded in lists of standard
stimuli. Electrophysiologically, the musicians demonstrated faster
updating of working memory in the auditory domain and allocated
more neural resources to auditory stimuli, showing increased sensitivity
to the auditory standard deviant difference and less effortful updating
of auditory working memory.
Halpern and Bower (1982), in a pilot study with 12 musicians and
12 non-musicians, briefly presented visually similar melodies that had
been rated as good or bad, followed by a 15-second retention interval
and then recall. The musicians remembered good melodies better than
bad ones while the non-musicians did not distinguish between them. In
one study, six musicians and six non-musicians were briefly presented
with good, bad and random melodies, followed by immediate recall.
The advantage of the musicians over the non-musicians decreased as
the melody type progressed from good to bad to random. In a second
study, seven students and professional musicians divided the stimulus
melodies into groups. For each melody, the consistency of grouping
was correlated with the memory performance found in the first two
experiments. The findings showed that the musicians used musical
groupings, while a simple visual strategy was used by the non-musicians.
Talamini and colleagues (2016) requested musicians and non-
musicians to perform a digit-span task that was presented aurally,
 6. The Impact of Musical Engagement on Memory  151

visually or audiovisually. The task was performed with or without a

concurrent task in order to explore the role of rehearsal strategies,
but also to manipulate task complexity. The musical abilities of all
participants were also assessed. The musicians had larger digit-spans
than non-musicians, regardless of the sensory modality and the
concurrent task. In addition, the auditory and audiovisual spans, but
not the visual alone, were correlated with one subscale of the music
test. The findings suggested a general advantage of musicians over
non-musicians in verbal working memory tasks, with a possible role of
sensory modality and task complexity. Similarly, Hansen and colleagues
(2013) administered a digit-span test, a spatial span test and a musical
ear test to non-musicians, amateur musicians and expert musicians. The
expert musicians significantly outperformed the non-musicians on the
digit-span test. These scores were also correlated with musical scores
and those on a rhythm subtest. No cross-group differences were found
on the spatial span test. Fennell and colleagues (2020), in a complex
experimental study with 22 non-musicians and 30 musicians, presented
participants with a memory element, three nouns, a melody or a dot
matrix, followed by a sentence and then a comprehension question on
each trial. After participants answered the comprehension question,
they had to judge whether a second memory element was the same
as the first one. The musicians performed more accurately on working
memory tasks, particularly those related to verbal and musical working
memory.
D’Souza and colleagues (2018) compared musicians, bilinguals and
individuals who had expertise in both skills, or neither. One hundred
and fifty-three young adults were categorised into one of four groups:
monolingual musician, bilingual musician, bilingual non-musician and
monolingual non-musician. Multiple tasks relating to cognitive ability
were used to examine the coherence of any training effects. The findings
revealed that musically trained individuals, but not bilinguals, had
enhanced working memory. Neither musical or language skill led to
enhanced inhibitory control.
Okhrei and colleagues (2016) explored the performance of the
working memory of musicians and non-musicians in tests with letters,
digits and geometrical shapes. The participants were students who, for
ten to fifteen years, had been engaged in regular musical practice (classed
152 The Power of Music

as musicians), and their peers, who had no previous musical experience

(classed as non-musicians). A computerised working memory test for
letters, digits and shapes, with successive presentation of stimuli, was
applied. The musicians and non-musicians did not differ in the overall
number of mistakes and latency of responses in all subtests for letters,
digits and shapes. The left hand made significantly more mistakes
than the right in both groups, but this regularity was more typical in
non-musicians. The righthand responded faster than the left while
carrying out all subtests in both groups, but such a motor asymmetry
was more evident for non-musicians. In the main, musicians did not
demonstrate an increase in latency of responses with task complexity,
while non-musicians did. Overall, the efficiency of working memory
test performance did not differ among musicians and non-musicians,
but the musicians had tighter interhemispheric cooperation during the
memory test, indicated by less motor asymmetry. Musicians had almost
equal latency of responses regardless of task complexity, while non-
musicians required more time for responding to stimuli during growing
task complexity.
Investigating specific aspects of working memory that differed
between adult musicians and non-musicians, Suárez and colleagues
(2015) compared the performance of 24 musicians and 30 non-musicians
matched for age, gender, years of formal education and verbal intelligence
on several working memory tasks. The musicians outperformed non-
musicians in tasks related to visual motor coordination, visual scanning
ability, visual processing speed and spatial memory, although no
significant differences were found in phonological and visual memory
capacity. The findings support the view that musical training is
associated with specific and not general working memory skills.
Ding and colleagues (2018) investigated to what degree the number
and duration of notes in a sequence influenced the tonal working memory
of participants with or without professional musical training. A forward
tonal discrimination task tested the maintenance of tonal information,
while a backward N-back tonal task probed the running memory span
of tonal information. The findings showed that the number of notes, but
not the duration of notes, in a tone sequence significantly affected tonal
working memory performance for musicians and non-musicians. In
addition, within a minimum musical context, musicians outperformed
 6. The Impact of Musical Engagement on Memory  153

non-musicians on a N-back tonal task but not a forward-tone sequence-

discrimination task. These findings indicate that the capacity of tonal
working memory is determined by the number of notes, but not the
duration of notes, in a sequence to be memorised, suggesting a different
mechanism underlying tonal working memory from verbal working
memory. Musicians held more items in memory for both tonal and
atonal auditory stimuli, but retained items longer than non-musicians
only for tonal stimuli.
Focusing on the role of attention, Pallesen and colleagues (2010)
measured activation responses dependent on blood oxygenation level
in musicians and non-musicians during working memory performance
relating to musical sounds, to determine the relationship between
performance, musical competence and generally enhanced cognition. All
participants easily distinguished the stimuli. The musicians performed
better, as reflected in reaction times and error rates. They also had larger
activation responses dependent on blood oxygenation level than non-
musicians in the neuronal networks that sustain attention and cognitive
control, including regions of the lateral prefrontal cortex, lateral parietal
cortex, insula and putamen in the right hemisphere, and bilaterally
in the posterior dorsal prefrontal cortex and anterior cingulate gyrus.
The relationship between task performance and the magnitude of the
response was more positive in the musicians than in the non-musicians,
particularly during the most difficult working memory task. The
results confirm previous findings that neural activity increases during
enhanced working memory performance. The results also suggest that
superior working memory task performance in musicians relies on an
enhanced ability to exert sustained cognitive control. This cognitive
benefit in musicians may be a consequence of focused musical training.
Similarly, Strait and colleagues (2011b) assessed the impact of selective
auditory attention on cortical auditory evoked response variability in
musicians and non-musicians. The outcomes indicated strengthened
brain networks for selective auditory attention in musicians in that they,
but not non-musicians, demonstrated decreased pre-frontal response
variability with auditory attention. Musicians’ neural proficiency for
selectively engaging and sustaining auditory attention to language
indicates a potential benefit of music for auditory training.
154 The Power of Music

Research with Children and Young People

Not all of the research has been with professional or expert musicians. One
strand of research has focused on children. Behavioural investigations
of children have shown that music training and musical aptitude are
associated with enhanced auditory working memory. For example, in a
longitudinal study of six- to eight-year-old children, half of the sample
was randomly assigned to biweekly keyboard training for six weeks,
while the other half received no training. Following the intervention,
only the training group demonstrated a significant improvement in
working memory capacity, measured with the backward digit-span task
(Guo et al., 2018).
Christiner and Reiterer (2018) tested preschool children’s abilities
to imitate unknown languages, to remember strings of digits, to sing
and to discriminate musical statements. Their intrinsic, spontaneous
singing behaviour was also assessed. The findings showed that working
memory capacity and phonetic aptitude were linked to high musical
perception and production ability as early as age five, suggesting that
music and foreign language learning capacity may be linked from
childhood. Early developed abilities may be responsible for individual
differences in both linguistic and musical performances. Working
with kindergarten children, Hallberg and colleagues (2017) studied
the impact of instrumental music instruction on cognitive processes
in children who were taught the violin using the Suzuki method for
five weeks, with a total of 15 hours of instruction. This group was
compared with a control group. Assessments were made using the
Stanford-Binet five working memory and visuospatial subscales and
the Kiddie Connor’s Continuous Performance Test attention subscales.
There were no statistically significant differences in the means of pre-
and post-change scores between the groups on the Stanford-Binet five
subscales, but there was an effect for the combined Kiddie Connor’s
Continuous Performance Test measures and one effect for a specific
subtest, hit response time. These findings demonstrate that attentional
control, a psychological process necessary in academic learning, may
be enhanced with instrumental music instruction when engaged within
early childhood.
In a longitudinal study, Bergman and colleagues (2014) analysed the
association between musical practice and performance on reasoning,
 6. The Impact of Musical Engagement on Memory  155

processing speed and working memory. Three hundred and fifty-

two children and young people between the ages of six and twenty-
five years old participated in neuropsychological assessments and
neuroimaging investigations on two or three occasions, two years apart.
Multiple regression analysis revealed that playing an instrument had an
overall positive association with working memory capacity, visuospatial
working memory, verbal working memory, processing speed and logical
reasoning across all three time points, after correcting for the effect of
parental education and other after-school activities. Those playing an
instrument also had larger grey-matter volume in the temporo-occipital
and insular cortex areas previously reported to be related to musical
notation reading. The change in working memory between the time
points was proportional to the weekly hours spent on music practice for
both of the working memory tests but not for reasoning ability. These
effects remained when controlling for parental education and other
after-school activities. Similarly, Lee and colleagues (2007) examined
the effects of music training in children aged 12 and young adults on
a forward digit-span, a backward digit-span, a simple spatial span and
complex spatial span tasks. The young adults performed better than the
control group with respect to the digit-span and non-word span tests,
while the children performed better than the control group in all of the
span tests. In a similar study, Roden and colleagues (2014a) investigated
the influence of group instrumental training on the working memory
of children learning instruments through a German Sistema-inspired
programme. A quasi-experimental design was used with children
receiving musical training, compared with those receiving natural
science training or no training. The music group received weekly lessons
for 45 minutes on musical instruments of their choice. The maximum
group size was five and the children could undertake practice at home.
The children were tested at three points over the course of 18 months
with a battery of tests, including seven subtests which addressed the
central executive, the phonological loop and the visuospatial sketchpad
components of Baddeley’s working memory model. The music group
showed a greater increase on every measure of verbal memory, verbal
learning, delayed recall and recognition than the science and control
groups. There were large effect sizes. These differences remained when
the statistical modelling took into account age and measured intelligence.
156 The Power of Music

Working with 42 school-aged children, Strait and colleagues (2011)

assessed auditory working memory and attention, musical aptitude,
reading ability and neural sensitivity to acoustic regularities. Neural
sensitivity to acoustic regularities was assessed by recording brainstem
responses to the same speech sound presented in predictable and
variable speech streams. The research revealed that musical aptitude
and literacy both related to the extent of subcortical adaptation to
regularities in ongoing speech, as well as to auditory working memory
and attention. Relationships between music and speech processing
were specifically driven by performance on a musical rhythm task,
highlighting the importance of rhythmic regularity for both language
and music. These data suggest common brain mechanisms underlying
reading and music abilities, which relate to how the nervous system
responds to regularities in auditory input.
In a longitudinal study, Saarikivi and colleagues (2019) investigated
the development of working memory in musically trained and untrained
children and adolescents, aged nine to twenty. Working memory was
assessed in 106 participants using digit-span forwards and backwards
tests and two trail-making tests. The tests were administered three
times—in 2011, 2013 and 2016. The findings showed that the younger
musically trained participants, in particular, outperformed their
untrained peers in the trail-making tests and the digit-span forwards
tests. These all require active maintenance of a rule in memory or
immediate recall. In contrast, there were no group differences in the
backwards test (which requires manipulation and the updating of
information in working memory). These results suggest that musical
training is more strongly associated with heightened working memory
capacity and maintenance than enhanced working memory updating,
especially in late childhood and early adolescence.
Ireland and colleagues (2018) developed age-equivalent scores
for two measures of musical ability, a rhythm synchronisation task
and a melody discrimination task, that could be reliably used with
schoolchildren aged seven to thirteen, with and without musical training.
These tasks were administered to children attending music or science
camps. Children’s paced tapping, non-paced tapping and phonemic
discrimination were measured as baseline motor and auditory abilities.
The musically trained children outperformed those without music
 6. The Impact of Musical Engagement on Memory  157

lessons, although the scores decreased as difficulty increased. Older

children performed the best. Years of lessons significantly predicted
performance on both music tasks, over and above the effect of age.
Degé and Schwarzer (2017) aimed to investigate whether an
enhanced articulatory rehearsal mechanism might explain higher
verbal memory scores in musically trained children compared with
untrained children. They tested 39 ten- to twelve-year-old children, 19
of whom were musically trained and 20 untrained. Verbal memory was
assessed with two-word lists. Children memorised one word list under
normal conditions and the other word list when they had to repeat an
irrelevant word over and over again (articulatory suppression). Gender,
socioeconomic status, intelligence, motivation, musical aptitude and
personality were controlled for. There was a significant difference
between musically trained and untrained children in favour of the
musically trained children in verbal memory in the normal condition.
However, in the articulatory suppression condition, the advantage of
musically trained children disappeared. The authors concluded that
an enhanced verbal rehearsal mechanism might be responsible for the
better verbal memory in musically trained children.
James and colleagues (2019) undertook a cluster randomised
controlled trial focused on musical instrumental practice, in comparison
to traditional sensitisation to music. Over the last two years of primary
school, 69 children aged 10 to 12 received group music instruction
by professional musicians twice a week as part of the regular school
curriculum. The intervention group learned to play stringed instruments,
whereas the control group was sensitised to music via listening, theory
and some practice. Broad benefits manifested in the intervention group
as compared to the control group for working memory, attention,
processing speed, cognitive flexibility, matrix reasoning, sensorimotor
hand function and bimanual coordination. Learning to play a complex
instrument in a dynamic group setting impacted development more
strongly than classical sensitisation to music. The results highlighted
the added value of intensive musical instrumental training in a group
setting within the school curriculum.
Escobar and colleagues (2020) investigated the perception of speech
in noise in 49 young musicians and non-musicians, who were assigned
to subgroups with high or low assessed working memory based on
158 The Power of Music

performance on the backward digit-span task. The effects of music

training and working memory on speech-in-noise performance were
assessed on clinical tests of speech perception in background noise.
Listening effort was assessed in a dual task paradigm and through
self-report. There was no statistically significant difference between
musicians and non-musicians, and no significant interaction between
music training and working memory on any of the outcome measures.
However, a significant effect of working memory on speech-in-noise
ability was found. This suggests that music training does not provide an
advantage in adverse listening situations, either in terms of improved
speech understanding or reduced listening effort. While musicians have
been shown to have heightened basic auditory abilities, the effect of this
on speech in noise and listening effort may be more subtle. Regardless of
prior music training, listeners with high working memory capacity were
able to perform significantly better on speech-in-noise tasks.
Some research has shown no effect of music training on working
memory. For instance, Banai and Ahissar (2013) researched whether
the pattern of correlations between auditory- and reading-related skills
differed between children with different amounts of musical experience.
Children in the third grade with various degrees of musical experience
were tested on a battery of auditory- and reading-related tasks. Very
poor auditory thresholds and poor memory skills were abundant
among children with no musical education. For these children, indices
of auditory processing were significantly correlated with and accounted
for up to 13 percent of the variance in reading-related skills. Among
children with more than one year of musical training, auditory processing
indices were better, but reading-related skills were not correlated with
them. Very poor auditory and memory skills are rare among children
with even a short period of musical training, suggesting that musical
training could have an impact on both. The lack of correlation in the
musically trained population suggests that a short period of musical
training does not enhance reading-related skills of individuals with
normal auditory processing skills.
Overall, as outlined in the previous section, cross-sectional studies
have shown that higher working memory capacity is associated with
better scores on rhythmic subtests of musical aptitude in children
as young as five. Where children were randomly assigned to music
 6. The Impact of Musical Engagement on Memory  159

training or control conditions, there was a causal effect of training

on working memory capacity. The evidence for a close relationship
between musical practice and working memory suggests that training,
rather than any predisposition, produces changes in working memory
capacity, although associations between working memory capacity and
measures of musical aptitude suggest that training-related advantages
are not independent of existing abilities. Musical training and musical
aptitude may both affect memory performance among children.

Older Adults
The experiences that individuals have throughout their lifetime influence
the quality of their cognitive ageing. In older individuals, former and
current musical practices are associated with enhanced verbal skills,
visual memory, processing speed and planning functions. Participating
in making music does not have an age limit (Thaut and Hodges, 2019).
Adults can take up musical activities, or resume or continue activities
pursued earlier in life in their older years. This can have several benefits:
supporting further learning, assisting in slowing cognitive decline and
supporting rehabilitation. For instance, taking piano lessons for six
months has been shown to enhance levels of concentration, attention
and planning in 60- to 85-year-old adults, compared to a control
group. The piano lessons were individualised, and consisted of motor
dexterity exercises and learning music theory. Participants were tested
on cognitive and working memory measures at three points in time:
pre-training, post-training and following a delay of three months. The
experimental group obtained significantly higher scores post-training
on a trail-making test and digit symbols than the untrained controls,
indicating an improvement in visual scanning, perceptual speed, and
working memory (Bugos et al., 2007). Similarly, Bugos (2010) examined
the effects of active piano-playing instruction compared with music-
listening instruction on executive function in healthy older adults,
aged 60 to 85. Seventy adults were matched by age, education and
estimated intelligence in two 16-week training groups (group piano
instruction or music-listening instruction). Participants completed
a battery of cognitive assessment tests pre- and post-instruction to
assess processing speed, verbal fluency, planning and cognitive control.
160 The Power of Music

Forty-six participants completed the study. There were no statistically

significant differences between the groups on measures of executive
function. Both groups demonstrated an increase in scores, although
those learning to play the piano had significantly enhanced processing
speed, verbal fluency and cognitive control. In a later study, Bugos
(2019) focused on motor skills. Participants were randomly allocated to
piano, percussion or music-listening groups, and undertook 16 weeks of
training with three hours of practice per week. The groups were matched
for age, education, intelligence and musical aptitude. In the piano and
percussion groups, improvements in processing speed, visual scanning
and working memory were recorded. All three music conditions led to
improved rhythmic accuracy and hand synchronisation. Similar results
have been reported after older adults have sung in a choir, engaged in
group music-making or played percussion instruments (Hallam et al.,
2014; Hallam and Creech, 2016).
Fauvel (2014) compared the performance of musicians and non-
musicians in middle and late adulthood on long-term memory, auditory
verbal short-term memory, processing speed, non-verbal reasoning
and verbal fluency. The musicians performed significantly better than
non-musicians on measures of processing speed and verbal short-term
memory. Both groups displayed the same age-related differences. In
relation to verbal fluency, musicians scored higher than controls and
displayed different age effects. A second study showed that when
musical training started in childhood or adulthood, it was associated
with phonemic, but not semantic, fluency performance. Musicians who
had started to play in adulthood did not perform better on phonemic
fluency than non-musicians. The current frequency of training did not
account for musicians’ scores on either of these measures. Overall, the
findings yielded little evidence of reduced age-related changes owing
to musical training. Phonemic fluency was the only variable that
exemplified a positive effect in ageing.
The influence of music on memory applies to listening to music
as well as participating in musical activities (Varvarigou et al., 2012;
Hallam and Creech, 2016). For instance, Degé and Kerkovius (2018)
investigated the effect of a music training programme on working
memory, verbal and visual, and as part of central executive processing
in older adults. The experimental group was trained in drumming and
 6. The Impact of Musical Engagement on Memory  161

singing, while one control group participated in a literature training

programme and a second group was untrained. Twenty-four female
participants, aged 70 years old on average, were randomly assigned to
either a music, literature or untrained group. The training lasted for 15
weeks. At the start of the programme, the three groups did not differ
significantly in age, socioeconomic status, music education, musical
aptitude, cognitive abilities or depressive symptoms. Following the
programme, there were no differences between the groups on central
executive function but there was a potential effect of music training
on verbal memory and an impact of music training on visual memory.
Musically trained participants remembered more words from a word
list and more symbol sequences correctly than both control groups.
Musical improvisation was used by Diaz Abraham and colleagues
(2020) to study its impact on verbal memory in older adults. Two
types of verbal memory were evaluated prior to the intervention: one
neutral, the other emotional. The participants were exposed to musical
improvisation in the experimental condition, while two control groups
carried out rhythmic reproduction or experienced a rest condition.
Memory performance was evaluated through immediate and deferred
free recall and recognition tests. The memory performance of those with
five or more years of training (defined as musicians) and non-musicians
was compared. There was a significant improvement in neutral verbal
memory among participants involved in musical improvisation.
They remembered more words than those in the control conditions.
Differences were also found according to the musical experience of the
sample, with musicians outperforming non-musicians.
Parbery-Clark and colleagues (2011) compared older musicians
and non-musicians on auditory and visual working memory, and the
ability to perceive speech in noise. They found that the musicians were
significantly better at perceiving speech in noise and performed better
in auditory, but not visuospatial, working memory capacity tasks. The
research also revealed a linear relationship between auditory working
memory and speech-in-noise performance, suggesting that these two
functions were related. Similarly, Grassi and colleagues (2018) reported
that older adult musicians outperformed older adult non-musicians on
auditory and visuospatial working memory tasks, as well as auditory
discrimination, although the groups did not differ on tests of short-term
162 The Power of Music

memory. Amer and colleagues (2013) also reported that older adult
musicians outperformed older adult non-musicians on several tests of
executive function, including visuospatial working memory.
One strand of research has explored the impact of different levels
of long-term engagement with music on cognition. For instance,
Hanna-Pladdy and MacKay (2011) evaluated the association between
musical instrumental participation and cognitive ageing. Seventy older
healthy adults, aged 60 to 83, participated in varied musical activities
and completed a comprehensive neuropsychological battery. Three
groups—non-musicians, those with low musical activity(one to nine
years through the lifespan) and those with high musical activity over ten
years—were compared. Participants were matched on age, education
and history of physical exercise. Those with at least ten years of musical
experience had better performance on non-verbal memory, naming
and executive processes in advanced age relative to non-musicians.
Years of musical activity, the age of commencement of that activity and
type of musical training predicted cognitive performance. In a later
study Hanna-Pladdy and Gajewski (2012) researched 70 older adults
aged 59 to 80, musicians and non-musicians, who were assessed on
neuropsychological tests and general lifestyle activities. The musicians
scored higher on tests of visuospatial judgment.
Another strand of research has tested the potential of music
intervention programmes to reduce the deleterious effects of ageing
on cognition. For instance, Hars and colleagues (2013) investigated
whether six months of music-based multi-task training had beneficial
effects on cognitive functioning and mood in 134 older adults aged
over 65 who were at increased risk of falling. The intervention group
consisted of 66 older people who attended once-weekly hourly
supervised group classes of multi-task exercises, executed to the rhythm
of piano music, or a control group of 68 individuals with delayed
intervention who maintained usual lifestyle habits for six months. A
short neuropsychological test battery was administered at the start of
the intervention and after six months. It included the mini mental state
examination, a clock-drawing test, a frontal assessment battery, and
anxiety and depression scales. For those participating in the musical
activities, there was an improvement in sensitivity to the interference
subtest of the frontal assessment battery, a reduction in anxiety level,
 6. The Impact of Musical Engagement on Memory  163

an increase in the mini mental state assessment score and a reduction in

the number of participants with impaired global cognitive performance.
Overall, six months of once-weekly music-based multi-task training was
associated with improved cognitive function and decreased anxiety in
community-dwelling older adults.
Engagement with music has also been found to reduce the risk of
dementia. For instance, Verghese and colleagues (2003) examined the
relationship between leisure activities and the risk of dementia in a
cohort of 469 participants aged 75 years of age and over, who resided
in the community and did not have dementia at the beginning of the
research. They examined the frequency of participation in leisure
activities at enrolment, and measured cognitive activity and physical
activity in terms of the number of days of the week when activity took
place. A range of possible confounding factors were controlled for
including age, sex, educational level, presence or absence of chronic
medical illnesses, and baseline cognitive status. Over a follow-up period
of five years, dementia developed in 124 participants, Alzheimer’s
disease in 61, vascular dementia in 30, mixed dementia in 25 and other
types of dementia in 8. Among leisure activities, reading, playing board
games, playing musical instruments and dancing were associated with a
reduced risk of dementia. A one-point increment in the cognitive activity
score was significantly associated with a reduced risk of dementia
but a one-point increment on the physical activity score was not. The
association with the cognitive activity score persisted after the exclusion
of participants with possible pre-clinical dementia at the start of the
research. The findings were similar for Alzheimer’s disease and vascular
dementia. Increased participation in cognitive activities at the start of
the research was associated with reduced rates of decline in memory.
Overall, participation in leisure activities was associated with a reduced
risk of dementia. In a co-twin study, Balbag and colleagues (2014)
showed that twins who played an instrument were 64 percent less likely
to develop dementia than their co-twins. The research examined the
association between self-reported playing of a musical instrument and
whether or not both twins developed dementia or cognitive impairment.
Controlling for sex, education and physical activity, playing a musical
instrument was significantly associated with less likelihood of dementia
and cognitive impairment. In a review, Schneider and colleagues (2018)
164 The Power of Music

concluded that playing a musical instrument was a potential protective

mechanism against cognitive decline among older adults.
Some studies have shown improvements in cognition and working
memory in patients with dementia after active singing interventions
(Maguire et al., 2015). Singing groups engaged in three vocal music
sessions each week including familiar, nostalgic and nonfamiliar,
novel, vocal music selections in four 50-minute singing sessions. The
programme progressively exercised individual vocal ranges, vowel
placements respiratory patterns and recruited cognitive engagement
through melodic structures, musical architecture and story development.
Participants were predominantly Caucasian, aged 70 to 99 years old,
and from two groups: one living in assisted accommodation, the other
in secure-ward dementia accommodation. Each group was divided into
singers and listeners. Participation in the singing groups was voluntary.
Levels of participation were assessed throughout the programme from
no attention to dozing off, through to brief periods of attention but not
singing. The category participation included singing for most of the
time, singing all of the time and singing with enthusiasm. The music
was varied each month and focused on four separate musical genres:
Valentine’s day, patriotic, musical theatre and folk patriotic. The music
was selected and arranged to incorporate relaxing, rhythmical elements,
rich harmonies, increased vocal range and exercise along vocal lines
and word articulation. Deep breaths, appropriate posture and vocal
resonance were consistently coached and promoted throughout all
sessions. Two of the weekly vocal music sessions were live music sessions
with a vocal music leader who sang and played piano accompaniment.
The other session consisted of a 50-minute taped DVD recordings. A
norovirus outbreak in the assisted living group led to a quarantine
period of one month in the middle of the study, resulting in no access to
any participants during this time.
Analysis of the data showed that the independent residents had
significantly higher scores than those with dementia. Singers with
dementia had significantly higher scores than listeners by the end of the
study. There was no significant difference between the clock-drawing
ability of singers and listeners with dementia initially, but singers scored
significantly higher after engaging with the singing. Overall, the findings
for those living independently and the dementia groups showed that
 6. The Impact of Musical Engagement on Memory  165

singers had significantly higher satisfaction with life scores than those
listening to music. The norovirus outbreak may have affected the scores
of the independent-living participants, as they had lower scores on the
mental state examination and the clock design test score. The findings
showed that an active singing programme, using an innovative approach,
led to significant improvement in cognitive ability in individuals with
dementia. Similarly, Pongan and colleagues (2017) aimed to determine
the efficacy of choral singing versus painting sessions on chronic pain,
mood, quality of life and cognition in patients with Alzheimer’s disease.
Fifty-nine patients with mild Alzheimer’s disease were randomised to
a 12-week singing or painting group. Chronic pain, anxiety, depression
and quality of life were assessed before, immediately after and one
month after the sessions. Both singing and painting interventions led
to significant pain reduction, reduced anxiety, improved quality of life,
improved digit-span and inhibitory processes. However, depression was
reduced only in the painting group, while verbal memory performance
remained stable over time in the singing group but decreased in the
painting group. Overall, the findings suggest that singing and painting
interventions may reduce pain and improve mood, quality of life, and
cognition in patients with mild Alzheimer’s disease, with differential
effects of painting for depression and singing for memory performance.
Also focusing on singing, Camic and colleagues (2013) worked with ten
people with dementia and their family carers in a singing-together group
for ten weeks. Measures of mood, quality of life, dementia, behavioural
and psychological problems, activities of daily living and cognitive
status were measured at pre-, post- and ten-week follow-up. Engagement
levels were monitored during the sessions and care partners were asked
to rate each session. Additional qualitative information was obtained
through interviews pre- and post-intervention and at follow-up. The
results showed that the dementia sufferers were deteriorating slowly
over the course of the study on all measures, but that they and their
carers’ quality of life remained relatively stable. Engagement levels
during the programme were very high, and attendance excellent.
The interviews provided strong support for the intervention, having
promoted the wellbeing of all participants.
In a randomised controlled study, Särkämö and colleagues (2014)
compared the effects of three different interventions on working
166 The Power of Music

memory on a group of patients with dementia. Each participant was

assigned to one of three 10-week group-based interventions: singing,
listening to music or usual care. The findings showed that participants
in the singing group showed a temporary improvement in working
memory, as measured by backward digit-span. Also using a randomised
controlled study, Narme and colleagues (2014) studied 48 patients with
Alzheimer’s disease or mixed dementia, and compared the effects of
music versus cooking interventions on their emotions, cognition and
behaviour, as well as on their professional caregivers. Each intervention
lasted for one hour, twice a week for four weeks. The findings showed
that music and cooking interventions led to positive changes in
emotional state and decreased the severity of behavioural disorders, as
well as reducing the stress levels of the caregivers, but there was no
benefit to the participants’ cognitive status.
Mansky and colleagues (2020) carried out a post-hoc observational
analysis of the Zurich disability prevention trial. Past and present musical-
instrument playing was correlated with mini mental state assessment
and a visual analogue scale using linear regression at baseline and
mixed model linear regression over one year. Two hundred community-
dwelling adults were included. Just over 48 percent of participants had
played a musical instrument, 35 percent had played in the past and
13.5 percent continued to play. At the start of the programme, those
currently playing an instrument had a higher adjusted mini mental state
assessment score than those who had never played. Over a 12-month
period, those who had continued to play showed significantly more
improvement from baseline in the mini mental state assessment than
those who had never played. This association remained significant
even after restricting the analysis to those participants who had not
undertaken higher education. Over time, no differences were observed
for the visual analogue scale, although past players had the largest
decline in health-related quality of life at 12 months. Overall, present
and past musical-instrument playing was able to assist in preserving
cognitive function in community-dwelling older adults. An ongoing
study is being undertaken by James and colleagues (2020) in Hannover
and Geneva over a 12-month period with elderly people receiving either
piano instruction or musical listening awareness. Testing is being carried
out at four time points: prior to the research, and after 6, 12 and 18
 6. The Impact of Musical Engagement on Memory  167

months, following training on cognitive and perceptual motor aptitudes,

as well as wide-ranging functional and structural neuroimaging and
blood sampling. The researchers hope to show that musical activities
can diminish cognitive and perceptual motor decline.
Overall, the research to date suggests that music training may
protect against age-related decline in working memory and can
improve performance among older adults who show decline in working
memory. Importantly, music training may be useful in the prevention
and treatment of dementia, although the benefits may be more related
to general wellbeing rather than cognitive enhancement. Not all the
research shows that engaging with music can help to stave off dementia.
Kuusi and colleagues (2019) examined the causes of death of Finnish
professional classical musicians, performing artists and church musicians
between 1981 and 2016 and showed that overall, there appeared to be
a protective effect of music for health, although there was increased
mortality in alcohol-related disease among female performing artists
and in neurodegenerative diseases among male performing artists.

Reviews and Meta-Analyses

Reviews of the role of active music-making on visual, verbal and working
memory have had mixed findings. On the basis of their review, Franklin
and colleagues (2008) concluded that the benefits of music training on
working memory were not limited to the auditory domain but could
lead to enhanced verbal working memory. Strait and Kraus (2011a)
suggested that the auditory expertise gained over years of consistent
music practice fine-tuned the human auditory system, strengthening
the neurobiological and cognitive underpinnings of both music and
speech processing, subsequently bolstering the neural mechanisms
that underpin language related skills, such as reading and hearing
speech in background noise. In a later review, Kraus and colleagues
(2012) examined the biological underpinnings of musicians’ auditory
advantages and the mediating role of auditory working memory. They
reported associations between working memory performance, music
training or aptitude, and neural encoding of speech. Moreno and
Bidelman (2014) argued that some programmes that aimed to impact
on the non-auditory functions necessary for higher order aspects of
168 The Power of Music

cognition, including working memory (for instance, visual arts), may not
yield widespread enhancement. They suggested that musical expertise
uniquely taps and refines a hierarchy of brain networks, which subserve
a variety of auditory, as well as domain-general, cognitive mechanisms.
From this, they inferred that transfer from specific music experience to
broad cognitive benefit might be mediated by the degree to which a
listener’s musical training fine-tuned lower and higher order executive
functions, and the coordination between these processes. Dumont and
colleagues (2017), in a review of five studies, reported mixed results.
One experimental study showed improved performance in those who
had participated in formal music lessons, but the remaining four
studies, although reporting positive or partially positive results, were
limited in the rigour of their methodology. Overall, there did seem to be
potential benefits of active engagement with music, but methodological
limitations did not allow clear conclusions to be drawn. On the basis
of their review, Benz and colleagues (2016) argued that music training
could have positive effects, but that these were frequently restricted to
the auditory domain.
In a meta-analysis examining the effects of music training on a
range of cognitive skills, Sala and Gobet (2017b), using random effects
models, showed a small overall effect size but slightly greater effect sizes
with regard to memory-related outcomes, although overall there was an
inverse relationship between the size of the effects and the methodological
quality of the design of the studies. In a later meta-analysis, Sala and
Gobet (2020) reanalysed data from 54 previous studies including a
total of 6,984 children. They found that music training appeared to be
ineffective at enhancing cognitive or academic skills, regardless of the
type of skill—verbal, non-verbal, speed-related, participants’ age or
duration of music training. Studies with high-quality designs showed
no effect of music education on cognitive performance.
Three meta-analyses were carried out by Talamini and colleagues
(2017), who focused on short-, long-term and working memory. The
studies involved young adult musicians and non-musicians using tonal,
verbal or visuospatial stimuli. The 29 studies in the analyses included
53 memory tasks. The results showed that musicians performed better
than non-musicians on tasks involving long-term memory, short-term
memory and working memory. A further analysis included a moderator:
the type of stimulus presented (tonal, verbal or visuospatial). This was
 6. The Impact of Musical Engagement on Memory  169

found to influence the effect size for short-term and working memory,
but not for long-term memory. The musicians’ advantage in terms of
short-term and working memory was large with tonal stimuli, moderate
with verbal stimuli, and small or null with visuospatial stimuli. The three
meta-analyses revealed a small effect size for long-term memory, and
a medium effect size for short-term and working memory, suggesting
that musicians perform better than non-musicians in memory tasks—
although this advantage was moderated by the type of stimuli.
Baird and Samson (2015) reviewed the literature on music cognition
in dementia, pointing out that different types of memory are not impaired
in the same ways in dementia. They argued that little rigorous scientific
investigation had been undertaken, and that large-scale randomised
control studies had questioned the specificity of the effect of music
and found that it was no more beneficial than other pleasant activities.
However, they acknowledged that music was unique in its power to elicit
memories and emotions, which could provide an important link to an
individual’s past and a means of non-verbal communication with carers.
Walsh and colleagues (2019)—in a meta-analyse which focused on
cognitive impairment or dementia as the outcome, and included studies
with learning to play a musical instrument as the main intervention—
found a 59 percent reduction in the risk of developing dementia for
those playing a musical instrument. However, they advised caution in
interpreting the findings, as the evidence base was limited by its size
and methodological issues.

Overview
The evidence presented in this chapter suggests that active engagement
with making music can have positive effects on some aspects of memory.
The effects are strongest when they relate to the aural skills which
active engagement with music is acknowledged to enhance: memory
for music and stimuli presented verbally. The evidence for the impact
on visual skills is less strong and is likely to depend on the extent to
which musicians’ skills include reading musical notation. Musicians
tend to have greater working memory capacity than non-musicians, but
measures of musical expertise suggest that training-related advantages
are not independent of existing abilities. Musical training and musical
aptitude may both affect memory performance among children.
 7. Executive Functioning
and Self-Regulation

Executive functions enable individuals to optimise performance on a

range of tasks. They improve concentration, facilitate planning, help with
the prioritisation of information, and promote flexibility in changing
strategies, switching between tasks, and adapting to change (Diamond,
2013). Most models of executive functions postulate three related but
separable components: inhibition or inhibitory control; shifting, cognitive
flexibility or switching; and updating or working memory updating
(Diamond, 2013; Gould, 2014; Lehto et al., 2003; Logue et al., 2012;
Miyake et al., 2000). Inhibition or inhibitory control requires the control
of thoughts or behaviour to override a response which has priority over
other possible responses. Cognitive flexibility requires an individual to
change perspective or switch between task demands, while updating
requires individuals to maintain, add, delete and manipulate items
within memory. These executive functions develop through childhood
and adolescence and can be improved with practice (Diamond, 2013;
Diamond et al., 2007; Miyake et al., 2000). Overall, executive functions
include the activities of working memory and involve the control of
actions, thoughts, emotions and general abilities including planning,
solving problems, and being able to adjust to novel or changing task
demands (Diamond, 1990; 2002; Lezak, 2004; Zelazo, 2004). Because of
the plasticity of the brain, they continue to develop over the lifespan,
although Friedman and colleagues (2008) argue that they are influenced
by a highly heritable (99%) common factor and that there are additional
genetic influences unique to particular executive functions. Supporting
this, they presented data from a multivariate twin study examining why
participants varied in each of the three elements of executive functioning
and why these abilities were correlated but separable. Other research has

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.07

172 The Power of Music

shown that the development of executive function is complex, as neural

changes are affected by synaptic proliferation, pruning, myelination,
neurofilament and neurotransmitter levels. Each of these has its own
developmental trajectory until, over time, the neural networks settle into
more stable states. Performance on three complex executive functioning
tasks has been shown to improve until at least age 15, although the pace
of improvement slowed with increasing age and varied across tasks
(Best et al., 2011). Understanding executive functions is important, as
they impact on the quality of life and performance in school and in the
workplace, and have been shown to improve with practice (Diamond,
2013; Diamond et al., 2007). This means that there is the possibility that
they can be trained.
Executive functions can be measured in several different ways.
Inhibition control can be assessed by a range of tests, including the
Stroop test and the stop-signal task. The Stroop test requires participants
to read colour words—for example, red, blue or green—presented on a
screen, and then to say the colour of the font aloud. In congruent trials,
the colour of the font is the same as the word, while in incongruent
trials, the colour of the font does not match the word. In neutral trials,
a string of asterisks appears. The Stroop effect is the difference in the
average of correct responses between incongruent and neutral trials. In
the stop-signal task, participants are required to fixate on a cross in the
centre of a screen, which is replaced by either a square or a circle. They
are instructed to push left as quickly as possible if they see a square, and
to push right as quickly as possible if they see a circle. On a quarter of
the trials, participants are presented with the shape, then hear a stop
signal (a beep from the computer), and are instructed to withhold any
response when they hear that signal. On each trial where there is a stop
signal, the onset of the stop signal is adjusted until participants can
correctly inhibit it for half of the responses. Performance is measured as
the stop-signal reaction time—an estimate of how long it takes to inhibit
an already initiated response.
Cognitive flexibility, or set-shifting, assesses the ability to shift from
one task to another. Participants are shown a set of five cards each with a
different figure on it. The figures switch around with each element. For
example, in one problem the figures on the cards might be three green
stars, one red circle, two yellow blocks, four yellow crosses and two red
 7. Executive Functioning and Self-Regulation  173

crosses. The participant sees four of the cards lined up in a row, and one
by itself below. He or she is told to match that card to one of the four
above, but not told the rule for matching. The participant does not know
whether to match by shape, colour or number. Feedback is only given on
whether the participant is right or wrong in the match made. Through
trial and error, the participant needs to work out the rule. The score is
how many correct sorts are made.
The updating or working memory element of executive function
tends to be assessed using various digit-span tests. For instance, in the
forward test the participant repeats a series of numbers in the order
that they are given. In the reverse digit-span, the numbers have to be
repeated backwards. In spatial spans, the assessor touches a series of
blocks in a particular order. The participants have to copy that order or
reverse it. The Tower of Hanoi test can also be used to assess working
memory. It requires the participant to rearrange disks to match a model
while following specific rules; for instance, not putting a large disk on
top of a smaller one. The goal is to complete the task in as few moves as
possible. These various tests have been used in research with adults and
children—both young and older people.
There has been great interest in whether making music might
enhance executive functions. When musicians engage in making music,
they read and decipher musical notation, recall music from memory
and may improvise new material. They produce musical sounds while
also planning ahead, keeping notation and rhythms in mind until they
are performed. They must monitor their performance but also attend
to the auditory streams produced by other performers so that they
can flexibly coordinate and adjust the sounds that they are producing
to match those of the group (Okada and Slevel, 2018). Managing
this complexity may enable individuals to become more effective in
managing equally complex tasks in other situations (Cabanac et al.,
2013). Musical activities, formal and informal, promote analytical
thinking, planning and prioritising, attention, problem-solving and
other executive functions (Serpell and Esposito, 2016). Each of the three
components of executive functioning has been linked to musical activity.
For instance, overriding expectations and unexpected resolutions of
musical ambiguity may draw on general inhibitory control mechanisms
(Slevc and Okada, 2015). Shifting is implicated in ensemble-playing,
174 The Power of Music

where musicians must coordinate their own playing with others in the
group (Jentzsch et al., 2014; Palmer, 2013). Playing with others requires
being able to flexibly shift between auditory streams (Loehr et al., 2013)
and also adjust dynamically to the other members of the ensemble
(Loehr and Palmer, 2011; Moore and Chen, 2010). Updating is crucial
in reading musical notation, particularly in sight-reading, as musicians
need to look ahead in the score to prepare for what to play next. Expert
sight-readers typically look at least four notes ahead of where they are
playing (Drake and Palmer, 2000; Furneaux and Land, 1999; Goolsby,
1994). This requires constant updating of the contents of working
memory, holding in memory what is being played and what is still to
be played. Indeed, there is evidence that being able to sight-read well is
related to non-musical measures of working memory capacity (Meinz
and Hambrick, 2010).
Music has been used to enhance executive functions, as it is a
multifaceted activity. Learning to play an instrument usually, although
not always, requires the learner to read music, translate printed notation
into planned motor sequences, develop fine motor coordination and
hold a great deal of information in memory (Peretz and Zatorre, 2005).
Formal music practice involves controlled attention for long periods of
time, keeping musical passages in working memory, encoding them
into long-term memory, decoding musical scores and translating them
into motor programmes. These activities draw on complex cognitive
functions which have been illustrated in brain-imaging research
(Stewart et al., 2003). Schon and colleagues (2002) investigated the brain
areas involved in reading musical notation using functional magnetic
resonance imaging. They compared reading musical notation to reading
verbal and numerical notation. Professional musicians were required to
play musical notation, read verbal information and read the numbers
displayed on a five-key keyboard. The three tasks revealed a similar
pattern of activated brain areas. Playing an instrument is also related
to an increased rate of cortical thickness maturation in the dorsolateral
prefrontal cortex and orbitofrontal cortex, areas often involved in
executive functions (Hudziak et al., 2014). Musically trained children
also show greater blood-oxygenation-level-dependent responses in a
task-switching paradigm in the bilateral ventrolateral prefrontal cortex
and supplementary motor area (Zuk et al., 2014)—regions linked to
executive functioning (Nachev et al., 2008; Nee et al., 2013).
 7. Executive Functioning and Self-Regulation  175

Listening to or tapping complex polyrhythms—for instance, tapping

four against three—requires inhibitory control and is associated with
activation in Broadmann Area 47, an area of the brain which is implicated
in the processing of syntax in oral and sign languages, musical syntax,
and the semantic aspects of language. It is also associated with activity
in the anterior cingulate cortex, which is implicated in empathy, impulse
control, emotion and decision-making (Vuust et al., 2006; 2011). Stewart
and colleagues (2003) scanned musically naïve subjects using functional
magnetic resonance imaging before and after they had been taught to
read music and play a keyboard. When participants played melodies
from musical notation after training, activation was seen in a cluster of
voxels within the right superior parietal cortex, consistent with the view
that music-reading involves spatial sensorimotor mapping.

Research with Adults

Much of the research with adults has been based on correlations
examining the relationship between levels of musical expertise and
performance on various tests of executive function. Some of this
research has used continuous measures of musical expertise, while
other research has compared the performance of musicians with
that of non-musicians. As seen in Chapter 6, a range of studies have
demonstrated that musicians may have advantages in performance
in working memory compared with non-musicians. This has been
demonstrated on measures of auditory and visual working memory
(Franklin et al., 2008; Fujioka et al., 2006; George and Coch, 2011; Lee
et al., 2007; Pallensen et al., 2010; Parbery-Clark et al., 2011). Other
research has explored other elements of executive functioning. For
instance, Hansen and colleagues (2012) administered digit- and spatial-
span tests and a musical ear test to non-musicians and amateur and
expert musicians. The expert musicians significantly outperformed the
non-musicians on the digit-span test. Digit-span forward scores were
also found to be correlated with musical ear test scores and scores on
a rhythm subtest. However, there were no differences between the
groups on the spatial-span task. Similarly, Strait and colleagues (2010)
administered a standardised battery of perceptual and cognitive tests to
adult musicians and non-musicians, including tasks which were more
176 The Power of Music

or less susceptible to cognitive control and more or less dependent on

auditory or visual processing. The outcomes indicated lower perceptual
thresholds in musicians, specifically for auditory tasks, including
auditory attention. There were no group differences for simultaneous
masking and visual attention tasks. Overall, long-term musical practice
strengthened those cognitive functions which benefited auditory
skills. Also focusing on auditory skills, Clayton and colleagues (2016)
investigated whether musicians would outperform non-musicians
in recognising a speech target in a multi-talker, cocktail-party-like
environment. Executive function assessment included measures of
cognitive flexibility, inhibition control and auditory working memory.
The musicians performed significantly better than the non-musicians in
spatial hearing and measures of auditory working memory. A multiple
regression analysis revealed that musicianship and performance on a
multiple-object tracking task significantly predicted performance on the
spatial hearing task, confirming the relationship between musicianship,
domain-general selective attention and working memory in solving the
cocktail party problem.
Some research has focused on the role that music might play
in enhancing attention. For instance, Medina and Barraza (2019)
explored the relationship between long-term musical training and the
efficiency of the attentional system. They compared performance on the
alerting, orienting and executive attentional networks of professional
pianists compared with a matched group of non-musician adults. The
executive attentional network was more efficient in musicians than
non-musicians, although there were no differences in the efficiency
of alerting and orienting networks between the groups. The findings
showed that the efficiency of the executive system improved with years
of musical training, even when controlling for age. The three attentional
networks of the non-musicians were functionally independent, while
for the musicians the efficiency of the alerting and orienting systems
were associated. Similarly, Pallensen and colleagues (2010) examined
working memory for musical sounds and found that, in comparisons
between musicians and non-musicians, the musicians had heightened
activity in neuronal networks that sustained attention and cognitive
control, including the prefrontal regions and the supplementary
motor area. The relationship between task performance and activation
 7. Executive Functioning and Self-Regulation  177

patterns was strongest in the musicians during the periods when the
load on working memory was the heaviest. Also focusing on attention,
Román-Caballero and colleagues (2020) investigated attentional and
vigilance abilities in expert musicians with a measure which allowed the
assessment of the functioning of the three networks that are concerned
with alerting, orienting, and executive control—along with two different
components of vigilance (executive and arousal vigilance). Forty-nine
adult musicians, from 18 to 35 years old, were matched on an extensive
set of confounding variables with a control group of 49 non-musicians.
The musicians showed advantages in processing speed and the two
components of vigilance, with some specific aspects of musicianship
(such as years of practice or years of lessons) correlating with these
measures.
Another strand of research has considered the relationship between
executive functions, music training and bilingualism. For instance,
Moradzadeh and colleagues (2015) investigated whether musical
training and bilingualism were associated with enhancements in specific
components of executive function: namely task-switching and dual
task performance. One hundred and fifty-three participants belonged
to one of four groups: monolingual musician, bilingual musician,
bilingual non-musician or monolingual non-musician. The findings
demonstrated reduced global and local switch costs in musicians
compared with non-musicians, suggesting that musical training can
contribute to increased efficiency in the ability to shift flexibly between
mental sets. The musicians also outperformed the non-musicians
on dual task performance, but there was no cognitive advantage for
bilinguals relative to monolinguals, nor an interaction between music
and language. The findings demonstrated that long-term musical
training, but not language training, was associated with improvements
in task-switching and dual task performance. Similarly, Moreno and
colleagues (2014) explored executive functions in musicians, bilinguals
and controls. Participants completed a visual go/no go task that
involved the withholding of key presses to rare targets. Participants in
each group achieved similar accuracy rates and response times, but the
analysis of cortical responses revealed significant differences. Success
in withholding a prepotent response was associated with enhanced
stimulus-locked neural activity. This was particularly the case for the
178 The Power of Music

musicians when compared with the bilinguals. The findings showed

that bilingualism and music training have different effects on the brain
networks supporting executive control over behaviour. A small amount
of research has examined the differences in executive functioning
between different types of musicians. For instance, percussionists have
been found to outperform vocalists and non-musician controls on an
integrated visual and auditory—plus continuous performance—test of
inhibition (Slater et al., 2017).
Much of the research has revealed inconsistency in terms of the
impact of musical activity on the different elements of executive
functioning. For instance, Zuk and colleagues (2014) carried out an
experiment with 30 adults with and without musical training using
a standardised battery of executive function tests. Compared to the
non-musicians, the musicians showed enhanced performance on
some measures of executive function, cognitive flexibility, working
memory and verbal fluency, but not on inhibition or shifting. Similarly,
Helmbold and colleagues (2005) studied the psychometric performance
of 70 musicians and 70 non-musicians on different aspects of primary
mental abilities: verbal comprehension, word fluency, space, flexibility
of closure, perceptual speed, reasoning, number and memory. No
significant differences were found between the musicians and non-
musicians except for flexibility of closure and perceptual speed,
where the musicians performed reliably better than non-musicians.
In research with older adults, Amer and colleagues (2013) also found
inconsistency. They investigated whether long-term music training and
practice were associated with enhancement of general cognitive abilities
in late-middle-aged to older adults. Professional musicians and non-
musicians matched on age, education, vocabulary and general health
were compared on a near-transfer task involving auditory processing,
and on far-transfer tasks that measured spatial span and aspects of
cognitive control. The musicians outperformed the non-musicians on
the near-transfer task, on most but not all of the far-transfer tasks, and
on a composite measure of cognitive control. The results suggested that
sustained music training or involvement was associated with improved
aspects of some elements of cognitive functioning in middle-aged to
older adults, but not all.
Using a continuous assessment of musical expertise, Slevc and
colleagues (2016) investigated the relationship between musical ability
 7. Executive Functioning and Self-Regulation  179

and executive functions by evaluating the musical experience and

ability of a large group of participants, and exploring whether this
predicted individual differences on inhibition, updating and switching
in both auditory and visual modalities. Musical ability predicted better
performance on both auditory and visual updating tasks, even when
controlling for a variety of potential confounds, but musical ability was
not clearly related to inhibitory control and was unrelated to switching
performance. Similarly, Okada and Slevc (2018a) used a large test battery
of tasks related to working memory, inhibitory control, and cognitive
flexibility, as well as an assessment of musical training. One hundred and
fifty participants completed the tests. Overall, the data showed a positive
relationship between individual differences in musical training and
working memory updating ability, but no relationship with inhibition
or shifting. The authors suggested that the inclusion of intelligence as a
covariate may have eliminated any positive association between musical
training and tasks assessing inhibition. Similarly, Brooke and colleagues
(2018) administered an executive function battery of tests containing
multiple tasks assessing inhibition, shifting and working memory
updating, as well as a comprehensive, continuous measure of musical
training and sophistication to 150 undergraduates. Overall, these
data showed a positive relationship between individual differences
in musical training and working memory updating ability, but no
relationship with inhibition or shifting. The differences in the tasks used
to assess shifting—or the use of comparisons between musicians with
non-musicians rather than the use of continuous musical measures—
may account for some of the inconsistencies in findings. In relation to
inhibition, measures of intelligence may have acted as mediators.
Working with Chinese participants, Chen and colleagues (2020)
examined the relationship between musical training and inhibitory
control through the go/no go response inhibition and Stroop tasks by
using event-related potentials. In the go/no go task, participants had
to press a keyboard button in response to white shapes, while they had
to inhibit responding to purple shapes. In the Stroop task, participants
were presented with Chinese colour words, printed in different colours.
The behavioural results showed that the music group had enhanced
performance compared with the control group in the Stroop task,
while the groups performed similarly in the go/no go task. The results
180 The Power of Music

showed that individuals that received music training had stronger

conflict-monitoring and motor-inhibition abilities when completing
the interference control task. As musical training appeared to enhance
inhibitory control, it was suggested that it might support those with
psychiatric disorders such as addictions, attention deficit hyperactivity
disorder and obsessive-compulsive disorder, all of which have been
shown to involve deficits in inhibitory control.
Some research has highlighted differences in performance depending
on the nature of the tasks. For instance, Fischer and colleagues (2013)
tested 16 healthy adults on performed magnitude and pitch comparisons
on numbers sung at variable pitch. The stimuli and response alternatives
were identical, but the relevant stimulus attribute, pitch or number
differed between tasks. Concomitant tasks required retention of either
colour or location. The findings showed that the spatial association for
pitch was more powerful than that for magnitude. There appeared to be
no automaticity of spatial mappings in either stimulus dimension.
Travis and colleagues (2011) expanded the area of investigation
beyond executive functioning to develop a unified theory of
performance. They compared professional and amateur classical
musicians matched for age, gender and education on reaction times
during the Stroop colour-word test, brain waves during an auditory
event-related potential task, paired reaction-time tasks, responses on
a sociomoral reflection questionnaire, and self-reported frequencies of
peak experiences. Professional musicians were characterised by lower
colour-word interference effects, faster categorisation of rare expected
stimuli, a trend for faster processing of rare unexpected stimuli, higher
scores on the sociomoral reflection questionnaire, and more frequent
peak experiences during rest, tasks and sleep. The authors suggested
that the findings could be interpreted as effectiveness being influenced
by the level of mind-brain development and emotional, cognitive, moral,
ego and cortical development, with higher mind-brain development
supporting greater effectiveness in any domain.
Working in a health context, Siponkoskhifors and colleagues
(2020) explored the use of musical activity for those with traumatic
brain injuries, particularly where there were impairments of executive
functioning. Forty patients with moderate or severe traumatic brain
injuries were randomly allocated to receive a three-month neurological
 7. Executive Functioning and Self-Regulation  181

music therapy intervention, either during the first or second half of a

six-month follow-up period. Neuropsychological testing, motor testing
and magnetic resonance imaging were performed at baseline, and
at three and six months. The findings showed that general executive
functioning and set-shifting improved more in the first group than
the second over the first three-month period, and the effect on general
executive functioning was maintained in the six-month follow-up.
Voxel-based morphometry analysis of the structural magnetic
resonance imaging data indicated that grey-matter volume in the right
inferior frontal gyrus increased significantly in both groups during the
intervention versus control periods, which also correlated with cognitive
improvement in set-shifting. These findings suggest that neurological
music therapy can enhance executive functioning and induce fine-
grained neuroanatomical changes in prefrontal areas in those with
traumatic brain injuries. Furthermore, Kuriansky and Nemeth (2020)
have developed a musical intervention for work with children who
have experienced environmental trauma, which can lead to deficits in
executive functioning.

Research with Children

Some research has indicated that participation in formal early music
education classes is linked with better self-regulation skills. Winsler and
colleagues (2011) compared a group of three- to four-year-old children
receiving weekly music and movement classes (Kindermusik) with a
group who had not experienced any structured early childhood music
classes. Those enrolled in the music classes showed better self-regulation
than those not enrolled, as measured by a battery of tests that required
children to wait, slow down and initiate or suppress a response. The
Kindermusik children were also more likely to use a range of positive
self-regulatory strategies, including private speech, during an attention
task, and singing or humming during a waiting task. Parent-child
music therapy efficacy studies have also indicated that joint active
music participation supports improved child-parent interactions, and
enhances impulse control and self-regulation skills (Malloch et al., 2012;
Pasiali, 2012). Galarce and colleagues (2012) reported enhanced self-
regulation in terms of speaking inappropriately to others, while Brown
182 The Power of Music

and Sax (2013) found that an arts-enriched programme, including

music, helped emotional regulation skills in low-income children when
compared to non-arts programmes.
Several studies have explored the relationships between active
engagement with music and executive functions in preschool children.
For instance, Bugos and DeMarie (2017) studied the effects of a
short-term music programme including creative activities, bimanual
gross motor training and vocal development on preschool children’s
inhibition. Thirty-six preschool children were randomly assigned to
musical activities or Lego training. Results pre- and post-programme
on a matching familiar-figures test—requiring inhibition and visual
discrimination—indicated fewer errors post-training by the music
group compared to controls. Overall, the findings showed that music
interventions involving vocal activity and improvisation on pitched and
non-pitched instruments enhanced inhibition on a matching familiar-
figures test, but not on the day-night Stroop test, after a six-week-long
intervention with 90 minutes of weekly musical training, compared to
children who undertook Lego training.
Similarly, the development of inhibition was observed in a study
of Finnish children who, after undertaking musical activities at home,
showed greater attention to other tasks, while their brains responded less
strongly to auditory distractors compared to their peers (Putkinen et al.,
2013). Working with 120 school-aged children, Putkinen and colleagues
(2014) conducted a longitudinal study and showed that children who
received formal musical training showed superior performance in tests
of executive functions, while Putkinen and colleagues (2015) found
that musically trained preschool and school-aged children attending
a musical playschool showed more rapid maturation of neural sound
discrimination than a comparison group. In China, Shen and colleagues
(2019) examined whether musical training enhanced executive function
in preschool children who had not undergone previous systematic
music learning. Participants were 61 preschool children from a
university-affiliated kindergarten in North China. The experimental
group underwent 12 weeks of integrated musical training including
music theory, singing, dancing and roleplay, while the control group
performed typical daily classroom activities. The three components of
executive function—inhibitory control, working memory and cognitive
 7. Executive Functioning and Self-Regulation  183

flexibility—were assessed. Executive functions were tested before and

after musical training. The results showed that the children’s executive
functions could be promoted by music training. In further tests
undertaken 12 weeks later, the effects were sustained.
In a highly controlled study, Moreno and colleagues (2011a)
assigned 71 four- to six-year-old children to either a computerised music
training programme or a computerised visual arts training programme.
The two programmes had the same learning goals, graphics, design,
duration, number of breaks and number of teaching staff. The music
curriculum was based on a combination of motor, perceptual and
cognitive tasks, relying primarily on listening tasks, and included
training in rhythm, pitch, melody, voice and basic musical concepts. The
visual art curriculum focused on the development of visuospatial skills.
The children engaged in the training programme in two daily sessions
of one hour each for five days per week. After four weeks of daily
training, the children who received the music training showed greater
gains in inhibitory control than the children who received visual arts
training, as well as a greater index of brain plasticity on no go trials in
a go/no go task. The children in the music group also showed greater
improvements in the ability to identify geometric figures on the basis of
colour while ignoring irrelevant variation in shape. These changes were
positively correlated with changes in functional brain plasticity during
an executive function task. However, there was no difference in reaction
times between the music and visual arts groups.
In a similar, longitudinal study in the Netherlands, Jaschke and
colleagues (2018) examined cognitive skills in 147 primary-school
children aged six to seven, randomly allocated to music, visual art or
passive control groups. The music group significantly outperformed
the other groups in planning, inhibition and verbal intelligence.
Neuropsychological tests assessed verbal intelligence and executive
functions. The findings showed that the children in the visual arts group
performed better on visuospatial memory tasks as compared to the
three other conditions. However, the test scores on inhibition, planning
and verbal intelligence increased significantly in the two music groups
over time as compared to the other groups.
In a quasi-experimental study where children were able to self-
select to take music lessons, Roden and colleagues (2014a) worked
184 The Power of Music

with children aged seven to eight years old over an 18-month period.
Those who self-selected to take music lessons on an instrument of their
own choosing outperformed children who received science lessons
on two tasks assessing updating ability: a counting-span test and a
complex-span test. Working with older children aged nine to twelve,
with different lengths of time spent having music lessons, Degé and
colleagues (2011) assessed five different executive functions: set-
shifting, selective attention, planning, inhibition and fluency. Significant
associations emerged between the months of having music lessons and
all the measures of executive function.
Adopting an approach where no musical notation was used,
Guo and colleagues (2018) investigated the effect of a six-week
instrumental practice programme playing the keyboard harmonica.
Forty children aged six to eight years old were randomly assigned to
either the experimental group or an untrained control group. Cognitive
measurements included verbal ability, processing speed, working
memory and inhibitory control. After the six-week training, only the
experimental group showed a significant improvement in the digit-span
test, especially the digit-span backward test that measures working
memory. No significant influences were found on the other cognitive
tests.
Saarikivi and colleagues (2016) investigated whether individual
differences in executive functions predicted training-related changes in
neural sound discrimination. They measured event-related potentials
induced by sound changes, coupled with tests for executive functions
in musically trained and non-trained children in two age groups (9 to
11 and 13 to 15). High performance in a set-shifting task, indicating
cognitive flexibility, was linked to enhanced maturation of neural sound
discrimination in both musically trained and non-trained children.
Musically trained children with good performance showed large neural
responses to sound in both age ranges, indicating accurate sound
discrimination. In contrast, musically trained low-performing children
showed an increase in sound responses with age, suggesting that they
were behind their high-performing peers in the development of sound
discrimination. In the non-trained group, only the high-performing
children showed evidence of an age-related increase in neural
responses, while the low-performing children showed a small increase
 7. Executive Functioning and Self-Regulation  185

with no age-related change. These findings suggest an advantage in

neural development for high-performing non-trained individuals.
There was an age-related increase in response only in the children who
performed well in the set-shifting task, irrespective of music training,
indicating enhanced attention-related processes in these children. This
research provided evidence that, in children, cognitive flexibility may
influence age-related and training-related plasticity of neural sound
discrimination.
Also studying primary-aged children, James and colleagues (2019)
performed research on 69 children aged ten to twelve. The children
received group music instruction by professional musicians twice a
week as part of the regular school curriculum. They learned to play
stringed instruments. In contrast, a control group was sensitised to
music through listening, theory and some practice. There were benefits
for the intervention group as compared to the control group for working
memory, attention, processing speed, cognitive flexibility, matrix
reasoning, sensorimotor hand function and bimanual coordination. The
findings highlighted the added value of intensive musical instrument
training in a group setting within the school curriculum. Working with
27 musically trained and untrained children aged nine to twelve, Zuk and
colleagues (2014) found that the musically trained children were better
at shifting but not at inhibition or updating. They showed enhanced
performance on measures of verbal fluency and processing speed, and
significantly greater neural activation during rule representation and
task-switching in regions of the brain known to be involved in executive
functions (compared to musically untrained children).
Focusing on older children aged 10 to 13, with or without musical
training, Kausal and colleagues (2020) assessed attention and working
memory, while brain activity was measured with functional magnetic
resonance imaging. Participants were presented with a pair of bimodal
stimuli, auditory and visual, and were asked to pay attention only to the
auditory, only to the visual, or to both at the same time. Both groups had
higher accuracy on items that they were instructed to attend to, but the
musicians had overall better performance on both memory tasks across
attention conditions. The musicians showed higher activation than
controls in cognitive control regions, such as the frontoparietal control
network, during all encoding phases. In addition, facilitated encoding
186 The Power of Music

of auditory stimuli in musicians was positively correlated with years

of training and higher activity in the left inferior frontal gyrus and the
left supramarginal gyrus, structures that support the phonological loop.
Working with adolescents, Gonzalez and colleagues (2020)
examined whether there was a relationship between time spent in
musical training and executive function. Adolescents between the ages
of 14 and 18 completed three tests of executive function: the Tower of
Hanoi test to assess working memory, the Wisconsin Card Sort test to
assess cognitive flexibility, and the Stroop task to assess inhibition. They
also completed a musical experience questionnaire, which included
their lifetime musical practice hours. The adolescent musicians were
found to have improved inhibitory control relative to non-musicians,
while inhibition scores correlated with music practice time. No other
elements of executive function were found to be associated with musical
training. These findings suggest that the impact of musical training may
not be the same for all executive functions and that there may be unique
associations between certain types of training and inhibitory control.
A few studies have worked with mixed age groups. For instance,
Holochwost and colleagues (2017) examined whether music education
was associated with improved performance on measures of executive
functions. Participants were 265 school-aged children from first to
eighth grade. They were selected by lottery to participate in an out-
of-school programme offering individual and large ensemble training
on orchestral instruments. Executive functions were assessed through
students’ performance on a computerised battery of common executive
function tasks. The findings showed that, relative to controls, students
in the music education programme exhibited superior performance on
multiple tasks of inhibitory control and short-term performance. The
largest differences in performance were observed between students
in the control group and those who had participated in the music
programme for two to three years, although conditional effects were
also observed on three of the executive function tasks for students
who had been in the programme for one year. Similarly, Hudziak
and colleagues (2014) assessed the extent to which playing a musical
instrument was associated with cortical thickness development among
232 healthy youths aged six to eighteen over a two-year period. While
there was no association between cortical thickness and years playing
 7. Executive Functioning and Self-Regulation  187

a musical instrument, follow-up analysis revealed that music training

was associated with an increased rate of cortical thickness maturation
within areas implicated in motor planning and coordination, emotion
and impulse regulation.
In another mixed-age study, Nutley and colleagues (2013) focused
on children and young people aged between 6 and 25. In a longitudinal
study with testing two years apart, they demonstrated that musical
practice had a positive association with working memory capacity, and
visuospatial and verbal processing speed and reasoning skills at all time
points, after taking into account parental education and participation
in other school activities. Those participating in musical activities
had larger grey-matter volume in the temporo-occipital and insular
cortex—areas which are known to be associated with the reading of
musical notation. Changes in working memory were proportional to
the number of hours spent in weekly practice, but this did not apply
to measures of verbal reasoning. It may be that reading notation is
important in the development of at least some executive functions as it
requires visuospatial working memory, rapid information processing,
visuospatial decoding and a constant updating of musical notation.
In some research where comparisons have been made between
music training and other interventions, similar effects have been found.
For instance, using second-language learning as a control, Janus and
colleagues (2016) compared the effects of short-term music training
and tuition in French on executive control. They pseudo-randomly
assigned 57 four- to six-year-old children matched on age, maternal
education and cognitive scores to a 20-day training programme offering
instruction in either music or conversational French. The children were
tested on verbal and non-verbal tasks requiring executive control. All
of the children improved on these tasks following training. Children in
both groups had better scores on the most challenging condition of a
judgement task about the correct grammar of a sentence, where it was
necessary to ignore conflict introduced through misleading semantic
content. Children in both training groups also showed better accuracy
on an easier condition of a non-verbal visual search task at post-test,
but the children in the French training group showed significant
improvement on the more challenging condition of this task. This
research showed that, while music may be able to enhance executive
188 The Power of Music

functioning, it is not alone in being able to do so. Similarly, Habibi and

colleagues (2018) compared children receiving music training with
those receiving sports training or those not enrolled in any systematic
after-school training. The children with music training showed stronger
neural activation in regions involved in response inhibition during a
cognitive inhibition task, compared with those in the no-activity control
group, despite no differences in performance on behavioural measures
of executive function. However, no such differences were found between
music and sports groups. Also using sport as a comparison group,
Sachs and colleagues (2017) investigated the effects of music training
on executive function with functional magnetic resonance imaging and
several behavioural tasks, including the colour-word Stroop task. The
14 children involved in the ongoing music training, aged eight to nine
years old, were compared with two groups of children with comparable
general cognitive abilities and socioeconomic status: one involved in
sporting activities, the other not involved in music or sports. During
the Stroop task, the children with music training showed significantly
greater bilateral activation in trials that required cognitive control
compared to the control group, despite no differences in performance on
behavioural measures of executive function. No significant differences in
brain activation or in task performance were found between the music
and sports groups. The results suggest that systematic extracurricular
training is associated with changes in the cognitive control network in
the brain, even in the absence of changes in behavioural performance,
whether the intervention is music- or sports-based. Taken together,
these studies indicate that, while music may be able to support the
development of executive functions in children, it is not alone in being
able to do so.
Not all of the research has found positive relationships between
musical training, executive functions and self-regulation. For instance,
Schellenberg (2011) found no link between music lessons and most
of the measures of executive function, which were assessed in trained
and untrained musicians aged nine to twelve years old. The musically
trained children had higher digit-span scores, which remained when a
range of socioeconomic factors were taken into account, but there were
no differences on any other measures. Overall, the association between
musical training and executive function was negligible. Similarly,
 7. Executive Functioning and Self-Regulation  189

Mehr and colleagues (2013) conducted two randomly controlled trials

with preschool children investigating the cognitive effects of a brief
series of music classes, as compared to a similar visual arts class or to
a no-treatment control. Parents attended classes with their children,
participating in a variety of developmentally appropriate arts activities.
After six weeks, the children’s skills were assessed on four cognitive
areas: spatial navigational reasoning, visual form analysis, numerical
discrimination and receptive vocabulary. Initially, the children from the
music class showed greater spatial navigational ability than children
from the visual arts class, while children from the visual arts class
showed greater visual form analysis ability than children from the
music class. However, a partial replication attempt comparing music
training to a no-treatment control failed to confirm these findings,
and the combined results of the two studies were negative. Overall,
children provided with music classes performed no better than those
with visual arts or no classes on any assessment. Similarly, Grinspun
and colleagues (2020) conducted an empirical study, in which a sample
of 61 second-grade school students from two elementary schools—
one from Ghent, Belgium and the other from Santiago, Chile—were
administered a musical aptitude test and an attention and inhibitory
control test. There was no statistically significant effect of musical
experience on sustained attention, cognitive flexibility or audiation.
In a study which explored the impact of different musical activities,
Norgaard and colleagues (2019) studied 155 seventh- and eighth-
grade middle-school band students, who were divided into groups
based on the type of musical training that they received. The key
area of interest for the researchers was whether the students learned
to improvise. Both groups received two months of instruction in jazz
phrasing, scales and vocabulary, but only the experimental group was
taught to improvise. All instruction was part of the warm-up routine
in regular band classes. All students were tested before and after
instruction on cognitive flexibility and inhibitory control. The findings
showed that improvisation training had different effects on executive
function depending on the students’ grade levels. In seventh grade,
the results showed that improvisation training enhanced the students’
abilities to inhibit irrelevant information, although this change was
only marginally significant. There was no effect of inhibition with
190 The Power of Music

eighth-grade students but there was a significant change in cognitive

flexibility. It may have been that their advanced technique allowed
them to be more engaged directly with tonal jazz improvisation
compared to the seventh-graders. The real-time evaluation of their
musical output according to tonal convention may have resulted in
them making quick adjustments to their performance. This may have
contributed to enhanced cognitive flexibility. In a study of similar
complexity, Bowmer and colleagues (2018) investigated the effect of
weekly musicianship training on the executive function abilities of
three- to four-year-old children in a London preschool, using a two-
phase experimental design. In Phase One, 14 children took part in eight-
weekly musicianship classes, provided by a specialist music teacher,
while 25 children engaged in nursery free-play. The children receiving
the musicianship training improved on measures relating to planning
and inhibition skills. In Phase Two, the musicianship group continued
with music classes, while a second group began music classes for the
first time and a third group took part in an art intervention. There
were no significant differences in performance improvement between
the three groups during Phase Two, although performance differences
between groups were nearing statistical significance for a peg-tapping
task.

Research with Older People

Some research has supported the beneficial effects of music training on
executive functions in older musicians. For instance, Hanna-Pladdy and
MacKay (2011) studied 70 older healthy adults—aged 60 to 83—varying
in musical ability who completed a comprehensive neuropsychological
battery. The groups (non-musicians and low- and high-activity
musicians) were matched on age, education and history of physical
exercise, while the musicians were matched on their age of starting to
play an instrument and formal years of musical training. The musicians
were classified in a low-level musical group with one to nine years of
experience, or a high-level musical group with more than ten years of
musical activity, based on their years of musical experience throughout
their lifespan. The findings showed that participants with at least ten
years of musical experience performed better on non-verbal memory,
 7. Executive Functioning and Self-Regulation  191

naming and executive processes in advanced age relative to non-

musicians. Several regression analyses evaluated how years of musical
activity, age of commencing musical training, type of training and other
variables predicted cognitive performance. Similarly, Hanna-Pladdy
and Gajewski (2012) researched 70 age- and education-matched older
musicians and non-musicians, aged 59 to 80. They were assessed on
neuropsychological tests and general lifestyle activities. The musicians
scored higher on tests of phonemic fluency, verbal working memory,
verbal immediate recall, visuospatial judgement and motor dexterity,
although they did not differ in the level of other general leisure activities
from the non-musicians. Level of education best predicted visuospatial
functions in the musicians, followed by recent musical engagement
which offset low levels of education. Early age of engaging with musical
activity, less than nine years old, predicted enhanced verbal working
memory in musicians, while the analyses for other measures were not
predictive. Recent and past musical activity predicted variability across
both verbal and visuospatial domains in ageing, implying that early age
of musical engagement, sustained and maintained during advanced age,
may enhance cognitive functions and act as a buffer to age and education
influences. Similarly, Strong and Mast (2019) examined similarities
and differences in the cognitive profiles of older-adult instrumental
musicians and non-musicians. They compared neuropsychological test
scores among older adult non-musicians, low-activity musicians (those
with less than ten years of lessons), and high-activity musicians (over
ten years of lessons), controlling for self-reported physical and social
activity, years of education and overall health. Significant differences
among groups were found on tasks of visuospatial ability, naming and
executive functioning. No significant differences were found on tests of
attention, processing speed or episodic memory. The findings support
the late-life cognitive benefits of early musical training, but only in
some cognitive domains, including language, executive functioning and
visuospatial ability.
Some research has adopted self-report methods to study the impact
of making music in older age. For instance, Gembris (2008) carried out
a questionnaire study with members of senior amateur orchestras with
an average age of 71 years old, and found music was seen as helping
them to cope and deal with difficult situations. Participants in singing
192 The Power of Music

activities (Clift et al., 2008) and a wide range of other musical activities
(Creech et al., 2014) have reported that making music stimulates
cognitive capacity, including improving their attention, concentration,
memory and learning. Executive functions, such as attention, inhibition,
planning, monitoring and meeting new challenges have also been
self-reported as improved in relation to musical activity (Hallam and
Creech, 2016; Varvarigou et al., 2012).
An intervention study with older adults aged 60 to 85 (Bugos et al.,
2007) who were randomly assigned to six months of individual piano
lessons or a non-lesson control group found that the music group
outperformed the control group on a test that assessed processing speed
in matching symbols with digits. There were significant improvements
in attention, concentration, planning, cognitive flexibility and working
memory. For these benefits to be maintained, regular practice and
tuition were needed, as decline followed when the activities ceased.
Another study further supported the benefit of group piano lessons on
executive functions such as verbal flexibility and inhibition control in
24 older adults (Bugos, 2010). The improvement in executive function
was significantly greater in those receiving music tuition compared to
a music appreciation group consisting of 22 older adults who learned
about musical elements while listening to music. However, both groups
demonstrated significantly improved executive performance. In a similar
study, Bugos and Kochar (2017) found that older adults who had short-
term piano lessons improved on category-switching in a verbal fluency
task. The research aimed to evaluate the efficacy of a short-term music
programme on executive functions in healthy older adults. Thirty-four
adult participants with little to no formal music training were recruited,
and completed a battery of standardised cognitive measures at three
time points: before training, after completion of a control time period
and after training. The piano training programme included 30 hours of
focused music theory, finger dexterity exercises, bimanual coordination
exercises, technical exercises, performance duets and standard piano
repertoire. The findings showed significantly enhanced verbal fluency
and processing speed following training, although no difference was
found in verbal memory performance. In a further study, Bugos (2019)
examined the effects of bimanual coordination in music interventions
on cognitive performance in healthy older adults aged 60 to 80. One
 7. Executive Functioning and Self-Regulation  193

hundred and thirty-five participants completed motor measures and a

battery of standardised cognitive measures, before and after a 16-week
music training programme with a three-hour practice requirement.
All participants were matched by age, education and estimate of
intelligence, and allocated to one of three training programmes: piano
training, fine motor, percussion instruction, gross motor and music-
listening instruction. The findings revealed significant enhancements in
bimanual synchronisation and visual scanning and working memory
abilities for fine and gross motor training groups as compared to the
listening group. Pairwise comparisons revealed that piano training
significantly improved motor synchronisation skills as compared to
percussion instruction or music listening. These findings suggest that
active music performance may benefit working memory and that the
extent of the benefits may depend upon coordination demands. In
another study using piano lessons, a four-month weekly group piano
lesson designed and implemented by a professional music teacher and
pianist resulted in improved performance on a Stroop test in 13 older
adults. This cognitive improvement was not observed in 16 older adults
in the control group (Seinfeld, 2013).
Also focusing on the type of activity, Biasutti and Mangiacotti (2017)
investigated whether cognitive training based on rhythmic musical
activities and music improvisation exercises could have positive effects
on executive functions in older participants. Thirty‐five residents in
a residential home with mild to moderate cognitive impairment and
healthy ageing were randomly assigned to an experimental group
which participated in cognitive music training composed of 12 biweekly
70-minute sessions, and a control group which attended 12 biweekly
45-minute sessions of gymnastic activities. A neuropsychological test
battery was administered at baseline and at the end of the programme.
There was significant improvement for the experimental group on a
mental state examination, a verbal fluency test and a clock-drawing test,
while the control group did not show any significant improvements.
No improvement was found in performance on an attentional matrices
test for the music group, although those participating in the gymnastics
activities showed a significant reduction in performance.
Evidence from neuroscience has shown that there are differences
in the frontal cortex of musicians and non-musicians (the area of the
194 The Power of Music

brain which is implicated in the regulation of attention; Gaser and

Schlaug, 2003; Sluming et al., 2002). Musical engagement increases
grey-matter density in the frontal brain areas which are involved
in controlling musical tasks (Hyde et al., 2009), while musicians
who continue to engage in music-making beyond 60 years old
show less or no degeneration of grey-matter density in the frontal
cortex. Practising a musical instrument seems to help to prevent
deterioration of executive functions involving monitoring and
planning (Sluming et al., 2002). Alain and colleagues (2019), using
an electroencephalogram, investigated the effects of music-making on
inhibition control and interference in 60 healthy older non-musicians,
who received three months of musical, visual art, or no training.
The music-based intervention included the use of body percussion,
voice and non-pitched musical instruments, as well as learning basic
music theory and melody and harmony concepts by singing simple
songs. The training was provided by a professional music teacher.
Transient differential neural activities were observed in frontocentral
sites in both intervention groups, but there was no improvement on
task performance. Using electroencephalography, Moussard and
colleagues (2016) used a visual go/no go task and demonstrated that
a group of 17 older musicians exhibited a neural response, indicating
a conflict-detect signal or inhibition of a prepotent response in the
central midline sites between go and no go conditions, compared to a
group of 17 older non-musicians.

Reviews of the Literature

Reviews of the literature have drawn different conclusions relating
to the role of music in enhancing executive functions. Moreno and
Bidelman (2014) concluded that research has demonstrated the robust,
long-lasting biological benefits of music training to auditory function—
the behavioural advantages conferred by musical experience extend
beyond enhancements to perceptual abilities and impact non-auditory
functions necessary for higher-order aspects of cognition (for instance,
working memory). They suggest that findings indicate that alternative
forms of arts engagement—for instance, visual arts training may not
yield such enhancements, suggesting that musical expertise uniquely
 7. Executive Functioning and Self-Regulation  195

refines a hierarchy of brain networks, subserving auditory as well as

domain-general cognitive mechanisms. They argue that transfer from
specific music experience to broad cognitive benefit might be mediated
by the degree to which a listener’s musical training enhances lower-
and higher-order executive functions, and the coordination between
them. They argued that understanding the impact of music on the
brain will provide a more holistic picture of auditory processing and
plasticity, and may also help inform and tailor remediation and training
programmes designed to improve perceptual and cognitive benefits.
Whether these structural changes lead to higher intelligence, better
memory or stronger cognitive processing in childhood continues to be
debated. In a later review, Moreno and Farzan (2015) concluded that
music training leads to robust and long-lasting benefits to behaviour
which extend to inhibitory control and its neural correlates. Other
forms of art engagement or brain training do not appear to yield
such enhancements. They suggest that music uniquely taps into brain
networks which are concerned with inhibitory control. Miendlarewska
and Trost (2014) go further and suggest that rhythmic entrainment is
the essential mechanism supporting the learning and development
of executive functions which, in turn, may underlie enhancements in
reading and verbal memory.
In their review, Loui and Guetta (2019) point out that music,
as an intrinsically creative art form, requires bottom-up and top-
down perceptual processing, attention and integration of executive
functions. Attention is a subset of executive functioning and underpins
goal-directed processes including conflict-monitoring, task-switching,
and working memory. Considerable research has addressed the
effects of musical training on these executive functions, but Loui and
Guetta argue that the findings from this research have been mixed
and inconclusive. Similarly, Okada and Slevc (2018b) argue that, as
the relationships between musical ability and executive functions have
mostly been demonstrated by correlational studies, the relationships
could have a range of different explanations. Musical experience could
draw on some or all aspects of existing executive functions, while
musical training could improve executive functions more broadly, or
the observed relationships could merely reflect selection bias, where
individuals with pre-existing skills that are useful for music-learning
196 The Power of Music

are more likely to pursue and persist in continued music lessons.

Alternatively, both explanations might be relevant, as music lessons
may exaggerate pre-existing differences. While these issues continue
to be debated, there is agreement that musical experience draws on
particular cognitive abilities, so that the relationships between musical
experience and cognitive abilities should reflect the specific abilities
that are critical to musical experience. However, it is difficult to know
exactly which, if any, executive functions are reliably related to musical
experience.
Focusing on issues relating to ageing, Sutcliffe and colleagues
(2020) note a lack of intervention studies with random assignment
of participants to conditions and a lack of well-matched control
conditions. These factors make it difficult to draw firm conclusions.
They argue that, while music training might be a valuable tool for
supporting healthy neuropsychological ageing and mental wellbeing,
well-controlled intervention studies are necessary to provide clear
evidence. Similarly, in their review focusing on older adults, Koshimori
and Thaut (2019) suggest that the cross-sectional and correlational
studies undertaken with musicians have shed light on the potential
benefit of formal musical training on executive functioning and brain
changes in the prefrontal area. Task-based studies have consistently
demonstrated that individuals with formal musical training have
differential brain activity during executive function tasks relative to
those without musical training. However, these studies do not allow
any direct and causal effects of music training on executive functioning
or brain changes to be demonstrated. Furthermore, the specific
effects of different types of musical training on executive function,
brain structure and function in the prefrontal area are still unclear.
Examining the evidence related to playing the piano, they concluded
that this activity may have beneficial effects on executive functions in
healthy older non-musicians because it is a complex process, requiring
the coordination of multiple sensory modalities, motor control,
monitoring, working memory, inhibition and attentional shifting.
However, the sample sizes of some of the studies were frequently
small and there were often additional methodological limitations. This
meant that the findings had to be interpreted with caution.
 7. Executive Functioning and Self-Regulation  197

Overview
Drawing firm conclusions about the impact of musical activity on
executive functioning is challenging for a range of reasons. Some
studies only investigate one cognitive process. Different assessment
tasks are used to measure the same executive function, which makes
comparisons difficult. While correlation studies are useful in identifying
areas for further research, they tend to use different ways of categorising
individuals into groups of musicians and non-musicians, or assessing
different levels of musical expertise. Research has been undertaken with
infants through to the elderly, sometimes with mixed-age groups, leading
to the possibility of a wide range of confounding factors. The evidence
also shows that musical interventions can have different effects on the
three elements of executive functioning. Different research projects have
shown benefits for working memory, inhibition or cognitive flexibility,
although it is clear that some elements of executive functioning can be
enhanced by musical training. It might be that the beneficial effects of
musical experience would be more pronounced in populations with
relatively lower executive functions, such as young children, elderly
adults or patients with neuropsychological issues.
Overall, the evidence from studies of children, adults and older
adults relating to the impact of actively making music on executive
functions is inconclusive. For more definite conclusions to be drawn,
more attention needs to be given to the type of programme adopted,
the nature of its musical content and the quality of its delivery to the
participants. Ideally music lessons should incorporate skills that build
on one another with gradual increases in complexity. To enhance
executive functions, activities might usefully include reading musical
notation, sight-reading, playing in an ensemble and practice with
complex polyrhythms. They should also start when children are young
and continue over many years, ideally throughout the lifespan.
Generally, the jury is still out on the possible impact of music training
on executive functions. Future research needs to attempt to establish
more clearly which executive functions may be implicated in transfer
and whether these relate to skills which have become automated or
are related to those requiring conscious cognitive processing or a
combination of these. Chapter 9 will consider the relationship between
198 The Power of Music

executive functions and measured intelligence. Music has an advantage

over many other possible interventions for enhancing executive
functioning, as it is generally an intrinsically motivating activity,
frequently offering opportunities for enjoyable social interactions. Many
aspects of music training—reading music, practising and playing in
ensembles—are likely to engage executive functions and because many
people enjoy music lessons for their intrinsic value, music training may
provide a relatively easy to implement naturalistic executive training
programme.
 8. Intellectual Development

The term intelligence is used in everyday life to identify differences

between individuals in the way that they are able to learn and carry
out particular tasks. Beyond this general everyday usage, there is no
clear agreement amongst the scientific community regarding the
nature of intelligence. The first test of intelligence was developed in
France by Binet and Simon (1916), to differentiate children’s ability to
learn in order to subsequently help teachers tailor instruction to meet
children’s needs. This test included the ability to name objects, define
words, draw pictures, complete sentences, compare items and construct
sentences. Statistical analysis of data from use of the test revealed that
responses were highly correlated, leading Spearman (1938) to suggest
that there was a single underlying general intelligence factor which
became known as ‘g’. This factor is generally accepted to relate to
abstract thinking, including the ability to acquire knowledge, adapt to
novel situations, and to benefit from instruction and experience. Terman
(1916) developed an American version of Binet’s test, the Stanford-Binet
Intelligence Test, which is similarly made up of tests of vocabulary,
memory of pictures, naming of familiar objects, repeating sentences and
following commands. There is also evidence for specific intelligences.
One such distinction is between fluid intelligence—which refers to
the capacity to learn new ways of solving problems and learning—
and crystallised intelligence, which refers to accumulated knowledge.
Crystallised intelligence increases with age, while fluid intelligence
tends to decrease with age. Since these initial conceptualisations, many
types of intelligence have been proposed. For instance, Thurstone (1938)
proposed seven clusters of primary mental abilities, word fluency, verbal
comprehension, spatial ability, perceptual speed, numerical ability,
inductive reasoning and memory. More recently, Sternberg (1985)
proposed a triarchic theory of intelligence which includes analytical,

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.08

200 The Power of Music

creative and practical intelligence. In contrast, Gardner (1983) proposed

eight intelligences: linguistic, logico-mathematical, spatial, musical,
kinaesthetic (related to movement), intrapersonal (personal insights),
interpersonal (interacting with others), and naturalistic (relating to
plants and nature).
Research exploring the impact of musical activities on intelligence
has tended to focus on general intelligence, although there are exceptions
to this. One of the most commonly used tests in this research is the
Wechsler Adult Intelligence Scale (WAIS). This consists of 15 different
tasks, including working memory, arithmetic ability, spatial ability and
general knowledge about the world. The WAIS-IV yields scores in four
domains: verbal, perceptual, working memory and processing speed.
Tests of non-verbal reasoning, which do not rely on literacy skills, have
also been developed. Raven’s Progressive Matrices (1981) is one of the
most commonly used. Each element requires the testee to identify a
missing element that will complete a pattern.
More recently, the concept of emotional intelligence has emerged.
This can be traced back to the work of Thorndike (1920), who referred
to the concept of social intelligence, which was described as the
ability to understand and manage people. Gardner (1983), within the
framework of multiple intelligences, elaborated the concept to include
intrapersonal and interpersonal intelligence, the former relating to the
capacity to understand oneself and to use such information to regulate
one’s own life, and the latter to the capacity to understand the intentions,
motivation and desires of others. Currently there are two constructs
of emotional intelligence. Ability emotional intelligence focuses on
the ability to process emotional information and use it to navigate the
social environment (Mayer et al., 2001), although it has further evolved
to include the abilities to accurately perceive emotions, to access and
generate emotions so as to assist thought and understand emotions
and emotional knowledge, and to reflectively regulate emotions so as
to promote emotional and intellectual growth (Mayer et al., 2004). In
contrast, trait emotional intelligence, or trait emotional self-efficacy,
concerns emotion-related self-perceptions. Trait emotional intelligence
was proposed by Petrides and Furnham in 2001 and is conceptualised as
an aspect of personality measured through self-report. Daniel Goleman’s
book (1996) popularised the concept of emotional intelligence, with the
 8. Intellectual Development  201

model he proposed being seen as combining ability and trait emotional

intelligence. Empathy is typically associated with emotional intelligence,
because it relates to an individual being able to connect their personal
experiences with those of others. The role of music in the development
of empathy is discussed in Chapter 12.

Nature or Nurture
An ongoing and contentious debate about intelligence is whether it is
determined by genetic or environmental factors. Clearly, if intelligence
is determined by genetic factors alone then musical interventions will
have no impact. Nowadays, it is increasingly recognised that measured
intelligence (IQ) is determined by both genetic predisposition and
environmental factors, although whether these operate additively or
interact with each other continues to be fiercely debated. Considerable
research has been undertaken to attempt to identify a gene or genes
responsible for intelligence. This research has shown that intelligence
within the normal range is a polygenic trait—in other words, influenced
by more than one gene, and in the case of intelligence, at least 500 genes.
Traditional additive genetic models have shown intelligence to
have extremely high heritability levels, while other research has
shown that it is extremely malleable. Sauce and Matzel (2018) suggest
that intelligence has unusual properties that create a large number of
hidden gene environment networks which allow for the contribution
of high genetic and environmental influences on individual differences
in IQ. They argue that current research methods underestimate gene
environment interplay and inflate estimates of genetic effects, which in
turn deflate estimates of the impact of the environment. They provide
evidence which shows cognitive gains in children through adoption
and immigration, and changes in heritability across the life span. They
also present evidence for gains in population IQ over time relating to
societal development, for a slowdown in age-related cognitive decline
and for gains in intelligence from early education. They acknowledge
that the high heritability of intelligence could have emerged from
independent genetic effects, while high malleability could have arisen
from independent environmental effects, but suggest that these cannot
account for individual differences and conclude that gene environment
202 The Power of Music

interplay is key to understanding intelligence given the present state of

evidence.
Brain imaging has provided the basis for research on the neurobiology
of intelligence by highlighting the important functional and structural
anatomical regions implicated, grey-matter volume and thickness, and
white-matter integrity and function in the temporal, frontal and parietal
cortices (Goriounova and Mansvelder, 2019). Genome-wide association
studies have made it possible to show that 98 percent of associated
genetic variants are not coded into functional protein and are likely to
have a regulatory function at different stages of neural development.
Those genes that do produce functional proteins are implicated in a
range of neuronal functions, including synaptic function and plasticity,
cell interactions and the metabolism of energy. Recent research in
cellular neuroscience has shown positive correlations between dendritic
size, action potential speed and IQ, but there is much that is still not
understood about what underpins individual differences in intelligence.
Considering the relationship between music, language and
intelligence, Jung and Haier (2007) developed a model parietofrontal
integration theory, which highlights the structural links common to
these areas specifically in shared neural structures, such as the prefrontal
cortex, the anterior cingandulate and a region within the temporal lobes.
This research, along with that indicating the malleability of intelligence,
suggests that music interventions may be able to enhance intelligence.
Also exploring genetic and environmental influences between music
and IQ, Mosing and colleagues (2016) undertook a co-twin study based
on more than 10,500 twins. Phenotypic associations were moderate,
although the relationship disappeared when controlling for genetic
and shared environmental influence. A twin highly trained in music
did not have a higher IQ than an untrained twin. The findings strongly
suggested that the associations between musical training and IQ were
not causal.

Correlational and Comparative Research with Adults

Correlational studies have shown that engagement with music can
enhance some skills which contribute to scores on intelligence tests.
The evidence suggests that the longer the training, the greater the
 8. Intellectual Development  203

impact (Corrigall et al., 2013; Degé et al., 2011a; Schellenberg, 2006),

and that the relationships between musical training and intelligence
remain when a range of confounding variables related to family
background are taken into account (Corrigall et al., 2013; Degé et al.,
2011a; Schellenberg, 2006; 2011a; 2011b; Schellenberg and Mankarious,
2012). For example, Schellenberg (2011b) studied 196 undergraduates
ranging in age from 17-26 years old, either with at least eight years of
extracurricular private music lessons or with no lessons. The musically
trained participants had higher scores than their untrained counterparts
on the IQ composite score, and on its verbal and non-verbal subtests.
These advantages were evident even when gender, parents’ education,
family income and first language were held constant. Similarly, Corrigal
and Schellenberg (2013) studied the relationships between cognition,
personality, participation in music lessons and length of participation.
One hundred and eighteen adults and 167 children aged ten to twelve
completed personality and cognitive ability tests. Cognitive ability
was associated with duration of musical involvement, even when
demographic variables were controlled for.
Swaminathan and colleagues (2017) examined whether the link
between intelligence and musical expertise was better explained by
formal music lessons or musical aptitude. Musically trained and
untrained adults completed tests of non-verbal intelligence, Raven’s
Advanced Progressive Matrices and musical aptitude. They also
provided information about their music lessons and socioeconomic
status. Duration of music training was associated positively with
socioeconomic status, non-verbal intelligence, and melodic and
rhythmic aptitude. Intelligence and music aptitude were also positively
associated. The association between musical training and intelligence
remained after controlling for socioeconomic status but disappeared after
controlling for musical aptitude, although musical aptitude had a strong
correlation with intelligence, even after accounting for music training
and socioeconomic status. The association between music training and
intelligence may arise because high-functioning individuals are more
likely than other individuals to have a strong aptitude for music, and
therefore to take music lessons.
Some research has focused on particular aspects of intelligence.
For instance, Anaya and colleagues (2017) assessed the visuospatial
204 The Power of Music

sequence learning and memory abilities of long-term musicians.

They recruited 24 highly trained musicians and 24 non-musicians,
who completed a visuospatial sequence learning task and receptive
vocabulary, non-verbal reasoning, and short-term memory tasks. The
findings showed that the musicians had enhanced visuospatial sequence
learning abilities relative to non-musicians. They also performed better
on the vocabulary and non-verbal reasoning measures. The large
difference observed on the visuospatial sequencing task remained
even after controlling for vocabulary, non-verbal reasoning, and short-
term memory abilities. Criscuolo and colleagues (2019) explored
the relationships between general intelligence, executive functions
and musical expertise. One hundred and one Finnish healthy adults
grouped as musicians, amateur musicians and non-musicians were
administered the Wechsler Adult Intelligence Scale III, the Weschler
Memory Scale III and the Stroop test. After being matched on a range
of variables, the musicians exhibited higher cognitive performance
than non-musicians on all of the tests. Linear regression showed
significant positive relationships between executive functions, working
memory and attention, and the duration of musical engagement, after
controlling for possible confounding variables.
Focusing on fluid intelligence, Meyer and colleagues (2018)
administered a test battery including measures of episodic memory,
working memory, attention, executive function and processing speed
to 72 undergraduate students with a range of musical expertise. Three
groups of students were identified:
• an expert group who had begun musical training at age ten or
younger and had engaged with music for ten years or longer.
They self-rated between three to five on two Likert scales
relating to sight-reading skills and improvisation skill;
• musical amateurs, who included those with more than one
year of musical training;
• non-musicians, who had less than one year of musical training
and typically no training at all.

The findings showed that the musicians with extensive experience

scored significantly higher in fluid cognition, attention and working
memory tests of executive functions and processing speed than did
 8. Intellectual Development  205

the non-musicians and the less well-trained musicians. There was no

statistically significant difference between amateur and non-musicians
on these subtests with one exception, the executive function test, where
the amateur musicians performed better than the non-musicians. A
regression analysis using age of onset of training and length of music
training in relation to fluid intelligence showed that these two factors
accounted for almost 30 percent of the variance. Age of onset predicted
fluid intelligence but the relationship with length of music education
was not significant. As for sub-scores, these two factors accounted for
almost 37 percent of the variance for the sub-score speed of processing.
Age of starting musical training predicted speed of processing, while
the relationship with length of music education was not significant.
Regression analyses for the other sub-scores yielded non-significant
results.
Silvia and colleagues (2016) adopted a bifactor modelling approach
to study data from a sample of 237 young adults who varied substantially
in musical expertise. Participants completed a range of tasks that
measured several lower-order abilities: fluid intelligence, crystallised
intelligence, verbal fluency and auditory discrimination ability. Simple
correlations showed that music training correlated with all four lower-
order abilities. A bifactor model, however, found that music training had
general, a strong association with general intelligence (g), and specific,
a moderate association with auditory ability, relationships.
Some research with adults has focused on the relationship between
musical and reading skills. For instance, Swaminathan and colleagues
(2018) sought to clarify whether the positive association between
music lessons and reading ability found in adults was explained better
by shared resources for processing pitch and temporal information,
or by general cognitive abilities. Participants had varying levels of
musical training and were native and non-native speakers of English.
The research assessed reading ability, music perception skills, general
cognitive ability including non-verbal intelligence, short-term and
working memory, and socioeconomic status. The association between
reading and music training was significant after socioeconomic status,
native language and music perception skills were controlled for. After
general cognitive abilities were held constant, there was no longer
an association between reading and music training. This suggested
206 The Power of Music

that the association between reading ability and music training was a
consequence of general cognitive abilities.
Not all of the research has shown positive relationships between
musical training and intelligence. For instance, Schellenberg and
Moreno (2010) recruited 40 undergraduates on the basis of their
musical background. Half had extensive training in music, at least
eight years of lessons, and had played regularly up until three years or
less before participating. The remaining 20 participants had little or no
musical training. The participants responded to tests of pitch processing
and completed the Raven’s Progressive Matrices to assess non-verbal
reasoning. The musicians exhibited superior performance on the
musical tests but not on the measure of general intelligence. Similarly,
Helmbold and colleagues (2005) compared 70 adult musicians with 70
non-musicians on psychometric performance on verbal comprehension,
word fluency, space, flexibility of closure, perceptual speed, reasoning,
number and memory. No significant differences were found for either
mean full-scale scores or for specific aspects of mental abilities, except
flexibility of closure and perceptual speed. In both these subtests,
musicians performed reliably better than non-musicians. Also comparing
musicians and non-musicians, Brandler and Rammsayer (2003) studied
differences in a range of cognitive tasks including verbal comprehension,
word fluency, space, closure, perceptual speed, reasoning, number and
memory. Significant differences were not found for either mean full-
scale scores or for specific aspects of intelligence, except verbal memory
and reasoning. While performance on verbal memory was reliably
higher for the musicians than for the non-musicians, the non-musicians
performed significantly better on all four subscales of Cattell’s culture-
free intelligence test.

Correlation and Comparative Research with Children

There has long been an interest in the relationship between musical
training and intellectual development. Many early studies focused on
how general intelligence might underpin musical ability (Beckham,
1942; Fracker and Howard, 1928; Hollingworth, 1926).
Later studies explored the nature of the relationships (Antrim, 1945;
Bienstock, 1942; Ross, 1936) but did not address issues of causality, which
 8. Intellectual Development  207

led to some arguing that the reason for the relationships was because
more intelligent children were drawn to participate in musical activities
(Farnsworth, 1946; Ross, 1936). Since these early studies, there has been
evidence that children who take up a musical instrument frequently have
higher-level academic skills prior to participating in musical activities
(Feldman and Matjasko, 2005; Fitzpatrick, 2006; Gibson et al., 2009; Hille
et al., 2011; Kinney, 2008; 2010; Ruthsatz et al., 2008; Schellenberg, 2011a;
Schellenberg and Mankarious, 2012). However, this is not always the
case (Habibi et al., 2014). Learning to play a musical instrument is often
related to the socioeconomic status of families and family make-up, both
of which support opportunities for musical engagement (Bugaj and
Brenner, 2011; Costa-Giomi, 2012; Elpus and Abril, 2011; Kinney, 2010;
Schellenberg and Weiss, 2013). Only intervention studies can establish
the direction of causality.
Overall, there have been a number of correlational and comparative
studies with children. Adopting a cross-sectional approach, Schlaug and
colleagues (2005) compared nine- to eleven-year-old instrumentalists
with an average of four years’ training with a control group. The findings
showed that the instrumental group performed significantly better than
the control group on musical audiation, left-hand index finger tapping
rate, and the vocabulary subtest of the WISC-III intelligence test.
However, there were non-significant trends in a phonemic awareness
test, Raven’s Progressive Matrices and a mathematics test. Similarly,
Loui and colleagues (2019) showed that children who played a musical
instrument for more than half an hour each week had higher scores on
verbal ability and intellectual ability, as well as higher axial diffusivity
in the left superior longitudinal fasciculus than those who did not play.
A correlation between the number of hours of practice each week and
axial diffusivity in the left superior longitudinal fasciculus suggested
that the relationship between musical practice and intellectual ability
was related to the maturation of white-matter pathways in the auditory-
motor system.
Some research has focused on multiple intelligences. For instance,
Singh and colleagues (2017) studied performance on multiple
intelligences in Indian children, comparing them with IQ scores. They
recruited 1065 school children between the ages of 12 and 16 from 2
government and 13 private schools in 5 towns, 6 cities and 2 villages across
208 The Power of Music

India. All of the children were administered a multiple-intelligences

questionnaire consisting of 30 true-false questions, to assess intelligences
in seven domains, including linguistic skills, logical mathematical
abilities, musical skills, spatial intelligence, bodily kinaesthetic skills,
intrapersonal intelligence and interpersonal intelligence. IQ scores were
assessed by Ravens Standard Progressive Matrices. The findings showed
that different students possessed different forms of intelligences, and
that most students had more than one form of intelligence. Of the seven
forms of intelligence, only three—logico-mathematical, musical and
spatial—were positively correlated with IQ scores.
Swaminathan and Schellenberg (2020) focused on the links between
musical expertise and language ability in a sample of six- to nine-year-old
children. Language ability was measured with tests of speech perception
and grammar, while musical expertise was assessed with a range of
tests of musical ability. Musical training was associated positively with
performance on a grammar test, musical ability, IQ, openness and age.
Overall, the findings showed that musical ability predicted language
ability independent of IQ and other confounding variables, but the
links between music and language seemed to arise primarily from pre-
existing factors and not from formal training in music.
Schellenberg and colleagues undertook a series of studies exploring
the relationships between musical engagement and intelligence in
children. For instance, Schellenberg (2006) administered standardised
tests of intelligence to approximately 300 children and adults who
varied widely in the extent of their musical experiences outside school.
The findings showed that, among the children, cognitive performance
was positively associated with months of music lessons, even after
holding constant parents’ education, family income and duration of
involvement. Associations were strongest for an aggregate measure of
intelligence, with no association between musical activity and particular
subtests when general intelligence was held constant. In a later study,
Schellenberg (2011a) compared 106 musically trained and untrained
nine- to twelve-year-olds on a measure of IQ and five measures of
executive function. The musically trained children outperformed the
untrained children across the four subtests and three IQ scores of the test
used. These findings replicated those reported earlier by Schellenberg
(2004; 2006b). However, the association between musical training and
 8. Intellectual Development  209

executive function was negligible. Further, Corrigal and Schellenberg

(2013) collected data from 167 ten- to twelve-year-old children, including
demographic information and measured cognitive ability. The duration
of music lessons was associated positively with age, socioeconomic
status, duration of non-musical extracurricular activities, IQ and school
performance. They concluded that the observed associations between
musical involvement and cognition were highly unlikely to be solely a
consequence of music training.
In a comparative study, Hille and colleagues (2011) explored the
impact of different types of musical activities on intelligence. They tested
194 boys aged eight to nine years old, just over half of whom had learned
to play a musical instrument. Non-verbal measures of intelligence were
higher for boys playing an instrument, with a moderate effect size, but
no difference in non-verbal measures of intelligence was found for boys
who sang in a choir and those who did not. Overall, active participation
in a choir or lessons called ‘First Experiences with Music’ did not show
the benefits associated with learning to play an instrument.
Degé and colleagues (2011a) investigated whether the association
between music lessons and intelligence was mediated by executive
functions. Intelligence and five different executive functions—set-
shifting, selective attention, planning, inhibition and fluency—were
assessed in nine- to twelve-year-old children with varying amounts of
music lessons. Significant associations emerged between music lessons
and all of the measures of executive function. Executive functions
mediated the association between music lessons and intelligence, with
the measures of selective attention and inhibition being the strongest
contributors to the effect. The results suggested that at least part of the
association between music lessons and intelligence was explained by
the positive influence that music lessons had on executive functions,
which in turn improved performance on the intelligence tests. Also
focusing on executive functions, Schellenberg (2011) compared
musically trained and untrained nine- to twelve-year-olds on a measure
of IQ and five measures of executive function. The findings showed that
IQ and executive function were correlated. The musically trained group
had higher IQs than their untrained counterparts and this advantage
extended across the IQ subtests. However, the association between
music training and executive function was negligible. These results do
210 The Power of Music

not support the hypothesis that the association between music training
and IQ is mediated by executive function.
Jaschke and colleagues (2018a) adopted a different approach,
assessing exposure to a musically enriched environment, including
listening to music at home, during play or when attending concerts.
A questionnaire was administered to a sample of 176 primary-school
children who also completed the verbal intelligence section of the
Wechsler Intelligence Scale (WISC III) and performed executive sub-
function tasks such as planning, working memory, inhibition and a short-
term memory task. Linear and multiple regression analyses showed
no significant relationship between exposure to a musically enriched
environment, executive sub-functions, planning, inhibition, working
memory and short-term memory. Experiencing a musically enriched
environment does not serve as a predictor for higher performance on
executive sub functions, although it can influence verbal intelligence.

Intervention Studies
Research which has adopted a retrospective approach to studying the
relationship between active engagement with music and intelligence—
while showing enhanced performance from musicians on a range of
intellectual skills—is not able to address the issue of causality. Those who
take up playing musical instruments may have higher IQ scores in the
first place, although the evidence regarding this is mixed. Intervention
studies can address this issue but have also served to demonstrate
the complexity of the issues involved in establishing the relationship
between musical engagement and intelligence. In an early study, Hurwitz
and colleagues (1975) assigned first-grade children to two groups,
one receiving Kodaly music lessons for five days each week for seven
months, and one a control group which did not receive musical tuition.
At the end of the study, the experimental group scored significantly
higher than the control group on three of five sequencing tasks and four
of five spatial tasks. No statistically significant differences were found
for verbal measures, although the children in the experimental group
had higher reading achievement scores than those in the control group.
These were maintained after two academic years.
Following this early study, Gromko and Poorman (1998) compared
preschool children in a group engaging in weekly musical activities with
 8. Intellectual Development  211

a control group and found that, for the three-year-olds participating

in the study, an intellectually stimulating environment resulted in a
gain in the ability to perform the spatial-temporal task element of an
intelligence test. Similarly, Bilhartz and colleagues (1999) studied the
relationship between participation in a structured music curriculum
and cognitive development in four- to six-year-olds. Half of the children
participated in a 30-week 75-minute weekly music curriculum with
parent involvement. Following this, the children were tested with six
subtests of the Stanford-Binet intelligence test and the Young Child
Music Skills Assessment test. There were significant gains for the music
group on the music test and the Stanford-Binet Bead Memory subtest.
In a series of studies, Costa-Giomi and colleagues (1999; 2004; Costa-
Giomi and Ryan, 2007) completed a longitudinal study on the effects
of piano instruction on children’s cognitive abilities. Children were
randomly assigned to an experimental or control group. Each child
received free instruction. The two groups of children were comparable
at the start of the study in terms of musical ability, cognitive abilities
and academic achievement in mathematics, language and motor skills.
After two years of instruction, the children in the experimental group
obtained significantly higher scores on the cognitive ability tests and
spatial scores. However, no differences were found after three years.
Additionally, no differences in the quantitative and verbal cognitive
abilities of the two groups were found after two years of the study.
A follow-up study conducted seven years after the completion of the
lessons showed no differences between groups. Similarly, analysis at a
ten-year follow-up (Costa-Giomi and Ryan, 2007) showed no differences
in IQ or memory. The initial gains became negligible over time. The
improvements were small and temporary, and seem to have depended
on the level of the children’s commitment and effort. After three years,
22 percent of the variance in cognitive improvement was explained by
the children’s attendance at lessons and time spent practising. Those
who were more committed gained more (Costa-Giomi, 1999).
In a carefully controlled study, Schellenberg (2004) randomly
assigned a large sample of children to four different groups—two of
which received music lessons, standard keyboard or Kodaly voice
lessons for a year, while the control groups received instruction in a non-
musical artistic activity, drama or no lessons. All four groups exhibited
increases in IQ, as would be expected over the time period, but the music
212 The Power of Music

groups had reliably larger increases in full-scale IQ, with an effect size
of .35. Children in the control groups had average increases of 4.3 points
while the music groups had increases of 7 points. On all but two of the
12 subtests, the music group had larger increases than control groups.
Notably, the music groups had larger increases on the four indexes that
measured specific abilities, verbal ability, spatial ability, processing
speed and attention. Catterall and Rauscher (2008), in a review of the
literature and a reanalysis of Schellenberg’s (2004) data, argue that the
gains seen in more general IQ were likely to be the result of specific gains
in visuospatial intelligence, although there may also be effects related to
the enhanced development of language and literacy skills.
In a more recent study, Moreno and colleagues (2011a; 2011b)
devised two interactive computerised training programmes with a
focus on music or art. After only 20 days of training, the children in the
music group exhibited enhanced performance on a measure of verbal
intelligence. These changes were positively correlated with changes in
functional brain plasticity during an executive function task, which the
authors suggested indicated that the impact of musical engagement on
intelligence could be related to executive functions. Similarly, Jaschke
and colleagues (2018b) studied 147 primary-school children, aged six
to seven years old, who were followed for 2.5 years. Participants were
randomised into four groups: two music intervention groups, one active
visual arts group, and a no-arts control group. Neuropsychological
tests assessed verbal intelligence and executive functions. Additionally,
national data on academic performance was available. Children in the
visual arts group performed better on visuospatial memory tasks as
compared to the three other conditions. However, the test scores on
inhibition, planning and verbal intelligence increased significantly in the
two music groups over time as compared to the visual art and no-arts
controls. Mediation analysis with executive functions and verbal IQ as
mediators for academic performance showed a possible far-transfer
effect from executive sub-function to academic performance scores.
In Tehran, Iran, Kaviani and colleagues (2014) worked with 154
preschool children from kindergarten. Sixty children aged between five
and six years old were randomly assigned to two groups, one receiving
twelve 75-minute music lessons and the other—matched for sex, age
and mother’s educational level—not receiving any music classes. The
 8. Intellectual Development  213

children were tested before the start of the music lessons and at the
end, with four subtests of an intelligence scale. The findings showed
a statistically significant increase in IQ in participants receiving music
lessons, specifically on verbal reasoning and short-term memory
subtests, although there were no differences in numerical and visual
abstract reasoning abilities. In Israel, research with children aged six
to twelve also found a causal effect of music training on intelligence.
Children who were assigned to a two-year music training programme
had larger increases in general intelligence compared to a control group
with no intervention (Portowitz and Klein, 2007; Portowitz et al., 2009).
Working in Spain, Carioti and colleagues (2019) tested 128 students in
a middle school at the beginning of the first class and the beginning
of the second class. Seventy-two students were able to access a music
curriculum, 30 with previous music experience, 42 without, while 56
accessed a standard curriculum. 44 with prior music experience and 12
without. The longitudinal comparison of the four groups of students
revealed that students experiencing the music curriculum had better
performance in tests of general cognitive abilities, visuospatial skills and
memory tests.
Studying children from low socioeconomic backgrounds, Barbaroux
et al. (2019) evaluated the impact of a classical music training programme
with particular reference to general intelligence, auditory and visual
attention, and working and short-term memory. The findings showed
that music training improved total IQ and symbol-search scores, as well
as concentration abilities.
Rose and colleagues (2019) investigated the effects of musical
instrument learning on the development of cognitive skills in 38 seven-
to nine-year-old children. Pre- and post-test measures of intelligence and
memory were compared in children who received either extracurricular
musical training or statutory school music lessons. The results showed a
significant association between musical aptitude and intelligence overall.
The children receiving extracurricular lessons showed a significant
increase in IQ—7 points—in comparison to 4.3 points for those receiving
standard school music lessons. No significant differences were found for
memory. In a comparison of two different music interventions, James and
colleagues (2019) undertook a cluster randomised controlled trial which
showed that musical instrumental practice, in comparison to traditional
214 The Power of Music

sensitisation to music, led to multiple transfer effects in cognition.

Sixty-nine children aged ten to twelve received group music instruction
by professional musicians twice a week as part of the regular school
curriculum. The intervention group learned to play string instruments,
whereas the control group was sensitised to music through listening,
theory and some practice. Broad benefits manifested in the intervention
group as compared to the control group for working memory, attention,
processing speed, cognitive flexibility and matrix reasoning.
Not all of the research has shown increases in IQ relating to active
participation in musical activities. For instance, Mehr and colleagues
(2013) conducted two randomised controlled trials with American
preschool children, on average aged four years old. They compared
participation in music classes with participation in visual arts classes.
The parents attended classes with their children. The classes ran for six
weeks, with a total of 4.5 hours of relatively unstructured musical activity
which involved singing, some work with percussion instruments and
movement. The children were tested on spatial navigational reasoning,
visual form analysis, numerical discrimination and receptive vocabulary.
In the first experiment, the children from the music group showed
greater spatial navigational ability, while children from the visual arts
class showed greater visual form analysis. However, a partial replication
with another group of children did not confirm these findings.
Working with secondary- and primary-aged students in two studies,
Rickard and colleagues (2012) reported on the impact of an increase in
school-based music training on a range of cognitive and psychosocial
measures for ten- to thirteen-year-olds. In the first study, the benefits of
increased frequency of classroom-based music classes were compared
with drama and art lessons. The second study compared the effects
of introducing a new classroom-based music programme with a new
drama programme for 100 primary-school students. Assessments were
obtained at baseline and approximately six months after implementation
of each programme. No benefits for school music classes were apparent,
although trends of interest were observed in non-verbal intelligence and
verbal memory.
 8. Intellectual Development  215

Music and Emotional Intelligence

There is evidence that group music-making can support the development
of emotional intelligence. For instance, Petrides and colleagues (2006)
investigated trait emotional intelligence in a study of 37 music students.
They found a positive relationship between trait emotional intelligence
scores and length of musical training. The research supported
the conceptualisation of trait emotional intelligence as a construct
of general emotionality. In contrast, in research assessing ability
emotional intelligence, Resnicow and colleagues (2004) worked with
24 undergraduate students. They found that there was a relationship
between the ability to recognise emotions in performances of classical
piano music and measures of emotional intelligence, which required
individuals to identify, understand, reason with and manage emotions
using hypothetical scenarios. Emotional intelligence and emotion
recognition in the music task were significantly correlated, which
suggests that identification of emotion in music performance draws
on some of the same sensibilities that make up everyday emotional
intelligence. There is also evidence that music training enhances
sensitivity to emotions in speech. Thompson and colleagues (2004)
revealed that music lessons promoted sensitivity to emotions conveyed
by speech prosody. Musically trained adults outperformed untrained
adults at identifying sadness, fear or neutral emotion, while six-year-
olds randomly assigned to one year of keyboard lessons performed
equivalently to a drama group and better than a no-lessons group at
identifying anger or fear.
Adopting a different approach, Theorell and colleagues (2014)
explored whether musical activities contributed to the prevention
of alexithymia, the inability to describe one’s own emotions. Eight
thousand Swedish twins aged 27 to 54 were studied. They completed
the Toronto Alexithymia Scale—a musical achievement scale—and
estimated the number of hours of musical practice during different
periods of their life. The findings showed that alexithymia was negatively
associated with musical creative achievement, having played a musical
instrument, total hours of musical training and ensemble-playing.
The associations between musical training and alexithymia remained
significant when controlling for education, depression and intelligence.
216 The Power of Music

Musical achievement and musical practice were both associated with

lower levels of alexithymia. They concluded that musical engagement
was associated with higher emotional competence, although the effect
sizes were small.
Not all of the research exploring the relationships between music-
making and emotional intelligence has found positive relationships.
This seems to depend on whether emotional intelligence is measured
as a trait, a behavioural disposition or an ability—a skill in processing
emotional information and using it in everyday life. Music training
seems to be more related to emotional intelligence as a trait (Petrides et
al., 2006) rather than as an ability.
Trimmer and Cuddy (2008), working with 100 undergraduates,
found that emotional intelligence, not music training or music
perception abilities, successfully predicted identification of intended
emotion in speech and melodic analogues. The ability to recognise
cues of emotion accurately and efficiently across domains may reflect
the operation of a cross-modal processor that does not rely on gains in
perceptual sensitivity, such as those related to music training. Similarly,
Schellenberg (2011b) studied 196 undergraduates ranging in age from
17 to 26 years old with at least eight years of extracurricular private
music lessons or no lessons. The musically trained participants scored
no higher than their untrained counterparts on a test of emotional
intelligence.
Despite this, some research with children has found positive
relationships between understanding emotions and music training.
For instance, Schellenberg and Mankarious (2012) found that seven-
to eight-year-olds with at least eight months of formal musical
training, mainly through private individual lessons, showed a positive
association between music training and emotional ability, although this
seemed to be mediated by higher levels of general intelligence. There
is also some evidence that music can enhance emotional competence
among children, which then supports their engagement with learning
(Adushkina, 2015).
In Korea, two studies—Shin (2006) and Lee (2010)—examined the
effect of music therapy on low-income elementary-school children’s
emotional intelligence. The music programme consisted of singing,
listening to music and song-writing. The findings showed that there were
 8. Intellectual Development  217

statistically significant increases in emotional intelligence compared

with a control group. Also in Korea, Kim and Kim (2018) adopted a
quasi-experimental design in which 30 children received a weekly group
musical instrument performance class with a regular music class, while
a control group of 30 children received only a regular music class that
was part of the elementary-school curriculum. Emotional intelligence,
anxiety and aggression were assessed at the beginning and end of the
24-week intervention. The musical instrument performance programme
improved the ability to perceive emotions, and reduced physical and
verbal aggression, but had no statistically significant effect on the level
of total emotional intelligence, anxiety or aggression.

Studies with Older Adults

Some research has focused on general cognitive functions with older
adults. As we saw in Chapters 6 and 7, there is evidence of the impact of
music on cognition in older people; for instance, on executive functions,
including various aspects of memory, attention, processing speed and
planning (Amer et al., 2013; Bugos et al., 2007; Bugos, 2010; Bugos,
2019; Degé and Kerkovius, 2018; Diaz Abrahan et al., 2020; Grassi et al.,
2018; Hanna-Pladdy and Gajewski, 2012; Hanna-Pladdy and MacKay,
2011; Hars et al., 2013; Strong and Mast, 2019). There have also been
improvements in cognition and working memory in patients with
dementia, and evidence that musical activity can prevent cognitive
decline (Camic et al., 2013; Maguire et al., 2015; Mansky et al., 2020;
Pongan et al., 2017; Särkämö et al., 2014).
In a pilot study with socioeconomically diverse older adults,
MacAulay and colleagues (2019) presented interim data on the effect of
music training. Thirty-five socioeconomically diverse older adults with
a mean age of 70 completed the programme. Participants took part in
12 weekly one-hour recorder lessons and underwent comprehensive
pre- and post-intervention neuropsychological assessments. The
results indicated improved executive function, global cognition, verbal
fluency and visual memory performance following the intervention.
The research suggested that music training is a cognitively stimulating
activity that has real-life applications for older people.
In a retrospective study, Fancourt and colleagues (2020)
examined whether lifetime musical training was associated with
218 The Power of Music

neuropsychological performance in a memory-clinic population of older

patients. A total of 478 patients, with an average age of almost 74 years
old, were included in a cross-sectional analysis. All of the participating
patients had been referred to the memory clinic due to cognitive
impairments. Participants were assessed using a neuropsychological
assessment battery. They also provided information on whether they
had played a musical instrument for at least five years during their lives.
The outcomes of the neuropsychological test results differed based on
the extent of musical training. Overall, there were no differences in any
domains of cognitive functioning, other than that patients with musical
training performed worse on word-list memory tasks. However, this
relationship varied based on the extent of cognitive impairment. Patients
who were cognitively unimpaired and had musical training showed
better word-list learning, whereas patients with cognitive impairments
and musical training performed worse in word-list learning and word-
list recall. Overall, there was little evidence of associations between
specific neuropsychological test results and musical training. Only in
cognitively unimpaired patients was there evidence that musical training
had beneficial associations. In patients with cognitive impairment, there
were suggestions of negative associations with verbal memory.
In a very large-scale study, Mansens and colleagues (2018) used
data from 1101 participants aged 64 and older from the Longitudinal
Aging Study Amsterdam. Multivariable linear regression analyses were
performed to test the association between time spent making music
and cognitive functioning. Making music was significantly positively
associated with letter fluency, learning, attention and short-term
memory, although time spent making music yielded no significant
results. Participants who only played an instrument compared to
participants who had not made music performed better on learning,
working memory and processing speed. For processing speed, the
instrument-only group also had a higher score than participants who
only sang. Making music at least once every two weeks—and especially
playing a musical instrument—was associated with better attention,
episodic memory and executive functions.
Overall, the research to date suggests that music training may protect
against age-related decline in working memory and may improve
performance among older adults who show some decline in working
 8. Intellectual Development  219

memory. Music training may also be useful in the prevention and

treatment of dementia.

Reviews and Meta-Analyses

Reviews and meta-analyses relating to the role of music in general
cognition are inconsistent in their findings. Črnčec and colleagues
(2006) concluded that music instruction conferred consistent benefits for
spatial-temporal reasoning skills; however, improvements in associated
academic domains, such as arithmetic, had not been reliably shown.
Similarly, Jaschke and colleagues (2013), in review of research on children
aged four to thirteen, suggested that the results of research exploring
the effects of active engagement with music on cognitive development
were either inconclusive or contradictory, because of the differences in
methods adopted and the different types of music education studied.
Dumont and colleagues (2017) focused on the role of music in child
development. Based on a detailed examination of 46 studies, they argued
that research on the impact of music interventions indicated positive
effects on a variety of skills which may support educational processes
and children’s development, although it was not possible to draw
definitive conclusions. Seven studies did not have sufficient evidence
and the results of a random controlled trial showed no effects, while two
experimental studies yielded mixed results. Three quasi-experimental
longitudinal studies and a longitudinal development study suggested
a partial positive impact of music. Evidence from five experimental
longitudinal studies suggested benefits for memory, although there
were methodological limitations. Of six quasi-experimental studies
exploring the impact on attention and executive functions, only two
reported positive outcomes. Five studies focusing on working memory
seemed to suggest a positive influence of music.
Protzko and colleagues (2017) reviewed five meta-analyses and
36 randomised controlled trials on the raising of IQ in children. They
found that supplementing a deficient child with multivitamins raised
IQ, as did providing iodine supplements. Learning to play a musical
instrument also enhanced IQ, although the role of iron supplements
and executive function training were unreliable. Papageorgi (2021) also
concluded that active engagement with music-making, particularly
220 The Power of Music

playing a musical instrument, had benefits for cognitive development,

while Kraus and Chandrasekaran (2010) argued that, although there is
convincing evidence for the overall benefits of engagement with music,
many questions remain unanswered. The evidence suggests that music
training facilitates cognitive development, but it is not clear whether the
improvements are an effect of the music training itself or the cognitive
load involved in the process of learning and playing a musical instrument
(which facilitates the development of a range of cognitive skills).
Sala and Gobet (2017; 2020) carried out two meta-analyses to
establish whether the available data supported an association between
music and cognitive skills. The first analysis (2017) examined 38 studies.
The results of the random effect models showed a small overall effect
size, but with slightly greater effect sizes with regard to intelligence
and memory-related outcomes. There was also an inverse relationship
between the size of the effects and the methodological quality of the
study design. The results suggested that music training does not reliably
enhance children and young adolescents’ cognitive or academic skills.
The later meta-analyses (Sala and Gobet, 2020) reanalysed data from
54 previous studies conducted between 1986 and 2019, and included
a total of 6,984 children. The analysis revealed that music training
appeared to be ineffective at enhancing cognitive or academic skills,
regardless of the type of skill (verbal, non-verbal or speed-related),
participants’ age or duration of music training. The authors found that
studies with high-quality design, such as those which used a group
of active controls—like children who learned a different skill, such as
dance or sports—showed no effect of music education on cognitive or
academic performance. Small effects were found in studies that did not
include controls, or where participants were not randomly assigned to
intervention or control groups.
Similarly, Cooper (2020) conducted a random effect meta-analysis
to measure the overall mean effects of music training on cognitive
measures in schoolchildren. The results showed small to medium
overall effects. When compared to active control groups, music training
yielded more improvement on a range of cognitive measurements.
While some studies did result in large effect sizes, significant moderators
related to methodological quality rendered the overall findings to non-
significant. Additional moderator analysis showed no clear advantage
 8. Intellectual Development  221

in cognitive function. The findings did not differ in relation to type of

music intervention. Overall, they suggested that music training may
have a positive impact on cognition in schoolchildren, but may not have
advantages when compared with other interventions.

Overview
Overall, taking the findings together, it would appear that active
engagement with making music can have an impact on intelligence and
cognitive development, although it frequently does not. However, the
research highlights a great many issues. Firstly, the nature of intelligence
itself is problematic from a research point of view, as it includes many
different subskills. Some of these are more likely to benefit from musical
interventions than others, as has been demonstrated in this and previous
chapters. The nature and relative importance of the relationship between
executive functions and measured intelligence is also a problematic area.
The type of musical interventions, their duration, intensity and quality
continue to be possible confounding factors. There is also an issue in
relation to the role of active control groups—for instance, sport, drama,
dance and visual art. If there is no difference between the outcomes of
musical training and these other activities, or indeed taking dietary
supplements, there seems to be an assumption that there is no impact
of musical activities where in fact it may be that all of these activities
can make a contribution to cognitive development. Just because music
has no greater impact on cognition than sport, this does not necessarily
mean that music has no impact. Indeed, the preference that an individual
has for any of these activities will contribute to their motivation and
subsequent propensity to maintain the activity over a long period of
time, at high levels of intensity with great commitment, all factors which
are important in determining impact on cognition.
It might be expected that active engagement with music would
support the development of emotional intelligence. There is no question
that music has a profound impact on our moods, emotions and arousal
levels, and that, as understanding of music develops, it may support
the development of understanding of emotions more generally. The
research to date does not entirely support this, although the evidence
for the impact of musical training on trait emotional intelligence is
222 The Power of Music

stronger than for ability intelligence. Trait emotional intelligence is

conceptualised as being aware of one’s own emotions. In musicians,
how this relates to the performance of music—a key element of which is
to convey emotion—is not clear.
 9. Musicians and Creativity

Understanding and researching creativity presents many challenges.

Several different approaches have been adopted. One strand of research
has focused on the characteristics of creative people; a second has
considered the process of creativity and its various stages, while some
research has been concerned with the outcomes of creativity (in other
words, its products). Another strand has considered the environment
emphasising social and cultural influences in the development and
expression of creativity. Hennessey and Amabile (1988) describe
creativity as the process of being original to suit a particular purpose,
while others have viewed creativity as the process by which normal
cognitive processes lead to a moment of insight in order to discover or
produce something new (Perkins, 1981). Torrance (1988) argues that a
key component of creativity is the ability to generate something novel or
unique, while Guilford (1967) proposed that at the heart of creativity is
divergent thinking—the ability to generate new information or solutions
from given information. The goal of divergent thinking is to generate as
many associations or solutions as possible without relying on guidelines
or constraints (Gibson et al., 2009).
There have been many approaches to assessing creativity. For
example, Csíkszentmihályi (1996) studied the characteristics of
individuals judged to have made significant creative contributions
to society. Simonton (1997) differentiated between Big C creativity,
which is said to occur when a person solves a problem or creates an
object that has a major impact on society, while Little C creativity is
seen on a daily basis when someone adapts to change or comes up
with new ways of understanding a problem. A measure of Little C
divergent thinking is Guilford’s (1967) alternative uses task, in which
participants list several possible creative uses for common household
items, such as a newspaper, a brick or a paperclip. There are no correct

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.09

224 The Power of Music

answers and participants have to produce as many unique and creative

uses as they can.
Domain-specific theories of creativity emphasise the non-
transferability of expertise from one creative domain to another (Baer,
2015). These theories are supported by findings that creative individuals
are rarely creative in more than a few domains—for instance, an
individual known for their creativity in physics is rarely also renowned
for their creativity as a musician (Kaufman and Baer, 2004; Baer,
2012). There are also low correlations between an individuals’ creative
output in different domains (Baer, 1991). Domain-specific theories are
consistent with evidence that Big C creativity—ideas that represent
a huge leap forward in a field—require specific knowledge and skills
in a domain, which in turn requires extensive practice and learning.
In contrast, domain-general theories emphasise the generalisability of
creative thinking across different domains (Hong and Milgram, 2020).
The domain-general view is supported by personality studies, which
suggest that there is a creative personality type (Martindale and Daily,
1996; Feist, 1998; Batey and Furnham, 2006) and evidence that when
people express themselves in different creative domains, these outputs
bear a recognisable style (Gabora et al., 2012).
Attempting to address this issue, Root-Bernstein (2001) focused on
scientists who had been musicians and on the ways that they had used
their musical knowledge to inform their scientific work. Root-Bernstein
argued that music and science are two ways of using a common set of
tools for thinking that unify all disciplines. He explored the notion that
creative individuals are usually polymaths who think in ways which
cross disciplines. Increasingly, scholars are taking a less dichotomous
view of creativity, which incorporates both domain-specific and
domain-general elements (Kaufman and Baer, 2004b; Gabora, 2017).
Some mechanisms for this cross-domain creativity have been suggested
and tested in empirical studies: for instance, Palmiero and colleagues
(2016; 2019). Even if creative individuals tend to express themselves
in one domain, this does not necessarily mean that prior phases of
their creative process are domain-specific. For instance, Root-Bernstein
(2001) demonstrated how artistic ideas can stimulate creativity in
scientists, while Scotney and colleagues (2019) demonstrated how
influences for creativity can come from diverse sources. They conducted
 9. Musicians and Creativity  225

two studies—one with 151 creative experts recruited over the internet,
the other with 463 undergraduate students from diverse academic
backgrounds. Participants listed their creative outputs, the things that
had influenced them and the sources of inspiration associated with
each of these outputs. These were then categorised into groups: within
subject domain and outside subject domain. In both studies, cross-
domain influences on creativity were found to be widespread, and
indeed more frequent than within domain sources of inspiration. These
results demonstrate that, even if individuals primarily express their
creativity in a single domain, they are often employing cross-domain
thinking when they are engaged in creative activities.

Neurological Studies of Creativity

One strand of research has explored the neurological basis of creativity;
for instance,

Limb and Braun (2008) studied the neural substrates of spontaneous

musical performance in jazz improvisation using functional MRI. They
found that improvisation, compared to the production of over-learned
musical sequences, was consistently characterised by a dissociated
pattern of activity in the prefrontal cortex, and extensive deactivation of
dorsolateral prefrontal and lateral orbital regions with focal activation
of the medial prefrontal cortex. This may reflect a combination of the
psychological processes required for spontaneous improvisation, in
which internally motivated, stimulus-independent behaviours unfold in
the absence of central processes that typically mediate self-monitoring
and conscious volitional control of ongoing performance. Changes
in prefrontal activity during improvisation were accompanied by
widespread activation of neocortical sensorimotor areas that mediate
the organisation and execution of musical performance, as well as
deactivation of limbic structures that regulate motivation and emotional
tone. This distributed neural pattern may provide a cognitive context
that enables the emergence of spontaneous creative activity. Similarly,
Liu and colleagues (2012) used functional MRI to study the neural
correlates of creativity using freestyle rap, a multidimensional form
of creativity at the interface of music and language. Participants were
scanned while they performed two tasks, each of which used an identical
226 The Power of Music

eight-bar musical background track, a spontaneous, improvised

freestyle rap and a conventional performance of an overlearned,
well-rehearsed set of lyrics. Task contrast analyses indicated that
improvised performance was characterised by dissociated activity
in medial and dorsolateral prefrontal cortices, providing a context in
which stimulus-independent behaviours may unfold in the absence
of conscious monitoring and volitional control. Connectivity analyses
revealed widespread improvisation-related correlations between the
medial prefrontal, cingulate motor and perisylvian cortices, and the
amygdala, suggesting the emergence of a network linking motivation,
language, affect and movement. Lyrical improvisation appeared to
be characterised by altered relationships between regions coupling
intention and action, in which conventional executive control may be
bypassed and motor control directed by cingulate motor mechanisms.
These functional reorganisations may facilitate the initial improvisatory
phase of creative behaviour. Freestyle rap was compared to conventional
rehearsed performance, using functional magnetic resonance imaging.
The results showed activation of medial and deactivation of dorsolateral
cortices, which may provide a context in which self-generated action
is freed from the conventional constraints of supervisory attention and
executive control, facilitating the generation of novel ideas. Altered
relationships within the prefrontal cortex appeared to have widespread
functional consequences, affecting motivation, emotion, language as well
as motor control. These may generalise to other forms of spontaneous
creative behaviour.
Gibson and colleagues (2009) compared classical music students
with other similar students on behavioural tasks using near infrared
spectroscopy, which uses the near infrared region of the electromagnetic
spectrum from 780 nm to 2500 nm. The findings showed that the
musicians had increased convergent and divergent thinking compared
with non-musicians, while the infrared spectroscopy revealed that they
had greater bilateral frontal activity. It may be that non-musicians rely
more on the left hemisphere when undertaking divergent thinking
than musicians. Using fMRI de Aquino and colleagues (2019) found
that there was a different role for the supplementary motor area and the
insula between musicians and non-musicians in a controlled musical
creativity task. During a rhythmic improvisation task, musicians
 9. Musicians and Creativity  227

showed greater activation of the motor supplementary area, the anterior

cingulate cortex, the dorsolateral prefrontal cortex and the insula, along
with greater deactivation of the default mode network in comparison
with non-musicians. There was also a positive correlation between
time improvising and the activation of the supplementary motor
area in the musicians, while in the non-musicians improvisation time
correlated with the activation of the insula. It appears that for musicians
the supplementary motor area plays a role in the representation and
execution of musical behaviour, while for non-musicians the insula
plays a role in the processing of novel musical information. The findings
also showed that there were no correlations between a general creativity
score, brain activity and performance on the magnetic resonance task.
The absence of these correlations suggests that musical creativity, both
from a cerebral and behavioural point of view, is specific to the musical
field, and not related to creativity capacities in more general domains.

Correlational and Comparative Research on Musicians

One strand of research has compared the performance of musicians and
non-musicians on tests of creativity. For instance, in research with higher
education musicians and engineers, Charyton and Snelbecker (2007)
found that the musicians scored higher on general and artistic creativity,
but that there were no significant differences in scientific creativity. The
musicians had statistically higher levels of measured general creativity,
creative attributes, creative temperament, and cognitive risk tolerance.
Similarly, Gibson and colleagues (2009) compared classical music
students with other similar students. The musicians scored higher on
creativity tasks, including a version of Guilford’s (1967) alternative uses
task, than non-musicians, while infrared spectroscopy revealed greater
bilateral frontal activity in the musicians.
Palmiero and colleagues (2019) studied the relationship between
musical expertise which did not involve improvisation training, and
divergent thinking. Expert and self-taught musicians were tested in
musical, verbal and visual divergent thinking, and were compared
with a group of non-musicians in verbal and visual divergent thinking.
The musical task required participants to generate different pieces
of music, using Happy Birthday as a starting point. The verbal task
228 The Power of Music

required participants to list unusual uses for a cardboard box, while the
visual task asked them to complete drawings, adding details to basic
stimuli. Fluency, flexibility and originality scores were measured for
each task. Overall, the expert musicians showed higher creative scores
in musical and verbal domains than self-taught musicians. On verbal
creative tests, they performed better than non-musicians. No group
difference was found in relation to the visual creative task. Musical
expertise enhanced not only musical divergent thinking but also verbal
divergent thinking. This effect seemed to be specifically supported by
formal musical training. Similarly, Sovansky and colleagues (2014)
investigated how level of musical expertise and engagement in the
creation of music related to divergent thinking in musically trained
adults. Sixty participants of varying musical expertise were tested for
divergent thinking using a modified version of the alternative uses task,
in which participants listed creative uses for two music items and two
non-music items. The findings showed that the musicians who created
music listed more creative uses for music items than non-musicians, and
musicians who did not create music. For non-music items, there were no
differences in divergent thinking.
Kleinmintz and colleagues (2014) adopted a different approach,
comparing the performance on divergent thinking tasks of three groups
of musicians—36 trained in improvisation, 40 not trained in improvisation
and a group of non-musicians. Participants were shown a list of five
common objects—shoe, button, stapler, drinking glass and cardboard
box—and were asked to list as many alternative uses as possible for each
object within a period of ten minutes, while trying to think of original
uses. Participants were also instructed to evaluate deviance by rating
each item on a five-point rating scale, ranging from not at all deviant to
highly deviant. The improvisation group scored higher on fluency and
originality compared to the other two groups. The authors concluded
that deliberate practice of improvisation enhanced creativity. In the non-
improvisation group, all of the participants reported playing classical
music as well as other styles. The improvisation group was much more
diverse in the styles they played, with more than a quarter reporting
playing jazz. The findings of this study suggested that musicians who
are trained in improvisation are more creative than both musicians
without improvisation training and non-musicians.
 9. Musicians and Creativity  229

High school and university music students have been shown to

score higher on tests of creativity than non-music majors, this being
particularly marked in those with more than ten years of music education
(Hamann et al., 1990). Hamann and colleagues (1991) assessed
creativity among 144 high-school students to determine whether any
significant differences existed between creativity scores, taking account
of gender, grade point average and varying degrees of participation in
the arts. No significant differences were found among the creativity
scores of participants by gender, jazz experience, visual art experience
or combined arts experience. Almost all of the variation could be
attributed to the influence of grade point average. Significant creative
mean score differences, however, were found in relation to participants’
musical experience and theatre experience after the influence of grade
point average as a covariate was considered. There were no differences
between music students and those working in other areas of the arts.
However, the greater the musical expertise as assessed by the number
of units of music classes taken, the greater the creativity. Students with
more than ten years of music education had higher creativity scores
than those with fewer than ten years of experience (Hamann et al.,
1991). Working with 173 high-school music students and 45 non-music
students, Simpson (1969) found that the music students scored higher
on several elements of the Guildford tests of creativity.
Working with younger children in Grades Two, Four and Six, Kiehn
(2003) compared music improvisation. Eighty-nine randomly selected
participants were given two measures of creativity: the Vaughan Test
of Musical Creativity and the Torrance Test of Creative Thinking. Two
independent judges scored responses on the Vaughan test to determine
music improvisational creativity. A significant grade-level difference
emerged for music creativity scores, with Grade Two students scoring
significantly lower than Grade Four and Six students. This suggests that
there may be a musical creativity growth stage between Grades Two to
Four, followed by a levelling off, as there were no significant changes
in test scores between Grade Four and Six. A weak but statistically
significant correlation was found between music creativity and figural
creativity.
230 The Power of Music

The Personality of Musicians and Creativity

Domain-general theories of creativity emphasise the generalisability of
creative thinking across different domains, suggesting that creativity can
transfer across domains (Hong and Milgram, 2010). Personality research
supports this, suggesting that there may be a creative personality type
(Batey and Furnham, 2006; Feist, 1998; Martindale and Daily, 1996).
Additionally, when individuals express themselves in different creative
domains, the outputs often have a recognisable style (Gabora et al.,
2012). Hughes and colleagues (2013) studied the relationship between
personality and self-rated creativity in 222 participants who completed
a multidimensional measure of self-estimated creativity, a self-rated
personal characteristics questionnaire and a Big Five personality
measure. Trait openness predicted all measures of self-estimated
creativity. Similarly, Dollinger and colleagues (2004) studied the
relationship between personality measures and creativity in 150 college
students who completed a test of creative thinking, an inventory of past
creative accomplishments and the Big Five personality test. A creative
personality adjective check list related to most creativity measures, as
did the Big Five ‘openness to experience’ measure. The findings from the
latter were particularly compelling. Together, these studies suggest that
there is a general personality characteristic which is related to creativity.
Some research has shown that musicians tend to have personalities
with high levels of openness to experience, which means that they
have the potential to be creative. Supporting this, Corrigall and
colleagues (2013), in a study of 118 adults and 167 ten- to twelve-year-
old children, collected demographic information, measured aspects of
cognitive ability and administered the Big Five personality test. The
findings showed that the personality characteristic ‘openness’ was
associated with duration of musical involvement. Exploring this issue
with different types of musicians, Benedek and colleagues (2014)
researched 120 college students studying jazz, classical or folk music.
They collected data about their musical practice and attainment, and
their personalities. The jazz musicians showed higher levels of divergent
thinking, were engaged in more creative musical activities and had
higher levels of achievement in those activities. The classical musicians
spent a great deal of time practising and won more competitions, while
 9. Musicians and Creativity  231

the folk musicians were more extroverted. The jazz musicians showed
higher ideational creativity as measured by divergent thinking tasks,
and tended to be more open to new experiences than the classical
musicians. Overall, the jazz musicians showed particularly high
creativity with respect to domain-specific musical accomplishments and
also in terms of domain-general indicators of divergent thinking ability.
This may be related to differences in the formal and informal ways of
practising and learning adopted by different musical groups, with jazz
musicians attaching more importance to informal practice while placing
a lower value on technical perfection and competitions. It may be that
individual differences in creative potential may be relevant for the
realisation of domain-specific creative activities and achievements (in
this case, musical improvisation).
As well as researching personality differences between sub-groups
of musicians according to types of employment and instrument group,
Vaag and colleagues (2018) investigated differences in personality
traits between professional musicians and the general workforce. In
2013, 1,600 members of the Norwegian Musicians’ Union answered a
questionnaire regarding type of employment, instrument group and a
shortened version of the Big Five personality inventory. Their responses
were compared to a sample of 6,372 of the general Norwegian workforce,
who answered the same personality questionnaire in the Norwegian
Generation and Gender Survey of 2007. The findings showed that the
musicians displayed higher degrees of ‘openness to experience’ than
the general workforce. This was especially evident among freelance
musicians and those who combined freelance work with employment.
Within instrument groups, the vocalists scored highest on ‘openness to
experience’. Similarly, Gjermunds and colleagues (2020) investigated the
Big Five personality traits in 509 musicians and 201 non-musicians, and
found that the musicians had significantly higher scores on ‘openness’
than the non-musicians. This was the most typical personality trait for
musicians. Focusing on rock and popular musicians, Gillespie and Myors
(2000) examined the personality characteristics of 100 rock and popular
musicians aged 17 to 49 years old who completed self-report versions
of a personality inventory and questionnaires about their musical
background. The group as a whole scored significantly above the norm
on ‘openness’. No background factors—such as instrument played,
232 The Power of Music

type of music performed, time spent playing, level of musicianship or

commercial success—moderated these findings.
Yondem and colleagues (2017) compared music and art students,
and found no differences between the groups in ‘openness’, while
Sandgren (2018) found that musicians did not score more highly on
measures of ‘openness’ than non-musicians.

Intervention Studies
Major national reports on the arts have emphasised their importance
in developing a range of transferable skills, including those related to
creativity and critical thinking (NACCCE, 1999). This evidence, while
demonstrating a relationship between musical skills and creativity, does
not address the issue of causality. This requires intervention research,
where controls are compared with those participating in musical
activities before and after the intervention. There are few intervention
studies focusing on the impact of active music-making on general
measured creativity.
In an early study, Wolff (1979) studied the effects of 30 minutes of daily
music instruction for an entire year on first-graders. Those participating
exhibited significant increases in creativity and in perceptual motor
skills, compared with controls. Similarly, Kalmar (1982) studied the
effects of singing and musical-group play twice weekly for three years
on preschool children of three to four years of age, and found that these
children scored higher than controls on creativity, had higher levels of
abstraction and showed greater creativity in improvised puppet play.
Passanisia and colleagues (2014) conducted a study to determine
whether participation in a group musical activity would enhance
interpersonal relationships and creativity in nine-year-old students to a
significantly greater degree than no participation in musical activities.
Performances on the Williams Creative Thinking Test (WCTT) and a
test of interpersonal relationships in two class groups—a musical group
of 36 and a non-musical group of 32—were compared by measuring
changes in pre- and post-test data. The results indicated that the
experimental group, compared with the control group, made significant
gains in scores for imagination and in interpersonal relationships,
particularly with peers. Focusing on improvisation, Lewis and Lovatt
 9. Musicians and Creativity  233

(2013) carried out two experiments and showed that 20 minutes of

verbal or musical improvisation significantly improved scores of
divergent thinking, as assessed by the alternative uses task. They also
showed that novel generation of music increased scores more than
playing learned melodies. The development of creative skills seems to
be particularly dependent on the type of musical engagement. This is
supported by Koutsoupidou and Hargreaves (2009,) who compared
two matched groups of six-year-olds over a period of six months. The
music lessons for the experimental group were enriched with a variety
of improvisatory activities, while those in the control group did not
include any improvisation, but were didactic and teacher-centred.
Children in the experimental group were offered opportunities to
experience improvisation through their voices, their bodies and musical
instruments. Webster’s Measure of Creative Thinking in Music was
administered before and after the six-month teaching programme, to
assess children’s creative thinking in terms of four musical parameters:
extensiveness, flexibility, originality and syntax. The analysis revealed
that improvisation significantly improved the development of creative
thinking. In particular, it promoted musical flexibility, originality and
syntax in children’s music-making. Similarly, Sowden and colleagues
(2015) focused on the potential for simple, arts-based improvisation
activities to enhance divergent thinking skills and creativity in primary-
school-aged children. They undertook two experiments. In the first,
they compared the effect of children taking part in an improvised
versus non-improvised dance class on their subsequent performance
on the instances task and on a creative toy design task. In the second
experiment, children took part in verbal and acting improvisation games
or in matched control games before completing a figural activity. In both
experiments, children who took part in the improvisation interventions
showed better divergent thinking and creativity.
Fritz and colleagues (2020) attempted to see if making music and
physical exercise combined would be beneficial for divergent thinking.
They investigated the relationship of physical exertion and being in
control of music on divergent thinking, wondering whether there
was an interaction effect. Seventy-seven young German participants
were tested with measurements of divergent thinking, collected after
either physical exercise with music listening, making music without
234 The Power of Music

physical effort or undertaking physical exercise with musical feedback.

In the music feedback exercise condition, each exercise machine was
modified with a movement sensor, which continually transmitted its
position to a computer that modified musical material to create musical
feedback (Fritz et al., 2013b) based on the current position of the
sensor. This effectively transformed each machine into an analogue for
a musical instrument. The music produced included harmonically and
rhythmically complex components and was described as experimental
electronic music. Participants completed three questionnaires assessing
demographic information: an alternative uses task, perceived musical
control, mood and feelings of being in touch with the music, and
perceived creativity. The experiment demonstrated that the music
feedback exercise condition significantly increased the participants’
scores in the alternative uses task. No effects on divergent thinking
were observed for the physical exercise with music listening and music
control-only conditions.
Investigating whether background music would have an impact
on creative performance, Ritter and Ferguson (2017) tested whether
listening to specific pieces of music (four classical music excerpts
systematically varying on valence and arousal), as compared to a silence
control condition would facilitate divergent and convergent creativity.
Creativity was higher for participants who listened to classical music
which was high on arousal and positive mood while performing a
divergent creativity task, than for participants who performed the task
in silence. No effect of music was found for convergent creativity.

Creativity in Later Life

There is much research considering the impact of creative musical activity
on wellbeing in later life. Despite this, there is relatively little research
considering whether engaging with musical activities specifically
enhances creativity more generally. An exception to this is research
which has studied song-writing activities. Such studies have reported
a range of positive findings relating to wellbeing (Creech et al., 2020).
Baker and Ballantyne (2013) found that group song-writing among
older adult retirees not only promoted happiness, meaningfulness and
engagement, but was perceived to enhance their creativity more broadly.
 9. Musicians and Creativity  235

Although musical creativity can continue throughout the lifespan, it can

also develop for the first time in later life. For instance, Varvarigou and
colleagues (2013) reported that a 90-year-old with no previous musical
training participating in a community music project wrote a song with
support from a musical expert, which was subsequently performed
publicly.

Reviews and Meta-Analyses

Compared with other areas of research, there have been relatively few
reviews relating to the role of music in enhancing creativity. Running
(2008) drew no firm conclusions, concluding that more research was
needed, while Loui and Guetta (2019) argued that music performance
requires perceptual processing (bottom-up and top-down), attention
and the integration of executive functions, while creativity entails
unconstrained thought processes that yield novel output. They argued
that considering these seemingly disparate aspects of cognitive function
in tandem might promote a more cohesive conceptualisation of music
within cognitive science more generally.

Overview
The evidence shows that musicians as a whole tend to score higher than
non-musicians on tests of creativity and on the personality characteristic
of ‘openness’, which is related to creativity. Those whose musical
activities are creative, for instance improvisation or composition, tend
to respond most positively. However, this does not mean that actively
engaging with music enhances creativity. It may be that those who tend
towards openness are drawn to those musical activities which require
creativity. There is little evidence from intervention research suggesting
that making music improves creativity, unless the musical activities
themselves are creative in nature. This has implications for music
education.
 10. General Attainment

There has been considerable research exploring the relationship

between actively making music and academic attainment. Most has been
correlational in nature, although there are some intervention studies.
Researching the impact of musical activity on academic attainment is
extremely challenging for a range of reasons. For instance, it may be that
not all areas of academic achievement are affected equally by the various
ways that music may impact on learning in children and young people.
Interactive models are needed to begin to unravel the complexity. One
such is Bronfenbrenner’s bio-ecological model (Bronfenbrenner and
Morris, 2006). This takes account of the interactions between process,
person, context and time. In the case of music, this means considering the
length of time engaged with music learning, the demands of the musical
training, the characteristics of the individual, the immediate learning
environment and the broader social environment which the individual
inhabits. Research must also take account of the different types of
attainment outcomes, general attainment or attainment in particular,
subject domains and the nature of the musical activities engaged with
and their quality. This implies the need for complex statistical analysis,
which can take account of the interactions between these. Earlier
chapters have explored the impact on literacy and numeracy and visual
and auditory competence. This chapter mainly focuses on attainment
across several subjects.

Correlation and Comparative Studies

Kinney (2008) examined sixth- and eighth-grade urban middle-school
students’ achievement test scores in fourth grade and during sixth- or
eighth-grade enrolment in a performing group. Ensemble participation,
band, choir or none, as well as socioeconomic status and home

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.10

238 The Power of Music

environment, were included. Fourth- and sixth-grade achievement tests

consisted of reading, mathematics, citizenship and science, while eighth-
grade tests included reading, mathematics, social studies, science,
and language arts (reading, writing, listening, speaking, viewing and
visual representation). Analyses indicated significant differences for
socioeconomic status and ensemble participation. Higher socioeconomic
status students scored significantly higher on all subtests except fourth-,
sixth- and eighth-grade reading. Sixth-grade band students scored
significantly higher than choir students and non-participants on every
subtest of sixth- and fourth-grade achievement tests. Eighth-grade band
students scored significantly higher than non-participants on fourth-
grade reading and mathematics and every subtest of the eighth-grade
achievement test except social studies. Similar results for both cohorts
suggested that playing in a band may attract higher achieving students
from the outset, and that test score differences remained stable over time
rather than being enhanced by musical activities.
In India, Swaminathan and Gopinath (2013) examined the English
second-language abilities of musically trained and untrained primary-
school children. Participants were tested on the verbal subscales of
an intelligence test designed for Indian children and an English word
reading test. The musically trained participants performed significantly
better on tests of comprehension and vocabulary. This persisted when
comparisons were made with an untrained group. Taking account
of more academic subjects, in Hong Kong, Tai and colleagues (2018)
investigated the relationship between the extent and outcome of Hong
Kong students’ musical training, their perceptions of the value of the
subjects they studied and their academic achievement. A total of 286
students in Primary Grades Four, Five and Six from a single school
reported the extent and outcome of their musical training, including the
number of instruments they studied, the number of years spent training
and the highest grade and level achieved. The findings showed that music
training positively predicted academic achievement in Chinese, English
and mathematics. Similarly, Yang and colleagues (2014) examined the
relationship between long-term music training and child development
based on 250 Chinese elementary school students’ academic development
of first and second language and mathematics. The findings showed that
musician children outperformed non-musician children only on musical
 10. General Attainment  239

achievement and second-language development. Although music

training was correlated with children’s final academic development of
first and second language and mathematics, it did not independently
contribute to the development of first language or mathematical skills.
Focusing on attainment across all school subjects, Wetter and
colleagues (2009), in a retrospective study, compared the school
performance of 53 children engaged in active music-making with 67
controls not engaged in music-making. Overall average marks, as well as
the average marks of all school subjects except sport, were significantly
higher in children who actively engaged in making music than those
who did not. In a multiple regression analysis, musical training, parents’
income, and educational level correlated significantly with overall
average marks. A slight decrease in overall average marks over four
years from Grades Three to Six was found in the control group, while
musical training appeared to help maintain school performance at a
high level over time.
Schellenberg (2006) studied the relationship between music lessons,
intelligence and academic performance in two studies. The first
examined the relationship of music lessons to intelligence, academic
achievement and social adjustment in six- to eleven-year-olds, while
the second examined the association between childhood music lessons
and academic achievement in 150 undergraduates. The findings
showed music lessons were associated with academic achievement
in both studies. Greater exposure to music lessons in childhood was
associated with higher scores on a measure of academic achievement,
higher elementary school and high school grade point average. These
associations held even after taking into account parental education,
family income and study participants’ involvement in non-musical out-
of-school activities.
In England, Hallam and Rogers (2016) drew on nationally available
data on attainment at age 11 and 16 relating to 608 students, 115 of whom
played a musical instrument to explore the impact of music training
on academic progress between ages 11 and 16. The findings showed
that the young people playing an instrument showed greater progress
and better academic outcomes than those who did not. The impact
was greater the longer a young person had been engaged in playing
an instrument. The instrumentalists performed at nearly one standard
240 The Power of Music

deviation better on almost all measures than those who did not play
an instrument at age 16, despite there being negligible differences at
age 11. Those who had been learning for four or five years had the best
results. When multiple regression analyses were undertaken, length of
time playing an instrument was a better predictor than attainment in
English at age 11 to a total points score calculated across all examination
subjects and the total number of points scored from performance in
the best eight examinations at age 16. Playing an instrument made a
statistically significant contribution to performance at age 16 across all
measures. The musicians showed greater progress between the two
examinations than non-musicians. Those who had been learning for the
longest period of time made the greatest progress. Also considering the
influence of music on progression over time, dos Santos and colleagues
(2015) analysed the academic performance of music and non music
students from seventh to ninth grade controlling for socioeconomic
status, intelligence, motivation and prior academic achievement. Data
were collected from 110 adolescents at two time points, once when the
students were between eleven and fourteen years old in the seventh grade,
and again three years later. The findings showed that music students
performed better academically than non music students in the seventh
grade and in the ninth grade. This difference was particularly evident in
scores in Portuguese language and natural science. The difference was
weaker in history and geography and least pronounced in mathematics
and English. A longitudinal analysis revealed better academic
performance by music students after controlling for prior academic
achievement indicating greater progress between the two assessment
points. This change remained when intelligence, socioeconomic status
and motivation were controlled for.
Not all of the research has had such clear cut results. For instance,
Schneider and Klotz (2000) compared the impact of enrolment in music
performance classes, band or choir, athletic extracurricular activities
or no such activities on the academic achievement of 346 students in
grades five through nine. The participating schools adopted a cross
section of different types of music programmes. The results showed that
although the mean scores for the musicians were higher than the non
musicians and non athletes, participation in music was not a conclusive
factor in predicting statistically higher academic scores than the other
 10. General Attainment  241

groups, although the musicians did score higher than the athletes and
over time this gap widened. The findings indicated that factors other
than enrolment in a performing music class affected the outcomes. The
findings also indicated an overall drop in standardized test scores in the
ninth grade for most students that was not seen for student musicians.

Large-Scale Research
A considerable amount of research has been based on large statewide
or national datasets. The evidence from correlation studies in the USA
has shown that students who participate in music education do better
than their peers on many measures of academic achievement. For
instance, using statewide data, Abeles (2007) reported that groups of
second grade children who participated in a weekly violin programme
having three lessons every two weeks outperformed non violin group
controls in performance on mathematics and language arts tests.
Morrison (1994) using data from the National Centre for Educational
Statistics representing over 13,000 students showed that high school
students who participated in music reported higher grades in English,
mathematics, history, and science than those who did not participate.
Similar outcomes have been reported by Cardarelli (2003), Fitzpatrick
(2006) and Trent (1996). A number of doctoral theses have also
supported these findings (Cobb, 1997; Gregory. 1988; Miranda, 2001;
Schneider, 2000; Underwood, 2000; Zanutto, 1997).

In China, Yang (2015) investigated whether music participation related

to academic achievement within the context of representative population
level data that adjusted for an array of socio demographic factors as
well as early academic achievement. The impact of music practice on
educational outcomes was analysed using multivariate regression
and individual fixed effects. The findings suggested that childhood
musical activity, either playing an instrument or singing, related
positively to educational achievements in adolescence. The magnitude
and significance of the estimated music coefficients for different music
indicators was robust when increasing the amount of individual and
family control variables but the size of the music estimates decreased
when the effect of parental education, other leisure activities and
previous educational achievements were held constant.
242 The Power of Music

In the USA, Fitzpatrick (2006) studied 15,431 students attending

Columbus public schools in Ohio and compared the performance on a
statewide test of academic attainment of instrumental music students
and their non instrumental classmates. The students were in fourth, sixth
and ninth grades. Students of like socioeconomic status were compared
on their performance on tests of citizenship, mathematics, science and
reading. The findings showed that instrumental students outperformed
non-instrumental students in every subject and at every grade level.
Instrumental students at both levels of socioeconomic status had higher
scores than their non-instrumental classmates from the fourth grade,
suggesting that instrumental music programmes attracted higher
scorers from the outset of instruction. However, the findings also showed
a pattern of increased achievement by lower socioeconomic status
instrumental students, who surpassed their higher socioeconomic status
non-instrumental classmates by the ninth grade in all subjects. Similarly,
Thorton (2013) conducted a statewide comparison of test scores for
students involved in voluntary music classes or ensembles, and students
not involved in such activities. Scores from almost 7,000 students in the
three grades tested by the state (Grades Five, Eight and Eleven) were
included. Significantly higher scores were found for students involved
in music compared with students not involved. It would seem that the
additional time spent in music activities did not disadvantage students
academically. Also using statewide data, some research has focused on
students who participate in statewide ensembles. For instance, Henry
and Braucht (2007) found that the most successful young musicians in
the USA who participated in statewide ensembles also had higher SAT
scores than state averages.

Southgate and Roscigno (2009), using two national data sets (ECLS-K
(20,000 US kindergarten students) and NELS:88 (25,000 adolescents))
and three measures of music participation—in school, outside school
and parental involvement in the form of concert attendance—found
that music involvement varied systematically by class and gender.
Involvement had implications for both mathematics and reading
achievement for young children and adolescents, and associations
between music and achievement persisted even when prior achievement
was taken into account. There was evidence of social class variation
within school music involvement in adolescents but not in early
 10. General Attainment  243

childhood, while the effects of class on parental music involvement were

strong and consistent in both samples. As a mediator of educational
outcomes, music involvement was significant for both mathematics
and reading achievement. It generally increased achievement levels,
although the gains were not distributed equally among all students: a
white student advantage existed. This may relate to the type of musical
activity engaged in and the opportunities afforded to the students
for performance, which may contribute to enhanced self-esteem and
increased motivation.
Working with young children and their families in Australia, Williams
and colleagues (2015) investigated parent-child home music activities in
a sample of 3031 children participating in the programme Growing Up
in Australia: The Longitudinal Study of Australian Children. Frequency
of shared home music activities was reported by parents when children
were two to three years old, and outcomes were measured by parent
and teacher report and direct testing two years later (when children
were four to five years old). A series of regression analyses controlling
for sociodemographic variables found frequency of shared home music
activities to have a small significant partial association with measures of
children’s vocabulary, numeracy, book-reading and shared home music
activities. Frequency of shared home music activities maintained small
partial associations with measures of attention and numeracy.
Not all of the evidence from large-scale studies has shown positive
outcomes for music tuition; for instance, Elpus (2013) examined the
college entrance examination scores of music and non-music students
in the United States, drawing data from the Education Longitudinal
Study of 2002 (a nationally representative education study). Analyses
of high-school transcript data showed that 1.127 million students
graduated high school having earned at least one course credit in music.
Fixed effects regression procedures were used to compare standardised
test scores of these music students with their non-music peers, while
controlling for demography, prior academic achievement, time use and
attitudes toward school. The findings indicated that music students did
not outperform non-music students on standard assessment tests once
systematic differences had been controlled for statistically. This pattern
of results remained consistent and robust through internal replications
with another standardised mathematics test, and when disaggregating
244 The Power of Music

music students by the type of music studied. Similarly, Miksza (2007)—

using data from National Education Longitudinal Study of 1988 and
a sample of 5,335—created a composite item which assessed student
participation in music for the entire duration of the study from eighth
to twelfth grade, and measured academic achievement in mathematics,
reading comprehension, science and social studies. There were
significant differences for all subtests in the initial testing in favour of
those who had participated in a band, choir or orchestra, but rates of
change in mathematics, science or social studies were no greater for the
music participants, and in reading achievement the music participants
increased more slowly than non-participants. In a later study, Miszka
(2010), using data from the Educational Longitudinal Study of 2002
and multilevel modelling, was able to take account of a wide range of
individual factors including socioeconomic status, minority status, peer
influence and music participation and school level factors, including
the number of music teachers. Outcome variables were standardised
mathematics scores, a composite community ethics score which
included strong friendships, helping people in the community and
working to correct social and economic inequalities, and a composite
school commitment variable including late arrival, skipping class and
absence from school. Music participation was related to all outcome
variables after controlling for all individual and school-level factors.
Students in high-school music ensembles were more likely to have higher
standardised mathematics achievement scores, be more concerned
about community ethics and be more committed to school.
A study in Germany by Hille and Schupp (2013) used the German
socioeconomic panel study longitudinal data to establish the impact
of musical training on attainment. The database included a detailed
assessment of the intensity and duration of music activities for
representative youth cohorts, school results and allowed consideration
of a wide range of parental characteristics. The findings on attainment
at age 17, taking account of a wide range of individual and family
characteristics, showed that children playing an instrument from age
eight to seventeen who had taken lessons outside school scored one-
sixth of a standard deviation higher than children not playing an
instrument. Similarly, in Canada, Gouzouasis and colleagues (2007)
found a positive relationship between music achievement in Grade 11
 10. General Attainment  245

and academic achievement in Grade 12 courses among a representative

dataset comprising over 50,000 secondary school students in British
Columbia.
Taking account of prior attainment, and thus able to focus on
progress, Guhn and colleagues (2020) carried out a multilevel mixed
model analysis in British Columbia, Canada of 112,916 students
in Grades Seven to Twelve. They compared the mean examination
grades of 15,483 students who took school music courses, with 97,433
who took none. Across all courses, English, science and mathematics
students who took school music courses had significantly higher raw
mean examination grades than students who took no music courses.
Mean differences ranged from 4.69 in English to 6.41 in science. Results
from the multilevel model, after adjusting for previous academic
achievement and socio demographic covariates, cultural background,
and neighbourhood showed that exam grade means across all academic
subjects were significantly higher for those who took music relative to
students who took no music. The adjusted mean differences in grades
ranged from 2.47 for English, to 3.76 for science. Comparisons were
made between the type of music engagement, instrumental or vocal and
academic achievement. Throughout secondary school, Grades ten to
twelve the results indicated that differences between the examination
means of students who took no school music and those who took school
music significantly differed by the type of school music. A significant
interaction for music participation, type of music, was observed
for all outcomes, English in Grades 10 and 12, science in Grade 10,
and mathematics in Grade 10. The students who took instrumental
music courses had significantly higher examination mean scores than
students who took vocal music courses, across all academic subjects.
The instrumental versus vocal music differences in mean examination
grades were particularly pronounced for mathematics and science in
Grade 10, compared with English in Grades 10 and 12. Additionally,
compared with students who took no music classes, students who took
vocal music as well as students who took instrumental music had, on
average, significantly higher examination means. The vocal music
students had examination means that were between 0.80 and 1.40 higher
than students who took no music. Students who took instrumental
music had examination means that were between 3.10 in Grade 10
246 The Power of Music

English and 5.11 in Grade 10 mathematics, higher than students

who took no music. Grades in vocal and instrumental school music
classes predicted academic achievement regression results, indicating
significant and positive linear associations between grades in vocal,
instrumental school music classes and academic grades, adjusting for
covariates. The results indicated that associations of music grades with
academic achievement examination scores significantly varied by type
of school music (solely vocal or solely instrumental) as the interaction
between music, grades and type of music was significant for all subjects,
English at Grades 10 and 12, science at Grade 10 and mathematics at
Grade 10. For vocal music, each one-unit increase in overall mean music
vocal grade was associated with predicted increases in examination
means in all subjects, ranging from 0.19 for English Grade 10 to 0.38
for mathematics Grade 10. Such associations between music grades
and academic examination scores were significantly higher for overall
mean instrumental music grades, with coefficients ranging from 0.26
for English Grade 10 to 0.50 for mathematics Grade 10. Higher levels
of music engagement, as assessed by the number of courses taken, was
related to higher examination scores in all subjects. This pattern was
more pronounced for very high engagement in instrumental music,
with medium effect sizes compared with vocal music where there were
small effect sizes. The effect sizes of these group differences were greater
than the effect sizes corresponding to average annual gains in students’
academic achievement during high school. In other words, highly
engaged instrumental music students were, on average, academically
over one year ahead of their peers. The positive relationships between
music engagement and academic achievement were independent of
students’ previous, Grade 7 achievement, sex, cultural background
and neighbourhood socioeconomic status, and were of considerable
magnitude. The findings suggest that multi-year engagement in music,
especially instrumental music, may benefit high school academic
achievement.
Although the quality of the music teaching is clearly important in
whether music has an impact on academic attainment, relatively little
research has taken account of this. An exception is the work of Johnson
and Memmott (2006), who studied 4,739 elementary and middle-school
students from four states in the USA and showed a strong relationship
 10. General Attainment  247

between third- and fourth-grade students’ academic achievement and

their participation in music programmes. Analysis of elementary school
data indicated that students in exemplary music education programmes
scored higher on both English and mathematics standardised tests
than their counterparts who did not have this high-quality instruction,
although the effect sizes were very small. Analysis of middle-school
data indicated that for both English and mathematics, students in
exceptional music programmes and deficient instrumental programmes
scored better than those who had no music classes or poor-quality
choral programmes. The effect sizes were moderate. Overall, the higher
the quality of the programme, the higher the academic attainment.
In the USA, exploring issues related to college entrance, Kaufman
and Gabler (2004) assessed cultural capital and the extracurricular
activities of girls and boys in the college attainment process using data
from the National Education Longitudinal Survey. They aimed to assess
the specific causal role these activities played in the college attainment
process. The research examined extracurricular activities in relation to
two different levels of college attainment: enrolment in any four-year
college or university, and enrolment in one of the nation’s elite, or most
selective universities. They found that, at the general college level,
hands-on training in the arts appeared to improve students’ chances of
going to college by enhancing their human capital but not their cultural
capital. In contrast, direct exposure to the arts did not appear to improve
students’ chances of going to an elite college, although having parents
who were interested in the arts did.

Research with Disadvantaged Populations

Evidence from El Sistema and Sistema-inspired projects has indicated a
positive impact of participating in musical activities on attainment. In
the UK, where the programme is based in schools in deprived areas,
Smithhurst (2011) reported that after one year of participation in the
programme, children in Years One to Four in one school were achieving
better scores in mathematics, reading and writing compared with their
peers who were not involved. Ninety percent of the children were
reaching target grades in maths compared with 68 percent not involved
in the programme. Similar trends were evident in reading, with 85
248 The Power of Music

percent of programme children reaching target grades compared with

62 percent not in the programme, and in writing, 65 percent compared
with 45 percent. Burns and Bewick (2011) reported that after two
years of participating in the programme where children engaged with
music for 4.5 hours per week, 43 percent of the children had progressed
more than four levels in maths, 53 percent in reading and 42 percent
in writing compared with a national average of three levels, despite
the fact that the participants included a high proportion of children
with special educational needs. However, the rate of improvement
slowed as participation continued. In a programme in Chile, Egaña de
Sol (2008) showed a positive effect on academic attainment in verbal
and mathematics skills. This was attributed in part to participants
holding higher expectations of their academic achievements, although
evaluations of other programmes in Chile had mixed results, with some
programmes having positive results and others no impact (Evaluación de
impacto programa prequestas juveniles e infantiles, 2010). Programmes
in the USA have indicated increased academic attainment as an outcome
of participation, with more children achieving roll of honour status,
particularly where children participated for an extended period of time
(Creech et al., 2013).
Creech and colleagues (2013), in their review of El Sistema and
Sistema-inspired programmes, concluded that, with few exceptions, the
studies demonstrate significant and steady improvement in academic
attainment and achieving targets and, in some cases, outperforming
comparison groups in maths, reading and writing. There is some
evidence that these effects may be cumulative, related to prolonged
engagement in the programmes (page 67).

Intervention Research
Most of the research exploring the links between participation in
musical activities and attainment has been based on correlation analysis,
which precludes the demonstration of causality, particularly as there
are many possible confounding factors. There is also the possibility
that music programmes may attract students who are already amongst
the highest attaining (Arnett-Gary, 1998; Costa-Giomi, 2012; Harrison,
1990; Hodges and O’Connell, 2007; Klinedinst, 1991; Schellenberg,
 10. General Attainment  249

2014; Shobo, 2001; Yoon, 2000). Overall, the evidence from correlation
studies has shown that students who participate in music education
tend to do better than their peers on many measures of academic
achievement, although there are exceptions. To demonstrate causality
requires intervention studies. There have been a small number of
experimental studies on the effects of participation in music on general
attainment. The findings have been mixed.
Several small-scale doctoral theses have focused on this issue,
including Hoffman (1995). Legette (1993) found no effect of music
instruction, while Hines (2000), studying students with learning
difficulties from kindergarten through to ninth grade, found neither
reading nor mathematics achievement was affected by type of music
instruction, motoric or non-motoric. In another small-scale study,
Cabanac and colleagues (2013) compared the performance of students
who participated in a music programme in a single school in Canada with
those who did not and found that the music students had consistently
higher attainment in all subjects.
Merh and colleagues (2013) conducted two random controlled trials
with preschool children investigating the cognitive effects of a brief
series of music classes, as compared to a similar but non-musical form of
arts instruction, visual arts classes or a no-treatment control. Consistent
with typical preschool arts enrichment programmes, parents attended
classes with their children, participating in a variety of developmentally
appropriate arts activities. After six weeks of classes, children’s skills in
four distinct cognitive areas were assessed, in which older arts trained
students had been reported to excel, spatial navigational reasoning,
visual form analysis, numerical discrimination and receptive vocabulary.
The findings showed initially that children from the music class showed
greater spatial navigational ability than children from the visual arts
class, while children from the visual arts class showed greater visual
form analysis ability than children from the music class. However, a
partial replication attempt comparing music training to a no-treatment
control failed to confirm these findings, while the combined results of
the two comparisons were negative. Overall, children provided with
music classes performed no better than those with visual arts or no
classes on any assessment.
Holochwost and colleagues (2017) examined whether music
education was associated with improved performance on measures
250 The Power of Music

of academic achievement and executive functions with 265 school

aged children in Grades 1 through 8. Fifty-eight percent were female,
and 86 percent African-American. They were selected by lottery to
participate in an out-of-school programme offering individual and large
ensemble training on orchestral instruments. Measures of academic
achievement, standardised test scores and grades in English language
arts and mathematics were taken from participants’ academic records.
Executive functions were assessed through students’ performance on a
computerised battery of common executive function tasks. The findings
indicated that, relative to controls, students in the music education
programme scored higher on standardised tests, earned better grades
in English language arts and mathematics, and exhibited superior
performance on selected executive function tasks and short-term
memory. Further analyses revealed that, although the largest differences
in performance were observed between students in the control group
and those who had received the music programme for two to three
years, conditional effects were also observed on three executive function
tasks for students who had been in the programme for one year.
Wallick (1998) examined the effects of a pullout string programme
on student achievement in the writing, reading, mathematics, and
citizenship sections of the Ohio Proficiency Test. One hundred and
forty-eight fourth-grade string students and 148 fourth-grade non-
string students from a southwestern Ohio city school district were
ability-matched according to their performance on the verbal section of
a cognitive abilities test. Scores on the Ohio Proficiency Test were then
recorded and compared. The results revealed a significant difference in
favour of the string students’ achievement in reading and citizenship,
although there were no significant differences between the two matched
groups in writing or mathematics. Also in the USA, Barr and colleagues
(2002) described a programme for the improvement of listening skills
in order to increase academic performance. The sample consisted of
elementary students in a middle-class community. The problem of
ineffective listening skills was documented through data, revealing the
number of students whose lowered academic performance was thought
to be because of a deficiency in listening skills. Staff reported that
students’ weaknesses in effective listening skills negatively impacted
on their academic performance. Three major categories of intervention
 10. General Attainment  251

were adopted: the direct teaching of effective listening skills, student

ownership of self-monitoring, and the effects of using music in the
classroom. Over the 16-week period of the interventions, the students
showed a notable improvement in academic achievement.
Adopting drama as a comparison group, Haywood and colleagues
(2015) evaluated the Act, Sing, Play programme which offered music
and drama tuition to Year Two pupils. The aim of the programme was
to evaluate whether music workshops had a greater impact than drama
workshops in terms of pupils’ mathematics and literacy attainment.
The programme ran for one academic year; 909 pupils participated in
19 schools in England. In each participating Year Two class, pupils were
randomly allocated to one of three groups: violin or cello workshops,
singing lessons or drama workshops. Workshops were held once a
week over 32 weeks. The findings provided no evidence that the music
workshops had a greater impact on maths or literacy attainment than
the drama workshops. This also applied to children from disadvantaged
families.
An unusual study was undertaken by Schiltz (2016), who researched
93 highly gifted children and adolescents suffering from school failure
at the beginning of adolescence. They were treated with an integrated
form of music psychotherapy and verbal psychotherapy in five separate
groups. The treatment combined active musical improvisation with
the writing of stories, or the production of drawings induced by
music, followed by verbal elaboration in the cognitive psychodynamic
psychotherapeutic tradition. A meta-analysis of the confirmatory results
in five subgroups showed a significant increase in concentration and in
school marks.

Reviews and Meta-Analyses

Over the years, there have been several reviews of the impact of
engagement with music on academic attainment (Arnett-Gary, 1998;
Costa-Giomi, 2012; Hodges and O’Connell, 2007; Schellenberg, 2014;
Shobo, 2001; Yoon, 2000). These and those undertaken more recently
(Benz et al., 2016; Dumont et al., 2017; Sala and Gobet, 2017) have
discussed the challenges and limitations of the research and offered
explanations for the variability of the empirical findings. The complexity
252 The Power of Music

of musical activities and their potential to affect children’s social,

emotional and cognitive experiences together have made it challenging
to formulate theoretical frameworks that account for the wide range of
empirical findings.
Miendlarzewska and Trost (2014) synthesised a large body of
studies, demonstrating that the benefits of musical training extended
beyond the skills which music aims to train, which then last into
adulthood. They argued that children who undergo musical training
have better verbal memory, second language pronunciation accuracy,
reading ability and executive functions. Learning to play an instrument
as a child may even predict academic performance and IQ in young
adulthood. In addition, the degree of observed structural and functional
adaptation in the brain correlates with the intensity and duration of
practice. The effects on cognitive development depend on the timing of
musical initiation as well as other moderating variables. They suggest
that motivation, reward and the social context of musical education are
important yet neglected factors which affect the long-term benefits of
musical training. They propose the notion of rhythmic entrainment as a
mechanism which may support learning, the development of executive
functions and temporal processing/orienting of attention in time, which
may underlie enhancements observed in reading and verbal memory.
Overall, they conclude that musical training uniquely engenders near-
and far-transfer effects, preparing a foundation for a range of skills thus
fostering cognitive development.
Winner and Cooper (2000) quantified the results of existing research
from 1950 to 1998, conducting five meta-analyses of studies assessing
the effects of arts education on academic achievement. The studies
examined the effects of the arts in general rather than specific art forms
(for instance, music or dance). The researchers found evidence for a
positive relationship between arts education and academic achievement,
but found no increase in verbal or mathematics achievement.
Sala and Gobet (2017) undertook two meta-analyses assessing
the effect of chess and music instruction on children’s cognitive and
academic skills. A third meta-analysis evaluated the effects of working
memory training. The findings showed that the effect sizes from the
studies were inversely related to the quality of the experimental design.
This pattern of results cast serious doubts on the effectiveness of chess,
 10. General Attainment  253

music and working memory training. In a later review, Sala and Gobet
(2018) presented a meta-analysis of music intervention studies with
3,780 children and found only a small overall effect size. When active
controls were implemented, the effect was practically null. An even later
review revealed similar findings (Sala and Gobet (2020). The analysis of
data from 6,984 children showed that once the quality of study design
was controlled for, the overall effect of music training programmes was
null and highly consistent across studies. Small statistically significant
overall effects were obtained only in those studies implementing no
random allocation of participants and employing non-active controls.
They concluded that music training was ineffective regardless of the type
of outcome measure (verbal, non-verbal, speed-related, the participants’
age, or the duration of training). They concluded that researchers’
optimism about the benefits of music training was empirically unjustified
and stemmed from misinterpretation of the empirical data and, possibly,
confirmation bias. Also adopting a meta-analytic approach, Gordon
and colleagues (2015) considered the impact of music engagement on
reading with studies that included music training and control groups,
pre- and post-comparison measures, and an indication that reading
instruction was constant across groups. Thirteen studies were identified
including 901 children. Two classes of outcome measures emerged with
sufficient overlap to support meta-analysis: phonological awareness and
reading fluency. Hours of training, age and type of control intervention
were examined as potential moderators. The results supported the
hypothesis that music training led to gains in phonological awareness
skills. The analyses revealed that transfer effects for rhyming skills
tended to grow stronger with increased hours of training. In contrast,
no significant aggregate transfer effect emerged for reading fluency
measures, although some studies reported large training effects.

Explanations for the Research Findings

Many different explanations for the mixed research findings have
been proposed. Some have suggested that the changes that music
participation has on the brain are responsible for a range of cognitive
and academic benefits. Other explanations relate to enhanced executive
functions, the length and types of programme and their quality, and the
254 The Power of Music

personality characteristics and motivation of participating children and

young people.

Neurological Studies
The kinds of skills gained through learning to play an instrument—
including auditory, audiation, reading and executive skills on different
instruments (for example, keyboard, string, percussion and wind
instruments) have been shown to impact on the auditory and motor
regions of the brain (Hyde et al., 2009). As discussed in earlier chapters,
music processing and playing instruments are related to activity in many
different areas of the brain (Gaser and Schlaug, 2003; Koelsch et al.,
2005; Koelsch and Siebel, 2005). Musicians, compared to non-musicians,
tend to have enlarged structures in parts of the brain, for instance the
left planum temporale and the cerebellum (Gaser and Schlaug, 2003;
Hutchinson et al., 2003; Schlaug et al., 1995a; 1995b). These changes
have been suggested to have implications for cognitive functions (Chan
et al., 1998; Ho et al., 2003). A number of studies have shown structural
differences in grey matter and white matter in children who engage in
music, particularly in early childhood compared with those who do not
(Fernandez, 2018; Groussard et al., 2014; Habibi et al., 2018; Huotilainen
and Tervaniemi, 2018; Pantev and Herholz, 2011). Benner and colleagues
(2017) found that Heschl’s gyrus multiplications occurred much more
frequently in musicians than in the general population and constituted
a functional unit with Heschl’s gyrus, while Schneider and colleagues
(2002, 2005) observed that increases in grey-matter volume in the
Heschl’s gyrus (HG) of musicians, as compared with non-musicians,
were linked with greater musical aptitude and audiation (Gordon,
1979; Gouzouasis, 1993). Audiation involves complex internal musical
processing, memory and anticipation; and these cognitive processes
overlap with executive functions. Some research has reported neural
changes alongside significant differences in associated reading skills,
sound processing skills and speech (Chobert et al., 2014; Moreno et
al., 2009; Trainor et al., 2012). While the structural changes observed in
the brain may impact on enhanced cognitive processes which lead to
enhanced academic attainment, not all of the evidence supports this.
The research findings are mixed (Dumont et al., 2017; Gordon et al.,
2015; Jaschke et al., 2013; Sala and Gobet, 2017; 2020).
 10. General Attainment  255

Adding to the complexity of understanding the findings from the

research on the impact of music on attainment, Schlaug (2001) and
Tervaniemi (2009) point out that, in the research, musicians have been
treated as a unified group, as if the demands of their musical activities
are equal in terms of perceptual, cognitive and motor functions. This is
clearly not the case. They are differentiated in terms of the instrument
that they play, the musical genre that they engage with, as well as
their approach to practice. As we saw in Chapter 1, the neuroscientific
evidence has shown differences between musicians in the parts of
the brain which develop in response to their musical activities. This
diversity has generally not been taken into account in the research on
general attainment.

Length of Engagement with Music

Several studies have shown that, the longer the engagement with
music, the greater the impact on attainment—for instance, Catterall
(2000), Corrigal and colleagues (2013), Hallam and Rogers (2016) and
Schellenberg (2006; 2019). Despite this, some authors have described
changes observed in participants after only one month. In several
studies, the effects were largest after two to three years (Holochwost
et al., 2017) or only observed after two or more years of learning music
(Holmes and Hallam, 2017; Schneider and Klotz, 2000). Overall, most
of the evidence suggests that the longer the programme, the greater the
impact (Corrigall et al., 2013; Degé et al., 2011a; Hetland, 2000). The time
and intensity of programmes have also been pointed out as important
(Habibi et al., (2014).
Learning to play an orchestral or band instrument to a high level
of expertise involves cumulative learning, with students typically
beginning to learn at an early age and putting in many hours of
practice. To become a professional musician takes years of dedicated
work. During this process, perceptual, cognitive and motor skills are
refined to enable musicians to undertake the complex tasks required for
solo and ensemble work. Intervention studies cannot mirror this level
of engagement, and the subsequent impact on music-related skills or
possible transfer to other areas. It is only in comparisons between expert
musicians and non-musicians that this is revealed.
256 The Power of Music

Type, Nature and Quality of Musical Training

The type of musical training and its quality are important in determining
any impact on academic attainment. There has been significant variation
in the quality of training and instruction between studies (Dumont
et al., 2017; Foster and Jenkins, 2017; Sala and Gobet, 2017). Musical
activities take many forms: composition, improvisation, theory, vocal
and instrumental music. These require different forms of learning and
practice. For instance, learning to play a musical instrument usually
entails reading musical notation, and hand-eye and spatial coordination
for physically playing the instrument. These skills are distinct from
those involved in vocal training, particularly choral singing. These
differences impact on neurological change and may impact on
executive functions and other factors such as motivation. Typically,
research has not taken account of these differences. However, there are
exceptions—for instance, Kinney (2008) considered multiple forms of
music education in elementary school and found positive associations
between instrumental music participation and academic achievement
tests, but no association for choral students. Habibi and colleagues
(2014) suggested that playing with others was associated with greater
development of auditory skills and executive functioning because of the
need to overcome and organise more auditory information, as well as
improve attention and concentration. Guhn and colleagues (2020) took
into account many of these variables, as well as level of commitment and
the interactions between them. They found that higher levels of musical
achievement may indicate higher levels of commitment, which may
lead to greater exposure to the various cognitive, social, emotional and
motivation-related experiences which, in turn, may support academic
achievement.
The quality of music interventions has also been raised. For example,
Johnson and Memmott (2006) examined the relationship between
academic achievement and participation in music activities across
nearly 5000 participants and concluded that the higher the quality of the
programme, the stronger the relationship. Similarly, Rauscher (2005)
experienced difficulties with implementation during the first two years
of a music programme and it was only at the end of the study, when the
children had received one year of high-quality tuition, that there were
any gains for the students.
 10. General Attainment  257

The Role of Executive Functions in Attainment

One possible explanation for the impact of actively engaging in music-
making and enhanced academic attainment is the mediating role of
executive functions (Degé et al., 2011; Jaschkeet al., 2018; Slevc et al.,
2016). The core competencies of executive functioning include self-
regulation, information-monitoring, working memory and flexibility
of changing between tasks (Diamond, 2013). These are all required in
music-making, particularly in ensembles. Musicians have been shown to
outperform non-musicians on various executive functions (Moradzadeh
et al., 2015; Zuk et al., 2014). Benefits for memory, particularly aural and
verbal memory, have also been demonstrated (Bergman et al., 2014;
Oechslin et al., 2013; Roden et al., 2014). The frontal lobe is hypothesised
to be particularly salient in executive functions (Miyake et al., 2000;
Stuss and Alexander, 2000) and music training in childhood and early
adolescence has been found to be related to lasting changes in the
corpus callosum, superior temporal gyrus, and middle temporal gyrus
(Schlaug et al., 2005; Steele et al., 2013).
Executive functions, as we saw in Chapter 8, have been shown to
be linked to academic performance (Best et al., 2011; Cortés Pascual et
al., 2019; Slevc et al., 2016; Visu-Petra et al., 2011). Cognitive flexibility,
working memory, processing speed and planning (Zuk et al., 2014) may
all support academic attainment. Audiation may represent an underlying
mechanism through which differences in executive function abilities, as
well as various facets of instrumental music learning, are connected.
Music learning may enhance executive functions and audiation, which
in turn may benefit learning capacity more broadly. Previous research
suggests that even though music-related cognitive gains may, to some
extent, be domain-specific—for instance, verbal but not visual memory
(Ho et al., 2003)—they commonly relate to a range of cognitive domains
(Forgeard et al., 2008; Schellenberg, 2004).

Personality Factors
Music students may also be more conscientious than non-music students,
which may explain why they are more successful at school than would
be indicated by their IQ scores. One personality factor of particular
258 The Power of Music

interest in relation to attainment is conscientiousness, as this may be

a mediating factor in explaining differences between young musicians
and non-musicians. There is certainly evidence that undergraduate
music students exhibit conscientious-like traits (Kemp, 1996; Marchant-
Haycox and Wilson, 1992), although composers and rock musicians are
less conscientious than the general population (Gillespie and Myors,
2000; Kemp, 1996). Corrigall and colleagues (2013) pointed out that
participation in music might influence changes in personality and, in
this way, interact with better achievement in school. They found that
individual differences in conscientiousness helped to explain school
grades. It may be that those who are more self-disciplined are more
likely to persevere in learning a musical instrument. Costa-Giomi
(2006) observed children for three years as they began, continued and
discontinued lessons. Those who completed three years of lessons
were more responsible, disciplined and able to concentrate. However,
these traits characterised the students before they started to learn an
instrument and did not change as a result of music instruction. Another
explanation comes from research by Butkovic and colleagues (2015),
who found that music-specific flow proneness was the best predictor
of time spent practising when openness to experience, motivation and
intelligence were taken into account.

Motivation
Motivation is clearly a key factor in the development of high-level musical
expertise and also in enhancing academic attainment. Motivation will
be discussed in depth in Chapter 12. However, the process of music
training—which frequently includes hours of practice, typically in
solitude, and a lengthy time commitment—might develop the habit
of self-discipline and the desire to achieve, both of which are likely to
support enhanced academic attainment. Students who learn that hard
work can lead to the mastery of complex skills and to desired learning
outcomes may develop a sense of self-efficacy and self-belief which will
impact on other areas of study. Music-based intervention programmes
have shown improvements in self-esteem, confidence, discipline
and motivation among young people (Hallam et al., 2017). Students
involved in music appear to show high levels of intrinsic motivation
 10. General Attainment  259

(Diaz, 2010). Higher levels of musical engagement relate to stronger

academic self-concept (Degé et al., 2014). Students engaging in musical
activities as part of a group may experience a sense of team bonding
and accomplishment (Adderley et al., 2003) which can contribute to
a positive learning climate. These various elements may interact with
each other over time. The context of learning itself is also important
in both music and academic work and, if supportive, can enhance
attainment. Being rewarded for success, musically and academically,
also promotes motivation. Motivational and socioemotional pathways
may underlie the associations between music learning and learning in
other subjects. A complex interplay of internal and external factors is
likely to influence a learner’s motivation to participate in and continue
long-term engagement with school music-making (Eccles and Wigfield,
2002) and shape an adolescent’s conception of their musical ability and
the value they place on music (Sichivitsa, 2007). In a large-scale study,
McPherson and O’Neill (2010) found that learning to play an instrument
or to sing seemed to contribute to higher motivation in other subjects,
language, mathematics and science. Participating in musical activities
can also affect aspirations, which enhance motivation and subsequently
attainment. This is particularly the case with children from deprived
areas (Devroop, 2009): for instance, those engaging in El Sistema and
Sistema-inspired programmes (Creech et al., 2013). Participating
in musical activities may enhance attainment through providing
opportunities to explore and develop different ways of learning,
including focused perception, making connections and imagining new
possibilities (Burton et al.,, 1999).

Overview
Overall, the evidence regarding the impact of engaging with music on
academic attainment is mixed. While the evidence from intervention
studies is limited, correlational and comparative studies identify some
clear links. While these have been criticised as not demonstrating
causality, research which has adopted a retrospective or longitudinal
approach has been able to demonstrate that those actively engaged in
making music make greater progress academically over time compared
with those not actively engaged in making music. What underpins
260 The Power of Music

this greater improvement in attainment over time is less clear. The

relationship may be mediated by neurological changes relating to aural,
phonemic, spatial or memory skills, executive functions, length, type or
quality of training, or personality or motivational factors. Only research
which is able to take account of all these factors will be able to develop
credible explanatory models.
 11. Music and Studying

There has been a great deal of research on the impact of music on

cognitive activities related to studying. Many different factors can
contribute to the outcomes, including the type of music, the nature of
the task being undertaken, individual differences and the relationship
of the individual to the particular music involved. Each of these will
be considered in this chapter. As many studies address several of these
issues simultaneously, each study will be considered in relation to its
main focus. The theories attempting to explain the various findings
will also be outlined. There has been some confusion in the reporting
of the research between studies where music is presented prior to the
task being undertaken (what has become known as the Mozart effect)
and research where music is played in the background while the task is
being undertaken. These different approaches are frequently considered
as equivalent. Here they are considered separately.

Listening to Music prior to Completing a Task

The positive effect of listening to music prior to undertaking a cognitive
task was first associated with the music of Mozart. A group of college
students performed a spatial-temporal task after they listened to
Mozart’s sonata for two pianos in D major, KV 448. Their performance
was compared to groups who either listened to a relaxation recording or
sat in silence before completing the task. The group listening to Mozart
performed significantly better than the other groups (Rauscher et al.,
1993). A second study, using the same Mozart composition, repetitive
music or a short story, replicated these findings (Rauscher et al., 1995).
Since this research, there have been many studies attempting replication.
The findings from these have been mixed. Some examples are set out
below.

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.11

262 The Power of Music

Rideout and Taylor (1997) studied 32 undergraduates who completed

two equivalent spatial reasoning tests: one following a control procedure
and one following the presentation of Mozart’s Sonata for two pianos in
D major. Their performance showed a small but significant improvement
immediately following presentation of the music. Similarly, Wilson and
Brown (1997) studied spatial reasoning in 22 college undergraduates
who were exposed to ten minutes of a Mozart piano concerto, repetitive
relaxation music or silence prior to undertaking a pencil and paper
maze task. The mazes varied in complexity and size. Limited support
for the Mozart effect was obtained for the number of maze recursions
and the overall quality of maze solutions.
Adopting a neurological perspective, Jaušovec and colleagues
(2006), in two experiments, investigated the influence that Mozart’s
sonata, K. 448, had on brain activity in the process of learning. In
the first experiment, individuals were trained in how to solve spatial
rotation tasks, and then were required to solve similar tasks. Fifty-six
students were divided into four groups: a control group which prior to
and after training relaxed, and three experimental groups—one group
who prior to and after training listened to Mozart, one who prior to
training listened to Mozart and subsequently relaxed, and a fourth
group who prior to training relaxed and afterwards listened to Mozart.
In the second experiment, 36 respondents were divided into three
groups: a control group, a second group who listened to Mozart prior
to and after training, and a third group who prior to and after training
listened to Brahms’ Hungarian Dance No. 5. In both experiments, EEG
data were collected during problem-solving. In the first experiment,
all of the respondents in the various music groups showed better task
performance than the control group, although those experiencing music
before and after the task displayed less complex EEG patterns and more
alpha-band synchronisation than did respondents in the other three
groups. In the second experiment, individuals who listened to Mozart
showed better task performance than did the respondents in the other
groups. They also displayed less complex EEG patterns and more lower
alpha-band synchronisation than did the respondents in the Brahm’s
music group. The authors argued that Mozart’s music, by activating
task-relevant brain areas, enhanced the learning of spatial-temporal
rotation tasks. The results supported Rauscher and colleagues’ (1993)
priming explanation of the Mozart effect.
 11. Music and Studying  263

Working with children, Hallam (2001) and Schellenberg and Hallam

(2005) replicated Rauscher’s study with over 6,000 children in the final
year of primary school. The children were randomly allocated within
their school to one of three groups: a group listening to the same Mozart
piano sonata as in the Rauscher study, one to pop music performed
by the pop groups Blur and Oasis, and the third to a talk about
experiments. Each of these sessions lasted for ten minutes. Following
this, the children completed two spatial reasoning tasks: a paper folding
task and a rotational task. The initial analysis (Hallam, 2001) showed
no statistically significant difference between the groups on either task.
A second analysis by Schellenberg and Hallam (2005) showed a slight
statistical advantage for the children listening to popular music. This
was interpreted in terms of raised arousal levels and higher motivation
because the children liked the popular music. Schellenberg (2005)
argued that such short-term effects resulted from the impact of music
on changes in arousal level and mood. Following this, Schellenberg
and colleagues (2007) undertook two further experiments. In the first,
Canadian undergraduates performed better on a symbol-search test
after listening to an up-tempo piece of music composed by Mozart in
comparison to a slow piece by Albinoni. However, the effect was evident
only when the two pieces of music induced reliable differences in arousal
and mood. Performance on other intellectual tasks was not affected. In
the second experiment, Japanese five-year-olds drew for longer periods
of time after singing or hearing familiar children’s songs than after
hearing Mozart or Albinoni. After hearing the children’s songs, their
drawings were judged by adults to be more creative, energetic and
technically proficient. These findings illustrate that prior exposure to
different types of music can enhance performance on a variety of tasks;
the effects are mediated by changes in emotional state and can generalise
across cultures and age groups.
Exploring whether arousal and mood were responsible for
Rauscher’s original findings, Thompson and colleagues (2001) studied
24 college students, aged 20 to 60 years old, who completed a test of
spatial abilities after either listening to a pleasant and energetic sonata
by Mozart, sitting in silence or listening to Albinoni’s adagio, a slow
reflective piece. Enjoyment, arousal and mood were also assessed.
Performance on the spatial task was better following exposure to the
264 The Power of Music

composition by Mozart. The two pieces of music induced differential

responding to measures of enjoyment, arousal and mood. When these
were controlled for, the Mozart effect disappeared. Focusing on the role
of mood, Smith and colleagues (2010) carried out two studies. The first
explored the effects of prior exposure to office noise on working memory,
while the second was a replication of Rauscher and colleagues’ (1993)
study. The first study showed that mental arithmetic tasks were initially
impaired by office noise, but that the effects of the noise disappeared
following ten minutes of exposure to office noise between tasks. The
second experiment successfully replicated Rauscher and colleagues’
(1993) study showing enhanced spatial reasoning following listening
to Mozart for 24 young adults, although assessment of the mood of
participants demonstrated that the effect was not caused by mood
change. Also focusing on the impact of mood and arousal on spatial
reasoning, Hussain and colleagues (2002) examined the effects of tempo
and mode. A Mozart sonata performed by a skilled pianist was recorded
and edited to produce four versions that varied in tempo (fast or slow)
and mode (major or minor). Participants listened to a single version and
completed measures of spatial ability, arousal and mood. Performance
on the spatial task was superior after listening to music at a fast rather
than a slow tempo, and when the music was presented in major rather
than minor mode. Tempo manipulations affected arousal but not mood,
whereas mode manipulations affected mood but not arousal.
Nantais and Schellenberg (1999) found that performance on a
spatial-temporal task was better after participants listened to a piece
composed by Mozart or by Schubert than after they sat in silence. In a
second study, the advantage for the music condition disappeared when
the control condition consisted of a narrated story instead of silence. The
participants’ performance was a function of their preference for either
the music or the story, with better performance following the preferred
condition. Similarly, Perham and Withey (2012) found that preferred
music increased spatial rotation performance regardless of the tempo
of the music. Participants listened to both liked and disliked music, in
either a fast or slow tempo, prior to completing a series of spatial rotation
tasks. At both tempos, liked music was associated with significantly
better spatial rotation performance than disliked music.
Some research has focused on music acting as a primer for memory
tasks with participants of varied ages. For instance, Hirokawa (2004)
 11. Music and Studying  265

examined the effects of preferred music and relaxation instructions on

older adults’ arousal and working memory. Fifteen female older adults
participated in ten minutes of three experimental conditions: participants’
preferred music, relaxation instructions or silence. Four subcategories of
arousal level, energy, tiredness, tension and calmness were measured
before and after experimental treatment using an adjective checklist.
After each experimental condition, participants completed a working
memory test. The findings showed that music increased participants’
energy levels, while relaxation and silence significantly decreased
them. Relaxation and silence interventions also increased tiredness
and calmness. All experimental conditions decreased tension levels,
although working memory performance was not significantly different
between the groups. Also focusing on working memory, Steele and
colleagues (1997) studied 36 undergraduate students who completed a
backwards digit-span task followed by exposure to ten minutes of music
composed by Mozart, a recording of rain, or silence and a repetition of
the task. No significant differences among treatment conditions were
found, although there was a significant effect of practice. In a later study,
Steele and colleagues (1999) followed the detailed procedural guidance
offered by Rauscher and colleagues needed to produce the Mozart
effect. Despite this, Steele and colleagues were unable to produce
either a statistically significant Mozart effect or an effect size suggesting
practical significance. They concluded that there was little evidence to
support the existence of the Mozart effect.
Also offering limited support to the Mozart effect, Twomey and
Esgate (2002) compared the performance of 20 musicians and 20 non-
musicians on spatial-temporal reasoning tasks following exposure to
Mozart’s Sonata K. 448. They based their research on the trion model
of neural functioning, which is highly structured in time and spatial
connections and predicts increased synchrony between musical
and spatial temporal centres in the right cerebral hemisphere. Since
increased left-hemispheric involvement in music processing occurs
as a result of musical training, the possibility of increased synchrony
with left-hemispheric areas in the musicians was tested. The results
were improved performance on language as well as spatial-temporal
tasks. In addition to spatial-temporal tasks, synonym generation and
rhyming-word generation tasks were employed. A Mozart effect was
demonstrated on the spatial-temporal task, although this was greater
266 The Power of Music

for the non-musicians. There was no effect of musical priming for

either group on verbal tasks, although the musicians scored higher
on rhyming-word generation. No systematic link was found between
performance on any task and the number of years spent in musical
training. The failure to induce a Mozart effect in the musicians on verbal
tasks, as well as the limited impact on their performance on the spatial-
temporal tasks, may have been associated with a ceiling effect due to the
long-term effects of music training.
Working with 448 younger and older adults with mean ages of 28 and
72 respectively, Giannouli and colleagues (2019) provided participants
with novel excerpts by Mozart, Vivaldi and Glass, or silence—after
which they completed a forward digit-span test and a word-fluency test
to assess verbal working memory and phonologically cued semantic
retrieval. Individual preference for each condition was also assessed.
Brief exposure to music had no beneficial effect on verbal working
memory and there was transient impairment after listening to Vivaldi,
although the Vivaldi excerpt did induce a marked enhancement in word
fluency, but only in the young adults. In contrast, listening to Mozart’s
music was followed by decreased word-fluency test scores in both age
groups. These findings suggest that, depending on specific musical
features, listening to music can selectively facilitate or inhibit ongoing
verbal functions. Similarly, Borella and colleagues (2019) examined
whether short- and long-term working memory training in older adults
could be enhanced by listening to music. Mozart’s Sonata K. 448 and
Albinoni’s Adagio in G minor were played to participants aged 65 to 75
years old before they started working-memory training activities. One
group of 19 participants listened to Mozart, another to Albinoni and
one to white noise, while eighteen participants served as controls and
engaged in other activities. Specific training gains on a task similar to
the one used in training and transfer effects to visuo-spatial abilities,
executive functioning and reasoning were assessed. Irrespective of the
specific listening condition, the trained groups generally outperformed
the control group. The white-noise group did not differ in performance
from the two music groups, although the group listening to the Albinoni
composition showed larger specific training gains in the criterion task in
the short-term and on transfer effects in the reasoning task in the short-
and long-term compared to the group listening to the composition by
Mozart.
 11. Music and Studying  267

Also working with older adults, but in this case with those with mild
cognitive impairment, Lake and Goldstein (2011) exposed participants
to a music and a silence condition, following which they performed
digit-span and coding tasks, both of which require attention for maximal
performance. Listening to music did not enhance performance for
either group. Researching a wider age range, Carr and Rickard (2016)
tested whether listening to emotionally arousing music enhanced
memory in 37 participants aged 18 to 50, who listened to two of their
own highly enjoyed music tracks, two self-rated neutral tracks from
other participants’ selections, and a five-minute radio interview. After
each listening episode, participants memorised a unique array of 24
images. Subjective and physiological emotional arousal was monitored
throughout the experiment and free recall of all images within the five
image arrays was tested at the end. Compared to the music and non-
music controls, self-selected enjoyed music elicited greater subjective
and physiological changes consistent with changes in emotion. More
details from images presented were recalled after enjoyed music
than after listening to the radio interview. The physiological changes
consistent with an emotional arousal response to enjoyed music reliably
predicted memory performance.
In a study exploring the impact of music from different cultures,
Giroux and colleagues (2020) examined whether listening to pleasant,
stimulating or familiar music prior to completing a task improved
working-memory performance. One hundred and nineteen Rwandan
participants were randomly assigned to a control group, who read
a short story prior to completing the task, or to one of four different
musical conditions varying on two dimensions: arousing or relaxing
music, or Western or Rwandan music. Working memory was measured
using the n-back paradigm, where participants are presented with a
sequence of stimuli one by one and need to decide if the current stimulus
is the same as one presented previously. The gap between current and
previous stimuli can be varied. The greater the distance, the harder the
task. The findings showed that there were no positive effects of familiar,
pleasant or stimulating music on working memory. Performance on the
n-back task tended to improve from before and after listening to music
across all conditions, but the improvement was less in participants who
listened to familiar Rwandan music compared to those who listened to
unfamiliar Western music or to a short story.
268 The Power of Music

In contrast, Silva and colleagues (2020) investigated the impact of

music on episodic memory. Two potential enhancers of music effects—
stopping music before task performance to eliminate music-related
distraction, and using preferred music to maximise reward—were
adopted. The main study included a sample of 51 healthy younger
adults, while a pilot study was conducted with 12 older adults, divided
into those classified as low- versus high-functioning according to
cognitive performance on a screening test. There was strong evidence
that music had no advantage in relation to episodic memory over silence
or environmental sounds in younger adults. Preferred music had no
advantage either. Among the older adults, low- but not high-functioning
participants’ item memory was improved by music, particularly by
non-preferred music compared to silence. The findings suggest that, in
healthy adults, music played prior to a task may be less effective than
background music in episodic memory enhancement despite decreased
distraction, possibly because reward becomes irrelevant when music
is stopped before the task begins. Low-functioning older participants
may relate to prior-to-task auditory stimulation in deviant ways when it
comes to episodic memory enhancement. Overall, for episodic memory,
the arousal, mood or reward effects usually afforded by music played
in the background (Blood and Zatorre, 2001; Ferreri and Verga, 2016;
Salimpoor et al., 2013; Schellenberg, 2005) may be lost or attenuated
when music is stopped before the task begins. Given that preference
also had null effects, and preference is strongly linked to reward, it is
possible that reward may be a key factor. Music-related reward may no
longer favour episodic memory if music is stopped before the task begins.
Gilleta and colleagues (2003) studied gender differences working with
26 females and 26 males, who completed a paper folding and cutting
task and a mental rotation task following a listening condition (in
which a Mozart piano sonata was played or participants sat in silence).
A statistically significant three-way interaction among gender, listening
condition and task indicated that an effect was present only for female
participants on the mental rotations task.
Exploring the differential effects of breaks filled with diverse
activities, as is common in everyday life, Kuschpel and colleagues (2015)
exposed young adults to breaks involving eyes-open resting, listening
to music or playing the video game Angry Birds before performing
 11. Music and Studying  269

an n-back working memory task. Playing the Angry Birds video game
during a short learning break led to a decline in task performance over
the course of the task, as compared to eyes-open resting and listening to
music, although overall task performance was not impaired. This effect
was associated with high levels of daily mind-wandering and low self-
reported ability to concentrate.
Working with children with learning difficulties, Gregoire (1984)
focused on the impact of prior listening to music on concentration in
subsequent performance on a matching-numbers classroom task with
17 six- to eleven-year-old children. The intervention condition consisted
of a brief taped story illustrated on a felt board, a rest period with
relaxing music, and five minutes of individual number-matching. The
control condition was identical but without the music. There were no
significant differences overall, although the older participants exhibited
significantly fewer behavioural issues during the music period than
during the rest phase.
Overall, the evidence for the priming benefits of music on cognitive
tasks is inconclusive. There is some evidence that musical neurological
priming can directly enhance performance on spatial reasoning tasks,
as proposed by Rauscher and colleagues, although the evidence for this
is not consistent. Music can also have priming effects relating to arousal
or mood, which may affect performance on a variety of tasks in a range
of different ways. To begin to understand these mixed findings, there
needs to be a greater focus on the underlying neural priming processes.

Background Music
There is now a substantial body of research which has examined the
impact of background music on performance on a range of cognitive
tasks in individuals across the lifespan. Music has also been used as a
stimulus for creative writing, but this practice needs to be distinguished
from music being played as a background to studying (Donlan, 1976).
During the 1950s, as radio became more commonplace, concerns were
raised as it was feared that listening to the radio while completing
homework would negatively affect children’s learning. Early studies
addressing these issues were not always well controlled, and many did
not specify the type of music being played or the nature of the task being
270 The Power of Music

undertaken. This made interpreting the findings extremely difficult. The

remainder of the chapter is divided into sections which will outline the
research, providing more detailed evidence relating to:
• the nature of the music played, including preferred music,
familiarity, liking and preference for music of one’s own
culture;
• the nature of the task to be completed, including memory,
attention, reading comprehension, second-language learning
and English as a second language;
• individual differences, including musical expertise, gender,
personality and metacognition;
• children’s behaviour and task performance, including
primary-school children and older students;
• children with emotional and behavioural difficulties, ADHD
and developmental difficulties;
• older adults and those with cognitive impairment;
• reviews and meta-analyses; and
• explaining the impact of background music on cognitive
performance, including an explanatory framework.

The research has been categorised in relation to its main focus, although
any single research project may have outcomes related to more than one
outcome.

The Nature of the Music

Some research has ignored the characteristics of the music being played,
assuming that all music would have a similar impact. For instance,
Cockerton and colleagues (1997) simply compared music with no music
in a repeated measures design with 30 undergraduates who completed
two cognitive tests: one in silence and the other with background music.
The students completed more questions and answered more questions
correctly when music was playing, although there was no difference in
the heart rate of those participating in each condition. Some attempts
have been made to address issues relating to the nature of the music
 11. Music and Studying  271

by differentiating music on the basis of genre, its perceived potential to

stimulate or relax, whether it is vocal or instrumental, and its cognitive
complexity. Despite this, such categorisations do not always capture
the complexity of music as it is listened to. This particularly applies
to Western classical music with its frequent changes of mood, tempo,
timbre and volume. To examine the issues further, some research has
investigated how exposing participants to different types of music
affected their performance on various cognitive tasks. Control groups
have listened to music from other genres or spoken text rather than
sitting in silence. In an early detailed study in the USA, Henderson and
colleagues (1945) explored the effect of music on the reading efficiency
of 50 first-year female undergraduates. Participants were divided into
three equally matched groups on the basis of psychological examination
and reading test scores. One group listened to popular music while
completing reading tasks, another classical music, while the third
worked in silence. The participants completed a questionnaire which
determined whether they were accustomed to studying with the radio
on, whether or not they thought that the radio reduced their study
efficiency, the amount of studying done with the radio on and the type
of programme that they usually listened to when studying. The popular
music used was ‘Two O’Clock Jump’, Harry James; ‘That’s What You
Think’, Krupa; ‘Sunday, Monday, or Always’, Frank Sinatra; ‘Mr. Five by
Five’, Harry James; ‘Prince Charming’, Harry James; ‘Tuxedo Junction’,
Glenn Miller; ‘Idaho’, Benny Goodman; ‘Crosstown’, Glenn Miller; and
‘Close to You’, Frank Sinatra. The classical music was ‘Symphony in D
Minor’ by Cesar Franck. The tests were administered on three successive
afternoons. The participants were asked to assume that they were in
their own rooms studying with the radio on. The differences between
the averages of the pre-test scores and the final test scores of each group
were calculated and the significance of the averages analysed. The
findings showed that the popular music acted to distract the students on
paragraph comprehension but not on the vocabulary test. The classical
music had no negative impact on either test. The authors explained the
results in terms of the simpler rhythms and melodies of popular music
being easily understood, and therefore listened to, by the participants,
diverting their attention from the task in hand. They argued that the
classical music was likely to be perceived as vague and not listened
272 The Power of Music

to, just providing a background against which the assigned task was
accomplished without interference. The popular music may have had
a greater impact on the comprehension task, as this task was more
complex and required sustained effort, while the vocabulary materials
were intermittent and unrelated. Overall, the authors concluded that
whether or not music is a real distraction depends on the complexity
of the music and the complexity of the test materials. There were no
significant differences depending on whether students were accustomed
to studying with the radio playing. Also using reading comprehension
as the outcome measure, Thompson and colleagues (2012) manipulated
changes in tempo and intensity to create four conditions: slow low-
intensity, slow high-intensity, fast low-intensity, and fast high-intensity.
In each condition, 25 participants were given four minutes to read
a passage, followed by three minutes to answer six multiple-choice
questions. Baseline performance was established by having control
participants complete the reading task in silence. A significant tempo-
by-intensity interaction was observed, with comprehension in the fast
high-intensity condition falling significantly below baseline. These
findings demonstrated that listening to background instrumental music
was most likely to disrupt reading comprehension when the music
was fast and loud. Similarly, Chou and colleagues (2010), working
with 133 Taiwanese college students, studied whether light classical
music was more or less distracting than hip-hop music or silence
during a comprehension task. The findings showed that music with
higher intensity was more distracting and had a greater effect on task
performance and concentration.
Yang and colleagues (2016) conducted two experiments: the first
tested for differences in perception of distractibility between tonal
and atonal music, while the second tested how tonal music and atonal
music affected visual working memory by comparing musicians and
non-musicians who were placed in contexts with background tonal
music, atonal music or silence. Participants were instructed to complete
a delayed matching memory task. The results showed that musicians
and non-musicians had different evaluations of the distractibility of
tonal and atonal music, possibly indicating that long-term training may
lead to a higher auditory-perception threshold among musicians. For
the working memory task, musicians reacted faster than non-musicians
 11. Music and Studying  273

in all background music cases, although the musicians took more time
to respond in the tonal background music condition than in the other
conditions. The results suggest that, for a visual memory task, background
tonal music may occupy more cognitive resources than atonal music or
silence for musicians, leaving few resources left for the memory task.
Despite this, the musicians outperformed the non-musicians. Similarly,
Tze and Chou (2010) explored whether different types of background
music affected the performance of a reading comprehension task in 133
Taiwanese college students. The study explored whether listening to
music affected the learners’ concentration on a reading task and also
whether light classical music was more or less distracting than hip-hop
music or silence. The findings showed that music with higher intensity
was more distracting, and had a greater effect on task performance and
concentration.
Using two contrasting tasks, Angel and colleagues (2010) assessed
the effects of fast-tempo music on cognitive performance among 56
male and female university students. A linguistic processing task and
a spatial processing task were selected to assess verbal and non-verbal
performance. Ten excerpts from Mozart’s compositions, matched
for tempo, were selected to be played in the background. The music
increased the speed of spatial processing and the accuracy of linguistic
processing. Focusing on performance on arithmetic tasks, Dolegui
(2013) used different genres of music, played at different volumes.
Thirty-two undergraduate students, ranging in age from 20 to 41 years
old, participated on a voluntary basis. Five different arithmetic tests
were used, consisting of 20 different operations of similar difficulty:
five multiplication, five division, five addition and five subtraction
problems. Loud music was defined as heavy rock metal music
represented by the song ‘Not Ready to Die’, Demon Hunters. Soft
music was defined as classical piano music, ‘Morning Light’, Beeson.
All participants were exposed to all five conditions. The first test was
conducted with soft music at low intensity, the second with loud music
at low intensity, the third in complete silence. The fourth and fifth tests
were conducted with soft and loud music. The tests were graded for
accuracy. Performance scores were significantly higher in silence than in
all four music conditions, intensity levels and types of music combined,
although overall, performance was significantly worse in the presence
274 The Power of Music

of loud music at high intensity. Similarly, Cassidy and MacDonald

(2007) investigated the effects of music with high arousal potential and
negative affect, music with low arousal potential and positive affect,
and everyday noise on the cognitive task performance of introverts and
extroverts. Forty participants completed five cognitive tasks: immediate
recall, free recall, numerical and delayed recall, and the Stroop test.
Ten participants completed each of these tasks in one of the four sound
conditions: high arousal and negative affect, low arousal and positive
affect, everyday noise, and silence. Participants were also assessed for
levels of introversion and extroversion, and reported their preferences
for music versus noise while studying. Performance was lessened across
all cognitive tasks in the presence of background sound, music or noise,
compared to silence. The two music conditions produced differential
distraction effects, with performance on all tasks being poorer in the
presence of high-arousal, negative-affect music as compared with low-
arousal, positive-affect music and silence. Performance was moderated
by internal arousal, with introverts performing better overall on each
task except the Stroop test, and appearing to be more detrimentally
affected by the presence of high arousal negative affect music and noise.
Some research has focused on the differential impact of vocal and
instrumental music. For instance, Jäncke and colleagues (2014) studied
226 participants who were randomly assigned to one of five groups,
who all completed a verbal learning task. One group served as a control
group, working in silence, while four further groups were exposed to
vocal or instrumental music during learning, with different subjective
intensity and valence. The four music listening conditions were vocal or
instrumental music, each with high or low intensity. As the high and low
intensity groups did not differ in terms of their rated intensity during
the main experiment, these groups were put together. This reduced the
sample to three groups: a control group, one listening to vocal music
and one listening to instrumental music. Recall of the number of learned
words was assessed immediately, after 15 minutes and 14 days later.
Verbal learning improved across the recall sessions without any strong
differences between the control and experimental groups. Exposure
to vocal or instrumental background music during encoding did not
influence verbal learning.
Adopting a neuroscientific approach, Nemati and colleagues
(2019) investigated the neural correlates of pleasure induced by
 11. Music and Studying  275

listening to highly pleasant and neutral musical excerpts using

electroencephalography. Analysis of the data showed a distinct gradual
change in the power of low-frequency oscillations in response to highly
pleasant, but not neutral, musical excerpts. Correlation analysis between
behavioural and electrophysiological data revealed that theta power was
correlated with subjective assessment of pleasantness. To study the link
between attention and positive valence, volunteers performed a delayed
match-to-sample memory task while listening to the musical excerpts.
Performance was significantly lower under highly pleasant conditions
compared to neutral conditions. Listening to pleasant music required
high degrees of attention, leading to an observed decline in memory
performance. Gradual development of low-frequency oscillations in
the frontal and posterior areas may be at least partly due to gradual
recruitment of higher levels of attention over time in response to
pleasurable music.
Exploring the impact of music on a simple perceptual motor
task, Nittono and colleagues (2000) compared the performance of
24 undergraduates on a self-paced line-tracing task with fast or slow
classical music or metronome tones in the background. The findings
showed that fast music accelerated performance compared with slow
music, whereas the tempo of the metronome tones did not affect
performance. Similarly, Bottiroli and colleagues (2014) measured how
different types of music affected performance on a processing-speed
task using no music, white noise, music with positive emotion and
high arousal levels (Mozart), or music with negative mood and lower
arousal (Mahler). Performance on the processing-speed task improved
when listening to Mozart. However, when participants were faced with
free-recall and phonemic-fluency tasks, Mahler’s music provided the
most beneficial conditions. Both types of music were advantageous over
white noise or silence for both types of task. In a real-life simulation,
Kallinen (2002) studied the effects of the tempo of background music
on reading business news in a crowded cafeteria environment. There
were three conditions: no music, or fast or slow music. The findings
suggested that the type of music (or silence) significantly affected
reading performance and the emotional evaluation of the news content.
Men evaluated the news most positively in the slow-music condition,
whereas women evaluated the news most positively in the no-music
276 The Power of Music

condition. Reading rate and efficiency were significantly lower in the

slow-music group than in the fast-music group. Also simulating a
real-life situation, Mayfield and Moss (1989) undertook two studies
to evaluate the effect of music tempo on task performance. In the first
study, 44 undergraduate business students were asked to be workers in
a stock-market project by collecting closing stock prices and calculating
the percentage of change in the price from week to week. Participants
were randomly divided into groups, such that they either listened to fast
or slow-paced music while they worked, or to no music. The quantity
and quality of work was assessed using music-listening habits as a
covariate. There were no statistically significant differences between
the performance of the two groups. In the second study, the students
completed the same task under the same conditions. In this study, the
women performed significantly better than the men and performance
was significantly higher in a rock-music condition than in a heartbeat
condition, although participants in the rock-music condition perceived
a higher level of distraction.

Preferred Music, Familiarity and Liking

One strand of research has explored whether participants’ familiarity,
preference or liking for background music has an impact on task
outcomes. For instance, Hilliard and Tolin (1979) studied the effect
of familiarity with background music on the performance of 64
undergraduates on simple and difficult reading comprehension tasks.
Unsurprisingly, scores on easier sections were higher than on difficult
sections, while overall scores were higher when familiar music was
playing. In a series of studies, Perham and colleagues explored issues
relating to preferred and different types of music. Perham and Vizard
(2011) tested serial recall under quiet, liked and disliked music
conditions, as well as steady-state and changing-state speech. The
findings showed that performance was poorer for both music conditions
and the changing-state speech, compared to quiet and steady-state
speech conditions. The findings suggested that musical preference did
not affect serial recall performance. Similarly, Perham and Sykora (2012)
asked participants to serially recall eight item lists in either quiet, liked
or disliked music conditions. Performance was poorer when music
 11. Music and Studying  277

was played compared with quiet, and in the liked as opposed to the
disliked music condition. In addition, participants were inaccurate in
perceiving their performance to be roughly equivalent in each of the
music conditions when liked music exhibited more task impairment
than disliked music. Changing the task to reading comprehension,
Perham and Currie (2014) studied 30 undergraduate students, ranging
in age from 19 to 65. The background music adopted included disliked
lyrical music, thrash metal, liked lyrical music, non-lyrical music, and
quiet. The thrash metal music selected were Death’s Angel’s ‘Seemingly
Endless Time’ and ‘The Ultra Violence’. Students who reported liking
this genre were omitted from the study. Liked music was selected by the
students themselves and included music by One Direction, Frank Ocean
and Katy Perry. In the study, participants were told not to attend to the
music which they listened to on headphones. A short questionnaire
was administered to participants upon completion, which comprised
Likert-scale questions that asked participants to rate how likeable,
familiar and distracting each sound condition was, as well as how well
they thought that they performed in each condition. Students read four
passages of text and then answered six multiple-choice questions on
each. Reading comprehension performance was greatest for the quiet
and non-lyrical music conditions and poorest for the two lyrical music
conditions. Participants perceived themselves to have performed best
in the liked lyrical, the quiet and the non-lyrical conditions, as well as
feeling that they were the most familiar experiences for them. They felt
that the liked and disliked lyrical conditions were most distracting to
performance, with quiet being much less distracting. It seems that, in the
case of reading comprehension and category recall, there is a conflict in
processing, as participants attempt to process task-related information
and background sound simultaneously.
Chew and colleagues (2016) recruited 165 undergraduate students
with a mean age of almost 22 years old who completed arithmetic, reading
comprehension and word-memory tasks while exposed to familiar or
unfamiliar, foreign or first-language music, or no music. There was a
significant impact on the word-memory task for the familiarity of the
music, but not in relation to whether it was in a foreign or first language.
Overall, depending on the task, familiarity but not the language of
the music affected learning and task performance when compared to
278 The Power of Music

a no-music condition. Similarly, Sutton and Lowis (2008) studied the

effect of musical mode on verbal and spatial task performance. Forty-
eight participants completed written verbal and spatial reasoning tests
while a piece of music in a major key by Handel was played, and again
when the same piece was digitally manipulated to create a version in the
minor mode. The findings showed that the music in the major mode was
rated more emotionally positive by both sexes than that in the minor
mode. Females scored higher than males in performance on the verbal
tasks when this was significantly enhanced with the major-mode music,
while males scored higher than the females on spatial reasoning when
the music was in the major mode.
Smith and Morris (1977) studied the effects of sedative and
stimulative music on memory performance, anxiety and concentration.
Sixty undergraduate students were exposed to one of five types of music:
classical, jazz and blues, country bluegrass, easy listening and rock
music. Participants indicated their preferred genre and were requested to
repeat a set of numbers backwards while listening to either stimulative,
sedative or no music. They were asked about their concerns about the
test, their emotionality or physiological affective arousal, their ability to
concentrate, their expectations of their performance, and whether they
liked or disliked the music. Compared with sedative music, stimulative
music increased worry scores, interfered with concentration and resulted
in lower performance expectancies. Participants performed best in the
no-music condition and worst while listening to their preferred music,
with performance to sedative music being between these extremes.
The authors argued that preferred music may serve to distract when
trying to complete a demanding task, perhaps because fewer cognitive
resources are available when attention is drawn to the lyrics, emotions
and memories that music can evoke. Complex interactive effects on task
performance were reported, suggesting that the effects of music need to
be understood in terms of cognitive processes rather than primarily on
the basis of physiological affective responses to musical stimuli. Another
explanation for the advantage of preferred music is that it is rewarding
(Blood and Zatorre, 2001; Ferreri and Verga, 2016). Reward may be one
additional mechanism underpinning the positive effects of music on
cognition (Ferreri and Verga, 2016).
 11. Music and Studying  279

Preference for Music of One’s Own Culture

Preference for music is predominantly determined by an individual’s
cultural background. For instance, a preference for Indian classical
music over Western classical music is seen in Indians from an average
socioeconomic background (Schafer et al., 2012). Each individual’s way
of responding to music is influenced by their liking and preference for
that music. For instance, Mohan and Thomas (2020) explored the effect
of background music on the performance of 34 Indian adolescents aged
13 to 14 on their comprehension of words and sentences in English.
Participants with average verbal ability and a preference for the Indian
music comprised the final sample. Two types of music were used: Indian
classical music (Raga Shanmukhapriya)—which is said to induce a
sense of calm and increase concentration—and Mozart’s Symphony No.
35. The findings revealed that playing music in the background resulted
in a significant increase in adolescents’ performance on the reading
comprehension task. The effect was greater when Indian classical music
was played, highlighting the importance of culture. Similarly, Kasiri,
(2015) studied the impact of non-lyrical Iranian traditional music on
the reading comprehension performance of Iranians learning to speak
English. Sixty English-as-a-foreign-language learners completed
two 50-itemed reading comprehension tests in no-music as well as
background-music condition. The results revealed a negative influence
of music on reading comprehension.

The Nature of the Task To Be Completed

In addition to research focusing on different types of music, a variety
of different tasks have been used—for instance, those related to various
different kinds of memory, tasks requiring high levels of attention,
reading comprehension and learning a second language.

Background Music and Memory

In research relating to memorisation, the findings have differed when
music is played concurrently with material which is to be remembered
aurally (Furman, 1978), when the task involves paired associate recall
280 The Power of Music

(Myers, 1979) or phonological short-term memory (Salame & Baddeley,

1989), or when recall is of written sentences presented visually (Hallam
et al., 2002). Where background music is vocal in nature, it may have a
greater negative impact on reading comprehension and other literacy
tasks (Martin et al., 1988). Some research has focused on visual memory,
where it might be expected that there would be less interference from the
music. For instance, Chraif and colleagues (2014) studied the influence
of relaxing music on an abstract visual short-term memory retrieval task.
Sixty-eight undergraduate students, aged between 19 and 23 years old,
participated. The findings showed that listening to relaxing music had
a significant positive effect in increasing the number of correct abstract
forms recognised.
Nguyen and Grahn (2017) examined the effect of background
music on different types of memory. One hypothesis for the impact of
background music on memory is that it modulates mood and arousal,
creating optimal levels to enhance memory performance. Another
hypothesis is that background music establishes a context that, when
reinstated, cues memory performance. The researchers presented music
during study time only, test only and both. They also assessed how
mood, arousal and context affected performance on recall, recognition
and associative memory tasks. Participants recalled more words when
they listened to low-arousal music than high-arousal music, regardless
of mood or whether context was consistent between study and test. For
recognition memory, participants also recognised more words when
they listened to low-arousal music than high-arousal music, but only
when the music was negative. For associative memory, no significant
effects of mood, arousal or context were found on recognition of
previously studied word pairs. Across all elements of the research,
background music (compared with silence) did not significantly
improve verbal memory performance. While mood and arousal affected
recall and recognition memory, overall background music did not
enhance memory.
Jäncke and Sandmann (2010) used musical excerpts which were
specifically composed for the research to ensure that they were unknown
to the participants. They were designed to vary in tempo (fast versus
slow) and consonance (in tune versus out of tune). Noise was used as
a control stimulus. Seventy-five participants were randomly assigned
 11. Music and Studying  281

to one of five groups and learned verbal material (non-words with

and without semantic connotation, and with and without background
music). Each group was exposed to one of five different background
stimuli: in-tune fast music, in-tune slow, out-of-tune fast, out-of-tune
slow and noise. There was no substantial or consistent influence of
background music on verbal learning. However, there were differences
in EEG measurements after word presentation for the group exposed
to in-tune fast music while they learned the verbal material, and for
the group exposed to out-of-tune fast music after word presentation.
Although there were different cortical activations in response to the
music, these did not relate to behavioural outcomes.
In an unusual study, Liu and colleagues (2012) studied the
recognition processes of Chinese characters in background music. Real
Chinese characters, upright or rotated, were used as target stimuli,
while pseudowords were used as background stimuli. Participants were
required to detect real characters while listening to Mozart’s Sonata K.
448 or in silence. The findings showed that the music mainly served as
a distracter in the recognition processes of real Chinese characters. The
impact was greater for the real than the rotated characters.
Some research has focused on episodic memory for verbal materials.
Generally, the effects of music are positive (Ferreri et al., 2013; 2014; 2015)
and tend to be consistent across younger and older adults (Ferreri et al.,
2015). Music facilitates the encoding of printed verbal materials not only
when music is compared to a silent context, but also when compared to
non-musical auditory contexts, such as environmental sounds or noise.
Music has a specific effect rather than a general advantage related to
sound.
Other research has extended the range of tasks explored. For
instance, Fassbender (2012) explored the use of background music on
game technology and its effect on learning. A virtual history lesson was
presented to participants with different background stimuli—music
or no music—to test the effect of music on memory. To test the role
of immersion on memory and its possible relationship to the music,
two different display systems (a three-monitor display system or an
immersive reality centre) were used. Overall, participants remembered
a significantly higher number of facts using the three-monitor display
system, particularly if no background music was played. Similarly,
282 The Power of Music

Richards and colleagues (2008) studied the benefits of immersive virtual

worlds as a learning environment, and the role that music plays within
these environments. They investigated whether background music of
the genre typically found in computer-based roleplaying games had
an effect on learning in a computer-animated history lesson about the
Macquarie Lighthouse within an immersive virtual world. In the first
experiment, musical stimuli were created from four different computer-
game soundtracks. Seventy-two undergraduate students watched the
presentation and completed a survey including biographical details,
questions on the historical material presented and questions relating to
their perceived level of immersion. While the tempo and pitch of the
music was unrelated to learning, music conditions resulted in a higher
number of accurately remembered facts than the no-music condition. One
soundtrack, in particular, showed a statistically significant improvement
in memorisation of facts over the other music conditions. There was
also an interaction between the levels of perceived immersion and
ability to accurately remember facts. The second experiment involved 48
undergraduate students. The soundtrack that had been most successful
in Experiment One (Oblivion) was used again with a silent condition.
In this experiment, the participants completed the tasks under both
conditions. Only one version of the tempo and pitch manipulations
was used: slow tempo, low pitch. The effect of different display systems
on feelings of immersion was tested. Half the participants watched the
computer-animated history lesson in a cone display system and the other
half was allocated to a three-monitor display system on a computer desk.
There were no statistically significant differences between the music and
no-music conditions. However, the three-monitor display system led to
enhanced memory performance. Similarly, Linek and colleagues (2011)
investigated the influence of background music within an educational
adventure game on motivational and cognitive variables. The results
suggested that the music had a high motivational potential. As neither
positive nor negative effects on learning were detected, background
music may be considered as a motivating design element of educational
games.
Using piped music, Langan and Sachs (2013) explored the impact
of piping music into an information literacy classroom on student
engagement and retention of information literacy concepts. The findings
 11. Music and Studying  283

from this study indicated positive relationships between background

music and student comfort, confidence and retention. Similarly, Musliu
and colleagues (2017) researched whether music could help in the
memorisation of different materials, for instance, nonsense syllables,
numbers and poems with rhyme. Seventy-four students aged between
17 and 22 years participated. The experiment included four different
tests. The first included 50 nonsense syllables. Following this, students
were separated into three groups, each with similar outcomes on
performance in the first test. The first group took subsequent tests in
silence, the second while listening to music with lyrics and the third
listening to relaxing music. The students were given five minutes to
memorise 50 different nonsense syllables,12 lines from poems and 50
different orders of numbers. They then wrote down what they could
remember. The music was the same during the memorising and writing
phases. There were significant differences in memorising between
students with or without music, in favour of those learning in silence.
Adopting a neuroscientific approach, Ferreri and colleagues (2013)
addressed the debate about the link between music and memory for
words—in particular, whether music specifically benefits the encoding
element of verbal memory tasks by providing a richer context for
encoding and, therefore, less demand on the dorsolateral prefrontal
cortex. Twenty-two healthy young adults were subjected to functional
near-infrared spectroscopy imaging of their bilateral dorsolateral
prefrontal cortex while encoding words in the presence of either
a musical or silent background. Behavioural data confirmed the
facilitating effect of background music during encoding on subsequent
item recognition. Functional near-infrared spectroscopy imaging
results revealed significantly greater activation of the left hemisphere
during encoding and a sustained, bilateral decrease of activity in the
dorsolateral prefrontal cortex in the music condition compared to
silence. These findings suggest that music modulates the role played
by the dorsolateral prefrontal cortex during dorsolateral prefrontal
cortex verbal encoding and opens up the possibility for applications in
clinical populations with prefrontal impairments, such as elderly adults
or Alzheimer’s patients. In a later study, Ferreri and colleagues (2015)
investigated whether verbal episodic memory could be improved by
background instrumental music. Twenty young adults were asked
284 The Power of Music

to memorise different lists of words presented against a background

of music, environmental sounds or silence. Their episodic memory
performance was then tested in terms of item and source-memory scores.
The findings revealed better memory performance under the music
condition than with environmental sounds or silence in retrieval. These
findings indicate that music can specifically act as a facilitating encoding
context for verbal episodic memory, which may have implications for
music as a rehabilitation tool for episodic memory deficits. Further,
Ferreri and colleagues (2015)—based on functional near-infrared
spectroscopy imaging studies on music, episodic encoding and the
dorsolateral prefrontal cortex—monitored the entire lateral prefrontal
cortex during both encoding and retrieval of verbal material. Nineteen
participants were asked to encode lists of words presented with either
background music or silence, and were subsequently tested during a
free-recall task. Meanwhile, their prefrontal cortex was monitored using
a 48-channel functional near-infrared spectroscopy system. Behavioural
results showed greater chunking of words under the music condition,
suggesting the employment of associative strategies for items encoded
with music. The functional near-infrared spectroscopy results showed
that music provided a less demanding way of modulating both episodic
encoding and retrieval, with general prefrontal decreased activity under
the music versus silence condition. This suggests that music-related
memory processes rely on specific neural mechanisms, and that music
can positively influence both episodic encoding and retrieval of verbal
information.

Background Music and Attention

There has been considerable research on the impact of music on
attention. For instance, Jiang and colleagues (2011) investigated the
influence of mood on attentional networks in a normal population.
Participants performed an attention-network test, which provided
functional measures of alerting, orienting and executive attention.
Positive or negative mood was induced by listening to music with a
positive or negative valence; neutral mood was induced by reading a
collection of basic facts about China. The results revealed that negative
mood led to a significantly higher alerting efficiency relative to other
 11. Music and Studying  285

moods, while there were no significant mood effects on orienting or

executive attention efficiency. Specifically, the increase in the alerting
function during negative mood states may be due to the modulation
effect of negative mood on the noradrenergic system, and/or to the
survival benefit resulting from an increase in automatic vigilance
towards negative information.
Another strand of work has been concerned with the impact of music
on attentional control—an executive function that allows an individual
to focus attention on a specific stimulus, while inhibiting distractors
from the environment. For instance, Fernandez and colleagues (2020)
reported improved perceptual judgment in young adults on a flanker
task (where individuals have to respond to one letter in a group and
ignore others) when joyful and arousing or sad and tender music was
playing, or they sat in silence. There was no overall effect of background
music on attentional control performance per se. Similarly, Burkhard
and colleagues (2018) studied the influence of background music on
executive functions, particularly inhibitory functions. Participants
completed a standardised go/no go task during three conditions: no
background music or relaxing or exciting background music. EEG was
recorded along with reaction times, omissions and commissions. Event-
related potentials revealed no differences between the three conditions
in reaction times, omissions or commissions. The findings suggested
that background music had no detrimental effects on the performance
of a go/no go task and its neural underpinnings. Using a visuo-spatial
flanker task, Cloutier and colleagues (2020) studied 19 older and 21
younger adults during three auditory conditions: stimulating music,
relaxing music and silence. Participants had to indicate as fast and as
accurately as possible the direction of a central arrow, which was flanked
by congruent or incongruent arrows. As expected, reaction times
were slower for the incongruent compared to congruent trials. This
difference was significantly greater under the relaxing-music condition
compared to other auditory conditions, for both age groups. Focusing
on the impact of mood on attention, Shih and colleagues (2012) studied
102 participants, aged 20 to 24, on concentration and attention with
music, with and without lyrics. The findings revealed that background
music with lyrics had significant negative effects on concentration and
attention. In a later study, Shih and colleagues (2016) studied 75 adults,
286 The Power of Music

ranging in age from 20 to 24, who completed an attention test and

emotion questionnaire. The findings showed that background music
with lyrics adversely impacted attention performance more than that
without lyrics. The listeners also self-reported feeling loved while music
was playing.
Adopting a neuroscientific approach, using Vivaldi’s Four Seasons,
Leigh (2013) explored the consequence of music exposure on cognitive
event-related potentials. Seventeen participants performed a three-
stimulus visual oddball task, where a set of the same stimuli were
presented with one different stimulus at various points, the oddball,
while event-related potentials were recorded. Participants were required
to differentiate between a rare target stimulus, a rare novel stimulus and
a frequent non-target stimulus. During task performance, participants
listened to the four Vivaldi concertos—‘Spring’, ‘Summer’, ‘Autumn’ and
‘Winter’—and experienced a silent control condition. The research also
examined the impact of different tempi. The data revealed that ‘Spring’,
particularly the first movement, enhanced mental alertness and brain
measures of attention and memory. Similarly, Du and colleagues (2020)
used event-related potentials to examine the effects of background
music on neural responses during reading comprehension and their
modulation by musical arousal. Thirty-nine postgraduates judged the
correctness of sentences about world knowledge without or with high
or low arousal background music. The results showed that the effect
elicited by world knowledge violations versus correct controls, was
significantly smaller for silence than for high and low arousal-music
backgrounds, with no significant difference between the two musical
backgrounds.

Reading Comprehension
As reading plays such an important role in the lives of many people,
considerable research has used reading comprehension as a task in
studies of the impact of background music. For instance, DeMers
(1996) compared two classes on their reading prior to the onset of the
study to establish equity of performance. The experimental group also
practised prior to the study, with Mozart’s Concerto No. 21 in C Major,
K. 467 playing in the background for several weeks prior to the study to
 11. Music and Studying  287

familiarise themselves with working to music. Both groups also practiced

undertaking a test prior to the experiment. The findings showed that
the group with background music performed significantly better on
the reading comprehension test. Similarly, Cooper and colleagues
(2008) gave participants three different reading comprehension tests
in three different conditions: no music, classical music and lyrical
music. The results showed slightly better performance on the reading
comprehension test in the no-music condition, but this difference was
not statistically significant. In a similar study, Liapis and colleagues
(2008) tested the impact of lyrical and non-lyrical music on reading
comprehension. Participants in the non-lyrical condition performed
better than the other group, although this difference was not statistically
significant. Drowns (2002) focused on the effect of classical background
music on silent reading comprehension and found an improvement
with music in the background, while Harmon and colleagues (2008)
showed that there was no significant difference among the three groups
who either listened to rock music, Mozart or worked in silence on a
reading comprehension test. Martin and colleagues (1988) carried
out a series of studies, the first of which demonstrated that speech but
not music interfered with reading comprehension, while music had a
greater interfering effect than speech on a music identification task. Two
further experiments showed that the detrimental effect of the speech
background on reading was due to their semantic rather than their
phonological properties.
Adopting a different approach Zhang, and colleagues (2018)
examined how listening to music affected eye movements when college
students read for comprehension. Two studies found that the effects of
music depended on word frequency and musical dynamics. The first
showed that lexical and linguistic features of the text remained highly
robust predictors of looking times, even when listening to music.
However, when exposed to music, readers spent more time rereading,
and gaze duration on words with very low frequency was less predicted
by word length, suggesting disrupted sub-lexical processing. A second
study showed that these effects were exacerbated for a short time as soon
as a new song was played. The results showed that word recognition
was generally unaffected despite music exposure and that extensive
rereading could, to some extent, compensate for any disruption.
288 The Power of Music

Second-Language Learning
A further area of interest has been second-language learning. Kang
and Williamson (2014) examined the effect of background music on
participants taking a beginners’ course on a CD in either Mandarin
Chinese or Arabic. Groups matched on age, gender, verbal intelligence,
musical training and working memory ability were randomly assigned to
a CD that contained accompanying music or no music. Individuals who
chose to learn Chinese performed better on all outcome tests compared
to those who learned Arabic. Within the Chinese learners, those who
received music CDs performed significantly better on tests of recall and
translation compared to those who received no music CDs. No music
effects were observed in the Arabic learners or on pronunciation ability
in Chinese.
Küssner and Hillen (2016) investigated individual differences in
the effects of background music on foreign-vocabulary learning. They
predicted that individuals with a high level of cortical arousal should
perform worse when learning with background music compared
to silence, whereas individuals with a low level of cortical arousal
would be unaffected by background music or may even benefit from
it. Participants were tested on a paired associate learning paradigm
consisting of three immediate word recall tasks, as well as a delayed recall
task one week later. Baseline cortical arousal assessed with spontaneous
EEG measurement in silence prior to the learning sessions was used
for the analysis. The findings revealed no interaction between cortical
arousal and the learning condition with background music versus
silence. However, there was a main effect of cortical arousal in the beta
band on recall, indicating that individuals with high beta power learned
more vocabulary than those with low beta power. To substantiate this
finding the study was replicated. A combined analysis of data from both
experiments suggested that beta power predicted the performance in
the word recall task, but that there was no effect of background music
on foreign vocabulary learning.
De Groot and Smedinga (2014) studied participants learning foreign-
language vocabulary by means of the paired associates method in
silence, with vocal music with lyrics in a familiar language playing in the
background, or with vocal music with lyrics in an unfamiliar language
 11. Music and Studying  289

playing in the background. The vocabulary to be learned varied in

concreteness and phonological typicality of the foreign words. When
tested during and immediately after training, learning outcomes were
poorer in the familiar language music condition than in the unfamiliar
language music and silence conditions. This effect was short-lived, as
shown in a delayed test one week after training. Learning outcomes
were better for concrete words than for abstract words and better for
typical foreign forms than for atypical ones.
Studying the impact of background music on writing rather than
learning a second language, Cho (2015) also took account of the
writer’s-second language proficiency. Twenty-eight students wrote an
argumentative essay in music and non-music conditions respectively.
The findings were analysed in terms of fluency and writing quality, and
showed significant differences in pause frequency between the music
and no music conditions. The comparison of high- and low-proficiency
groups showed a significant group by condition interaction, indicating
marginally different effects of music depending on the writers’
proficiency level.

Background Music and English as a Second Language

In Iran, Khaghaninejad and colleagues (2016) evaluated the effect
of classical music (a Mozart sonata) on the reading comprehension
performance of Iranian students having had four months of tuition in a
private college teaching English. The participants were required to learn
reading passages and then take two tests of reading comprehension,
either in a music (Mozart) condition or a no-music quiet condition.
The music group outperformed those with no background music.
Also in Iran, Rashidi and Faham, (2011) studied the effect of classical
music on students’ reading comprehension. A standardised text was
used and students answered 20 multiple-choice items. Two groups of
students, 60 in total, over a period of three months, were taught reading
comprehension with a music background or no music. The group
taught with a music background outperformed those taught with no
music. Similarly, Sahebdel and Khodadust (2014) studied the effect of
background music on reading comprehension in Iranian English for
foreign-language learners. The participants were 57 Iranian learners
290 The Power of Music

between the ages of 14 and 16 in two third-grade high-school classes

at pre-intermediate proficiency level. Before the research, experimental
and control groups took a reading comprehension. The researchers
played Mozart sonatas as background music to the experimental group
and asked them to read the passage silently and then answer the reading
comprehension questions. The procedure was the same for the control
group but with no music. After ten sessions, the students of both groups
were asked to take a parallel form of the same reading comprehension
test. The findings showed that the experimental group outperformed
the control group in reading comprehension. Listening to background
music while reading silently had a significantly positive effect on the
reading comprehension of Iranian learners for whom English was a
foreign language.

Individual Differences
Research taking account of individual differences has taken account of
personality, musical expertise, gender and metacognition.

Musical Expertise
Some research has considered whether having musical expertise
makes a difference to the possible enhancing or detrimental effects of
music. For instance, Darrow and colleagues (2006) explored whether
music compromised selective attention differently in those who were
majoring in music to non-music majors. Eighty-seven undergraduate
and graduate students participated. They were required to bring to the
study music that they typically listened to while driving, studying or
engaged in other activities. The music brought represented all musical
periods and styles. Participants completed a test of attention under
alternating music and no music conditions. There were no significant
effects for non-music majors; however, music majors who heard the
music first completed significantly fewer total items in the following
non-music condition, and music majors who listened to instrumental
music completed significantly more total items than those who listened
to music with vocals. Overall, the findings showed that participants
processed significantly more items under the music condition, and music
 11. Music and Studying  291

majors processed significantly more items than non-music majors. There

were no significant differences based on music or no music in relation
to the number of errors made, the number of items processed minus
errors, or concentration performance. However, there were differences
for the three measures based on musical training. Music majors made
significantly fewer errors than the non-music majors, processed
significantly more items correctly and their concentration performance
scores were significantly higher than the non-music majors’ scores.
Similarly, Yang and colleagues (2016) investigated how background
music with different instruments affected trained musicians’
performance on cognitive tasks. Participants completed three sets of
cognitively demanding intelligence tests in a design where each group
listened to a different piece of music, involving their own and other
musical instruments. The results showed that musicians’ performance
on cognitive tasks was more impaired when listening to music featuring
their own instruments than when listening to other instruments.
Patston and Tippett (2011) administered a language comprehension
task and a visuospatial search task to 36 expert musicians and 36
matched non-musicians in conditions of silence and piano music
played correctly or incorrectly. Musicians performed more poorly on
the language comprehension task in the presence of background music
compared to silence, but there was no effect of background music on
the musicians’ performance on the visuospatial task. In contrast, the
performance of the non-musicians was not affected by music on either
task. Additionally, the musicians outperformed the non-musicians on
both tasks, reflecting either a general cognitive advantage in musicians
or enhancement of more specific cognitive abilities (such as processing
speed or executive functioning). Similarly, Haning (2016) studied
whether background music impaired language comprehension scores
in musicians but not in non-musicians. Thirty-five participants with
musical training and 15 without musical training completed a 30-item
reading comprehension test. Participants completed the test instrument
in silence or in the presence of background music. The findings indicated
that there was no significant main effect for either music training or the
presence of background music, and no significant interaction between
the two conditions.
Gold and colleagues (2013) studied dopamine release in the ventral
striatum, as this plays a major role in the rewarding aspect of music
292 The Power of Music

listening. Striatal dopamine also influences reinforcement learning, such

that people with greater dopamine efficacy better learn to approach
rewards, while those with lesser dopamine efficacy better learn to
avoid punishments. This research explored the practical implications of
musical pleasure through its ability to facilitate reinforcement learning
via non-pharmacological dopamine elicitation. Participants from a wide
variety of musical backgrounds chose a pleasurable and a neutral piece
of music from an experimenter-compiled database, and then listened
to one or both of these pieces according to pseudo-random group
assignment as they performed a reinforcement learning task dependent
on dopamine transmission. Participants’ musical backgrounds, as well
as typical listening patterns, were assessed. Behaviour for the training
and test phases of the learning task was assessed separately. Participants
with more musical experience trained better with neutral music and
tested better with pleasurable music, while those with less musical
experience exhibited the opposite effect. Assessment of results regarding
listening behaviours and subjective music ratings indicated that these
effects arose from different listening styles: namely, more affective
listening in non-musicians and more analytical listening in musicians.
In conclusion, musical pleasure was able to influence task performance,
and the shape of this effect depended on group and individual factors.

Gender
Palmiero and colleagues (2016) studied gender differences in visuospatial
and navigational working memory when background music which was
designed to induce positive or negative moods was playing. The findings
showed that the positive music group scored significantly higher than
other groups and that male participants outperformed females on one
task when negative background music was playing.

Personality
Personality factors are implicated in creating optimal arousal levels for
completing cognitive tasks. Introverts have higher resting levels of arousal
than extroverts and are more susceptible to over-arousal, which impacts
on their task performance when there are certain types of background
 11. Music and Studying  293

music (Cassidy and MacDonald, 2007). Furnham and colleagues

(1999) examined the effects of vocal and instrumental music upon the
performance of introverts and extroverts on three cognitive tasks. One
hundred and forty-four sixth-form pupils—introverts and extroverts—
completed a reading comprehension task, a logic problem and a coding
task. An interaction was predicted such that instrumental music would
impair and enhance the test performance of introverts and extroverts
respectively, and that these effects would be magnified in the vocal music
condition. No significant interactions were found, although there was a
trend for the introverts to be impaired by the introduction of music to
the environment, and extroverts to be enhanced by it, particularly on the
reading and coding tasks. A main effect of extroversion was found in the
reading comprehension task. There was a condition effect on the logic
task, with participants doing best in the presence of instrumental music.
Similarly, MacDonald (2013) examined the relationship between music
preference and extroversion on complex task performance in a sample
of 34 college students. The students were separated into two groups of
high and low extroversion. Each participant experienced three different
music conditions (preferred, preset and silence) while performing a
complex reading comprehension task. The results revealed a significant
interaction effect between level of extroversion and music condition.
Individuals with higher levels of extroversion performed significantly
better listening to preferred music during the complex task compared
to silence and a preset music selection. There were no other statistically
significant outcomes. Avila and colleagues (2011) investigated the effect
of familiar musical distractors on the cognitive performance of introverts
and extroverts. Participants completed a verbal, numerical and logic test
in three music conditions: vocal music, instrumental music and silence.
The findings showed that, during the verbal test, overall performance
for all participants was significantly better in silence, suggesting that
lyrics interfere with the processing of verbal information. However, no
significant music and personality interactions were found.
Dobbs and colleagues (2011) studied the cognitive test performance
of introverts and extroverts in the presence of silence, UK garage music
and background noise. One hundred and eighteen female secondary-
school students carried out three cognitive tests. It was predicted that
introverts would perform more badly on all of the tasks than extroverts
294 The Power of Music

in the presence of music and noise but, in silence, performance would be

the same. A significant interaction was found for all three tasks. It was
also predicted that there would be a main effect of background sound.
Performance would be worse in the presence of music and noise than
silence. The findings confirmed this prediction with one exception.
Furnham and Strbac (2002) extended previous work by examining
whether background noise would be as distracting as music. In the
presence of silence, background garage music and office noise, 38
introverts and 38 extroverts carried out a reading comprehension task, a
prose-recall task and a mental arithmetic task. It was predicted that there
would be an interaction between personality and background sound on
all three tasks. Introverts would do more badly on all of the tasks than
extroverts in the presence of music and noise but, in silence, performance
would be the same. A significant interaction was found on the reading
comprehension task only, although a trend for this effect was clearly
present on the other two tasks. It was also predicted that there would
be a main effect for background sound. Performance would be worse
in the presence of music and noise than silence. The results confirmed
this prediction. These findings support the hypothesis that there is a
difference in optimum cortical arousal in introverts and extroverts.
Adopting a different approach, Doyle and Furnham (2012) explored the
distracting effects of music on the reading comprehension of creative
and non-creative individuals. In the presence of musical distraction and
silence, 54 individuals participated. No significant interactions were
found, although trends indicated that creative individuals performed
better than non-creative individuals in the music distraction condition.
The creative individuals tended to listen to more music while studying
and reported lower distraction levels.

Background Music and Metacognition

The extent to which learners are used to working with music playing
in the background may be important in the extent to which it disrupts
or enhances their task performance. For instance, Etaugh and Michal,
(1975) gave 16 male and 16 female college students tests of reading
comprehension which they completed in quiet surroundings or while
listening to preferred music. The more frequently students reported
 11. Music and Studying  295

studying with music, the less the music impaired their performance.
Similarly, Su and Wang (2010) studied the relationship between cognitive
memory and background music. According to whether or not the testees
were used to listening to background music, the author divided them
into two groups. When the participants were exposed to three different
music scenes, the impact of different background music on testees’
cognitive memory differed. The results showed that pure pop music
disturbed both groups and pure soft music improved the performance
of those who were used to background music but hindered those who
were not. There were no statistically significant differences between
groups under no music conditions. Also taking account of familiarity
of working with background music, Crawford and Strapp (1994) used
three timed visuospatial and verbal tests undertaken while vocal or
instrumental music was playing. Vocal music disrupted performance
significantly more than instrumental music on maze-tracing speed
and logical reasoning tests. Both vocal music and instrumental music
disturbed performance more than no music on an object-number test
which assessed associative learning and long-term memory but this was
moderated by studying preference. On this test, those who typically did
not study with music showed deterioration across conditions from no
music, through instrumental music to vocal music, while those who
typically studied with music performed no better in the no-music
condition than either music condition. Although extroversion was not
a significant covariate of performance, those who typically studied with
music were more extroverted and reported greater skills in focusing
attention during distracting situations and reported less sensitivity to
noise in general on a test of noise sensitivity.
Some students may be able to control their responses to music better
than others. For instance, Christopher and Shelton (2017) explored
whether existing differences in working memory might impact on
the outcomes of research looking at the effect of music on working-
memory performance. Undergraduate students worked on reading
comprehension and mathematics tasks under music and silence
conditions, before completing a battery of working-memory capacity
assessments. Although music led to a significant decline in performance
overall, working-memory capacity moderated this effect in the reading
comprehension tasks. This suggests that individuals who are better able
296 The Power of Music

to control their attention, as indicated by working-memory capacity, may

be protected from music-related distraction when completing certain
kinds of academically relevant tasks. In addition to this, performance
may be influenced by metacognition (the extent to which participants
are aware that the music is interfering with task performance and
consciously adopt strategies to prevent this). Kotsopoulou and Hallam
(2010) administered rating-scale questionnaires to 600 students in three
age groups—12 to 13, 15 to 16 and 20 to 21—from Japan, the UK, Greece
and the USA. The questionnaires explored the extent of playing music
while studying, the kinds of tasks undertaken when music was played,
the perceived effects of music on studying, the characteristics and types
of music played, and the factors that influenced the decision to play
music. Statistical analysis revealed both commonality and differences
in playing music while studying, related to both age and culture. Some
tasks were more frequently accompanied by music than others, while
students reported being able to make decisions about the impact of
background music on their performance on various tasks and taking
action to arrange music to support their learning. Competence in
managing the use of music so it did not interfere with task performance
increased with age.

The Impact of Background Music on Children’s

Behaviour and Task Performance
Historically, research on background music in educational contexts has
explored the impact on children at different ages, with special educational
needs and undertaking a range of different tasks. For instance, in young
children there is evidence that arousing music increases activity. For
instance, Rieber (1965) studied the activity of five- and six-year-old
children in a specially designed playroom under conditions of silence
and two types of music (fast and slow). Activity rates were higher
during the intervals when music was played, with fast music having
the more marked effect. Music did not affect the variability of activity,
which showed a steady decline during the time spent in the room.
There is also evidence that the type of play may change. For instance,
Gunsberg (1991) found that there was an increase in interactive play
when arousing music was playing. Ziv and Goshen (2006) explored
 11. Music and Studying  297

the effect of sad and happy background music on the interpretation

of a story in five- to six-year-old children. The children heard a story
with a background of happy, sad or no melody. The findings showed
that background music affected children’s interpretation of the story.
Happy background music led to positive interpretations, whereas sad
background music led to more negative interpretations. The effect of the
happy music was stronger than that of sad music.
Koolidge and Holmes (2018) explored the effects of background
music on puzzle-assembly task performance in young children.
Participants were 87 primarily European-American children aged four
to five years old enrolled in early childhood classes. Children were
given one minute to complete a 12-piece puzzle task in one of three
background music conditions: music with lyrics, music without lyrics
and no music. The music selection was ‘You’re Welcome’ from the
Disney movie Moana. The findings revealed that children who heard
the music without lyrics completed more puzzle pieces than children in
either the music-with-lyrics or no-music condition. Background music
without distracting lyrics may be beneficial and superior to background
music with lyrics for young children’s cognitive performance, even
when they are engaged independently in a non-verbal task. Focusing
on drawing, Gur (2009) investigated the effect of classical music on the
cognitive content of children’s drawings. The sample consisted of 84 six-
year-old children from private kindergartens in higher socioeconomic
status areas in Ankara in Turkey. The sample was divided into three
groups. The first engaged in free drawing while listening to classical
music, the second engaged in free drawing with no music and the third
group acted as a control. The results showed that there was a positive
effect of classical music on the cognitive content of the drawings.

Background Music and Primary-School Children

Mitchell (1949) was interested in the effect of radio programmes on
the silent reading achievement of 91 sixth-grade students. At the time
of the study, radio had become an integral part of American culture.
It seemed pertinent, therefore, to determine whether radio broadcasts
had any effect on the ability of pupils to concentrate sufficiently on their
studies in order to acquire knowledge and information. Ninety-one
298 The Power of Music

students carried out silent reading tests with either a music or a variety
radio programme playing in the background, or they worked in silence.
Overall, the variety programme disrupted performance more strongly
for the boys than the girls. Performance during listening to the music
programme was unaffected. In fact, the boys performed slightly better
with the music playing. Working in Taiwan, Su and colleagues (2017)
tested whether the Mozart Sonata for Two Pianos (K. 448) playing
in the background impacted on the learning anxiety, reading rates
and reading comprehension of students reading e-books. Sixty-two
elementary students participated. The findings showed that, when
compared with reading without music, the music had a positive effect
in reducing learning anxiety and improved the students’ reading rates,
reading comprehension and direct process performance. However, the
music had a negative effect on the students’ attention when they had to
interpret what they had read. This was explained in terms of the music
taking up attentional resources which were required for the task.
Working in a school setting, Ivanov and Geake (2003) found some
evidence of an impact related to playing Mozart in the background with
upper-primary-school-aged children. Scores on a paper-folding task
for a class which listened to Mozart during testing were significantly
higher than the scores of a control class. A similar result was obtained
for another class which listened to Bach during testing. The musical
educational experience of the children did not significantly contribute
to the variance in scores.
Koppelman and Scott (1995) explored the impact of different kinds
of music on children’s writing content. Nineteen students from a second-
grade class participated in ten 15-minute writing sessions, accompanied
in each session by one type of background music: classical, jazz, popular,
country or silence. The writing was analysed for tone, consistency and
number of words. The findings showed that students wrote more words
under the classical music condition and there were fewer inconsistencies
in writing when listening to jazz. Popular music from the top 40 had
a significant negative effect on writing, perhaps because the students
were familiar with it. Hallam and Godwin (2015) explored the impact
of music on creative writing in primary-school children. Children aged
ten to eleven were asked to write an exciting story while listening to
arousing, calming or no music. They then completed a questionnaire
 11. Music and Studying  299

to establish their awareness of the music and its effects. The music
appeared to have little effect on basic literacy skills in the children
but stories were rated as more exciting when the calming music was
playing. The children had little conception of the detrimental effects of
the exciting music on their writing.
Mowsesian and Heyer (1973) studied whether music would
distract performance in a testing situation. Four groups of participants
were randomly assigned to one of four music conditions. The control
group experienced optimal testing conditions as defined by accepted
standards. Results on arithmetic, spelling and self-concept measures
indicated no differences in mean test scores across groups, regardless of
the test condition. The authors suggested that, since a variety of noises is
a normal part of the environment, music as a distractor was not an issue.
Hallam and colleagues (2002), working with primary-school children
aged ten to twelve, undertook two studies exploring the effects of music
perceived to be calming and relaxing on performance in arithmetic and
on a memory task. They found that calming music led to an improvement
in children’s performance on memory and mathematics tasks, compared
with a no-music condition. Music perceived as arousing, aggressive
and unpleasant disrupted performance on the memory task and led
to a lower level of reported altruistic behaviour by the children. This
suggests that the effects of music on task performance are mediated by
arousal and mood rather than directly affecting cognition. Also in the
UK, Bloor (2009) administered four tests to three classes in different
primary schools, two with music and two with silence, to see if the music
had an impact on the behaviour and attainment of the children during
testing. The results were then cross-referenced with the children’s self-
evaluation of their own musicality, to ascertain if those children who
experienced disruption of attainment and behaviour were musicians. The
findings suggested that the music may have supported performance on
reading tests but conversely disrupted mathematics tests. Batur (2016)
formed experimental and control groups of students in the fifth and
sixth grades on the basis of scores on Turkish language exams. Overall,
80 students participated (40 from each grade), with half participating
in the intervention and half acting as controls. The students were given
20 minutes to write about any subject that they wished. Those in the
intervention groups worked with background music playing, while the
300 The Power of Music

others worked in silence. The findings showed that those who wrote
with music in the background used more words in their essays than the
control group and wrote more fluently.
Focusing on task behaviour, Davidson and colleagues (1986)
determined the effect of background music on 26 pupils in a fifth-
grade science class. The children were observed for 42 class sessions
over a period of four months. Observational data were recorded every
three minutes. Time series analyses were performed to determine the
effects. There was a significant increase in task performance for the male
students and for the total class when music was playing, although there
was a ceiling effect for females.

Background Music and Older Students

There has been considerable research with high-school students, as this
is the age when music is often played while homework is completed.
Kiger (1989) studied the effects of music information load on a reading
comprehension task. Twenty-seven male and 27 female high-school
students read a passage of literature in the presence of silence, or low-
or high-information-load music. Comprehension was best in the low-
information-load music condition and worst when the high-information-
load music was playing. Similarly, Fogelson (1973) explored whether
music acted as a distracter on reading. Playing popular instrumental
music during a test proved to be distracting and lowered the reading
test performance of 14 eighth-grade students. The less able students
were more adversely affected than those who were of higher levels of
competence.
Hall (1952) studied the effect of background music on the reading
comprehension of 278 eighth- and ninth-grade students in study-hall
conditions. Almost 58 percent of the 245 students tested, exclusive
of the control group, showed an increase in score when the test was
administered with background music. The difference in means showed
a substantial gain with background music during the first lesson in
the morning and during the first and second afternoon lessons. Over
67 percent of the students in these periods showed an increase in
score with music background. Also studying reading comprehension,
Anderson and Fuller (2010) investigated the effect of lyrical music on
 11. Music and Studying  301

the performance of adolescents. A reading comprehension test was

administered to 334 seventh- and eighth-grade students in a non-music
environment or with accompanying music comprising top hit singles
from 2006. Following the music portion of the test, students completed
a survey to assess their preference for or against listening to music while
studying. The findings showed that performance declined significantly
when background music was playing. For students exhibiting a strong
preference for listening to music while studying, there was a pronounced
detrimental effect on comprehension.
At college level, Taylor and Rowe (2010) focused on assessment
in mathematics, specifically trigonometry. During six major tests of
trigonometry, 69 students were played music by Mozart. The results
were compared to the performance of 59 students who took the same
tests with no background music. The results indicated that the students
performed significantly better when Mozart was being played as
background music during the assessment.

Research with Children with Emotional

and Behavioural Difficulties, ADHD and
Developmental Difficulties
Calming music has a positive impact on the behaviour of children
with emotional and behavioural difficulties, reducing their stress and
anxiety in a variety of settings, although for some children with learning
difficulties—for instance with Attention Deficit Disorder (ADD) or
Attention Deficit Hyperactivity Disorder (ADHD)—stimulating music
is more effective in improving their behaviour, replacing the children’s
need for activity and self-stimulation. These differences in response
mean that music interventions aimed at changing behaviour need to be
tailored to the requirements of specific groups of children.

Children with Attention Deficit Hyperactivity Disorder

and Attention Deficit Disorder
Music has been used to help reduce hyperactivity in children with
Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity
302 The Power of Music

Disorder (ADHD) (Scott, 1970). Cripe (1986) proposed that rock music
could be used as an adjunctive therapy to other more conventional
treatments—rock music has the advantage that it can be ‘administered’
without the need for training staff. It was hypothesised that rock music
would decrease activity level in children with ADD and increase their
attention span. Eight males with ADD, aged six to eight years old,
were introduced to rock music in a playroom. Activity level, number
of activities, attention span and length of time attending to one task
were assessed. The results indicated a statistically significant reduction
in the number of motor activities during the music periods within the
test sessions, although there were no significant differences regarding
attention span.
Pelham and colleagues (2011) examined the effects of music and
video on the classroom behaviour, and performance of boys with and
without ADHD, as well as the effects of the drug methylphenidate.
Forty-one boys with ADHD and 26 controls worked in the presence of
no distraction, music or video. Video produced significant distraction,
particularly for the boys with ADHD, while music improved their
performance. There were individual differences in response to the
music such that some boys were adversely affected and others benefited
relative to no distractor. In a second study, music and methylphenidate
were assessed in an additional 86 boys with ADHD to further examine
the music results. In the presence or absence of music, methylphenidate
improved performance relative to placebo. Similar individual
differences were found as in the first experiment. Similarly, Abikoff
and colleagues (1996) evaluated the impact of extra task stimulation
on the academic performance of children with ADHD. Twenty boys
with ADHD and 20 boys without ADHD worked on an arithmetic
task during high stimulation, music, low stimulation, speech, and no
stimulation (silence). The music distractors were individualised for
each child, and the arithmetic problems were set at each child’s ability
level. The non-ADHD young people performed similarly under all three
auditory conditions, while the children with ADHD did significantly
better under the music condition than speech or silence conditions.
However, arithmetic performance was enhanced only for those children
with ADHD who were exposed to music as the first condition. Maloy
and Peterson (2014) undertook a meta-analysis of the effectiveness
 11. Music and Studying  303

of music interventions for children and adolescents with ADHD. The

analysis revealed that music interventions were minimally effective as
an intervention for increasing task performance.

Emotional and Behavioural Difficulties

Savan (1989; 1999) observed children with behavioural difficulties
during science lessons. She suggested that the behaviour of pupils with
special educational needs was, in part, resulting from frustration due to
lack of physical coordination and the consequent inability to perform
manual tasks effectively and efficiently. She investigated the possibility
that specific properties of certain Mozart orchestral compositions
might, in combination, improve the coordination skills of pupils with
emotional and behavioural difficulties. Audio tapes of Mozart orchestral
compositions provided a sound stimulus for ten boys aged twelve and
over, identified as having special educational needs and emotional and
behavioural difficulties. The tapes were then edited in an attempt to
establish which musical qualities produced the effects. Measurements of
blood pressure, body temperature and pulse rate were taken to establish
which sound stimulus had an effect on the physiology and metabolism
of the participants. In each case, an improvement in coordination was
observed, accompanied by a corresponding drop in physiological
measures and an observed improvement in behaviour. Improvements
were also observed in cooperation, aggression was reduced during the
lessons immediately following the science lessons.
Hallam and Price (1998) studied the effects of providing background
music in the classroom on the behaviour and performance on
mathematical tasks of ten children aged nine to ten attending a school
for children with emotional and behavioural difficulties, who exhibited
a high frequency of disruptive behaviour. The music consisted of
songs from children’s films and other music which was popular and
well known to the children—the music had been previously identified
by other children in the school as calming and relaxing. There was a
significant improvement in behaviour and mathematics performance for
all of the children. The effects were particularly marked for those whose
problems were related to constant stimulus-seeking and overactivity.
Reardon and Bell (1970) tested three predictions of the effects of
musical stimulation on the activity level of 11 six- to seventeen-year-old
304 The Power of Music

institutionalised boys with severe developmental delay. Participants’

activity scores during sedative and stimulating music were compared
with levels during silent baseline and non-musical, spoken recording
conditions. Fourteen behavioural categories were rated by trained
observers during eight hours of observations under each of the
four conditions. Activity level varied significantly on the day of the
experimental work, suggesting that the novelty of the recordings was
a significant factor. Differences in activity due to the conditions tended
to confirm the prediction of lower activity levels during the more
stimulating music.

Older Adults and those with Cognitive Impairment

There has been increasing interest in the ways in which actively making
music and listening to it may help older people, and particularly those
with dementia. This section focuses on issues related to background
music and learning. For instance, Foster and Valentine (2001) studied
elderly individuals with mild to moderate, high-ability or moderate low-
ability dementia who answered autobiographical memory questions
drawn from three life eras (remote, medium-remote and recent) with
backgrounds of familiar music, novel music, cafeteria noise or quiet.
Recall was significantly better in the high-ability than the low-ability
group, in sound than in quiet, and in music than in noise. Recall was
significantly related to life era, declining from remote to recent memory.
The superiority of recall with music compared with noise was apparent
for recall from remote and medium-remote but not recent eras. The
findings may be interpreted in terms of enhanced arousal or attention
deployment, and a possible subsidiary role for associative facilitation
from the particular music.
Thompson and colleagues (2005) investigated the effect of listening
to an excerpt of Vivaldi’s Four Seasons on category fluency in healthy
older-adult controls and Alzheimer’s disease patients. Participants
completed two one-minute category-fluency tasks whilst listening
to an excerpt of Vivaldi and two one-minute category-fluency tasks
without music. The findings showed a positive effect of music on
category fluency, with performance in the music condition exceeding
performance without music in both the healthy older-adult control
 11. Music and Studying  305

participants and the Alzheimer’s disease patients. The findings

suggested that music enhanced attentional processes in healthy adults
and those with Alzheimer’s disease. Irish and colleagues (2006) studied
the enhancing effect of music on autobiographical memory recall in
ten individuals with mild Alzheimer’s disease and ten healthy elderly
matched individuals. Each participant was assessed on two occasions:
once in the music condition (listening to ‘Spring’ from Vivaldi’s ‘The
Four Seasons’) and once in silence. Considerable improvement was
found for Alzheimer individuals’ recall on an autobiographical memory
in the music condition. There were no differences in terms of overall
arousal using galvanic skin response recordings or attentional errors
during a sustained attention to response task. A significant reduction in
state anxiety was found in the music condition, suggesting that anxiety
reduction may be a potential mechanism underlying the enhancing
effect of music on autobiographical memory recall. Also using Vivaldi’s
‘Four Seasons’, Mammarella and colleagues (2007) examined whether
listening to music had a positive effect on older adults’ cognitive
performance on two working-memory tasks. Participants were presented
with the forward version of the digit-span task and phonemic-fluency
tests accompanied by classical music, white noise or no music. The
classical music significantly increased working-memory performance
compared with the no-music condition. The effect did not occur with
white noise.
It is particularly important to study the effect of background music in
older adults, since attentional control can be impaired in normal cognitive
ageing. Older adults tend to be more sensitive to distractions in the
environment (Darowski et al., 2008), although they also tend to be more
accurate in cognitive tasks than their younger counterparts, but slower
(Hsieh and Lin, 2014). Reaves and colleagues (2016) investigated the
impact of background music on a concurrent paired-associate learning
task in healthy young and older adults. Young and older adults listened
to music or sat in silence while simultaneously studying face-name
pairs. Participants’ memory for the pairs was then tested while listening
to either the same or different music. Participants also made subjective
ratings about how distracting they found each song to be. Despite the
fact that all participants rated music as more distracting than silence,
only older adults’ associative memory performance was impaired by
306 The Power of Music

music. These findings are consistent with theories that older adults may
fail to inhibit the processing of distracting task-irrelevant information.
Alain and Woods (1999) and Andrés and colleagues (2006)
demonstrated that adding irrelevant sounds to a visual discrimination
task impaired the reaction times of older adults more than young
adults, as well as the amplitude of the event-related potential linked
to the processing of distraction. Fernandez and colleagues (2020)
demonstrated that, compared to silence or sad and tender music,
joyful and highly arousing background music enhanced perceptual
judgements in a flanker task in both older and young adults, although
no background music effect was found on older adults’ attentional
control performance. However, this study used a modified version of
the flanker task, which measured several components of attention and
included cues before the trials. A more challenging task measuring
attentional control specifically might have produced different results.
Music has also been found to have an impact on arousal in older
people. For instance, Hirokawa (2004) examined the effects of
participants’ preferred music and relaxation instructions on older adults’
arousal and working memory. Fifteen female older adults participated
in ten minutes of three experimental conditions: participant preferred
music, relaxation instructions and silence. Four subcategories of arousal
level,—energy, tiredness, tension and calmness—were measured
before and after the experimental treatment. After each condition,
participants completed a working-memory test. The findings indicated
that music increased participants’ energy levels, while relaxation and
silence significantly decreased energy levels, and increased tiredness
and calmness. All experimental conditions decreased tension. Scores
on the working-memory test were not significantly different among the
conditions. There were no clear relationships between the four arousal
levels and working-memory scores. Overall, the findings indicated that
preferred music had the potential to increase older adults’ energetic
arousal and reduce tension.
The literature on episodic memory suggests that background
music may have positive effects on younger and healthy older adults
(Bottiroli et al., 2014; Ferreri et al., 2015), although it may be particularly
beneficial among older adults with cognitive impairment, contributing
to arousal, mood and reward systems. Music may also recruit brain
 11. Music and Studying  307

areas spared after degeneration, and elicit compensatory mechanisms

(Ferreri and Verga, 2016) which are not activated in healthy participants
under the same music stimulation. Alternatively, music may reduce
task-related anxiety, which is expected to be higher in cognitively
impaired participants. For instance, Ferreri and colleagues (2014)
investigated whether music could improve episodic memory in older
adults while decreasing prefrontal cortex activity. Sixteen healthy
older adults aged 64 to 65 encoded lists of words presented with or
without a musical background, while dorsolateral prefrontal cortex
activity was monitored using an eight-channel continuous wave near
infrared spectroscopy system. Behavioural results indicated a better
source-memory performance for words encoded with music compared
to words encoded with silence. There was a bilateral decrease of
oxyhaemoglobin values in the music-encoding condition compared to
the silence condition, suggesting that music modulated the activity of
the dorsolateral prefrontal cortex during encoding in a less demanding
direction. Overall, the results indicated that music can help older adults
in memory performance by decreasing their prefrontal cortex activity.

Reviews and Meta-Analyses

The number of reviews and meta-analyses on the impact of background
music on cognitive tasks is relatively limited compared with other
areas of research. In a review of studies adopting a priming condition
before performance on a cognitive task, Pietschnig and colleagues
(2010) observed that the Mozart effect (as first researched by Rauscher
and colleagues (1993)) had been difficult to replicate, leading to an
abundance of conflicting results. They conducted a meta-analysis of
nearly 40 studies involving over 3000 participants, and found a small
overall estimated effect for samples exposed to the Mozart sonata K.
448 and samples that had been exposed to a non-musical stimulus or no
stimulus at all preceding spatial-task performance. Calculation of effect
sizes for samples exposed to other musical stimuli and samples exposed
to non-musical stimuli or no stimuli at all yielded effects similar in
strength. There was also evidence for confounding publication bias,
requiring downward correction of effects. Overall, Pietschnig and
colleagues concluded that there were noticeably higher overall effects
308 The Power of Music

in studies performed by Rauscher and colleagues than in studies

performed by other researchers. Overall, they found little evidence for a
specific, performance-enhancing Mozart effect.
In a meta-analysis undertaken by Kämpfe and colleagues (2011),
the overall effect of listening to background music was established as
null. Further examination led the authors to the conclusion that this
finding was most likely caused by the averaging-out of specific effects,
such as improved arousal positively influencing achievement in sports,
or detrimental effects on reading or memory. Not all of the reviews have
come to quite such negative conclusions, in part because their focus was
different. For instance, Schwartz and colleagues (2017) undertook a
systematic literature review and identified 20 studies between 1970 and
2014 focusing on the role of contingent and noncontingent background
music to facilitate task engagement, enhance performance and alter
behaviour. They concluded that, although the research addressing
background music had mixed results, there was evidence suggesting
that this could be an effective strategy for increasing task engagement
and performance, and decreasing stimulatory behaviour for individuals
with developmental disabilities. As providing musical stimuli is
relatively inexpensive and may be less intrusive in comparison to other
strategies, they argued that its use merited additional study to explore
how and to what extent music could affect behaviour. Similarly, Peck and
colleagues (2016) reviewed existing anecdotal and empirical evidence
related to the enhancing effects of music exposure on cognitive function
and provided a discussion of the potential underlying mechanisms that
might explain music’s effects. Specifically, they outlined the potential
role of the dopaminergic system, the autonomic nervous system and
the default network in explaining how music may enhance memory
functions in persons with Alzheimer’s disease.
De la Mora Velasco and Hirumi (2020) synthesised the findings from
30 studies that examined the effects of background music on learning
from 2008 to 2018. Frequencies and percentages were used to describe
background music’s effects on learning across studies, the methods
used and the background music characteristics manipulated. They
concluded that the results were inconclusive and the findings from the
research were inconsistent. Drawing similar conclusions, Ferreri and
Verga (2016) reviewed the evidence for the role of background music
 11. Music and Studying  309

on verbal learning and memory. They argued that the existing research
provided conflicting findings. Although several studies had shown a
positive effect of music on the encoding and retrieval of verbal stimuli,
music had also been suggested to hinder mnemonic performance by
dividing attention. They argued that the extent to which music boosted
cognitive functions relied on the relative complexity of the musical and
verbal stimuli employed. Overall, background music has been found to
have beneficial, detrimental or no effect on a variety of behavioural and
psychological outcome measures. The reasons why this might be the
case are discussed below.

Explaining the Impact of Background Music on

Cognitive Performance
There are several theories which have attempted to explain how listening
to music prior to undertaking a cognitive task may enhance performance.
The first is a neural priming effect, associated specifically with spatial-
temporal reasoning. The second is the arousal and mood hypothesis
(Thompson et al., 2001), which suggests that music enhances arousal
and promotes a positive mood, consequently affecting and benefiting
attentional processes (Husain et al., 2002). This theory postulates that
introducing a preferred auditory background prior to a task makes the
task increasingly interesting, thereby enhancing the learner’s levels of
arousal, and that this level of heightened and increased arousal leads to
an increase in attention, thus enhancing performance.
The explanations of the effects of background music in terms of arousal
and mood also apply to music played in the background. Research has
demonstrated this effect when music is presented simultaneously with a
variety of executive tasks, such as cognitive flexibility, working memory
and attentional control (Fernandez et al., 2020; Jiang et al., 2011; Shih
et al., 2016; Thompson et al., 2005). However, not all of the available
research findings fit well within this theoretical relationship between
music and cognitive performance. For example, some research suggests
that highly pleasant music requires more attentional resources and thus
may impair cognitive performance in the context of attentional tasks
(Nemati et al., 2019). For instance, music can positively affect working
memory (Revelle and Loftus, 1989) which results in more material being
310 The Power of Music

processed by the learner consecutively, enhancing their performance,

while mood improvement enhances cognitive performance through
increased dopamine levels in the brain (Ashby et al., 1999). Explanations
relating to arousal also need to take account of anxiety, as some studies
have shown that high anxiety is associated with lower task efficiency
(Tanaka et al., 2006). Byrne and Eysenck (1995) also found that the
task efficiency of participants with high anxiety was lower than that of
low-anxiety participants. Where individuals select background music
themselves, there may be a rewarding effect in terms of the enjoyment it
may bring (Arnett, 1995).
Music may also interfere with cognitive processes. Concentrated
listening to music requires cognitive effort for processing, analysis and
extracting meaning (Berlyne, 1971). Listening to complex, arousal-
evoking music may therefore reduce the attentional space available
for task performance. When individuals play music while carrying
out a cognitive task, they do not attend to both the music and the task
simultaneously; attention switches between the two (Madsen, 1987).
Depending on their interest, their focus may be greater on the task or
the music.
Another explanation for the impact of music comes from its ability
to provide rewards. Salimpoor and colleagues (2013) point out that
listening to music is amongst the most rewarding experiences for humans.
Music has no functional resemblance to other rewarding stimuli, and
has no demonstrated biological value, yet individuals continue listening
to music for pleasure. It has been suggested that the pleasurable aspects
of music listening are related to changes in emotional arousal, although
this link has not been directly investigated. Salimpoor and colleagues
(2013), using methods of high temporal sensitivity, investigated
whether there was a systematic relationship between dynamic increases
in pleasure states and physiological indicators of emotional arousal,
including changes in heart rate, respiration, electrodermal activity, body
temperature and blood volume pulse. Twenty-six participants listened
to self-selected intensely pleasurable music and neutral music that
was individually selected for them based on low pleasure ratings they
provided based on other participants’ music. The ‘chills phenomenon’
was used to index intensely pleasurable responses to music. During music
listening, continuous real-time recordings of subjective pleasure states
 11. Music and Studying  311

and simultaneous recordings of sympathetic nervous system activity,

an objective measure of emotional arousal, were obtained. The findings
revealed a strong positive correlation between ratings of pleasure
and emotional arousal. Importantly, a dissociation was revealed, as
individuals who did not experience pleasure also showed no significant
increases in emotional arousal. There are broader implications for these
findings in that strongly felt emotions can be rewarding in the absence
of a physically tangible reward or specific functional goal.
Neuroscientific studies have established a relationship between
music, emotion and changed brain activity. For instance, Blood and
colleagues (1999) used positron emission tomography to examine
cerebral blood-flow changes related to affective responses to music.
Ten volunteers were scanned while listening to six versions of a novel
musical passage varying systematically in degree of dissonance.
Reciprocal cerebral blood-flow covariations were observed in several
distinct paralimbic and neocortical regions as a function of dissonance
and of perceived pleasantness versus unpleasantness. The findings
suggested that music may recruit neural mechanisms similar to those
previously associated with pleasant or unpleasant emotional states,
but different from those underlying other components of music
perception, and other emotions such as fear. In a later study, Blood and
Zatorre (2001) showed that intensely pleasurable responses to music
correlated with activity in the brain regions implicated in reward and
emotion. Positron emission tomography was used to study neural
mechanisms underlying intensely pleasant emotional responses to
music in ten university students aged between 20 and 30, each with
at least eight years of music training. Each participant selected one
piece of music that consistently elicited intensely pleasant emotional
responses, including chills. The music was all in the classical genre,
and included pieces such as Rachmaninov’s ‘Piano Concerto No. 3 in
D Minor’, ‘Opus 30’ and ‘Intermezzo Adagio’ and Barber’s ‘Adagio
for Strings’. These are instrumental works with no lyrics. Participants
reported that their emotional responses were intrinsic to the music
itself, producing minimal personal associations or memories. Cerebral
blood-flow changes were measured in response to participant-selected
music that elicited the highly pleasurable experience of shivers down
the spine or chills. Subjective reports of chills were accompanied by
312 The Power of Music

changes in heart rate, electromyogram measures and respiration.

As intensity of chills increased, cerebral blood flow increases and
decreases were observed in brain regions thought to be involved in
reward and motivation, emotion, and arousal, including the ventral
striatum, midbrain, amygdala, orbitofrontal cortex and ventral medial
prefrontal cortex. These brain structures are known to be active in
response to other euphoria-inducing stimuli, such as food, sex and
recreational drugs. This finding links music with biologically relevant,
survival-related stimuli via their common recruitment of brain
circuitry involved in pleasure and reward. Activity in these regions in
relation to reward processes is known to involve dopamine and opioid
systems, as well as other neurotransmitters. Dopaminergic activity
appears to be the common mechanism underlying reward response
to all naturally rewarding stimuli. Support for involvement of opioid
systems specifically in response to music comes from a preliminary
study that demonstrated that blocking opioid receptors with naloxone
decreased or inhibited the chills response in some participants. The
possibility of a direct functional interaction between the hippocampus
amygdala and midbrain is supported by the exactly opposite correlation
of dorsomedial midbrain and left hippocampus amygdala with
chills intensity. Thus, activation of the reward system by music may
maximise pleasure, not only by activating the reward system but also
by simultaneously decreasing activity in brain structures associated
with negative emotions. The amygdala and hippocampus both receive
inhibitory presynaptic input from cholinergic neurons, suggesting
a possible mechanism for decreased activity in these regions as a
consequence of activity increases in ventral striatum. Brain structures
correlating with intensely pleasant emotion differed considerably
from those observed during unpleasant or pleasant responses to
musical dissonance or consonance in an earlier study (Blood, 1999).
In particular, right parahippocampal activity—previously observed to
correlate with unpleasant responses to dissonance—did not correlate
with chills intensity, supporting the notion that parahippocampal
activity may be specifically related to negative emotion. In addition,
regions associated with reward-motivation circuitry, such as the ventral
striatum, dorsomedial midbrain, amygdala and hippocampus, were
found to correlate with chills intensity but not with the more mildly
 11. Music and Studying  313

pleasant emotion associated with consonance. These discrepancies

provide further evidence that different emotions are associated with
activity in different groups of brain structures.
Nemati and colleagues (2019) also investigated the neural correlates
of pleasure induced by listening to highly pleasant and neutral musical
excerpts, using electroencephalography. Power-spectrum analysis of the
data showed a distinct gradual change in the power of low-frequency
oscillations in response to highly pleasant, but not neutral, musical
excerpts. Specifically, listening to highly pleasant music was associated
with relatively higher oscillatory activity in the theta band over the
frontocentral area and in the alpha band over the parieto-occipital area,
and a gradual increase in the oscillatory power over time. Correlation
analysis between behavioural and electrophysiological data revealed
that theta power over the frontocentral electrodes was correlated
with subjective assessment of pleasantness while listening to music.
To study the link between attention and positive valence, volunteers
performed a delayed match-to-sample memory task while listening to
the musical excerpts. Their performances were significantly lower under
highly pleasant conditions compared to neutral conditions. Listening
to pleasant music requires higher degrees of attention, leading to the
observed decline in memory performance. Gradual development of
low-frequency oscillations in the frontal and posterior areas may be (at
least partly) due to gradual recruitment of higher levels of attention
over time in response to pleasurable music.
As demonstrated in the earlier sections of this chapter, any single
research project generally has a limited focus, and cannot take account
of the complexity underlying the impact of background music on task
performance. There are also methodological issues relating to the
types of task considered. These have included reading comprehension,
the completion of mathematical tasks, a range of memory tasks and
those relating to attention. There is also an issue relating to how
the impact on performance of those tasks is assessed—for instance,
physiologically, neurologically, by task performance, observation
or rating scales. This is particularly important, as the relationships
between these different measures are frequently inconsistent. There
are challenges in systematically categorising the nature of the music
used in terms of its potential to arouse or generate different moods
314 The Power of Music

and the extent to which it is liked or disliked. The music can vary in
genre, tempo, timbre, intensity, type (instrumental or vocal), and use
of consonance versus dissonance. The relationships between these are
complex (Salimpoor et al., 2009), although generally music influences
physiological arousal in the expected direction: that is, exciting music
leads to increased arousal, calming music the reverse (Abeles and
Chung, 1996). These responses are based on pre-wired connections
related to the primitive elements of music—for example, loudness,
timbre, pitch, and tempo (Peretz, 2010). Favourite music, whether
stimulating or relaxing, tends to lower the experience of tension,
although not necessarily having a similar impact on physiological
responses (Iwanaga and Moroki, 1999). It may also act as a distraction
to completion of the task. Finally, there are the subjective aspects of
music perception. Individuals respond to the same music in very
different ways depending on their musical preferences and their
individual characteristics. The structural features of the music (tempo,
modality, instrumentation, genre), cultural factors (aspects of the
environment including tonality and the way that musical associations
are culturally shaped and learned) and associative factors (for example,
the personal and subjective meanings placed on a particular piece of
music depending on musical experiences) all play a part in responses
to music. Where associative factors come into play, the structural
and cultural aspects of the music are superseded by personal and
associative aspects (see Figure 11.1). Preference may therefore render
very different types of music as functionally equivalent. For example,
the music which young people may choose to play while studying
may differ widely but lead to similar physiological effects. Music may
be linked with particular experiences in an individual’s life, evoking
pleasant or distressing memories (Robazza et al., 1994). It is also related
to identity (MacDonald et al., 2009). Quite different music can thus
change mood in the same direction (Field et al., 1998). Formal music
training, perhaps because of its impact on identity, affects responses
but there are no clear patterns relating to gender, age or social class
(Abeles and Chung, 1996). The complex and interacting nature of the
factors which influence responses mean that it is difficult to predict the
exact effects of any particular piece of music on any individual.
 11. Music and Studying  315

Figure 11.1

There are, of course, interactions between these various factors.

In relation to the undertaking of cognitive tasks, a key one is the
relationship between the difficulty of the task and the optimal level
of arousal needed to undertake it. The Yerkes–Dodson law provides
one explanation, stating that arousal levels increase performance up
to an optimal level, beyond which overarousal leads to deterioration.
Arousal is known to act according to an inverted U shape, where both
extremely low and extremely high arousal damages performance, while
moderate levels benefit it. This occurs more quickly when the task to
be performed is complex or underlearned. Completing a simple task
requires a higher level of arousal for concentration to be maintained,
while complex tasks require lower arousal levels. Evidence of the way
that loud and fast music disrupts reading comprehension (a complex
task) supports this explanation (Thompson et al., 2012). Personality
factors are also implicated in optimal arousal levels. Introverts have
higher resting levels of arousal than extroverts, and are more susceptible
to overarousal, which impacts on their task performance when there is
background music (Cassidy and MacDonald, 2007; Dobbs et al., 2011).
Related to this is the attention drainage effect, which describes attention
as a reservoir of mental energy from which resources are drawn to meet
situational attentional demands for task processing (Kahneman, 1973;
Chou, 2010). Music may, in some circumstances, draw attention away
from the task, as it is only possible to pay attention to one thing at a
time (Madsen, 1987). For instance, music with lyrics is more likely to
interfere with a reading comprehension task than instrumental music
if the music is played concurrently with task completion, but this may
not apply if the music is used to prime the activity. Music with lyrics
may not interfere with task completion if the task is non-verbal. In
316 The Power of Music

general, shared attentional resources are involved when processing

stimuli from different modalities, including music, and this can lead to
impairment in the processing of one or both modalities. Recently, there
has been particular interest in the impact of music on the elderly. This
has shown that different factors may come into play for this age group,
particularly if they are experiencing cognitive impairment. Music
played concurrently may distract from task completion, while music
played prior to the task may act to enhance motivation and arousal, thus
enhancing task performance. Addressing some of these issues, Gonzalez
and Aiello (2019) considered the interactions between music-based,
task-based, and performer-based characteristics. They hypothesised that
music, along with its complexity and volume, would facilitate simple
task performance and impair complex task performance, and that an
individual’s preference for external stimulation (a dimension of boredom
proneness) would moderate these effects. To test this, participants
completed cognitive tasks either in silence or with music of varying
complexity and volume. The findings showed that music generally
impaired complex task performance, complex music facilitated simple
task performance, and preference for external stimulation moderated
these effects.

An Explanatory Framework
Hallam and MacDonald (2016) discussed the subjective aspects of
music perception and how individuals benefited from music or not.
They considered how this varied and could even fluctuate within the
same listener, because individuals respond differently to the same music
depending on the features of the music itself, the individual’s cultural
context and additional experience-driven, associative aspects. Individual
preferences and ways of responding to music determine whether music
influences mood, level of arousal and the capacity to perform better
because of these physiological effects. Overall, the impact of background
music on performance on any particular task depends on many
interacting factors. Figure 11.2 sets out a model of possible contributory
factors including the nature of the music itself: its genre, whether it is
stimulating or relaxing, its complexity, whether it is familiar, liked, vocal
or instrumental, and has been selected by the individual listening to it or
 11. Music and Studying  317

imposed on them by others. The model suggests that the effects of music
are mediated by the characteristics of the individual: their age, ability,
personality, metacognitive skills, musical expertise, familiarity with
the music being played and the frequency with which they normally
listen to music when they are studying. The current emotional arousal
and mood state of the individual may also be influenced by individual
characteristics and recent life events. Individual characteristics also
have a direct effect on learning outcomes, and a further indirect effect
through metacognitive activity. The environment within which the
activity is taking place may also be important—for instance, whether
the individual is alone or in a familiar place, and whether there are other
distractions. The characteristics of the task (for instance, the nature of
the processing required, its difficulty, and whether it is perceived as
interesting or boring) will also play a part. Currently, little research
takes account of all of these factors. Individuals need to be aware of the
impact of music on their task performance and adjust their behaviour
accordingly. As a general rule, background music which creates high
levels of arousal will disrupt work on complex tasks, although it may
prevent boredom if a task is repetitive or boring. Working in silence
or with relaxing music may enhance performance on a difficult task.
Preferred music is likely to have advantages over disliked music. Music
with lyrics may be disruptive, particularly if the task is verbal in nature
(see Figure 11.2).

Overview
It is clear that understanding how music can affect task performance
is complex and requires many factors to be taken into account. Each
individual needs to assess their own situation and the task facing them
at any given time, and make a decision as to whether music will assist or
disrupt their performance, then act accordingly. In the classroom, unless
calming music is used to simply lessen general exuberant behaviour,
working in silence is likely to be most beneficial to the majority of
students, unless they have particular behavioural difficulties or problems
with attention (for instance, ADHD or ADD).
 318
The Power of Music

Figure 11.2: A model of the effects of background music on behaviour and learning
(derived from Hallam and MacDonald, 2016)
 12. Re-Engagement
and Motivation

Active engagement with music has been shown to support the positive
development of young people who are from areas of high deprivation
and may be at risk of disaffection, not fully engaged with education,
exhibiting poor behaviour or involved in the criminal justice system.
Music has also been found to help with the rehabilitation of prisoners
and their successful reintegration into society. This chapter begins
by setting out the various influences on an individual’s motivation,
followed by an exploration of evidence as to how active engagement
with music may contribute to bringing about change.

Motivation
Lack of motivation is a problem in formal education across much of
the developed world. There is concern about high levels of student
boredom and disaffection, high dropout rates, poor attendance and poor
behaviour leading to exclusions from school, particularly in urban areas.
Some students report viewing school as boring, or as a game where they
try to do as well as they can with as little effort as possible. Disaffection
increases as students progress through school, particularly in the final
years of compulsory education. These issues are particularly acute in
boys, some ethnic minorities and those with special educational needs.
Young people from lower socioeconomic groups are underrepresented
in higher education, and those who take up opportunities to participate
in formal education as mature adults tend to be those who have already
been relatively successful. There is a substantial group of individuals
whose motivation is insufficient to sustain engagement with formal
learning in the short-, medium- and long-term.

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.12

320 The Power of Music

The complex interactions which occur between the environment

and the individual which influence self-development, motivation and
ultimately behaviour are set out in Figure 12.1. An individual’s identity
or self-concept represents the way he or she thinks about him or herself
and his or her relationships with others (Mead, 1934; Rogers, 1961;
Sullivan, 1964). Identity is developed in response to feedback received
from the environment. The desire for social approval, particularly from
those we admire and respect, leads us to behave in particular ways. Over
time, values and beliefs leading to behaviour associated with praise
are internalised. Positive feedback from others raises self-esteem and
enhances confidence. Identity develops as a result of these processes.
The family has a crucial role to play in this process in the early years
but as the child’s social contacts broaden, others (including teachers
and peers) become important. Individuals set themselves goals, which
determine their behaviour. Goals are influenced by identity, ideal and
possible selves, as well as environmental factors. Behaviour is the end
link in the chain, but at the time of enactment, it too can be influenced
and changed by environmental factors. There is interaction between the
environment and the individual at every level in the long- and short-
term. Individuals can also act upon the environment to change it or seek
out new environments more conducive to their needs.
Behaviour is influenced by the individual’s interpretation of
situations and events, their expectations and the goals that they have,
which mediate and regulate behaviour (Mischel, 1973). While each
individual has needs and desires, these are tempered by consideration
of the consequences of actions prior to attempts to satisfy them.
Cognition plays a role in the ways in which we attempt to enhance our
self-esteem, leading us to attribute our success or failure to causes which
will allow us to maintain a consistent view of ourselves. When a learner
has completed a learning task successfully, this will have an impact on
self-esteem and motivation which will be carried forward to subsequent
learning tasks. Conversely, when learning outcomes are negative,
motivation is usually (but not always) impaired.
There are complex interactions between learning and motivation.
The more successful and enjoyable our learning in a domain, the more
likely we are to be motivated to continue engaging with it. At the same
time, the more interested and motivated we are in a domain, the more
 12. Re-Engagement and Motivation  321

likely we are to persist when we fail or face difficulties, particularly if we

believe that, ultimately, we can be successful. If early engagement with
learning in a particular domain is enjoyable and positively rewarded, self-
efficacy beliefs are supported and learning continues. This brings further
rewards and a positive possible self develops in that domain-enhancing
motivation and increasing persistence for the future. Motivation to learn
is related to identity and the goals individuals set for themselves in the
short-, medium- and long-term. The value attached to learning tasks is
related to the extent to which they support this developing identity and
the goals derived from it. Throughout life, an individual will engage
with learning across several domains and it is inevitable that they will
be more successful and interested in some domains than others, and that
some will be more closely linked with their personal goals. From time
to time, personal goals may be in conflict and individuals may have to
make choices based on their relative importance. The difficulty during
the years of compulsory schooling, and on occasion after that (when
individuals may be required to undertake further training), is that in
these circumstances the individual’s freedom to choose what and how
to learn is removed. If there is little relationship between personal goals
and those determined by the educational system and teachers working
within it, then motivation is likely to be poor and learners are likely
to become disaffected. The more closely the goals of learners, teachers
and educational systems are matched, the more likely that effective
learning will occur. Motivation is crucial in how well children perform
at school and is closely linked to self-perceptions of ability, self-efficacy
and aspirations (Hallam, 2005). Actively engaging with music can
help enhance motivation and change behaviour through changing self-
beliefs and aspirations, and through the transferable skills that it can
develop. A study by the Norwegian Research Council for Science and
Humanities supported this, finding a connection between having musical
competence and high motivation, which led to a greater likelihood of
success in school (Lillemyr, 1983). There were high correlations between
positive self-perception, cognitive competence, self-esteem, and interest
and involvement in school music.
322 The Power of Music

Motivation Developed through

Engagement with Music
The process of learning to play an instrument or sing frequently requires
hours of practice, typically in solitude, and a commitment to music even
when there are competing curricular and extracurricular activities. This
may foster motivation-related characteristics (Evans, 2015; Evans and
Liu, 2019). Students who learn that repeated music practice can lead to
the mastery of complex skills and the achievement of desired outcomes
(such as positive examination outcomes or successful performances)
develop a mastery-focused learning approach (Degé and Schwarzer,
2017). This may lead to the internalisation of a sense of self-efficacy,
which may then be applied to learning in non-musical domains.
Bandura (2005) suggests that efficacy beliefs are multifaceted,
although they may covary across distinct domains of functioning.
Self-efficacy developed in one area of learning may generalise to other
areas. For instance, self-efficacy developed through learning in music
may generalise to other areas of learning, particularly when similar
subskills are involved. Similarly, self-regulation acquired through
music may generalise to other areas. Such transfer of self-efficacy or
other motivation-related characteristics is plausible given the parallels
between music education and traditional academic subjects. Instruction
and feedback are required for both, and there are tangible outcomes
in relation to examinations or performance. Self-efficacy is associated
with achievement (Caprara et al., 2011), while mastery-learning and
self-efficacy develop in an iterative, mutually reinforcing manner
(McPherson and Renwich, 2011). Some research has demonstrated
how recognition for achievement in music, leading to high levels of self-
efficacy, can enhance self-efficacy and self-esteem, which then transfers
to motivation for other schoolwork. For instance, McPherson and O’Neill
(2010) found that students who were engaged in learning music reported
higher competence beliefs and values and lower task difficulty across all
school subjects in comparison with those not engaged in making music.
Overall, having experience of learning to play an instrument or sing
enhanced motivation for other school subjects.
Burnard (2008) explored the attempts of three secondary-school
music teachers to re-engage disaffected young people through music
 12. Re-Engagement and Motivation  323

lessons. They reported that they democratised music-learning,

emphasised creative projects and used digital resources. Similarly, the
Musical Futures project was designed to devise new ways of engaging
young people (aged 11 to 19) in music activities. Initially, this entailed
young people working in small groups, learning to copy recordings of
popular music by ear. A large-scale evaluation of the project showed
that the music teachers perceived students to be more motivated, better
behaved and demonstrating higher levels of participation, greater focus,
enhanced musical skills, more confidence, improved small-group and
independent-learning skills, and enhanced leadership skills. Those who
benefited the most were lower- and middle-ability students (Hallam et
al., 2017). The pupils themselves reported improved listening skills and
an impact on other schoolwork, including less reliance on the teacher,
enhanced concentration and using music to help with other subjects
(for instance, making up songs to help with remembering facts). Team-
working skills also transferred to other lessons (Hallam et al., 2018). Non-
music staff in the participating schools also reported that the Musical
Futures approach had had a positive impact on student motivation,
wellbeing, self-esteem, concentration, organisation, attitudes towards
learning, progression and team-working (Hallam et al., 2016).
Similarly, students randomly assigned to weekly piano lessons over
the course of three years demonstrated gains in self-esteem, particularly
its academic dimension, whereas a control group showed no such
gains (Costa-Giomi, 2004). A quasi-experimental study revealed that
students who received a higher number of music lessons over several
years reported gains in academic self-concept that were unmatched by
those in a comparison group (Rickard et al., 2013). Positive relationships
have also been reported between the number of music lessons taken
and academic self-concept (Degé et al., 2014) and higher levels of
musical engagement (Degé et al., 2014; Degé and Schwarzer, 2017).
The experiences of students in musical groups may also contribute to a
general sense of accomplishment and collaboration, which may support
enhanced interactions in school, leading to a more positive school
climate, greater academic achievement and decreased disaffection
(Rumberger and Lim, 2008).
 324
The Power of Music

Figure 12.1: Model of motivation

 12. Re-Engagement and Motivation  325

Children and Young People Facing Challenging Life

Circumstances
Children born into areas of high deprivation face considerable life
challenges. Typically, they only acquire low-level skills and qualifications,
and in adulthood they are less likely to be employed and more likely to
have lower earnings than those from more affluent areas (Blanden et al.,
2008). Other long-term consequences include those relating to health
(mental and physical) and involvement in criminal activity (Feinstein
and Sabates, 2006). Parental involvement in their child’s education,
lack of cultural and social capital, negative experiences at school, low
aspirations and exposure to multiple risk factors are all implicated in
the relationship between deprivation and poor educational outcomes.
In relation to music, there is some evidence that children from deprived
areas are less likely to have played a musical instrument (Scharff, 2015)
and are more likely to have negative experiences with instrumental
teachers, interpreting this as their own failure and feeling less
comfortable and confident learning classical music (Bull, 2015).
Group music-making offers the opportunity to engage in wider
cultural experiences, explore new ideas, places and perspectives, and
support social cohesion through broadening experience (Israel, 2012).
This not only benefits participants but also increases parents’ attendance
at cultural events and their exposure to culture more generally (Creech
et al., 2016). A range of musical projects have focused on the role that
music can play in enhancing the lives of vulnerable children, providing
them with a range of transferable skills. Some of these programmes will
be discussed here, while others will be addressed in detail in Chapter 16,
which addresses issues of social inclusion (for instance, the inclusion of
refugee children), while Chapter 14 considers programmes supporting
the psychological wellbeing of children from war zones.
Music can be a vehicle for re-engaging young people in education and
supporting those who are at risk in making changes in their lives. The
context within which projects operate is important for their success, as
are the musical genres adopted and the quality of the musical facilitators.
Deane and colleagues (2011) found that, whilst music-making acted
as a hook in terms of initial project engagement, it was frequently the
326 The Power of Music

building of a trusting and a non-judgemental relationship between a

young person and their mentor that supported change.

El Sistema and Sistema-inspired Programmes

Internationally, the largest group of programmes supporting children
living in deprived areas and at risk of disaffection are El Sistema
programmes and those inspired by El Sistema. El Sistema was founded in
1975 as social action for music by Jean Antonio Abreu. It was premised
on a utopian dream in which an orchestra represented the ideal society—
and the idea was that, if a child was nurtured in that environment, it
would be better for society. El Sistema has survived through many
different administrations and has a large network of youth and children’s
orchestras. In addition, there are many programmes around the world
which have been inspired by El Sistema and share its values. The goal of El
Sistema is to use music for the protection of childhood through training,
rehabilitation and the prevention of criminal behaviour. Evaluations of
El Sistema or Sistema-inspired programmes show that they offer a safe
and structured environment which ensures that children are occupied
and at reduced risk of participating in less desirable activities (Creech
et al., 2013; 2016). Evaluations of individual programmes report that
children’s sense of individual and group identity is enhanced and that
children take pride in their accomplishments. They show increased
determination and persistence, and become better able to cope with
anger and express their emotions more effectively (Creech et al., 2013;
2016).

Raised Aspirations and Motivation for Learning

In England, Lewis and colleagues (2011) showed that participants in
a Sistema-inspired programme, In Harmony, exhibited more positive
attitudes and improved behaviour. Parents and teachers indicated that
the pupils had a greater sense of purpose and self-confidence, and their
aspirations were raised. This was, in part, attributed to contact with role
models in the form of the In Harmony teachers and other visiting artists
(Lewis et al., 2011). A prominent theme reported in the evaluation of Big
Noise, Scotland (GCPH, 2015) was the raised aspirations of participants.
 12. Re-Engagement and Motivation  327

The researchers reported qualitative evidence demonstrating enhanced

motivation, determination, willingness to be challenged, and the ability
to imagine and achieve goals, particularly amongst the secondary-
school participants. In particular, the aspirations of the 15- to 16-year-
olds were raised (GCPH, 2015). Qualitative interviews with 35 parents
of children involved in Big Noise, Scotland (Gen, 2011a) provided strong
evidence that they considered the programme to have enriched their
children’s lives. Twenty-nine parents took part in a quantitative survey,
which revealed a positive impact attributed to Big Noise with regard to
confidence, friendships, hope for the future, happiness, concentration
and behaviour.
Not all of the research on Sistema-inspired projects has been positive.
For instance, Rimmer (2018) explored children’s reflections on the value
of their participation in the English programme, In Harmony. Interviews
were undertaken with 111 primary-school children aged six to eleven,
from three programmes in Newcastle, Telford and Norwich. Parents,
siblings and the school environment were all important in the way
participating children viewed the programme. The value of engaging
with music in the family was particularly important in influencing
the children. Challenges in handling or holding instruments—and
perceptions of the sounds created as somehow lacking in desirable
qualities—emerged. The absence within the programme of some of the
valued visual, representational and kinetic aspects of popular music
emerged in many accounts. The compulsory nature of In Harmony
participation contrasted with the valued dimensions of popular music-
related activities which were associated with freedom, choice, self-
directedness and play.
Raised aspirations were noted by Uy (2010) in the Chicago núcleo of
Chacao, where all of the students were enrolled in high school, university
or conservatoires, with 40 percent of those studying music while
others pursued careers in engineering, medicine or other subjects. In
comparison with other underprivileged communities, Uy described this
as astounding. Other programmes reported similar raised aspirations and
self-beliefs, including The Boston Conservatory Lab Charter School (2012),
El Sistema Colorado (2013), In Harmony Stockton, Kalamazoo Kids in Tune,
KidZNotes, OrchKids, The San Diego Community Opus Project, YOLA, The
People’s Music School Youth Orchestras and El Sistema Chicago. Numerous
328 The Power of Music

USA programmes have included measures in their evaluations which

demonstrate the successes they have achieved in realising motivational
goals (Case, 2013; Duckworth, 2013; In Harmony Stockton, 2013;
Orchestrating Diversity, 2013; Silk et al., 2008; and Smith, 2013—for a
review, see Creech et al., 2013; 2016). Other programmes report similar
findings. For instance, Devroop (2009) explored the effects of music
tuition on the career plans of disadvantaged South-African youth and
found positive outcomes, while Galarce and colleagues (2012) reported
that academic aspirations had improved as a result of engagement in
the programme and that students were less likely to procrastinate in
their schoolwork. Similarly, Cuesta (2008) found that 63 percent of
participants achieved better outcomes in school compared with 50
percent of non-participants, while Wald (2011) researched two Sistema-
inspired programmes in Argentina and found evidence of enhanced
motivation and commitment. Programmes in Scotland and Ireland also
showed enhanced aspirations, engagement with learning and improved
behaviour (Kenny and Moore, 2011). In their review, overall, Creech
and colleagues (2013; 2016) concluded that raised aspirations were one
of the most frequently cited positive outcomes of El Sistema and Sistema-
inspired programmes.
In some programmes (for instance, In Harmony Liverpool) changes
in aspirations were not restricted to the children participating in the
programme but extended across the community. Burns (2016) showed
progress in academic attainment at age 11, enhanced musical attainment,
and enhanced perceptions of children’s social and emotional wellbeing.
Parents and carers noted changes in musical ability, communication,
confidence, focus, concentration and behaviour. As families engaged
with the musical activities and the children took home new skills and
shared them with other family members, there was a direct impact
on family life. Individual aspiration and community pride changed,
creating a virtuous cycle of change. In what was perceived as a
severely deprived area, residents now saw some hope. Also working
in Liverpool, Robinson (2015) found that parents participating in the
research were actively supporting their children and felt that their
lives had been transformed, as their children developed new skills and
had greater opportunities, experiences of other places and a greater
appreciation of music.
 12. Re-Engagement and Motivation  329

In an evaluation of all of the English Sistema-inspired programmes,

Lord and colleagues (2013) collected evidence through pupil surveys,
including a matched-comparison sample drawn from schools not
participating in In Harmony, as well as case study interviews. The
findings showed improvements in pupils’ attitudes to learning, self-
confidence, self-esteem, wellbeing and aspirations to improve. This was
borne out by the national inspection agency for schools, Ofsted, whose
reports highlighted pupils’ social, emotional and spiritual wellbeing.
They attributed this (at least in part) to participation in In Harmony.
These positive wellbeing outcomes were thought to be influenced by
the group work ethic which involved discipline, focus and teamwork.
Comparison between the well-established In Harmony programmes
in England (Liverpool and Lambeth) with more recently established
programmes revealed statistically significant differences with regard to
children’s application of self to learning and their view of their future
prospects. Children from the more established In Harmony schools
who had participated in the programme for longer had more positive
scores, suggesting that the programme had had a positive impact with
regards to dispositions towards learning and future aspirations. When
the established In Harmony schools were compared with matched-
comparison schools not accessing In Harmony, statistically significant
differences were also found in relation to application of self to learning
and children’s views of their future prospects, as well as self-assurance,
security and happiness. It seemed that, over time, the programme
impacted on children’s wellbeing, leading them to become young,
confident learners with clear future aspirations.
An evaluation of a summer residential orchestral programme also
demonstrated the impact on personal wellbeing amongst participants
(NPC, 2012; Hay, 2013). Thirty-five young people aged nine to eighteen,
including some with special educational needs, completed a survey of
wellbeing before and after the course. While caution must be exercised
in interpreting the data—as the sample size was small—there were
indications of enhancement in self-esteem, emotional wellbeing,
resilience and life satisfaction. A large effect size was reported for each
of these measures, although the girls seemed to benefit more than the
boys. Compared with national baseline scores for these measures, boys’
post course scores for self-esteem and resilience were in the top quartile
of what might be expected in a national sample.
330 The Power of Music

Uy (2010) carried out a cross-cultural comparison of El Sistema

in Venezuela and the USA, and reported consistency with regard to
positive outcomes relating to personal development. Overall, parents
and students from both contexts reported improvements in focus and
discipline, time management, relaxation and coping, communication,
ability to work with others, academic performance and aspirations,
creative thinking, and self-esteem. In South America, considering the
impact of the Batuta, Colombia programmes, which offer strategies for
social, educational and cultural development, and support the national
system of youth orchestras in Colombia, Cuéllar (2010) drew on key
findings from the CreCe report (Matijasevic et al., 2008). Qualitative
data provided examples of personal development similar to those
reported elsewhere. Students reported positive changes in respect,
tolerance, honesty, solidarity, teamwork, sense of responsibility and
emotional regulation which helped control aggressiveness, intolerance
and impatience. Self-esteem was enhanced, particularly self-efficacy,
through feeling competent. Students also reported greater self-care,
resilience, happiness and enhanced aspirations. Their social networks
were greater and there were enhanced family interactions.
Many USA programmes identified elevated aspirations and goals
as key to bringing about change. They included in their evaluations
measures to assess these, which demonstrated their success (Case,
2013; Conservatory Lab Charter school, 2012; Duckworth, 2013; In
Harmony Stockton, 2013; Orchestrating Diversity, 2013; Renaissance
Arts Academy, 2012a; 2012b; 2013; Silk et al., 2008; Smith, 2013; The
People’s Music School Youth Orchestras - El Sistema Chicago, 2013). For
instance, the Renaissance Arts Academy in Los Angeles demonstrated
elevated academic and professional aspirations in their students as a
result of participating in an academically and musically rigorous intense
programme. Their high graduation rate of 100 percent, coupled with the
percentage of students who continued their education at university, 95
percent exemplified the huge transformations that occurred, in terms
of not only what students believed they could accomplish, but also the
goals and expectations that they set for themselves as a result of this
realisation. Accomplishments in music and the arts transferred to their
beliefs about their academic capabilities, and their elevated goals and
achievements in both these areas showed the shifts that can take place
 12. Re-Engagement and Motivation  331

in possibilities as a result. Many other programmes have measured and

reported raised aspirations and greater self-esteem amongst students.
In the Caribbean, OASIS—a Sistema-inspired orchestral programme
established for youth at risk—showed that, after a six-month period of
participation, students were significantly less likely to be provoked to
anger and display aggressive behaviours including teasing, shoving,
hitting, kicking or fighting, or to be involved with delinquent peers. They
also had higher educational aspirations. After 18 months, the findings
showed positive overall outcomes (Galarce et al., 2012). In terms of
academic aspirations, 62 percent of the OASIS group, as compared with
41 percent of a control group, expressed hopes to be able to obtain a
doctoral degree. Increases in self-regulation were also seen. Seven
percent of the OASIS group, as compared to 21 percent of the non-
OASIS students, reported speaking inappropriately to others. They were
also less likely to report that pleasurable activities prevented them from
achieving their work goals and were less likely to procrastinate in their
schoolwork, be involved in fights, or use alcohol or marijuana. After the
six-month stage, the results from the Haitian programme were similar
to those of Jamaica, with OASIS students being significantly less likely to
be angered easily, less likely to be involved in aggressive behaviours and
to have delinquent peer relationships. Within 18 months, the results for
Haitian OASIS students mirrored those of Jamaica in terms of academic
aspirations, with 80 percent as opposed to 61 percent hoping to attain a
doctoral degree. They were also less likely to have disagreements with
parents or caregivers, and were more likely to be involved in sports.

Self-Beliefs
Positive self-beliefs regarding what can be achieved (self-efficacy) and
what is possible (possible selves) are crucial to motivation. El Sistema
and Sistema-inspired programmes have prioritised the personal and
social development of participants, and many evaluations point to
the positive impact of the programme on self-beliefs (Esquaea Torres,
2001; 2004; Galarce et al., 2012; Israel, 2012; Uy, 2010). Participation in
two Argentinean Sistema-inspired orchestras was explored by Wald
(2011b) who found that students, parents, coordinators and directors
perceived participation in the orchestras as being related to self-esteem,
332 The Power of Music

self-worth, self-confidence, and pride about achievements, motivation

and commitment. Frequent opportunities for performance helped
to raise aspirations (Billaux, 2011) and created safe opportunities for
risk-taking (Uy, 2012) which allowed children to experience success on
many occasions, enhancing their self-efficacy and self-esteem.

School Attendance and Positive Attitudes

towards School
Creech and colleagues (2013; 2016), in their review of El Sistema and
Sistema-inspired programmes, showed that a major area of focus for
many American programmes was the impact on students’ rates of
attendance and punctuality at school. Several programmes documented
positive evidence regarding school attendance, including Austin
Soundwaves (2011-2012), In Harmony Stockton (2013), Kalamazoo Kids in
Tune (2013), KidZNotes (2012), OrchKids (Potter, 2013), The Renaissance
Arts Academy (2012a; 2012b; 2013), The San Diego Community Opus Project
(Smith, 2013), and the YOURS programme (2013). Evaluation findings
in America showed that Sistema participants generally increased their
attendance at school. The B Sharp Programme (Schurgin, 2012) reported
a decrease in absenteeism between 2012 and 2013, from an average of 6.5
days to 4.5 days per child. Many Sistema participants attended schools
where the majority of students qualified for free or reduced-price school
meals. Attendance rates at schools attended by Sistema students had
higher than state or local average evaluation results in the USA, and
showed that Sistema students generally had improved attendance at a
higher rate than the average for their schools.
In England, the primary school at which In Harmony Liverpool is
based saw a drop in absence from almost eight percent in 2009 to six
percent in 2012 (Burns and Bewick, 2012). This compared with a sector
average of five percent. Although absenteeism rose in 2010, an analysis
of attendance rates between 2009 and 2013 showed an overall significant
improvement, with a school average rate of absence of 6.5 percent by
2013 (Burns and Bewick, 2013). In contrast, in Scotland there was no
evidence showing that involvement in Big Noise improved attendance
(Gen, 2011a), although qualitative data did suggest that the programme
was making a difference in this regard. More recently, the 2015 report
 12. Re-Engagement and Motivation  333

suggested that the programme was associated with improved school

attendance. In Raploch, school attendance was 93 percent among Big
Noise participants, four percent higher than the eligible population.
Govanhill school data showed attendance among Big Noise participants
to be almost 93 percent—nearly two percent higher than the eligible
population (Glasgow Centre for Population Health, 2015). In Canada,
Morin (2014) found no improvements in school attendance, although
in New Zealand, Wilson and colleagues (2012)—reporting on Sistema
Aorearoa—indicated that there was a reasonable improvement in overall
attainment, engagement and social skills in school, but insufficient
data to comment on attendance. Overall, although the data relating to
attendance is mixed, there is some evidence of enhanced achievement.

Emotional and Behavioural Difficulties

Alemán and colleagues (2017) assessed the effects of a Sistema-inspired
music programme on children’s developmental functioning in the
context of high rates of exposure to violence. The trial was conducted
in 16 music centres during 2012 and 2013. In total, 2,914 children aged
six to fourteen participated, with approximately half receiving an
offer of admission to the programme in September 2012 and half in
September 2013. The children in the treatment group participated for
one semester more than the control-group children. After one year,
there was evidence of improved self-control and reduced behavioural
difficulties. The effects were larger among boys and children with less
educated mothers, especially those exposed to violence. Following
participation in the programme this group exhibited lower levels of
aggressive behaviour. The programme improved self-control and
reduced behavioural difficulties, with the effects concentrated among
subgroups of vulnerable children. In Columbia, Castaneda-Castaneda
(2009) explored the impact of intensive guitar workshops offered
as part of a rehabilitation programme on young people in a youth
detention centre. The findings showed improvements in musical and
citizenship skills.
334 The Power of Music

Transferable Skills
Parents and teachers of children participating in some of the El Sistema
or Sistema-inspired programmes referred to the way that the programme
developed transferable skills, including concentration (Hallam and
Burns. 2018). One parent commented:

‘The impact on the kids is enormous, the concentration. I’ve got nephews
in other schools and the difference is huge. Our kids can sit there in a
massive big place listening to classical music without coughing or
fidgeting and sit there and be well behaved for that length of time. There’s
not many primary kids who can do that. We’ve got special education
kids as well and they can do that.’

Another parent emphasised the impact on learning more generally.

‘These children are dedicated to this. Other areas of her learning have come on
in leaps and bounds because of this. Without a doubt it is the music.’

Some parents recognised the impact on confidence. ‘Their confidence has

gone up sky high. She says she’s really nervous but she seems calm.’ Another
parent commented: ‘The music brought my daughter out of her shell into a
confident young lady.’ Some of the older students were able to self-reflect
on the wider benefits of participation:

‘You learn things from it that you don’t learn at school. You learn lots
of skills for life and you make links with people, like being able to talk
to new people, like being able to work on things, so like, team work,
listening to others. So even if you don’t want to do music for a career, in
five years’ time you’ll have those skills and you’ll be able to say I learnt
this in orchestra and it will have paid off.’

The young people were also able to develop leadership skills from the
mentoring that they were engaged with. This was recognised by staff
and parents.

Music Interventions Unrelated to El Sistema

There are several music interventions in addition to El Sistema or
Sistema-inspired programmes which have been designed to support
disadvantaged children. For instance, Pasiali and Clark (2018) worked
with 20 children aged five to eleven years old on a programme that
 12. Re-Engagement and Motivation  335

consisted of eight 50-minute music sessions, where teaching social skills

through song lyrics and improvisation were central. Social competence,
antisocial behaviour and academic competence were assessed, and the
outcomes showed that the number of low-performance, high-risk skills
decreased significantly, while teacher assessment indicated significant
improvement in communication and a decrease in hyperactivity, autistic
behavioural tendencies, overall problem behaviours and internalisation.
Parent ratings generally mirrored those of teachers. Similarly, Millar
and colleagues (2020) reported positive outcomes for the COOL project,
a 12-month intervention which involved 16 sessions of participatory
music-making with 32 hard-to-reach young people aged 12 to 17. The
programme aimed to increase confidence and self-esteem, and improve
social skills through music that resonated with the young people’s lived
experience.
One study examined the impact of a singing programme, Sing Up,
on 48 children and young people (Hampshire and Matthijsse, 2010).
The findings indicated that participants’ self-confidence and aspirations
were enhanced, and that they developed new friendships and better
connections with parents. However, Hampshire and Matthijsse
cautioned that children and young people from privileged backgrounds
benefited more than those from disadvantaged backgrounds, as the
latter risked rejection by their existing friends due to the programme
being perceived as cheesy or gay. This emphasises the importance of any
musical intervention being seen as relevant to the participants.
School music lessons themselves can be therapeutic. For instance,
in a case study of a general music class in a Spanish public secondary
school, undertaken with disaffected learners who had received a total
of 130 reprimands throughout the school year for poor behaviour and
systematically rejecting school rules, Rusinek (2008) established that
they enjoyed their music lessons. This may have been because the music
teacher generated enthusiasm through an inclusive pedagogy in which
the principle of ‘music for all’ was adopted. Arrangements for percussion
instruments, in four to twelve parts, of pop, classical and film music
were played by each class. The goal of performance was shared by the
children and the teacher, and was widely accepted as an important part
of school culture. Similarly, an Australian study showed that a group
of boys who were identified with behavioural issues who engaged in a
336 The Power of Music

proactive music-making activity showed notable improvements in both

classroom cooperation and self-esteem. The drumming exercises in the
programme were among the most popular and connected closely to the
participants’ sense of maleness. The activities were fun and provided
opportunities for students to enhance positive values such as group
cohesion and self-esteem, along with their behavioural and social
competence (Smith, 2001).
Drumming seems to be a particularly effective form of musical
intervention when children are disaffected. It can support anger
management, team-building and substance-abuse recovery, leading
to an increase in self-esteem and the development of leadership skills
(Mikenas, 2003). Group drumming can foster a sense of cohesion, as
it teaches coordination and teamwork, with participants having to
assume different roles and work together (Drake, 2003). Faulkner and
colleagues (2012) developed a drumming programme as a way of
engaging at risk youth, while simultaneously incorporating themes and
discussions relating to healthy relationships with others. The evaluation
of the programme with a sample of 60 participants in Western
Australia’s wheatbelt region used quantitative and qualitative methods,
including informal discussions with staff and participants, observation,
participant and teacher questionnaires, and school attendance and
behavioural incident records. The findings showed an increase in scores
on a range of social indicators that demonstrated increased connection
with the school community. Also in Australia, O’Brien and Donelan
(2007) reported on the effectiveness of the creative arts as a diversionary
intervention for young people at risk. In this three-year government-
funded study, ten arts programmes were conducted across urban and
rural areas. The findings demonstrated that arts programmes could
have a significant and positive impact on marginalised young people,
offering opportunities for skill development and social inclusion, while
in Canada, Wright (2012) argued that music education in schools could
lead to social transformation
Research on the impact of music-making on children living in care
(looked-after children) in the UK has shown that engagement in high-
quality music-making projects can support the development of resilience
in dealing with challenges. Salmon and Rickaby (2014) researched how
developing a musical play could facilitate skills development, improve
 12. Re-Engagement and Motivation  337

mental health and strengthen resilience in young people in care.

Participants were able to develop new skills, confidence and resilience,
and felt more socially connected. In a review, Dillon (2010) showed
that music-making could contribute to improved negotiation skills and
cooperative working; learning to trust peers; developing the capacity
for self-expression and a stronger sense of self-awareness; increased
self-discipline and responsibility; a sense of achievement; feelings of
belonging and shared identity; and the opportunity to make friends
and develop positive relationships with adults. Music-making provided
respite from problems and opportunities to have fun. In addition, there
was evidence of increased confidence and the acquisition of a wide
range of skills. In Norway, Waaktaar and colleagues (2004), in a study of
young people who had experienced serious and or multiple life stresses
leading to behaviour difficulties, found that a music programme was
able to enhance resilience. Positive peer relationships and self-efficacy
also improved when the young men demonstrated coherence and
creativity as they produced a music video for public viewing. Zanders
(2015) also showed how music therapy could support young people in
foster care, helping to create stability and find resources and meaning
in their lives to promote healing, addressing the displacements, abuse,
grief and loss that many had experienced. In England, the evaluation
of the Youth Music mentoring programme, which included a total
of 419 mentees, showed that participants were aware of the musical
opportunities available to them and had increased their agency (as
assessed by feeling respected, capable and in control). Mentees indicated
enhanced ability to work with others, express themselves, respect other
people’s views and be punctual (Lonie, 2011). Similarly, Brown and
Nicklin (2019) explored the impact of a global youth-work project that
aimed to engage young people in social issues through the medium of
hip hop. Most participants—who were from a range of British ethnic
backgrounds—were not in education, employment or training, or were
otherwise identified as marginalised, due to having a criminal record
or being excluded from mainstream education. The project aimed to
challenge the exclusion implied by labels such as ‘marginalised’, and
value participants’ experiences, aiming to engage them with global and
social issues. The sessions ran over three years and considered financial
independence, political identity and mental health, with an overarching
338 The Power of Music

focus on money, power and respect. Activities were creative, including

lyric-writing, art, interviews and developing tracks to build self-
esteem. The outcomes showed that the project built self-esteem and
positive attitudes to learning. Participant perceptions suggested that the
programme provided them with positive experiences of learning and
skills development, thus enhancing self-esteem and reducing risk factors
for antisocial behaviour. Hip hop was used to connect young people to
social issues and engage them in learning, developing their transferable
skills and building confidence, as well as increasing their employability,
prosocial behaviour and engagement with social issues. Sessions were
interactive, facilitating dialogue and providing peer mentoring. Studio
facilities with recording equipment were available. Data included
project reports, interviews, field notes, session plans and feedback. The
findings suggested that opening informal spaces with opportunities for
creative experiential learning (such as hip hop) had positive outcomes
for young people and facilitated engagement with prosocial behaviours.
A review of 15 projects funded by Youth Music (Qa Research, 2012)
showed a range of positive outcomes associated with engaging those
not in education, employment or training, or those at risk, in music-
making activity. Outcomes included increased motivation to engage
in education, employment or voluntary activity, including gaining
qualifications, heightened aspirations and a more positive attitude
towards learning. Participants also developed a range of transferable
skills, including basic academic skills, listening, reasoning and decision-
making, concentration, focus, team-working, time-keeping, goal-setting
and meeting deadlines. There was also evidence of enhanced wellbeing
including increased self-esteem, self-respect, pride, empowerment, sense
of achievement and confidence, and an expansion of friendships, trust
and improved relationships with adults. Aggression, hyperactivity and
impulsivity decreased as participants learned to control their emotions.
The projects also broadened horizons, including increased awareness of
different cultures and traditions.
An evaluation of the European Social Fund project, Engaging
Disaffected Young People (Lancashire Learning Skills Council, 2003),
found that music and sport activities could encourage participants back
into learning by changing negative attitudes and perceptions towards
education. Following completion of the project, 85 percent of the 173
 12. Re-Engagement and Motivation  339

project participants were working towards a qualification. Alvaro and

colleagues (2010) evaluated the pilot phase of the European Union’s
E-motion project, which was designed to utilise youth-friendly music
software in order to engage 14- to 17-year-olds who had dropped out
of school, or who were at risk of dropping out. Three experimental pilot
programmes were delivered to groups containing between 19 and 26
students in single schools in three different countries: Italy, Romania and
the UK. Teachers completed a scorecard for each student at the beginning
and end of each programme. Overall, there were improvements in a
range of basic academic skills and personal skills including listening,
speaking and alcohol avoidance. Interviews also indicated a reduction
in offending, antisocial behaviour and substance abuse and, for some
participants, enhanced interest in schoolwork, improved school
attendance, attention, self-confidence, self-belief, motivation, cultural
awareness and communication skills.

School Attendance and Attitudes towards School

Taetle (1999) investigated the relationship between daily school
attendance and enrolment in fine arts electives. Three secondary schools
participated. Students were divided into three groups according to
their elective participation: fine arts courses only, non-fine arts courses
only, and a combination of fine arts and non-fine arts courses. Students
were then stratified according to grade point average (low or at risk,
medium and high). Attendance rates were computed as a percentage
of days absent. The findings showed that students with lower absence
rates had a higher grade point average, students not enrolled in fine
arts electives had significantly higher absence rates than those students
with at least one fine arts elective, and students with a low grade
point average (at risk) who were not enrolled in fine arts electives had
significantly higher absence rates than those students who were enrolled
in at least one fine arts elective. Similarly, Oreck and colleagues (1999)
reported that participants in an arts-based programme stated that their
involvement enabled them to make friends, establish support networks,
and feel accepted and valued. Davalos and colleagues (1999) examined
extracurricular activity, perception of school, ethnic identification, and
the association with school retention rates among Mexican American
340 The Power of Music

and white non-Hispanics. Participants engaging in extracurricular

activities were considerably more likely to be enrolled in school than
were those not participating. Similarly, Lashua (2005) and Lashua
and Fox (2007) studied a recreation project that taught young people
aged 14 to 20, mainly from Aboriginal backgrounds, to make their own
music using computers and studio production software. They showed
how participants with literacy problems were able to create complex,
spontaneous rhymes through the medium of rap. The participants
reported that the programme was meaningful and made school more
enjoyable, helping them to stay out of trouble. Activities such as rap
battles provided an acceptable outlet for aggression and enabled
participants to demonstrate their skills, gain respect and learn humility.

The Integration of Young People with Special

Educational Needs into Mainstream Education
Increasingly in Europe, young people with social, emotional and
behavioural difficulties are taught in mainstream schools. This
presents particular challenges for teachers. Many of these children
have difficulties in learning, which may or may not be related to their
behaviour. As a result, a prominent area of work in music therapy has
become the integration of children with special educational needs. This is
particularly the case in Germany and Italy, where government strategies
have focused on the integration of children with special educational
needs into mainstream schools. In Germany, Hippel and Laabs (2006),
Kartz (2000), Koch-Temming (1999), Kok (2006), Mahns (2002), Neels
and colleagues (1998) and Palmowski (1979) have explored how music
therapy could help children with special educational needs integrate
into mainstream classrooms. Similarly, in Italy, Pecoraro (2006) reviewed
how music therapy could help young children, some with special
educational needs, to learn in mainstream classes, while D’Ulisse and
colleagues (2001) also considered how music therapy could be applied
in schools. In the UK, some student music therapists have focused on the
role of music therapy in supporting children with special educational
needs in mainstream schools (Carson, 2007; Crookes, 2012; Hitch, 2010).
Historically, improvisation with individuals has been the principal
method adopted in music therapy (Darnley-Smith and Patey, 2003)
 12. Re-Engagement and Motivation  341

but increasingly music therapists work in a range of different contexts,

including in child and adolescent mental health services, with social
services, and in educational settings. Working in schools is a developing
area. Carr (2008) undertook a review of 57 relevant papers, 12 of
which included outcomes. Although successive governments in the
UK have been concerned with the wellbeing of children, in schools
music therapy has played a limited role. In a review, Carr and Wigram
(2009) found only ten papers which specifically addressed work
within mainstream schools. The main recipients were children with
mild emotional, behavioural or social problems. Different therapeutic
approaches were adopted. For instance, Jenkins (2006) advocated a
flexible approach, while Strange (1999; 2012) adopted client-centred
music therapy for emotionally disturbed teenagers who had moderate
language disabilities. Butterton (1993) used music in the pastoral care of
emotionally disturbed children aged 13 to 18 using psychotherapy with
music improvisation and drawing, while Nöcker-Ribaupierre and Wölfl
(2010) described a preventative approach, introducing music therapy
into two secondary boarding schools in Germany with the aim of
helping students to express their emotional state and release aggressive
tension. The project proved particularly successful in classes with
migrant students from diverse cultures, who were able to communicate
effectively through shared improvisation.
Pethybridge and Robertson (2010) suggested that music lessons
in schools should consist of improvisation, which they believed had
the potential to guide the student into areas of learning as a result of
experiences acquired through musical interaction. Students from a
language and communication unit attached to a mainstream school
participated in their study, which involved child-led creative music-
making and structured activities to enhance social skills. The findings
showed that working in small groups led to greater ability to address
educational objectives, both musical and non-musical. Further,
Pethybridge (2013) evaluated ways in which music therapists might
support teachers to offer interactive group music-making to children
with additional support needs. Working with a nursery teacher,
Pethybridge planned and delivered an 11-week intervention for three
children on the autistic spectrum. The findings showed that experiential
music therapy groups offered some level of transferable learning for
342 The Power of Music

teaching and support staff, and the potential for developing more
indirect approaches. Derrington, in a series of papers (2004; 2005;
2010; 2011, 2012; Derrington and Neale, 2012) also argued for the need
to offer music therapy in mainstream schools and pupil referral units
to disaffected young people, with an emphasis on creative activities
including song-writing, while McFerran (2020) reviewed the research
literature in education, mental health and community music, suggesting
that grouping knowledge in this way offered new perspectives on the
types of programmes offered and the way that they were evaluated.

School-Based Music Therapy Interventions for

Children with Emotional and Behavioural Difficulties
There are examples of the use of music therapy with young children. For
instance, Brackley (2012) describes the increasingly common need for
music therapy work in behavioural support programmes in pupil referral
units for children aged between five and nine, who have been excluded
from mainstream education. She referred to music therapy’s potential
to recreate the conditions of the early mother-infant relationship,
allowing the music therapist to revisit problematic stages of the pupil’s
early development and aid their ego development. Similarly, De Silva
(2006) also illustrated how music therapy could bring about radical
transformation in the behaviour and emotional interaction of younger
children, while Thomas (2014) undertook a qualitative case study of
two primary-school children with social, emotional and behavioural
difficulties, one who exhibited withdrawn behaviour, the other poor
behaviour. Music lesson interventions over a period of one year benefited
the children in terms of personal competence, self-regulation, self-
confidence and self-esteem; task competence, enjoyment, engagement,
motivation, social competence, collaboration and social connectedness.
Montello and Coon (1999) also studied the impact of active and
passive group music therapy with pre-adolescents with emotional,
learning and behavioural disorders. Teachers were asked to rate and
confirm changes in the students’ attention and motivation. After a period
of four months, there were significant changes in aggression, brought
about by the facilitation of self-expression, which provided a channel
for frustration, anger and aggression. Similarly, Horton (2005) showed
 12. Re-Engagement and Motivation  343

that group music therapy with female adolescents in an educational

treatment centre—involving stepping, a series of body percussive
movements such as foot-stamping and hand-clapping, and chanting
or singing—significantly increased group cohesion. The participating
adolescents were identified as being at risk of dropping out of school,
and were engaged in violent and risky sexual behaviours. The stepping
procedure promoted positive social behaviour.
Gold and colleagues (2001) assessed the benefits of music therapy
for those with emotional and behavioural difficulties, and showed
that children’s needs for relationships and opportunities for emotional
expression were met by the therapy. In a review, Gold and colleagues
(2004) analysed music therapy studies, comprising a total of 188
children and adolescents, and found that the benefits were greater
for those who had behavioural problems. Similarly, McIntyre (2007)
showed that nine weeks of music therapy with adolescent boys with
behavioural and or emotional disorders helped them to develop new
skills, enjoy music, experience group cohesion and increase self-esteem.
Hirst and Robertshaw (2003) investigated the impact of the Otherwise
Creative project, an intervention which involved a wide range of arts
activities (including music production and song-writing), targeting
young people in pupil referral units with a range of emotional and
behavioural difficulties. Following engagement in the project, the
participants demonstrated growth in confidence and self-esteem, and
an enhanced ability to communicate with staff and to resist negative
peer pressure. Chong and Kim (2010) examined how an after-school
education-oriented music therapy programme impacted on students.
The intervention lasted for 16 weeks and used musical activities
to promote academic, social and emotional skills. A rating system
completed by teachers assessed change and showed that social skills
and problem behaviour improved significantly, although there were no
improvements in academic competency.
Using drumming to promote self-expression, Ho and colleagues
(2011) compared the effects of 12 weeks of school-counsellor-led
drumming on social and emotional behaviour in two fifth-grade
intervention classes, with two standard control classes. The children in
the intervention classes improved significantly compared with controls
on multiple areas of social and emotional behaviour, as assessed by their
344 The Power of Music

teachers. Thompson and Tawell (2017) studied the effects of an arts-

based intervention on young people deemed at risk of school exclusion
because of social, emotional and behavioural difficulties. Eleven young
people aged 11 to 16 were studied using observations and interviews.
The interventions offered to the young people provided alternatives
to their personal, cultural and historical ways of experiencing the
world. Experimenting with different arts media and trying out ideas
enabled them to develop a new identity for themselves. The findings
suggested that imagination, invoked through the intervention, helped
the disengaged young people to change their perceptions of their future.
Sausser and Waller (2006) showed that, with proper planning
of musical activities, students could benefit from a music therapy
programme structured for the success of each individual. They reviewed
how music therapy had been used with students with emotional and
behavioural difficulties, and proposed a model of music therapy for
students in a psychoeducational setting. The model was designed to
combine the music therapy process with the nine-week grading period
of the school setting. It suggested ways for music therapy and other
therapeutic modalities to work collaboratively with students with
emotional and behavioural difficulties.
Krüger (2000) set up work in a contemporary secondary school in
Norway as part of a new strategy for helping secondary-aged students
with emotional and behavioural problems. The students had been
labelled as the ‘bad guys’ and were living up to this name. By gaining
attention because of their challenging behaviour, they were able to
maintain this role within the school. Krüger found the computer to
be a source of new meaning for those who had not learned to play an
instrument. Technology led to broad possibilities of exploring, mastering,
arranging, creating and improvising music. Participants quickly became
confident at using it and being in control. Krüger showed how one child
who had threatened other pupils, had very low respect for authority
and was difficult to talk to was able to engage in the therapy. Through
the shared use of information technology, the process of developing a
trusting and communicative relationship was enabled. Krüger reported
how he encouraged the boy to master recording techniques but also
allowed the child to express anger and shout at him to show that he
would always be there. This helped to create a bond and the opportunity
 12. Re-Engagement and Motivation  345

to talk about what was wrong in the child’s life. Ultimately, the process
of using information technology led to a product, and the child became
very involved in music-making, burning CDs and creating covers for
the CD cases, selling his work and even publishing his music on school
radio.
Some research has focused on interventions with children exhibiting
highly aggressive behaviour. For instance, Choi and colleagues (2010)
investigated 48 such children, who were allocated to either a music
intervention or a control group. The music intervention group engaged
in 50 minutes of musical activities twice weekly for 15 consecutive weeks.
After 15 weeks, the music intervention group showed a significant
reduction in aggression and improvement in self-esteem compared with
the control group. These findings suggested that music could reduce
aggressive behaviour and improve self-esteem in children with highly
aggressive behaviours. Similarly, Hashemian and colleagues (2015)
studied whether 12 90-minute music therapy sessions could reduce
aggression in visually impaired Iranian adolescents compared with
a control group matched in relation to age, socioeconomic status and
the education level of parents. Two behaviour questionnaires showed
a significant decline in aggression in the intervention group. Ye and
colleagues (2021) carried out a meta-analysis of research, exploring
whether music therapy could reduce aggressive behaviour in children
and adolescents. Ten studies were included. The research showed a
significant decrease in aggressive behaviour and a significant increase
in self-control compared with control groups, whereas there were no
differences in a music medicine group and the control group. Music
interventions with durations of less than 12 weeks and more sessions
per week were more efficient in reducing aggressive behaviour.
Some work has been undertaken with refugee students. For instance,
Baker and Jones (2005; 2006) studied the effects of a music therapy
programme in stabilising the behaviours of newly arrived refugee
students. The research examined the effects of a short-term music
therapy programme on changes to behaviour of 31 refugee youths
attending an English-language reception centre in Brisbane. Two five-
week intervention periods were employed, with group music therapy
sessions conducted once or twice a week. The findings indicated that
music therapy led to a significant decrease in externalising behaviours,
with particular reference to hyperactivity and aggression.
346 The Power of Music

One of the main aims of music therapy for children with emotional
and behavioural difficulties is to address behaviour within the
classroom. This is particularly prevalent in research in the USA. For
instance, Eidson (1989) studied the effect of behavioural music therapy
on the generalisation of interpersonal skills from therapy sessions to
the classroom by middle-school students with emotional difficulties.
Also in the USA, Haines (1989) studied the effects of music therapy on
the self-esteem of emotionally disturbed adolescents and showed that
music therapy enhanced group cohesion and cooperation. Krout and
Mason (1988,) using computers and electronic music resources, worked
with behaviourally disordered students aged 12 to 18, either in a self-
contained or integrated classroom. Students had the option of enrolling
in a music elective class which met three times each week, or of receiving
individual music therapy services that focused on learning a musical
instrument. Both programmes emphasised targeted social behaviours
or skills while learning about music. Kivland (1986) noted the effect
of individual music therapy sessions on self-esteem in an adolescent
boy with a diagnosis of conduct disorder. Self-esteem was measured
by frequency of both positive and negative self-statements, and by his
ability to accept positive comments appropriately. By the twelfth week
of therapy, he was able to list independently what he had done well
at each session, and was able to accept positive comments from others
appropriately. In addition, his ability to list what he had done well and
what he needed to improve transferred to other disciplines. In Canada,
Buchanan (2000), working in mainstream services, studied the effects of
music therapy interventions with adolescents aged 15 to 19 who were
designated as ‘at risk’. The intervention gave them an opportunity for
self-expression in a group setting. Similarly, Cheong-Clinch (2009)
studied the use of music as a tool to engage young people with English
as a second language in a high school and a residential care facility, in
particular newly arrived immigrant and refugee students.
Carr and Wigram (2009) identified existing research and clinical
activity utilising music therapy with mainstream children, as well as
a potential need for music therapy with this group of children. They
undertook a systematic review relating to work with children in
mainstream schools. Sixty papers were identified, 12 of which were
outcome studies. There was evidence that music therapy was used with
 12. Re-Engagement and Motivation  347

children in mainstream schools, both in the UK and abroad. They showed

that the literature at the time of the review suggested that music therapy
was effective in addressing the needs of mainstream schoolchildren—
several therapists had documented the benefits of music therapy as a
way to increase student’s self-esteem, address challenging behaviour,
motivate learning and help develop interpersonal relationships
(Procter, 2006), although more evidence was needed. Derrington (2012)
studied whether music therapy could improve the emotional wellbeing
of adolescents who were at risk of exclusion or underachievement. The
research took place in a mainstream secondary school and its federated
special school for students with emotional and behavioural difficulties.
Over 19 months, the intervention group received 20 weekly individual
music sessions, while a waiting-list comparison group received the
same treatment later. Quantitative data were collected four times
during the research from students, teaching staff and school records,
while the students were also interviewed. Very few pupils dropped out
and the majority of teachers reported improvement in students’ social
development and overall attitude.

The Role of Rap and Hip Hop in Therapy

in School Contexts
The cultural significance of music for youth populations has long been
recognised, both in terms of the performance and production of music
itself, and the stylised identities surrounding its consumption. Perhaps
it is not surprising, therefore, that music-based interventions have been
particularly effective at positively impacting the mental health and
wellbeing of young people. The kind of music which adolescents prefer
is related to their experience of emotional and behavioural difficulties
(Took and Weiss, 1994), including expressions of anger (Epstein et
al., 1990). Armstrong and Ricard (2016) suggest that rap, hip hop,
and rhythm and blues provide a cultural lens, through which many
urban adolescents forge identity and express themselves. The music
therefore has the potential to combat emotional and interpersonal
distress. Creative techniques that incorporate these genres of music can
be used to help adolescents understand and regulate coping responses
to difficult and emotionally sensitive situations. Schwartz and Fouts
348 The Power of Music

(2003), studying 164 adolescents who preferred light or heavy qualities

in music or had eclectic preferences, found that each of the three music
preference groups was inclined to demonstrate a unique profile of
personality dimensions and developmental issues. Those preferring
heavy or light music qualities indicated at least moderate difficulty in
negotiating some aspects of personality and/or developmental issues,
while those with more eclectic music preferences did not indicate
similar difficulties. Despite this, when Gardstrom (1999) examined
offenders’ perceptions of the relationship between exposure to music
and their criminal behaviour, only four percent perceived a connection
between their musical preferences and their deviant behaviour,
although 72 percent did believe that the music influenced the way that
they felt at least some of the time. Most believed that music mirrored
their lives rather than being a causative factor in their behaviour. Music
was perceived by some as being cathartic, and by some as only harmful
when applied to pre-existing states of negative arousal.
In 2000, Elligan introduced rap therapy as a psychotherapeutic
intervention for working with at-risk youths, primarily African-
American males whose identities were highly influenced by rap music.
Rap is able to engage a population of youth who often enter counselling
apprehensively (Elligan, 2000; 2004; Allen, 2005). Gonzalez and Grant
Hayes (2009) reviewed rap culture, its relationship to inner city youth
and the benefits of Elligan’s rap therapy with at-risk youth. Kobin
and Tyson (2006) also used rap lyrics as the impetus for therapeutic
dialogue and the facilitation of empathic connections between clients
and therapists. This aided in breaking the ice, encouraging participants
to engage in projective narration, and helped the therapist to establish
relevant, client-centred treatment goals. In Australia, de Roeper and
Savelsberg (2009) showed that taking part in a community-based hip-
hop culture project helped at-risk young people to develop confidence,
skills, ambition and a stronger sense of identity, although they urged
caution in interpreting the findings, as the data were limited.
Cobbett (2007) illustrated an integrative approach to working
therapeutically with individual children experiencing emotional and
behavioural difficulties, which combined music therapy with other
creative therapies, particularly play therapy and drama therapy. In 2009,
Cobbett developed the approach, suggesting that such interventions
would be more effective if they were available in schools and utilised
 12. Re-Engagement and Motivation  349

materials which were relevant to the young people concerned (e.g. rap
music or electronic music). In 2016, Cobbett compared 52 young people
receiving arts therapy—including music, drama or visual arts—and a
control sample of 29 young people on a waiting list over a year-long
period in two schools for children with emotional and behavioural
difficulties. Two outcome measures were used: a staff-rated Goodman’s
Strengths and Difficulties Questionnaire and a self-rated scoring
system. The Strengths and Difficulties Questionnaire outcomes showed
a significant difference in improvement for those in the therapy group
compared to the control group for all measures related to emotional
and conduct difficulties. The effect sizes were large. Three out of four
self-rated categories also showed significant differences in improvement
between the groups. Interviews with six young participants suggested
that the young people felt that the arts brought benefits that augmented
verbal interventions. Examples from the interviews are set out in Box
12.1. In a further paper (2016b), Cobbett outlined a systemic approach
which would further support young people.

Box 12.1: Teenagers’ comments about music therapy (derived from

Cobbett, 2016)

It helped me find music and I like music a lot now and I can play some
instruments. It made me discover a lot of stuff and things I was able to do.
It (music therapy) was easy because I know how to use Fruity Loops (a
music software programme) and I can make stick beats.
Sometimes the music helped me get stuff out of my head but sometimes it
was just calm too, it helped me cool down. Get myself away from the rest
of the world for a bit.
It was a good session because you wouldn’t only get to speak about any
problems you had in the day. You could also put it into some music.
It made me realize what I wanted to do and then I had to focus more on
my future.
If it was just blatant therapy it would put me off, like you need to speak
about things that you don’t want to talk about maybe, but when you’re
doing music or something you just feel yourself, it’s just expression of
yourself.
When we’re jamming away, while we’re doing it, we could speak about
what’s kind of bothering me or whatever and it kind of leads on from that.
350 The Power of Music

Parker and colleagues (2018) undertook a small-scale, qualitative

interview study in a secondary school over ten weeks with marginalised
and at-risk children. The programme was delivered by a team of young
people aged 18 to 25, the majority of whom had previous experience of
the criminal justice system. They facilitated a single, two-hour music
session once a week for approximately 15 pupils. All sessions took place
during the course of the normal school day and consisted of a series
of activities which involved lyric-writing, usually rap and composing
beats, mostly using Logic Pro software on Mac computers, although
those pupils who could play musical instruments also did so. The music
they composed was recorded and performed. The 32 students aged
13 to 16 were selected to participate because their general behaviour
had been disruptive and they had demonstrated defiant, angry,
aggressive behaviour towards other pupils and teachers. To remain
on the programme, they had to maintain positive interactions with
other students and teachers. Some were considered ‘at risk’ because of
previous involvement with the criminal justice system or involvement
with gangs. The students revealed in the interviews that music-making
increased their confidence, improved their attitudes towards teachers
and peers, induced feelings of calm, and improved their communication
skills. Parker and colleagues concluded that music-making activities
could provide significant psychosocial benefits for young people,
particularly when combined with mentoring support.
In a series of papers, Uhlig (2011a; 2011b; 2013; 2015) considered
how the voice could be used as a primary therapeutic instrument.
Initially, Uhlig worked with children with special educational needs in
a public-school setting in New York. She showed that at-risk children
demonstrated honesty in expressing their most personal desires and
fears through vocal music therapy. Cursing, shouting, singing, rapping,
chanting and song-writing helped them to survive their personal and
familiar environments, and increased their learning potential. Together
with the therapeutic relationship based on sharing rap, behavioural
changes occurred. In later research, Uhlig and colleagues (2013)
carried out a systematic review and reported that many studies had
demonstrated the effects of music on emotion and emotionally evoked
processes. In 2015, Uhlig and colleagues investigated the performance of
rap-music therapy in a non-clinical, school-based programme to support
 12. Re-Engagement and Motivation  351

the development of self-regulative abilities to promote wellbeing and to

reduce the risk of low academic performance attributable to troubled
mental health. All adolescents in Grade 8 of a public school were invited
to participate, and randomly assigned to either rap-music therapy or
to regular classes. The rap-music classes took place once a week over a
period of four months. Measures of change were taken at four monthly
intervals. Primary outcome data included measures of psychological
wellbeing, emotion regulation, self-esteem, self-description, language
development and executive functioning. Secondary outcome data
consisted of the subjective experiences of participants collected in
follow-up interviews with members of the experimental group. In 2016,
Uhlig and colleagues carried out a survey in the Netherlands of the use of
rap and singing by 336 qualified music therapists. The results indicated
that rapping and singing applications in music therapy could enhance
self-regulative skills during the process of emotional expression. Rapping
occurred considerably less frequently than singing but was considered
to decrease aggressive behaviour. Singing was applied daily and was
associated with the support of deeper emotional involvement. However,
the findings suggested the need for more consistent descriptions of
therapeutic interventions using rap styles in music therapy practice,
and the development of specialised protocols for research studying
its effects. In 2018, Uhlig and colleagues investigated ‘rap and sing’
music therapy in a school-based programme designed to support self-
regulative abilities. One-hundred and ninety adolescents in Grade 8 of a
public school in the Netherlands were randomly assigned to participate
or act as a control group. The intervention took place once a week over
a period of four months. Significant differences between groups were
found on the teacher Strength and Difficulties Questionnaire, indicating
stabilisation in the ‘rap and sing’ music group as opposed to increased
problems in the control group.
Porter (2012) also planned a trial to determine if improvised
music therapy could lead to clinically significant improvement in
communication and interaction skills in young people experiencing
social, emotional or behavioural problems. In 2017, Porter and
colleagues studied 251 children aged eight to sixteen with social,
emotional, behavioural and developmental difficulties from six child
and adolescent mental health service community-care facilities in
352 The Power of Music

Northern Ireland. The children were randomly allocated to 12 weekly

sessions of music therapy in addition to their usual care, or acted as a
control group. Follow-up occurred at 13 and 26 weeks. For participants
aged 13 and over in the intervention group, communication was
significantly improved, although this was not the case for their carers.
Overall, self-esteem was significantly improved and depression scores
were significantly lower at Week 13, although there was no significant
difference in family or social functioning at this time point. While the
findings provided some evidence for the benefits of the integration of
music therapy into clinical practice, differences between subgroups and
secondary outcomes indicated that further research was needed.
Olson-McBride and Page (2012) described the implementation of a
specialised poetry therapy intervention, which incorporated hip-hop
and rap music, with high-risk youths. The programme supported the
young people’s use of self-disclosure. The intervention involved creative
writing and the use of popular music, primarily from the rap and
rhythm and blues genres, during the receptive prescriptive component
of the session. In some sessions, the facilitator chose the music, but in
others group members did so. Group members created a collaborative
poem, a structured individual poem or an unstructured individual
poem. The symbolic ceremonial component of the session involved
group members reading the poems created during the session aloud
to the group and soliciting appropriate feedback. Each poetry-therapy
group intervention was ten sessions in length, lasting 45 to 60 minutes.
Three interventions were conducted with participants selected from
two facilities—an alternative school and a transitional living program
designed to meet the needs of individuals between the ages of 12 and
21 who were deemed ‘at risk’ due to problems such as family poverty,
family instability, academic problems and behaviour problems. The
majority of group participants had histories of serious externalising
behaviour problems. Some participants were in state custody as a result
of involvement with the juvenile justice system. Data were collected
for each group session via video camera. Overall, the intervention
fostered a group environment in which guarded, difficult-to-engage,
at-risk adolescents felt comfortable and connected enough to engage in
surprisingly honest and bold self-disclosure, an initial step in addressing
their problems.
 12. Re-Engagement and Motivation  353

Zarobe and Bungay (2017) undertook a rapid review exploring the

role of arts activities in promoting the mental wellbeing and resilience
of children and young people aged between 11 and 18. Only studies
related to activities that took place within community settings, and
those related to extracurricular activities based within schools, were
included. Eight papers covering a wide range of interventions were
included. It was found that participating in arts activities could have a
positive effect on self-confidence, self-esteem, relationships and sense of
belonging: qualities which are associated with resilience.

Music Programmes for Young Offenders

Adolescents who are in secure residential accommodation are frequently
angry, detached, frustrated and in conflict with their peers. They may
have experienced trauma, abuse, drug or alcohol use, peer pressure, or
gang-related activities. They often lack a structured home environment
and may also have learning difficulties or mental health problems. This
presents challenges to those attempting to rehabilitate them. Music has
been suggested as one possible means of engaging them. McKay (1956)
argued that music could benefit young people in juvenile institutions,
helping with teamwork and providing a means of letting off steam.
In South Africa, Lotter (2006) developed a music programme for
adolescents who had been referred by the courts as a means of social
rehabilitation. The programme was based on the Circle of Courage
which includes four components: belonging, mastery, independence
and generosity. The research explored how the Circle of Courage might
be integrated into music therapy. Thompson (2016) studied the role of
rap music composition in the experience of the incarceration of African-
American youth, while Nelson (1997) focused on high-risk adolescent
males’ self-efficacy in relation to choral performance. A systematic
review of research on the impact of active music-making on young
people at risk within the criminal justice system in the UK, Australia, the
USA, Canada and South Africa—undertaken by Daykin and colleagues
(2011)—showed that music offered the potential for improvement in self-
efficacy, self-esteem and self-concept. Overall, the review concluded that
music projects could help in positive-identity construction, providing a
safe means for young offenders to express difficult emotions and anger,
354 The Power of Music

although very short projects where participants were unable to meet

their goals could lead to frustration (de Roeper and Savelsberg, 2009).
Fouché and Torrance (2005), in South Africa, successfully worked
with rival gang members. The young people were brought to the venue
by police escort, having volunteered to join the project which met each
week. The participants shared their stories and improvised music
together. Within the gangs, music was perceived as a cool activity, and
rap and hip-hop culture made any musicians heroes. This supported
the process. Rapp-Paglicci and colleagues (2012) evaluated the Prodigy
cultural arts programme, an early prevention programme for at-risk
young people aged five to eighteen. The programme used visual and
performing arts to help young people develop life skills including
communication, leadership, problem-solving, anger management,
career aspirations and goal-setting. Each class was conducted by a
professional artist who served as teacher and mentor. Through art, the
young people built confidence, learned how to showcase their skills and
developed lifelong habits for future success. Over 95 percent of those
enrolled did not have contact with law enforcement, and those who
did only committed minor offences. Over 89 percent did not reoffend.
Prodigy students showed improvement in their ability to control
behaviour, affective responsiveness and academic self-efficacy. There was
a significant decrease in anger, depression, anxiety, suicidal thoughts,
somatic problems, risk behaviours and mental health symptoms, and
improved behavioural regulation in addition to increases in academic
performance.
Yun (2014) investigated how a music therapy programme was
experienced by violent juvenile offenders. Six adolescents participated
in 12 consecutive weeks of group music therapy sessions, and were
interviewed individually based on open-ended questions which
addressed their autonomy, competence and relatedness. The analysis
also investigated how the change brought about through the music
therapy transferred to their everyday life. Autonomy was promoted by
making choices about songs and instruments, deciding how to play,
and expressing opinions about music. Competence was associated with
developing skills on musical instruments, creating their own music,
concentrating on their own project and demonstrating their abilities,
while relatedness concerned collaborating, exchanging opinions and
 12. Re-Engagement and Motivation  355

playing a part in musical projects. In addition, participants’ behaviour

changed. They became more self-aware and there was greater mutual
exchange and group support. Changes were evident in their school life.
In the UK, De Viggiani and colleagues (2013; 2014) reported on a
three-year music project with 118 young people from 19 youth justice
programmes. Each music programme had up to ten participants and
ran for six half-days, each lasting from one-and-a-half to three hours.
The approach was active and participatory including singing, word
association, lyrics, artwork, instrumental work, music composition,
and the production of a CD or the giving of a live performance. Most
participants identified the music as being familiar and safe. For some
it brought credibility and celebrity success with peers, but also the
expression of criminal identity, genres associated with drugs, guns,
gangs and misogyny. There were a great many challenges for the
tutors in implementing the programme, including the highly varied
demographics of participants, their transience, drop-outs, lack of
opportunities for follow-up, dependence on gatekeepers, difficult group
dynamics, a lack of decision-making skills in participants, and passivity
or resistance as a self-preservation strategy. Despite this, the programme
showed the potential to support young people in coping with difficult
circumstances and, for some, delivering life-changing benefits. Also in
the UK, Anderson and Overy (2010) examined whether music and art
classes could engage young offenders in ongoing education. Fourteen
young offenders in Scotland voluntarily participated in the ten-week
study. Participants were divided into three groups: music, art and a
control education group. They completed pre- and post-interviews
and measures that examined their emotions, self-esteem, self-control
and literacy skills. Behavioural reports and enrolment in education
courses were reviewed for three months before and after the project.
The findings indicated increased engagement with education during
and after the project for individuals in the music and art groups but,
overall, the findings were mixed. There were increases in self-esteem
for the music intervention and control groups, but not for the art group.
All participants felt that they had less control over their behaviour
following the project, although emotion scores showed improvement in
the music and art groups, but not in the control group. Those in the
music and art group indicated that they found the sessions engaging
356 The Power of Music

and meaningful. There was a decrease in behaviour-related incidents—

for instance, breaking prison rules for the music group—as well as
increased engagement with education during and after the project for
the music and art groups, with the largest increase in the music group.
In South Africa, Mathiti (2002) and Woodward and colleagues (2008)
evaluated a programme that provided instruction in African marimba
and djembe ensemble performance on the behaviour of young juvenile
offenders. The programme integrated music-teaching, mentoring
and intercultural exchanges aimed at the acquisition of musical skills
that offered opportunities for diversion from crime and successful
reintegration into society. Participants were matched with mentors and
reported enjoying the sessions, stating that music-making helped them
to stay away from crime, providing them with a sense of purpose and
alternative ways to spend their time. Having someone listen to them and
to confide in was also important. The programme allowed participants
to take on new identities as a result of sharing their skills with others
and having them respond positively. The researchers observed that
music-making had a therapeutic effect on participants by triggering
positive emotions and by giving them a chance for self-expression. In
turn, learning a new skill gave mentees a sense of achievement and
increased their self-esteem. Interviews with parents revealed that family
relationships improved and that the students were more cooperative
and helpful, demonstrating respect and acting responsibly. There
were also positive outcomes in terms of attitudes towards school. The
reoffending rate for the pilot group in the six months post-programme
was nine percent, while in the second six months, this dropped to zero,
with no repeat offences committed. The programme was successful in
aiding the young people to connect with their families, communities
and culture.
In the USA, Kennedy (1998) assessed the effects of music activities on
the self-esteem and self-efficacy of 45 participants in two homes for at-risk
youth and a juvenile detention centre. Musical performance, supported
by instrumental coaching, was compared with other interventions,
including cognitive behaviour strategies and vicarious experience
in the form of observation of videotaped performance by others. The
self-efficacy scores, for those involved in musical performance alone
and for those with whom this was combined with cognitive behaviour
 12. Re-Engagement and Motivation  357

interventions, were significantly higher than for those receiving

cognitive behaviour interventions alone or vicarious experience alone.
The self-esteem scores for those involved in musical performance
also improved significantly following the intervention, although the
results did not differ significantly when compared with alternative
interventions. Those involved in either the vicarious experience or
cognitive intervention alone scored lower than the control group with
no intervention, suggesting that these two intervention groups were
better without treatment. Some participants showed improvements in
mood, reduced anger, increased motivation and improved behaviour.
Similarly, Baker and Homan (2007) studied the implementation of a
music programme including piano, guitar, rapping, computer-based
music sequencing and composition for a group of predominantly black
youths within a detention centre, offering a highly practical and direct
means of allowing youth offenders to express a particular form of
creativity in connection with their existing music and cultural interests.
The treatment centre where the programme was based dealt primarily
with anger-management and substance-abuse problems. Young people
remained in the facility for an average of 90 days, and only those with
good behaviour were allowed to participate in the musical activities.
Lessons were conducted with individuals or in small groups. While
there were many benefits of the programme, there were also considerable
challenges, including time pressure, access to lessons which depended
on the accumulation of privileges, lack of opportunities for practice and
lack of opportunities for continuation on release. The process of writing
music can help young people to redefine themselves, especially where
projects promote positive expression and seek to challenge lyrics that
glorify criminal lifestyles or contain profane, sexist or discriminatory
language. The findings showed that such censorship was often met
with resistance from young people, who felt that this served to diminish
the truth of their feelings and experiences. Lyric-writing allowed those
in custody to explore and express thoughts and emotions which may
otherwise be repressed—for instance, forgiveness, healing, overcoming
and regret.
Also in the USA, Tyson (2002) studied the effects of hip-hop therapy
on self-concept and peer relations in a residential setting for at-risk
youth. The programme comprised hip hop, bibliotherapy and music
358 The Power of Music

therapy that involved discussion of rap lyrics, emphasising positive

themes including positive racial identity, group identity, peace and
unity. Participants spoke highly of the project, although there were no
statistically significant changes in quantitative measures of outcomes.
Similar findings were reported by Gann (2010), who assessed the effects
of rap therapy on self-concept and peer support in a small sample of
13 at-risk pupils from two urban schools. The results were mixed,
with anticipated improvements in self-concept and social support not
confirmed in statistical analysis.
Bittman and colleagues (2009) evaluated the effectiveness of a
novel creative musical expression protocol with young people in
the juvenile justice system. Participants were randomly assigned to
participate in an adolescent health RHYTHMS drumming protocol and
normal structured routines that included therapeutic and educational
programmes focusing on current events, independent living, housing,
social skills, grief and loss, health, drug and alcohol use, employment,
sexual abuse, sexuality, anger management and conflict resolution.
Instruments included hand drums, a variety of auxiliary percussion
instruments, bells, maracas, a clavinova and a computerised electronic
keyboard. The first session began with a brief welcome, a discussion
of expectations and an overview, followed immediately by a five- to
ten-minute nonstructured jam session. A total of 52 African-American,
Asian, Caucasian and Puerto-Rican participants, ranging in age from
12 to 18, participated. Statistically significant differences between
intervention versus control groups emerged, with improvements in
schoolwork, role performance, depression, negative self-evaluations and
anger. In addition, extended impact was characterised by statistically
significant improvements six weeks after completion of the protocol.
Other reported benefits included improved social skills, attention
span, stress management, anger management, emotional expression,
anxiety, depression, coping skills and self-esteem in young people and
adults, with a reduction in rates of reoffending. Skills development
and employment were further supported by employing people from
marginalised groups, such as ex-offenders, to deliver the arts activities
to the groups.
Clennon (2013) examined music workshops mainly consisting of
group composition through the process of learning to play in a rock
 12. Re-Engagement and Motivation  359

band, bass, keys, guitar, vocals, drums and electronic composition,

using the software Logic. The transformative effect of participating
in community music sessions on young people’s attitudes towards
offending behaviour was assessed. The results suggested that there was
a small but measurable improvement in the attitudes towards offending
that the young people who participated in the music workshops had,
especially relating to their perceptions of their life problems and how
these problems could contribute to potential offending behaviour.
Similarly, Hickey (2018) undertook a long-term qualitative study
to assess the impact of a music composition programme at an urban
youth detention centre. Over a period of five years, more than 700
youths participated in the programme and created primarily rap-music
compositions. Comments from their feedback, as well as interviews,
showed that they enjoyed the programme; it gave them positive feelings
and a sense of competence. Creativity emerged as a key element in
enhancing competence and autonomy.
Chong and Yun (2020) introduced a music therapy project for
young offenders through community collaboration. The project was
carried out with collaboration between the educational institution, the
district prosecutor’s office and a corporate sponsor, forming a tripartite
networking system. Project implementation was evaluated with 178
adolescents involved with the juvenile justice system. The music therapy
programme was developed with 15 sessions of music-making and
song-writing. Three scales, self-concept, resilience and stress coping
skills were used, and there was improvement on all following the
music intervention. On the basis of 20 interviews, the intervention was
reported as helpful in gaining new perspectives, providing courage to
challenge and persevere, and self-knowledge.
Ezell and Levy (2003) evaluated the impact of a programme of
integrated arts therapy on young female delinquents who experienced
emotional and behavioural problems in a correctional institution. The
intervention was introduced as part of a curriculum involving art
therapy, drama therapy, music therapy and dance movement therapy
sessions that were facilitated twice a week during a five-week period.
Participants aged 14 to 17 either participated in the intervention or
acted as controls. Self-report questionnaires were administered prior
to and after the intervention to screen for conduct, emotional and peer
360 The Power of Music

problems, hyperactivity, and prosocial behaviour—and to investigate the

frequencies of aggressive, withdrawn and prosocial behaviour. There
were statistically significant reductions in three of the five emotional
and behavioural problems measured by the Strengths and Difficulties
Questionnaire including conduct and emotional problems, an increase
in prosocial behaviour, and significant differences in the frequency of
aggressive behaviour.
Rio and Tenney (2002) developed a programme for juvenile offenders
in a residential treatment setting. Many of the clients had difficulty
establishing positive relationships, having had severely dysfunctional
relationships throughout their lives. The music therapy process was
designed to improve social interaction and relatedness, increase
self-expression and self-esteem, and decrease hostile and disruptive
behaviour. The programme also emphasised the development of
empathy and appropriate channels for energy release. The client groups
evolved somewhat differently, illustrating how individual personalities
and abilities affected the group dynamic and relationships between
group members and therapists. In Australia, Barrett and Baker (2012),
along with the Australian Children’s Music Foundation, implemented a
number of music programmes in juvenile detention centres as a means
to assist young people to develop their sense of self-worth, build skills
in self-discipline and communication, foster resilience, and re-engage
with life and the community. In a qualitative case study, participants’
perceptions of the learning outcomes were sought—musical and extra-
musical—that emerged from participation, the learning and teaching
practices, and contextual factors that supported the outcomes. Findings
indicated that the programme generated significant musical and extra-
musical learning outcomes: in particular, a learning identity.
Skaggs (1997) reported on a music-centred creative arts therapy
programme in a residential treatment programme for male juvenile
sex offenders, while in Seoul, Korea, the district attorney provided arts
programmes instead of social labour hours for youths with conditional
suspension. After one year, it was reported that the recidivism rate
decreased from 54 percent to 14 percent (Ewha Music Wellness Research
Center, 2015).
 12. Re-Engagement and Motivation  361

Music Programmes for Adult Offenders

Music education in prisons has existed since the mid-nineteenth
century, but research in the field has been sparse (Lee, 2010). However,
recently there has been a surge in activity. Positive outcomes for music
interventions have been reported with adult offenders. Participants
enhanced their communication and social skills, increased their
confidence, became better able to reflect on their situation, and believed
that they could change and attain their goals. Early studies were
undertaken by Baron (1955) and Benedict (1953). There is evidence that,
after participation in such projects, prisoners sought out opportunities
for further education and training (Daykin et al., 2012). A number of
Master’s and doctoral theses have explored these issues—for instance,
Apicella (1952)—aimed to establish which music activities were used
as part of correctional education in prisons. Similarly, Hodson (1951)
carried out a survey of music education programmes in state prisons,
as did Littell (1961). Sporny (1941) explored the value of music in
correctional settings, while Hess (1956) appraised the music programme
in a single institution. In a retrospective study, Richmiller (1992) studied
the residual effects of the music education experiences of being in a
prison choir 29 years after participation in it. In a doctoral thesis, Cohen
(2007) studied choral singing in prison contexts, while Elliot (1981)
studied a way of teaching instrumental music to adult offenders. Cohen
and Duncan (2015) explored the relationship between restorative and
transformative justice and music education in prison and other contexts,
while Cohen and Henley (2018) examined music-making in USA and
UK prison contexts, pointing out the wide variations in practice and
how inmates’ opportunities for self-expression could be restricted.
However, community music approaches within prisons have improved
self-esteem, social support and a sense of accomplishment, and reduced
reoffending. The complex power dynamics of prison contexts have
emphasised the importance of the welcome and hospitality offered by
community music.
362 The Power of Music

Choirs
Many of the interventions and evaluations in prison have focused on
choirs. For instance, in the USA Weber (2018) evaluated the Voice of
Hope women’s prison choir, while Cohen (2007), in Australia, explored
inmate and volunteer experiences of singing in a prison-based choir.
Similarly, Cohen (2009) carried out two experiments, the first with a
choir of ten inmates which only performed within the prison, the second
with a larger choir of 48, which included inmates and volunteers and
performed externally. There were no significant differences in wellbeing
between the two groups overall, but the group who were able to perform
externally scored higher on measures of emotional stability, sociability,
happiness and joviality. Later, Cohen and Trachsel (2010) discussed
voice as the intersection between music and language in the context of
the writing component of a prison choir, while Cohen (2010) considered
music programmes and restorative practices in prisons across the USA
and the UK.
Cohen and Wilson (2017) examined pedagogical strategies for
facilitating and developing song-writing skills with 17 males incarcerated
in a USA medium-security prison. They investigated the participants’
sense of self-worth, purpose and social adjustment related to their
participation in a songwriters’ workshop. The song-writing sessions
spanned two 13-week, 60-minute workshops and one 9-week 90-minute
workshop, totalling 35 weeks. The researchers analysed 42 sets of original
lyrics, written reflections from three instructors, transcriptions of four
workshop sessions and narrative data from participants. The findings
showed that the collaborative and social nature of the song-writing
workshops provided a supportive atmosphere where participants
generated new songs for enjoyment and expression. They wrote about
struggles and hardships, especially relationship problems, and the data
suggested that the discussions about song topics helped them cope with
their incarceration. Cohen (2019) showed that choral singing in prisons
could help incarcerated individuals identify as returning citizens
instead of felons. Maruna (2010) argued that, while many legal and
penal rituals exist to convince individuals to identify as offenders, few
such rituals are in place to reconnect formerly incarcerated people to
identify as community members outside of prison. Maruna described
 12. Re-Engagement and Motivation  363

successful reintegration rituals as symbolic and emotive, repetitive,

community-based, and infused with challenge and achievement, while
choral singing models are positive reintegration rituals that promote
prosocial connections between returning citizens and the societies to
which they are restored.
Messerschmidt (2017) explored the effects of singing with
incarcerated choir members and the effects of listening to a live prison
choir perform on non-incarcerated people—in particular, their attitudes
towards prisoners. Forty-one singers from four choirs who sang with
prison choirs, a control group of 19 who had no experience of prison
choirs, and 78 audience members at a prison choir concert completed an
attitude-towards-prisoners scale and answered open-ended questions.
The findings showed that it was possible for people to change their
attitudes towards prisoners through experiences with a prison choir.
Almost 70 percent of those volunteering said that their attitudes
towards prisoners were more positive since joining the choir. Audience
members were also more positive after attending a concert. Roma (2010)
examined a men’s prison chorus in a high-security Ohio prison. The
research aimed to understand how a men’s prison choral community
impacted on inmate self-perception, intragroup relationships and
external connections. The CD recordings made of the choir were sold
and the sales benefited charities of the inmates’ choosing. This helped
the prisoners connect with the larger society outside prison. The
researchers explored how musical performance, especially of inmate-
composed choral repertoire, affected the choir as a community.

Projects Using Gamelan

Several programmes have used gamelan for prison interventions, as
they do not have affiliations that may alienate anyone and they are
generally easy to learn, requiring no previous experience. Groups can
learn quickly: in one two-hour session, players can master a composition.
There is no leader or conductor and players can swap instruments,
and changes in dynamics or tempo are decided as a group. The Good
Vibrations programme was set up with the aim of trying out gamelan
workshops in prisons. Eastburn (2003) evaluated a gamelan Indonesian
percussion programme in a prison setting. Data were collected on the
364 The Power of Music

participants’ self-esteem, basic and key skills. There were questionnaires

for prison contacts and workshop leaders. One hundred and twenty-
four prisoners participated in taster sessions and 64 completed in-depth
workshops. The project helped prisoners to develop basic and key skills,
and enhanced their self-esteem. At the start of the programme, about a
quarter of the prisoners had very low literacy and numeracy skills. Half
had never engaged in any musical activity and nearly 40 percent had
never participated in any kind of prison workshop. Prison education
staff rated the taster sessions as providing good opportunities for people
to deploy basic and key skills including teamwork, communication,
listening, concentrating, numeracy and motor skills. They agreed that
prisoner self-confidence had grown, as had their teamwork skills. Most
agreed that the programme was more effective than other short arts
projects. Eighty-nine percent of participants indicated that they felt better
about themselves, and had a sense of achievement, pride and increased
confidence, while 57 percent of adult respondents and 71 percent of
young offenders spontaneously mentioned enjoying and learning from
the experience of working in a team. Two prison education managers
reported improved behaviour or performance in education, and one
reported participants signing up for further prison education activities.
Henley and colleagues (2012) investigated the short-, medium- and
long-term impact of a gamelan project and found that participation in a
Good Vibrations project acted as a catalyst for positive change. The research
found that, not only did participants feel more able to communicate
with other offenders within the project, they found confidence in their
own voice so as to continue to develop their communication and coping
skills within prison and as ex-offenders in the community. Furthermore,
the project contributed to the development of anger management skills
and provided an outlet for self-expression, leading to a feeling of being
normal. Henley (2015) investigated the learning processes occurring
within a Javanese gamelan project in a young offenders’ institution and
highlighted the parallels between musical learning processes and the
development of certain attributes linked to desistance from crime. The
desistance paradigm centres on changing a criminal identity through
the development of social and personal attributes. This resonates with
recent research on the transformative effects of music and how musical
identity can be changed positively through active and successful
 12. Re-Engagement and Motivation  365

music-making. The research was carried out in a UK Young Offender’s

Institution and involved 19 young people between the ages of 18 and 24
over a period of eight weeks. Observation revealed how personal and
social development occurred through participation. Mendonça (2010)
also focused on the Good Vibrations programme, examining the approach
from the perspectives of prisoners, administrators and teachers.

Assorted Music Therapies

Wilson and colleagues (2009) argued that there was growing awareness
amongst policymakers and those working in the criminal justice system
of the contribution that could be made by the arts in prisons—in
particular, by innovative projects that offer participants a creative outlet
and have a positive impact on offenders, not least by encouraging them
to engage with further learning and education. Tuastad and O’Grady
(2013) explored the concept of music as a freedom practice in and
outside prisons in two studies. Most of the prisoners and ex-prisoners
participating reported that music helped them to feel momentarily free
from the harsh realities of both prison life and the world outside. The
findings described how, through music, prisoners found a free space
in an authoritative, suppressing and institutionalised environment, and
how music activities helped them in building ties to the world outside
prison while connecting to personal emotions and becoming humanised
in a dehumanising setting.
Chen and colleagues (2015) investigated the effects of group music
therapy on improving anxiety, depression and self-esteem in Chinese
prisoners. Two-hundred male prisoners were randomly assigned to
music therapy or standard care. The music therapy consisted of 20
sessions of group therapy compared with standard care. Anxiety,
depression and self-esteem were measured by standardised scales at
baseline, mid- and post-programme. Anxiety and depression in the
music therapy condition decreased significantly at mid- and post-
test; self-esteem improved significantly at mid-test and at post-test.
Improvements were greater in younger participants and in those with
a lower level of education. Overall, group music therapy was effective
in improving anxiety, depression and self-esteem, particularly for
younger and lower educated prisoners. Some programmes employed
366 The Power of Music

people from marginalised groups, such as ex-offenders, to deliver the

activities, thus supporting skills development and employment. Other
reported benefits included improved social skills, attention span, stress
management, anger management, emotional expression, anxiety,
depression, coping skills and self-esteem, and a reduction in rates of
re-offending. Gold and colleagues (2014) also showed how music
therapy reduced mental health problems and could be beneficial in
the rehabilitation of prisoners. They compared group music therapy
with standard care for prisoners in a randomised controlled trial that
started with the establishment of music therapy services in a prison
near Bergen in Norway in 2008. One hundred and thirteen prisoners
agreed to participate. Anxiety, depression and social relationships were
assessed at baseline and every two weeks in the intervention group, and
after one, three and six months in the control group, then at release. No
restrictions were placed on the frequency, duration or contents of the
music therapy. Duration of stay in the institution was short, typically
less than one month. Only a minority of participants reached clinical
cutoffs for anxiety and depression at baseline, but music therapy was
well accepted and attractive for prisoners, and there was a reduction
in anxiety after two weeks of music therapy. Positive outcomes for
music interventions have also been reported in relation to self-harm
among women prisoners (Digard et al., 2007). Participants enhanced
their communication and social skills, increased their confidence, were
better able to reflect on their situation, and believed that they could
change and attain their goals. Hakvoort and colleagues (2015) studied
the effect of music therapy on anger management, coping skills and
dysfunctional behaviour. A pre- and post-test design was used with
random assignment of fourteen patients to either treatment or control
conditions. All participants received treatment as usual, while nine
received a standardised music therapy anger management programme.
Five controls received an unplanned aggression management
programme. The findings suggested that anger management skills
improved for all participants. The improvement of positive coping skills
and the diminishing of avoidance as a coping skill were measured, and
showed greater changes in music therapy participants. When controlling
for the exact number of treatment hours, the outcomes suggested that
music therapy might accelerate the process of behavioural change.
 12. Re-Engagement and Motivation  367

Maruna (2010) showed how music teaching, rehearsing,

recording, performance, improvisation and composition could aid
the rehabilitation of prisoners and ex-prisoners. Participants almost
uniformly expressed passionate support for the organisation providing
the music intervention, and many insisted that music had changed their
lives. The changing tunes logic model developed a sense of collective
ownership, responsibility, emotional energy, increased confidence and
therapeutic alliance with the facilitator, and led to the management
of depression. The programme also led participants to find their
own voice and developed creativity, group bonding, mutual support,
anger management and an identity separate from being an offender.
It provided a way for participants to test their limits, a drug-free way
of escape or coping with imprisonment and increased employability.
Public performance and acknowledgement led to a calmer prison
environment, and praise fostered a sense of achievement. Participants
reported that the programme provided them with a form of escape from
the cycle of punishment, shame, anger and defiance that prisoners and
ex-prisoners found themselves trapped in. Maruna (2010) discovered
that increased confidence was the most commonly cited long-term
benefit of participation in the Changing Tunes project. As a result, many
participants felt more optimistic about their futures. A small number of
participants reported that taking part in music sessions had improved
their symptoms of depression and Post-Traumatic Stress Disorder.
Respondents often spoke of the respectful way that they were treated
by project leaders and the humanising effect that this had. Participation
in arts programmes appears to provide prisoners with new ways of
thinking about themselves, allowing them to move away from previously
entrenched offender identities by assigning more prosocial labels such
as ‘musician’, which often brought with them new aspirations.
Ascenso (2017) reported the outcomes of The Lullaby Project, where
the Royal Philharmonic Orchestra worked with refugees, migrant
mothers and fathers from a London prison. The programme paired
expectant and new mothers with professional musicians to create
a lullaby for their children. The programme developed wellbeing
through enabling a strong sense of accomplishment, meaning and
connectedness, along with the experience of positive emotions. It
encouraged proactivity through promoting initiative, both musical and
368 The Power of Music

relational, and reflection through stimulating a richer perspective on life

and positive coping mechanisms. The project was motivating, offering
challenge and a highly valued goal. It was geared towards connecting
at a very human level, placing centrality on individuality, a positive
agenda, and maintaining two universals at its core: music and parental
love. Similarly, Rodrigues and colleagues (2010) studied the BbBb project
that combined education and artistic performance in a process that
was centred on music, babies and their parents. The findings showed
that a very strong bonding developed among parents, babies, families
and the community. In Alaska, Warfield (2010) reported a study of a
400-bed facility for multi-level adult female offenders which offered a
unique educational programme, an orchestra. This was founded in 2003
by a volunteer, and membership grew from eight to twenty-two female
offenders between 2003 and 2009.
Bilby and colleagues (2013) considered the possible relationships
between the process of abstaining from crime and the influence that
taking part in some form of art-based enrichment activity might have on
participants. The research specifically explored how arts interventions
contributed towards enabling people to form positive identities, build new
narratives and build positive relationships with peers, staff and family. It
also began to investigate how arts interventions enabled people to make
significant behavioural changes. The research team investigated five arts
projects in four criminal justice settings, including practising visual arts
in a high-security adult male prison; music and DJ-ing skills with young
offenders in the community; a music-making project in a resettlement
open prison; and creative writing and bookbinding in a closed female
prison. The research team spent at least four sessions with each of the
projects, observing the activities and interviewing participants, arts
practitioners and prison staff. Evidence included participants’ written
work and evaluations, and examples of the work produced in the arts
activities. The findings demonstrated a clear link between taking part
in art-based activities and movement towards secondary desistance.
Analysis of the data across all five projects showed that participation in
arts activities enabled individuals to begin to redefine themselves. Arts
projects facilitated high levels of engagement, led to greater participation
in education and work-related activities, and could have a positive
impact on how people managed themselves during their sentence,
 12. Re-Engagement and Motivation  369

particularly on their ability to cooperate with others, including other

participants and staff. This was related to increased self-control and
better problem-solving skills. Engagement with arts projects facilitated
increased compliance with criminal justice orders and regimes, while
arts projects could be responsive to participants’ individual needs.
Overall, art provided a safe space to explore challenging questions and
to create, which allowed prisoners to discover what they could do, thus
enhancing their confidence.
Cox and Gelsthorpe (2008) evaluated eight Beats and Bars projects,
including 71 participants. The research showed a reduction in
adjudications for rule-breaking during and after the project, an increase
in confidence to participate in other educational programmes, and
confirmation that music projects can play a role in fulfilling the seven
pathways to reducing re-offending. The men’s experiences of the project,
particularly their feelings of encouragement to try things without
judgement and to work together, clearly facilitated the development of
their individual competencies and self-esteem. The participants learned
to cooperate, relate to others, negotiate and share. These can all lead
to improved outcomes following release from prison. Following on
from this, Cartwright (2013) evaluated the first phase of the Sounding
Out ex-prisoner programme, tracking participants over a nine-month
period. The research showed that Sounding Out was successful in
offering a programme of multi-dimensional support to participants. This
took the form of financial support, making new friends and contacts,
ongoing help to access other training and performing opportunities, a
lift in motivation, hope and self-esteem, a clear sense of achievement
and a positive use of time. It was found that being paid appropriately
for their time and commitment acted as an incentive not to reoffend,
and a support in the face of financial hardship. Additionally, being
paid engendered a sense of professionalism and pride. Taking part
also contributed to rebuilding positive family relationships and being
seen in a more positive light by others. Conceived as a year-long
intervention, the programme was structured around an initial rehearsal
period and concert, followed by two more high-profile performances.
Within this period and afterwards, participants were given support
to access additional opportunities such as further music training and
employment. The Sounding Out participants were paid at a rate of £90
370 The Power of Music

per day for all rehearsals and performances. In the case of shorter time
periods, this sum was adjusted to an hourly rate of £15. Additionally,
travel and food expenses were provided. Built into the programme was
the opportunity for a number of the participants to undertake roles as
supporting musicians on Making Tracks, a programme to support young
people at risk of coming into contact with the criminal justice system.
Making Tracks focused on an intense music-writing and rehearsal period,
followed by a performance, but additionally offered weekly sessions to
the young people after the intensive project, allowing them to further
hone their musical skills. In total, seven former prisoners were recruited
for the project. Two had both been out of prison for a number of years.
Since their release, they had been involved with various projects and one
was on the board of trustees as an advisor. They took on a supporting
role as excellent musicians, proven team members and ex-prisoners who
had successfully made the challenging transition from prison to release.
The remaining five participant members were all recruited within a year
of release. They ranged in age from mid-twenties to fifties. The offending
histories of the participants were varied. However, all the participants
were on licence and had served custodial sentences of a minimum of
three years; they had been convicted of relatively serious crimes. Two
had spent the previous 20 years periodically offending and returning to
prison at regular and frequent intervals. At the time of the Sounding Out
project, none of the group was in employment or undertaking training or
education, and all five were receiving state benefits. Four members were
in accommodation regulated by the probation service. Sounding Out
made a significant impact on reducing participant reoffending levels.
Music was found to be a primary motivation, given that the participants
were all passionate about playing and performing. The process of creative
music-making and preparing for performances fostered participants’
teamworking and negotiation skills, self-confidence, achievement
and sense of pride. Participants reported that one of the most striking
aspects of the programme was the level of trust placed in them from the
outset. Being treated in this way led participants to foster a strong sense
of responsibility to the organisation and staff. Additionally, this sense
of responsibility was a strong motivation not to reoffend, at the risk of
letting others down. A later evaluation (Massie et al., 2019) showed
similar outcomes.
 12. Re-Engagement and Motivation  371

There have been a number of reviews of the research on music

therapy with adult offenders. For instance, Hughes (2005) examined the
application and impact of arts practice in the three key areas of criminal
justice service provision:
• prevention: arts practice with young people up to 21 years old
who are at risk of offending or escalation of existing offending;
• custodial and community sentencing: arts as interventions
in sentencing, both in prison and community contexts and
resettlement; and
• arts as an intervention made to assist reintegration into society.

The findings showed that, at the time of the review, there was a
paucity of high-quality research and evaluation in the field, but the
survey findings showed very clearly that the arts had the capacity and
potential to offer a range of innovative and practical approaches that
could enhance and extend provision of educational, developmental and
therapeutic programmes across the criminal justice sector. The review
showed that the arts are associated with positive outcomes and can
play an important part in changing individual, institutional and social
circumstances which sponsor criminal behaviour. The grey literature
highlighted the depth and breadth of arts provision, with many
examples of interesting, challenging and creative projects in a range of
settings. Analysis of the variety of practice identified a series of common
effective programme and practice models and features. However,
flexibility and responsiveness were key indicators of success. The
quantity and consistency of findings from the key areas suggested that
there was a strong case to be made for the effectiveness of arts practice
across a range of areas. Arts interventions in criminal justice contexts are
successful because they offer a non-traditional, non-institutional, social
and emotional environment; a non-judgemental and non-authoritarian
model of engagement; and an opportunity to participate in a creative
process that involves both structure and freedom. At the same time,
engagement in the participatory arts requires respect, responsibility,
cooperation and collaboration.
Coutinho and colleagues (2015a; 2015b) reviewed 28 articles, mainly
qualitative and narrative reports of group music therapy, educational
music-making, choir interventions, individual music therapy sessions,
372 The Power of Music

and a range of musical projects and case studies. Cohen and Henley
(2018) examined music-making in prisons in the UK and USA,
contrasting the different approaches and practices of imprisonment and
their impact on music therapy, but pointing out that community music
within prisons provided a means toward desistance, improved self-
esteem, social support and a sense of accomplishment. Cheliotis and
Jordanoska (2016) critically reviewed the empirical research literature
on the contributions that arts-based programmes make to the process
of desistance from crime. They focused on evaluations of programmes
run by practitioners inside prisons, and the effects of arts-based prison
programmes after participants are released into the community.
Kougiali and colleagues (2017) carried out qualitative meta-analyses
of 12 articles published worldwide. The findings suggested that music
programmes in prison are perceived by participating prisoners as
liberating, which encourages participation and allows for noncoercive
personal development. The therapeutic potential of music programmes
is located in the combination of the benefits emanating from the effect
and practice of music and the creation of mental, spatial and temporal
zones of free expression, as well as those that derive from the egalitarian
and nonauthoritative approach employed by the facilitators.
Chen and colleagues (2016) in a meta-analysis assessed the
effectiveness of music therapy on improving the mental health of
offenders in correctional settings. Five studies with 409 predominantly
male participants were included and showed that music therapy was
effective for promoting offenders’ self-esteem and social functioning.
Effects on anxiety and depression depended on the number of sessions.
For both outcomes, the studies with 20 or more sessions had larger
effects. No significant effects were found for behaviour management or
between different music therapy approaches.

Overview
A great deal has been written about the role of music in supporting
young people from disadvantaged backgrounds and helping those
who are disengaged back into education or employment, as well as
supporting those in the criminal justice system to successfully reintegrate
into the community and not reoffend. Across each of these areas, much
 12. Re-Engagement and Motivation  373

of the literature is descriptive. Some sets out the details of particular

interventions and advocates their use while other papers argue more
generally that music therapy has an important role to play and set
out a theoretical stance. Some research has assessed the outcomes of
interventions, but frequently this is based on single case studies or
small group interventions. Nevertheless, it is possible to draw some
conclusions. It is clear that making music can have positive benefits:
for instance, generating positive attitudes towards school, improving
attendance, enhancing motivation for academic schoolwork and helping
to improve basic and key skills. Across a range of environments, music
offers the potential for enhanced self-efficacy, self-esteem and self-
concept, improvements in mood, reduced anger, reduced aggression and
improved behaviour. Music programmes can reduce rule-breaking and
levels of disruption in institutions, as well as improving relationships.
Programmes aimed at resettlement have had some success in supporting
ex-offenders into training and employment by helping them to develop
a range of personal and social skills which increase employability, as
well as facilitating the acquisition of formally accredited educational
skills and qualifications. Some participants make a career out of music,
becoming mentors or workshop leaders. This means that participants
are less likely to reoffend. Some programmes have changed the wider
community’s views of those in the criminal justice system.
The common elements for success, whatever the nature of the
programme, seem to be:
• creating a safe space;
• providing a high-quality musical experience;
• providing highly interactive and enjoyable musical activities;
• using music with which participants can relate and engage;
• having a facilitator who acts as a role model and treats
participants with respect;
• enabling trusting and non-judgemental relationships to
develop with music facilitators and mentors;
• engendering feelings of belonging in a group;
• encouraging learning to work with others;
374 The Power of Music

• supporting the development of interpersonal bonds and

shared goals;
• creating opportunities for developing new skills;
• enabling musical progression;
• providing opportunities to perform;
• maintaining regular and frequent contact;
• recognising and rewarding excellence;
• facilitating positive affirmation from others relating to musical
activities, particularly performance;
• providing opportunities to reflect on and articulate emotions;
• providing opportunities to feel a sense of pride;
• providing opportunities for creativity to develop self-efficacy
and express feelings;
• facilitating opportunities for participants to gain respect as
musicians;
• providing opportunities to learn transferable skills;
• providing opportunities to develop communication skills;
• promoting the giving and receiving of criticism;
• supporting the development of confidence and resilience; and
• allowing time for developing an understanding of self.

There are issues related to how long interventions need to be. Ten
mentoring sessions, usually at weekly or fortnightly intervals, seem to
be a minimum, although some suggest that a mentoring relationship
needs to last for a year to be effective.
 13. Personal, Social and
Physical Development

This chapter focuses on the way that active engagement with music
and listening preferences can affect the way that individuals develop
personally, socially and physically.

Personal Development
This section on personal development includes the way that an
individual’s identity, personality and self-beliefs are shaped by their
interactions with the environment, including activities related to music.

Music and Identity

At any point in time, an individual may hold multiple identities
depending on their current social context. Identities constantly evolve
as they are challenged and reconstructed, based on the feedback that is
received from interactions with others. This may be complementary or
contradictory. DeNora (2017) identified several properties of personal
identity, including status. This infers that identity can be raised or lowered
in relation to others. The malleable nature of identities means that they
can be combined to form new ones through a form of hybridisation.
Music can play an important role in this process. Individuals use
music to express themselves and explore their identities (Macdonald
et al., 2017). Active listening to music supports this exploration and the
integration of identities (Larson, 1995), helping individuals to decide
who they are and what they aspire to be. In addition, music assists
in sending a message about those decisions to others. Music is used

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.13

376 The Power of Music

consciously and unconsciously, to demonstrate attitudes, values and

beliefs (Larson, 1995; Lull, 1987; North and Hargreaves, 1999). It is also
used to gain knowledge about others (Macdonald et al., 2017).
Expression of identity is connected with young people’s lifestyle,
language, personality development and the music that they listen
to (Schwartz and Fouts, 2003). Adolescents’ musical identity may be
context-specific, and can be different at school and in out-of-school
contexts (Rideout et al., 2010). It can be defined through attending
concerts, actively making music or listening to specific musical genres.
Engagement in musical activities develops several aspects of identity
in relation to the family and the school environment, and contributes
to physical, cognitive, social, emotional and affective development
(Hargreaves and Lamont, 2017). Musical preferences are used for self-
identifying as a member of a specific peer group and musical subculture
(Miranda and Claes, 2009; North and Hargreaves, 2008), creating social
identities and membership of an in-group (Bakagiannis and Tarrant,
2006; Hargreaves et al., 2006; Rentfrow et al., 2009). Adolescents also
use musical preferences to acquire valid and reliable information about
others (Rentfrow and Gosling, 2006).
Young people spend a great deal of time listening to music (Keen,
2004; North and Hargreaves, 2000). This can be beneficial (Tarrant et
al., 2000). It can help them to regulate emotions (North et al., 2000),
act as a support when they face problems, help to alleviate loneliness
and increase emotional sensitivity (Cook, 2013). Music also helps
adolescents to develop a sense of connection and belonging, as they
make friends with those with similar musical tastes (Lewis et al., 2012;
Selfhout et al., 2009).
Adolescents who belong to minority ethnic groups use music as
a means of developing their ethnic identity and resilience (Buffam,
2011; Lundström, 2009; Schweigman et al., 2011). Travis and Bowman
(2012) found that having a positive ethnic identity was associated with
music, in that music could be empowering. For example, rap music can
inspire young people to connect with others, consider the experiences
of others, think critically about their environment and want to change
their communities. To bring about change requires agency—the ability
to act regardless of barriers. This is key to achieving positive outcomes.
Dedman (2011) argues that those who actively engage in hip-hop
 13. Personal, Social and Physical Development  377

culture are responding to, and continuously resisting, mainstream

images and messages from which they feel disconnected. The way that
identities can change explains the findings of many studies of the effects
of music in migrant communities (Baily and Collyer, 2006; Lenette et al.,
2016; Marsh, 2013). Ilari (2017) discusses the role of ethnic identity in
the perceptions and interactions of minority groups living among other
ethnic and racial groups, such as Mexicans in the USA and South-Eastern
Asians and Eastern Europeans in the UK, and how this affects their
developing self-perceptions. Ilari argues that an important aspect of the
ability to deal with the experience of being an immigrant or refugee is to
be able to negotiate multiple identities. Hybrid identities can provide a
wider family in which they can feel welcome. One of the main ways this
can be achieved is through music. Children’s cultural musical heritage
cannot be removed as a result of external circumstances (Ilari, 2017).
Cultural diversity impacts the development and construction of social
and musical identities across the lifespan in a wide range of contexts,
including educational settings.
Musical identity, part of the self-system, refers to the self that listens to
and creates music (MacDonald et al., 2002). It can support the building
of a positive self-identity and effective learning routines (Hallam et
al., 2016), As discussed in Chapter 12, disaffected young people and
those engaged with juvenile or adult justice systems can develop new
identities as musicians, leading to positive changes in their behaviour.
Creating possible positive musical selves in this way can lead to broader
changes in self-beliefs (Oleś, 2005), aspirations and subsequent career
plans (Taylor and Hallam, 2011). Developing a positive possible musical
self can occur at any point in the lifespan (Creech et al., 2014).

Music and Personality

There has been considerable research exploring the personalities of
musicians. Some has compared musicians with non-musicians, while
some has examined differences between musicians playing different
instruments or engaging with different genres. The difficulty of
interpreting this research in terms of personal development is that it is
not possible to determine whether individuals with certain personality
types are drawn to playing particular instruments or engaging with
378 The Power of Music

particular genres, or whether playing particular instruments or engaging

with specific genres develops certain personality characteristics. It may
be that elements of both apply and that there are interactions between
them.
Musicians require a great many skills to be able to perform:
imagination, flexibility, discipline, concentrated attention, emotional
expression and intellectual, communication and motor skills (Juslin,
2003; Palmer, 1997). Some of these skills may be related to personality.
The evidence from a range of studies shows that, as a group, musicians
tend to be open to new experiences. Overall, they are more creative,
imaginative and interested in change than the general population
(Gibson et al., 2009; Kemp, 1996). Research with ten- to twelve-year-
old children by Corrigal and colleagues (2013) showed that duration
of music training was associated with openness to experience. It was
also associated with conscientiousness. At seven to eight years old,
when children frequently begin to take formal music lessons, the best
predictors of participating in music training were parents’ openness to
experiences and the child’s agreeableness (Corrigall and Schellenberg,
2014). This may indicate a tendency in very young musicians to comply
with parental wishes.
Beyond the evidence regarding openness to experiences, as we saw
in Chapter 10, there are differences between musicians on other aspects
of personality. In a seminal study, Kemp (1996) identified common
personality traits among Western classical musicians. He showed that
they were bold introverts who directed energy inwards and appeared
outwardly reserved. He argued that the nature of solitary practice
may encourage autonomy and independence of thought. String
players tended to be introverted, imaginative and radical, while brass
players were more extroverted and had lower levels of self-discipline
in comparison to other performing groups. Percussionists also tended
towards extroversion. These findings suggested that the extent of
practice required for these different instruments—typically more for
string players, brass, wind and percussion players—either attracted
people with personality characteristics suited to these roles or caused
these characteristics to develop in response to the particular demands
made of them by their chosen roles in the music profession (Kemp,
1996; Wills and Cooper, 1988).
 13. Personal, Social and Physical Development  379

Cribb and Gregory (1999) studied folk fiddle players and Salvation
Army brass band members who completed a personality inventory
and a questionnaire concerning their opinions about the personality
characteristics of orchestral violinists, orchestral brass players, folk
fiddlers, and Salvation Army brass band members. The findings showed
greater neuroticism among string players but not greater extroversion in
brass players (which had been found in previous research). Participants’
views about the personality characteristics of orchestral brass players
and orchestral violinists echoed those found in previous research, but
their views on the Salvation Army brass players and on folk fiddlers did
not. The findings showed that personality differences or stereotypes of
musicians are probably determined more by the history and traditions of
the group in which they are perceived to belong than by the instruments
that they play.
Since Kemp’s research, many other studies have been undertaken.
For instance, Bell and Cresswell (1984) assessed personality traits in
a sample of secondary-school musical instrumentalists and student
instrumentalists attending a college of music. In both samples,
significant differences were found between the musical sample and
the normative population from which they were drawn. In the college
sample, further differences were found between students whose main
instrument of study was strings, woodwind or brass. The authors
suggested that some personality characteristics predisposed individuals
to pursue instrumental performance studies, whilst others reflected
habitual performance on different types of musical instrument. Also
studying music students, Shuter-Dyson (2000) found that they scored
higher on extroversion than non-musicians, and that female music
students were more neurotic and tender-minded than female non-
musicians. Undergraduate music students also exhibit conscientious-
like traits (Kemp, 1996; Marchant-Haycox and Wilson, 1992), although
composers and rock musicians tend to be less conscientious than
the general population (Gillespie and Myors, 2000; Kemp, 1996).
Buttsworth and Smith (1995), comparing the personality profiles of
performing musicians aged 17 to 41 years old with non-musicians,
found that the musicians were less intelligent but more emotionally
stable, sensitive and conservative. The male musicians were more
sensitive and shrewd than their female counterparts, while brass
380 The Power of Music

players were more suspicious, imaginative, apprehensive and radical

when compared with singers, and more extroverted (but less anxious
and creative) when compared with string players. Keyboard players
were more warm-hearted, emotionally stable and shrewd than those in
the other instrumental groups. MacLellan (2011) explored personality
differences among high-school band, string orchestra and choir students
according to ensemble membership. The participants were 355 high-
school students who had participated in a musical group for one or
more years. There were personality differences between the members of
the different ensembles, indicating that choir students were more likely
to be extroverted when compared to orchestral students. There were no
significant differences among the ensembles on the sensing intuition,
thinking, feeling or judging/perceiving scales. Compared to high-school
norms, the students in each ensemble were significantly more likely to
be intuitive and feeling, while the band students were more likely to be
perceiving, and the choir students to be extroverted. Hille and Schupp
(2015), using a large data set from the German Socioeconomic Panel
(SOEP), found that 17-year-old adolescents with music training were
more conscientious, open and ambitious than non-musicians. These
effects were stronger among adolescents from families with lower
socioeconomic status.
Comparing musicians to a representative sample of the general
workforce, Vaag and colleagues (2018) found lower levels of
conscientiousness but higher levels of neuroticism and openness.
There were no significant differences in extroversion or agreeableness.
Gjermunds and colleagues (2020) compared the responses of 509
musicians and 201 non-musicians on the Big Five personality traits.
The findings confirmed the higher levels of openness for musicians
frequently found in previous research. The musicians scored lower on
conscientiousness and there were no significant differences between
the groups in extroversion, agreeableness, emotional stability or
neuroticism. Similarly, Kuckelkorn and colleagues (2021) gathered
data from 7,000 respondents: professional, amateur and non-musicians
playing different instruments. The findings showed that the professional
musicians scored higher than the amateurs, who in turn scored higher
than non-musicians on openness to experience. The singers scored
higher on extroversion than instrumentalists, while the professional
 13. Personal, Social and Physical Development  381

musicians scored higher on neuroticism, lower on agreeableness, and

lower on conscientiousness than the amateurs. Although there were
personality differences between those playing different instruments, no
consistent patterns emerged, which suggested that the differences were
not related to instrument choice per se, but were perhaps moderated by
musical genre and the social context of music-making in each group.
Langendörfer (2008) examined personality differences among 122
professional orchestral groups of six top-level professional orchestras
in Germany. The three instrumental groups—strings, woodwind, and
brass players—displayed fewer differences in their personality traits
than the stereotyped view of them had suggested. Apart from the
finding that the string players were more conscientious than the other
musicians, differences found in other studies were not replicated.
Butkovic and Modrusan (2019) examined whether differences in
personality attributed to musicians were based on actual differences
or stereotypical views. One hundred and eighty-two string, brass and
woodwind students, singers, pianists and music pedagogy students
evaluated their own personality traits and the personality traits of the
other groups. Comparison of self-reports with in-group and out-group
peer reports showed that there were stereotypes of different groups of
musicians. The most pronounced differences between self-reports and
peer reports were in relation to openness and agreeableness. Similarly,
Sandgren (2018) investigated whether there were differences in the
personality traits of vocalists and instrumentalists. The findings from the
108 participants indicated that vocalists had significantly higher levels
of extroversion, agreeableness and openness than a control group—but
the instrumentalists did not.
Exploring motivational intensity and self-esteem, MacIntyre and
Potter (2013), in an online survey recruiting an international sample of
599 musicians, examined differences between guitar and piano players
and those who composed music, those who planned to compose
in the future, and those who did not compose and did not intend to
compose. The findings revealed instrument-based differences between
pianists’ and guitarists’ levels of motivational intensity, desire to learn,
introjected regulation, perceived competence and willingness to play.
The group who composed music also had significantly higher levels of
musical self-esteem, willingness to play, motivational intensity, desire
382 The Power of Music

to learn and perceived competence. Overall, the findings suggested that

pianists and guitarists were both intrinsically motivated, but for different
reasons. The authors concluded that the underlying motivational needs
that are met by the instrument’s culture appear to focus on competence
for pianists, and on autonomy and relatedness for guitarists.
Examining differences in genre, Butkovic and Rancic Dopudj (2017)
compared 249 musicians playing either classical or heavy-metal music,
and found that there were no significant differences in personality traits
between the groups, although they differed significantly in personality
from population norms, having higher scores on extroversion,
agreeableness and intellect. Similarly, comparisons of classical and
pop/rock musicians on measures of sensation-seeking found higher
levels in the pop/rock musicians (Vuust et al., 2010). Benedek and
colleagues (2014) compared students of classical, jazz and folk music
with respect to their musical activities, creativity and personality.
The jazz musicians were more frequently engaged in extracurricular
musical activities, had completed a higher number of creative musical
achievements, demonstrated higher ideational creativity and tended to
be more open to new experiences than the classical musicians.
Overall, on the basis of the existing evidence it is not possible to
say with any certainty that there are systematic personality differences
between musicians playing different instruments, although as a group
they appear to be more open to new experiences than members of the
general population. Emerging differences may be related to the genre
within which musicians work—for instance, jazz, pop, rock, or classical
music. The research sheds no light on whether the observed differences
are influenced by the different environments the musicians play in, or
whether they existed prior to choice of instrument or genre.
Kemp (1996) studying young classical musicians found that
they were motivated almost to the point of obsession. A high degree
of perfectionism and intrinsic motivation seemed to be associated
with being a classical musician. This may have indicated greater
conscientiousness, although there are mixed findings relating to this.
Stoeber and Eismann (2007) found elevated scores for conscientiousness
among young musicians, whereas Yöndem and colleagues (2017) found
lower scores. In a meta-analysis of studies in the general population,
Smith and colleagues (2018) showed that there was a relationship
 13. Personal, Social and Physical Development  383

between perfectionistic concerns and conscientiousness, although these

were moderated by gender, age and the perfectionism subscale used.
There is considerable evidence that many musicians experience
performance anxiety and distress across a variety of musical genres
including classical, jazz and popular music (Papageorgi et al., 2013).
Vaag and colleagues (2016) also showed that symptoms of anxiety
and depression were highly prevalent among professional musicians.
These findings have been related to perfectionism. There can be adverse
health-related consequences of perfectionistic over-involvement in
work. However, Stoeber and Eismann (2007) have shown that only
some facets of perfectionism are associated with anxiety and distress,
whereas other facets are associated with positive characteristics and
outcomes such as motivation and achievement. To investigate how
different facets of perfectionism were related to motivation, effort,
achievement and distress in musicians, 146 young musicians completed
measures of perfectionism: striving for perfection, negative reactions to
imperfection, perceived pressure to be perfect, intrinsic and extrinsic
motivation, effort, achievement and distress. The findings showed that
striving for perfection was associated with intrinsic motivation, higher
effort and higher achievement. Perceived pressure from music teachers
was also associated with intrinsic motivation, while negative reactions
to imperfection were associated with extrinsic motivation and higher
distress. The findings demonstrated that perfectionism in musicians
can have positive and negative aspects. While negative reactions
to imperfection are clearly unhealthy, striving for perfection can be
regarded as a healthy pursuit of excellence. Similarly, working with 132
students in music academies in Poland, Lawendowski and colleagues
(2020) investigated study addiction. Seven core addiction symptoms
related to studying were assessed, along with measures of personality
and wellbeing. Study addiction was positively related to learning
engagement but also to low extroversion, high social anxiety, longer
learning time, lower academic performance and indicators of decreased
wellbeing. Overall, the evidence suggests that being a professional
musician or preparing for a career as a professional musician can have a
negative impact on some aspects of personality.
384 The Power of Music

Self-Beliefs
Historically, the term self-concept has been used to refer to how
individuals perceive and evaluate themselves in different areas of their
lives. In the same way that an individual can hold multiple identities,
the self-system is made up of a number of self-images, including those
relating to self-esteem, self-efficacy, ideal selves and possible selves.
These are often context- or situation-specific and develop in interaction
with the environment (Hallam, 2009; 2016). Active engagement with
music can support the development of musical and other identities,
and can also impact on self-beliefs. Depending on the feedback received
from others, the impact may be positive or negative. Much of the
evidence supports the positive impact of music on self-esteem and self-
confidence but there are exceptions, typically when feedback is negative.
Performance and receiving feedback from it are crucial in this process
and can lead to positive or negative responses. Maintaining positive self-
esteem is argued to help to maintain positive emotions, which motivates
individuals to act and shields them against anxiety (Pyszczynski et al.,
1999). Positive self-esteem is essential for individuals to have agency to
act, rather than feeling powerless and depressed (Kuhl, 2000).
Bae and Kyungsuk (2020) examined the effects of the creation of a
musical play on the self-esteem, self-expression, and social skills of 14
children between first and third grade, and 14 from fourth to sixth grade.
Half of the children acted as controls. The activity involved making a
script, composing song lyrics and music, and performing the completed
musical play. Self-esteem and social-skill scales were administered before
and after the intervention. The experimental group exhibited significantly
higher scores than the control group on all of the scales except those of
self-expression and social skills. The results showed that group music
therapy could facilitate children’s engagement in groupwork, and that
playing an important role in the group could positively impact on self-
perceptions. In the UK, Harland (2000) showed that the most frequent
overall influences on pupils derived from engagement with the arts
in school were related to personal and social development. In music,
those who played instruments referred to an increase in self-esteem and
sense of identity. Research on the benefits of playing an instrument and
participating in extracurricular music groups has been shown to impact
 13. Personal, Social and Physical Development  385

on participants’ self-confidence and self-esteem. Tolfree and Hallam

(2016), in a qualitative study of children in the latter years of primary
education and the early years of secondary education, showed that the
children had a sense of achievement from playing an instrument. This was
most prevalent amongst the younger boys and the older girls, who also
expressed having pride in playing well more frequently than the other
groups. All age groups reported frustration when they did not achieve.
This was mentioned least by the older boys. University music students
reflecting on their previous musical experiences at school highlighted
the contribution of making music to the development of a strong sense
of self-esteem and satisfaction. They reported enhanced personal skills,
encouraging the development of self-achievement, self-confidence and
intrinsic motivation. A further study with non-music students who had
previously participated in musical groups established similar benefits,
with a particular preoccupation with the impact of group music-making
on self and personal development (Kokotsaki and Hallam, 2007; 2011).
Some early studies exploring the role of music education on self-
esteem showed positive relationships between participation in choir,
band or formal music instruction and self-esteem (Amchin et al.,
1991; Nolin and Vander Ark, 1977; Wood, 1973). Wig and Boyle (1982)
studied the effects of a keyboard learning approach and a traditional
general music approach on sixth-grade general music students’ music
achievement, and self-concept regarding music ability. Those in the
keyboard group made significantly greater gains in musical attainment
and musical self-concept than the control group. Duke and colleagues
(1997) administered questionnaires to a large number of children
studying piano in various regions of the USA, their parents and their
piano teachers, and found that the children, their parents and their
piano teachers believed that piano instruction improved the students’
lives in many ways, including enhanced self-esteem. Similarly, Austin
(1990) found a relationship between music, self-esteem and degree of
participation in school and out-of-school music activities among upper
elementary students.
In England, the evaluation of a national singing programme involving
approximately 6000 children found that those participating had more
positive self-concepts than non-participating children (Welch, 2010).
There was a positive linear relationship between singing development
386 The Power of Music

and self-concept. Similarly, Welch and colleagues (2014), using data

from 6087 participants, showed that the higher the normalised singing
development rating, the more positive the child’s self-concept and sense
of being socially included, irrespective of singer age, sex and ethnicity.
Also in England, an evaluation of the Musical Futures approach—
where young people work in the classroom in small groups, copying
a popular song and ultimately creating their own—showed that non-
music teachers and senior staff in participating schools reported that
the approach had a positive impact on students’ self-esteem, confidence,
motivation and independent learning (Hallam et al., 2015; 2017; 2018).
A study by the Norwegian Research Council for Science and
Humanities found high correlations between positive self-perception,
cognitive competence scores, self-esteem, interest and involvement
in school music (Lillemyr, 1983), while Whitwell (1977) argued that
creative participation in music improved self-image and self-awareness,
and created positive self-attitudes. Similar findings have been found
with urban black middle-school students (Marshall, 1978). Dege and
colleagues (2014) showed that the number of music lessons experienced
by 12- to 14-year-olds contributed significantly to the prediction of
academic self-concept and also motivational characteristics (for instance,
perseverance), while Degé and Schwarzer (2018) investigated the
influence of an extended music curriculum at school on academic self-
concept. They compared the academic self-concept of children between 9
and 11 years old before they started the extended music curriculum and
after one year of participation, and compared it with non-participation.
Thirty children were assessed in relation to their academic self-concept,
with the amount of non-musical out-of-school activities controlled for.
The extended music curriculum had a positive influence on academic
self-concept following a year of engagement.
Rickard and colleagues (2013) studied the impact on over 350 young
children in Grades 1 and 3 of Kodaly music classes (for the youngest
children in Grade 1) and instrumental classes, predominantly string-
based, for the children in Grade 3, in comparison with control groups.
The findings showed that these school-based music classes prevented
the decline in global self-esteem measures experienced by the control
group in both the younger and older cohorts, and in both general and
academic self-esteem for the older cohort. The data suggested that
 13. Personal, Social and Physical Development  387

increasing the frequency and quality of arts-based activities can be

beneficial for the self-esteem of primary-school-aged children. Clements-
Cortes and Chow (2018) also showed that music could prevent a decline
in self-esteem. Music interventions have proven to be a protective factor,
as positive social experiences instil confidence. Active engagement
with music can improve emotional regulation and resilience, and foster
identity and self-image, while facilitating social acceptance and a sense
of belonging in a nurturing community.
Not all of the research has shown positive outcomes. Several doctoral
dissertations have failed to find any impact of engagement with music
on self-esteem (Linch, 1994). Legette (1994) compared the effects of two
types of music instruction on first- and third-graders’ self-concepts, and
found no difference in the two types of musical activity or their impact
on self-concept. Some research has shown different outcomes for boys
and girls. For instance, Lomen (1970) found an increase in one element
of self-concept in boys only, while Wamhoff (1972) noticed a decrease
in one element of self-concept for girls taking instrumental lessons, as
compared to non-participants and girls who dropped out of the lessons.

Self-Beliefs, Deprivation and Disaffection

In Chapter 12, a range of evidence was presented which showed that
engagement with musical activities enhanced the self-beliefs, self-
esteem and positive possible selves of young people and adults involved
with a range of criminal justice systems. It also set out how music
could enhance the self-beliefs of those from communities suffering
deprivation. For instance, most evaluations of the outcomes of young
people participating in El Sistema or Sistema-inspired programmes have
pointed to a positive impact on self-beliefs.
El Sistema and Sistema-inspired programmes have prioritised the
personal and social development of participants, and many of the
evaluations point to the positive impact on self-beliefs (Esqueda Torres,
2001; 2004; Galarce et al., 2012; Israel, 2012; Uy, 2010). However, Lewis
and colleagues (2011) found no significant changes in self-esteem over
time, although comparisons of the self-esteem of children in the two
participating schools where there were differences at the beginning of
the project had disappeared by the time of the second survey. Children
388 The Power of Music

with low self-esteem at the start of the programme benefited the most.
Lopez and Berrios (2007) showed that El Sistema orchestras were
perceived as providing a positive space for self-affirmation and identity
formation. Participation was perceived to show openness to new
realities and values, tolerance to diversity, the development of personal
identity and self-affirmation. Provenzano and colleagues (2020) studied
the effects of an El-Sistema-inspired university-partnered after-school
music programme on developmental health, social and educational
outcomes. The participants were 93 fifth-grade students in a racially
and ethnically diverse, low-income elementary school. Over a period
of four years, outcomes were assessed with surveys, interviews with
music instructors and the school principal, and parent and participant
focus groups. There were significant changes in students’ perceptions
of their music-making ability, their connection to other students and
an enhanced sense of school pride. Creech and colleagues (2013; 2016)
attributed the impact of El Sistema and Sistema-inspired programmes on
self-esteem to recognition by participants of their own abilities and of
these being acknowledged by families and friends.
Shin (2011) investigated how participation in weekly music
workshops affected the academic self-concept and self-esteem of
middle-school students in low-income communities. The programme
lasted for seven weeks and consisted of playing percussion instruments,
singing, improvisation, jamming, group dancing, and dynamic and
rhythmic exploration. The assessment included a self-description
questionnaire, a parent survey and student interviews. The findings
demonstrated that there were significant differences in general school
self-concept and mathematics self-concept from pre- to post-test. Both
parents and students indicated that participation in the programme
had positively influenced students’ self-esteem. Similarly, Zapata and
Hargreaves (2017) researched the impact of a project undertaken in a
school located in a deprived neighbourhood of Bogotá, the capital of
Colombia. Two groups of 52 six- to eight-year-old children participated.
The experimental group followed an 18-week programme of singing
workshops of Colombian traditional songs and musical improvisation,
whereas the control group had no such experience. Children, teachers
and parents were involved in assessing the outcomes. A perceived
competence scale for children was administered before and after the
 13. Personal, Social and Physical Development  389

singing programme. Analysis revealed that musical activities had a

significant impact on children’s self-esteem, especially its cognitive
component.
Wood and colleagues (2013), in a ten-week intervention that
included group drumming, showed that 180 at-risk twelve-year-olds in
19 schools had a ten percent increase in self-esteem scores and improved
relationships with peers, as evaluated by teachers. School data showed a
decrease in reported behaviour incidents for 29 percent of participants.
Overall, the evaluation indicated that the DRUMBEAT programme
provided a creative medium for working with at-risk young people and
helped develop self-esteem and social relationship skills.
Some research found no differences. For instance, Costa-Giomi
(2004) randomly assigned nine-year-olds to three years of individual
piano lessons or a no-lesson control group. The two groups did not differ
in self-esteem at any point in time. Similarly, children who received a
two-year music intervention did not differ from control groups at the
beginning or end of the study (Portowitz et al., 2009). In these studies,
the children received individual music instruction and were not engaged
in group music-making. In contrast, Devroop (2012) investigated the
social-emotional impact of group instrumental music instruction on
84 disadvantaged South-African students over a period of two years.
The findings showed that there were generally increased levels of self-
esteem, optimism, happiness and perseverance after participation in an
instrumental music programme. It seems that an important element in
enhancing self-esteem through music-making may be participation in
ensembles.

Children with Special Educational Needs

and Disabilities
Some early research with children with low self-esteem or behavioural
difficulties showed no impact of musical engagement on self-esteem. For
instance, Michel (1971) researched black disadvantaged students with
low self-concept who learned to play rhythm guitar through automated
instruction. There was no effect on their self-esteem. A second study
with students with special educational needs also showed no impact.
Similarly, Michel and Farrell (1973) worked with disadvantaged boys
390 The Power of Music

aged ten to twelve with a range of problems in an all-black elementary

school, and found that the boys—who were taught to play and perform
simple chords on a ukulele—showed no enhancement of self-esteem.
Choi and colleagues (2010), working with children exhibiting
aggressive behaviour, showed that after participation in a music
programme, children showed enhanced self-esteem compared with
controls. In a qualitative study with two children with social and
behavioural difficulties, Thomas (2014) showed that, after experiencing
music lessons for a period of a year, the children demonstrated enhanced
self-confidence and self-esteem. Broh (2002) showed that students who
participated in musical activities talked more with their parents and
teachers, and concluded that these social activities were likely to lead to
higher self-esteem and self-efficacy. Keen (2004) worked with troubled
adolescents who often have low self-esteem and found that music
therapy was successful in raising self-esteem. Various techniques were
adopted including song discussion, listening, writing lyrics, composing
music and performing.
MacDonald and Miell (2002) demonstrated that educational
programmes in music composition and learning to play an instrument
could increase self-esteem in children with learning disabilities and
developmental disorders. These children face particular challenges
as they struggle with intellectual or motor issues, which physically
differentiate them from their peers and lead to them being shunned by
those around them. Participating in public performances highlighted
healthy elements which may have gone unnoticed because of the
children being assigned a label of disability. Engaging in music as a
rightful member of a musical group can change how disabled people
see themselves, enhancing self-esteem and improving relationships
with others.

Ensemble Participation
One strand of research has focused on the impact of ensemble
participation on self-esteem. In the USA, research has explored the
impact of being a member of a school band. For instance, Brown (1980;
1985) found that 91 percent of non-band parents, 79 percent of non-
band students, 90 percent of drop-out band parents and 82 percent
 13. Personal, Social and Physical Development  391

of drop-out band students agreed that participating in a band built

self-esteem, self-confidence and a sense of accomplishment. A study
with students who participated in band festivals (Gouzouasis and
Henderson, 2012) found that students valued instrumental music and
participation in band festivals as a positive, rich educational experience,
and experienced a sense of accomplishment after a good performance.
Evans and Liu (2019) examined the impact of psychological need
satisfaction and frustration in a high-school orchestra programme.
Seven hundred and four participants were surveyed in orchestra
programmes in three schools in the midwestern United States. The
influence of psychological need satisfaction and frustration were
assessed as predictors of time spent practising, intentions to continue
participation and self-esteem. Psychological need satisfaction predicted
all three outcomes, although psychological need frustration, in contrast,
showed mixed results and predicted self-esteem negatively.

Musical Preferences and Self-Esteem

Some research has focused on the relationship between self-esteem and
musical preferences. Rentfrow and Gosling (2003) failed to uncover
significant relationships between self-esteem and musical preferences,
suggesting that perceived self-worth had no effect on musical preference,
or vice versa. In contrast, Shepherd and Sigg (2015) assessed differences
in music preferences and self-esteem in 199 university students and
found that music preference scores for clusters of music genres were
found to significantly correlate with self-esteem.
In a review including 14 studies, Lawendowski and Bieleninik
(2017) examined the evidence regarding music therapy participation
and self-esteem. They argued that participation offered opportunities
to engage in identity work, defining, developing and reflecting on
personal understanding, and cultivating new expressions of self-
identity. They suggested that self-understanding developed and led to
self-acceptance and personal growth. They also drew attention to the
marked variation in research depending on the type of music therapy
used, the participants, settings, outcomes and measurement tools. A
qualitative analysis showed that expression of emotion and a sense of
agency were valuable for both participants and those around them as
392 The Power of Music

a way of providing damaged selves with ways to heal, thus improving

self-esteem.

Social Development
Music and Early Social Development
In a review, Creighton (2011) argued that early experiences of
emotional communication contribute to mother-infant attachment
and impact upon an infant’s neurological, social and emotional
development. Similar conclusions were drawn by Ilari (2016) in a
review which examined young children’s musical engagement from
a social perspective, integrating research from a wide range of fields
and theoretical orientations. Children begin to develop social skills with
their caregivers from birth. Music can play a role in this development
and in the way that mothers bond with their newborn children. For
instance, Cevasko (2008) examined the effects of mothers’ singing on
their adjustment to and bonding with their newborn infants, as well
as the use of music in the home environment in the first two weeks
after their infants’ birth. Fifty-four full-term infants and mothers and
20 premature infants (alongside 16 of their mothers) were randomly
assigned to experimental or control conditions. Mothers in both groups
were recorded singing songs of their choice for use at home. Recordings
of each pre-term mother’s voice were played for 20 minutes, three to five
times each week, at a time when the mother was not able to visit her
infant in hospital. All full-term and pre-term mothers in experimental
and control groups completed a post-test survey two weeks after the
infants were discharged. There was a significant difference between
the mothers’ perceived value of music, with the pre-term experimental
group valuing music more. They also sang to infants more than the
control group. Pre-term mothers more strongly agreed that knowing
that their child was listening to their singing helped them to cope
with their infants’ stay in hospital. In addition, pre-term infants who
listened to the CD recording of their mother’s singing left the hospital
an average of two days earlier than those in the control group, although
this difference was not statistically significant.
 13. Personal, Social and Physical Development  393

There is considerable evidence that mother-infant singing leads

to increased perceived emotional closeness and strengthening of the
mother-infant bond (Fancourt and Perkins; 2018). Fancourt and Perkins
(2017) compared the effects of singing to babies with listening to
music. Singing to babies on a daily basis was associated with enhanced
wellbeing, self-esteem and self-reported mother-infant bonding. Persico
and colleagues (2017) compared groups of women who had or had
not engaged in singing lullabies at antenatal classes in the 24th week
of pregnancy with a follow-up at three months after birth. Postnatal
bonding was significantly greater in the singing group three months
after birth.
Gerry and colleagues (2012) found that six-month-old infants
exposed to active music lessons where they were encouraged to repeat
the songs and rhymes every day at home led to superior development of
prelinguistic communicative gestures and social behaviour, compared
to infants assigned to a passive musical experience. Similarly, Pitt and
Hargreaves (2017) investigated the role of and rationale for parent and
child, up to three years old, group music-making activities in children’s
centres. The perceptions of parents and practitioners were sought
through a questionnaire which was completed by 49 practitioners and
91 parents. The questionnaire was based on a previous qualitative study
which had revealed seven thematic categories of the perceived benefits
of music: social, emotional, learning, teaching, links to home, parenting
and organisational. Statistical analyses revealed significant differences
between the expressed views of parent and practitioner groups, as
well as between parents in different broad age groups. Practitioners
expressed more positive views about the perceived benefits of music for
parents than were expressed by the parents themselves. Parents in the
majority age group, 27 to 35 years, expressed significantly more positive
opinions on a variety of questionnaire items than did parents in both
younger and older age groups.
Researching older children, Williams and colleagues (2015)
investigated parent-child home music activities in a sample of 3031
Australian children aged two to five years old, and found that shared
home music activities had a small significant partial association with
measures of children’s prosocial skills. However, Hartas (2011) found
no relationship between parents’ reported frequency of singing songs
394 The Power of Music

and rhymes or playing music at three years old and teacher-rated

performance of social emotional development at five years old.
Kawase and colleagues (2018) focused on the age of onset of group
music lessons at a music school on children’s levels of sociability.
A preliminary survey of the association between age of onset and
extracurricular musical training or activity in non-music majors implied
that musical experience from a very early age positively influenced
social skills during adulthood. In the main study, Kawase and colleagues
conducted a survey of 276 children aged four to five and six to seven
years old who commenced music lessons at ages one, two, four and six.
The findings showed that the empathy scores of children aged six to
seven who began lessons when they were one year old were greater
than those who began lessons at four years old. The communication
scores of children aged four to five who began lessons at one year old
were greater than those who began lessons when older than one year
old. The empathy and extroversion scores were high in those aged six
to seven who began lessons in that age range. In the lessons for the very
young children, simultaneous parent-child musical activities were also
likely to lead to enhanced attachment. Overall, the findings suggested
that participation in group music lessons two to four times a month can
be effective social training for very young children and foster their later
sociability.
Research with disadvantaged children and their parents has also
demonstrated the benefits of participation in musical activities. For
instance, Nicholson and colleagues (2008) explored the effectiveness
of a ten-week group music therapy programme on 358 parents who
were socially disadvantaged, young or had a child with a disability. The
children were under five years of age. Musical activities were used to
promote positive parent-child relationships and children’s behavioural,
communicative and social development. Significant improvements
were found for therapist-observed parent and child behaviours, parent-
reported irritable parenting, educational activities in the home, parent
mental health, child communication and social play skills. Other
research has shown that group music lessons for children can improve
accompanying parents’ mood (Kawase and Ogawa, 2018).
 13. Personal, Social and Physical Development  395

The Role of Synchronisation

Synchronisation of movement plays an important role in social
development. Engagement with musical rhythms at a young age
supports synchrony and more altruistic behaviour between children and
adults (Trainor and Cirelli, 2015). Parent-child attachment induced by
synchronisation increases children’s social cognitive skills (Thompson,
2008). Behrends and colleagues (2012), on the basis of the literature,
argued that coordinated movement fosters empathy and prosocial
behaviour, and synchronous and imitated movement is associated with
liking and prosocial behaviour. Supporting this, Cirelli and colleagues
(2014) arranged that each of 48 14-month-old infants were held by an
assistant and gently bounced to music while facing the experimenter,
who bounced either in or out of synchrony with the way that the infant
was bounced. The infants were then observed and placed in a situation
in which they had the opportunity to help the experimenter by handing
to her objects that she had accidentally dropped. The infants were more
likely to engage in altruistic behaviour and help the experimenter to
pick up the objects after having been bounced to music in synchrony,
compared with infants who were bounced asynchronously. A further
experiment, using anti-phase bouncing, suggested that this was due to
the contingency of the synchronous movements as opposed to movement
symmetry. These findings supported the hypothesis that interpersonal
motor synchrony might be a key component of musical engagement
that encourages social bonds among group members, but also that
motor synchrony to music may promote the very early development of
altruistic behaviour.
Kirschner and Tomasello (2009) hypothesised that children would
spontaneously synchronise their body movements to an external beat at
earlier ages and with higher accuracy if the stimulus was presented in
a social context. A total of 36 children in three age groups—2.5, 3.5, and
4.5 years old—were invited to drum along with either a human partner,
a drumming machine or a drum sound coming from a speaker. When
drumming with a social partner, children as young as 2.5 years old
were able to adjust their drumming tempo to a beat outside the range
of their spontaneous motor tempo. Children of all ages synchronised
their drumming with higher accuracy in the social condition. Similarly,
396 The Power of Music

Kirschner and Tomasello (2010) examined the relationship between

collaborative music activity and helping behaviour in four-year-old
children who engaged in three minutes of musical collaboration, and
suggested that the children who synchronised with peers showed more
spontaneous cooperative and helpful behaviour, relative to a carefully
matched control condition with the same level of social and linguistic
interaction but no music. The ability to synchronise with other children
in group music lessons also predicts attentional behaviour (Khalil et
al., 2013).
Parent-child coordination during musical activity has been shown to
be beneficial for good relationships. For instance, Wallace and Harwood
(2018) assessed parent-child musical engagement in childhood and
adolescence as a predictor of relational quality in emerging adulthood.
These findings persisted when controlling for other forms of positive
parent-child activity. Since younger children require more support from
their parents, attachment might increase through musical engagement
in younger classes as compared to older classes.
Synchronising movements with others encourages a collective social
identity, leading to increased cooperation within a group. For instance,
Good and colleagues (2017) investigated whether movement synchrony
impacted on social categorisation and cooperation across intergroup
boundaries. Two three-person groups were brought together under
movement synchrony conditions designed to emphasise different social
categorisations. All individuals moved to the same beat while each
minimal group moved to a different beat, or each individual moved to
a different beat. The findings demonstrated that movement synchrony
influenced social categorisation and cooperation across intergroup
boundaries. Valdesolo and colleagues (2010) showed that rocking in
synchrony enhanced individuals’ perceptual sensitivity to the motion of
others and increased their success in a subsequent joint-action task that
required the ability to dynamically detect and respond appropriately to
a partner’s movements. These findings support the view that in addition
to fostering social cohesion, synchrony enhances the abilities that allow
individuals to functionally direct their cooperative motives. Similarly,
Valdesolo and DeSteno (2011) manipulated rhythmic synchrony and
showed that synchronous others were not only perceived to be more
similar to the participating individual, but also evoked more compassion
 13. Personal, Social and Physical Development  397

and altruistic behaviour than asynchronous others having the same

experience. These findings support the view that a primary function of
synchrony is to mark others as similar to the self and that synchrony-
induced affiliation modulates emotional responding and altruism.
Keller and colleagues (2013) reviewed the psychological processes
and brain mechanisms that enable rhythmic interpersonal coordination,
including an overview of research on the cognitive motor processes
that enable individuals to represent joint-action goals and to anticipate,
attend and adapt to other’s actions in real time. They concluded that
music supports social cognitive tendencies including empathy and
affects coordination, which affects interpersonal affiliation, trust and
prosocial behaviour.

Musical Ensembles and Teamwork

Making music with others in small and large groups requires teamwork,
particularly when music is to be performed. Teamwork relies on
participating individuals supporting each other and developing trust and
respect. Group music-making provides an ideal vehicle for developing
prosocial, teamworking skills. Musical ensemble performance
constitutes a refined form of joint action that involves the non-verbal
communication of information about musical structure and expressive
intentions through co-performers’ sounds and body movements. From
a psychological perspective, ensemble performance necessitates precise
yet flexible interpersonal coordination of sensorimotor, cognitive,
emotional and social processes. Such interpersonal coordination is
facilitated by representations of shared performance goals, which
are consolidated during rehearsal. During actual performance, these
shared goal representations interact with sensorimotor and cognitive
processes that allow co-performers to anticipate, attend to and adapt
to each other’s actions in real time. Shared representations involve the
integration of information related to one’s own part, others’ parts and
the joint-action outcome. Shared musical representations facilitate real-
time interpersonal coordination by dynamically embodying intended
action outcomes related to the self, others and the ensemble as a whole
(Keller, 2014).
398 The Power of Music

Small ensembles, such as string quartets, are argued to be significant

examples of self-managed teams, where all members contribute equally
to a task. In larger ensembles, such as orchestras, the relationship
between conductor and orchestra clearly emerges as they come to know
each other (Volpe et al., 2016). Within small musical groups, social
relationships and the development of trust and respect are crucial for
their functioning (Davidson and Good, 2002; Davidson and King, 2004;
Goodman, 2000; Young and Colman, 1979). For long-term success,
rehearsals have to be underpinned by strong social frameworks, as
interactions are typically characterised by conflict and compromise
related mainly to musical content and its coordination, although some
interactions are of a more personal nature (for instance, approval;
Murninghan and Conlon, 1991; Young and Colman, 1979). The smaller
the group, the more important personal friendship seems to be.
Kawase (2015; 2016) studied the relationship between daily social
skills, styles of handling interpersonal conflict, non-verbal behaviour
and leadership. They requested 68 female music majors to complete
questionnaires assessing these different skills and behaviours, and
showed that a performer’s daily social skills, an integrating style of
handling interpersonal conflict, and leadership in daily communication
affected the evaluation of ensemble performance through social
behaviours during ensemble practice. Overall, daily social skills were
correlated with behaviours during ensemble practice. Performers with
a high evaluation of their ensemble performance tended to employ two
types of social behaviours: an integrating style of handling interpersonal
conflict and leadership in daily communication. No correlation was
observed between non-verbal skills in daily communication and the
evaluation of ensemble performance.
The impact of making music with others has been studied in children.
For instance, Pasiali and colleagues (2018) examined the potential
benefit of a music therapy social skills development programme to
improve the social skills of school-aged children with limited resources
in an after-school programme. Twenty students aged five to eleven years
old participated. The programme consisted of eight 50-minute sessions.
The results showed that music therapy had the potential to promote
social competence in school-aged children with limited resources,
particularly in the areas of communication and low-performance, high-
risk behaviours.
 13. Personal, Social and Physical Development  399

In the UK, peripatetic instrumental teachers working in schools

have reported considerable benefits of learning to play an instrument,
including the development of social skills, teamwork and a sense of
achievement, and enhanced confidence, self-discipline and physical
coordination (Hallam and Prince, 2000). Also in the UK, an evaluation
of informal music learning where students work in small groups to
copy popular songs by ear and ultimately create their own songs
showed a positive impact on listening skills and collaborative, peer and
teamworking as reported by music and non-music teachers and senior
staff in the schools (Hallam et al., 2016; 2017; 2018).
Being involved in the extracurricular rehearsal and performance of a
school show has been shown to facilitate the development of friendships
with like-minded individuals and make a contribution to social life
through a widespread awareness of the show by non-participants (Pitts,
2007). Such participation increased pupils’ confidence, social networks
and sense of belonging, despite the time commitment which inevitably
impinged on other activities. Similarly, Cuadrado and colleagues
(2017) researched Musicalizatech, a collaborative music production
project for secondary and high-school students. Forty-six participants
from secondary education and high schools in Seville and Cordoba,
grouped in 15 preformed bands, joined the project. The research used
questionnaires, a focus group, online diaries and interactions in an online
chatroom. The results showed impact on participants’ development of
social and emotional skills, ability to problem-solve and work in teams,
development of technological skills and clear improvements in the
process of musical creation.
Research in the USA has shown that involvement in group music
activities in high school helped individuals to learn to support each
other, maintain commitment and bond together for group goals (Sward,
1989). The benefits of band participation have been reported to include
maturing relationships. For instance, band directors talked in general
terms about the benefits of teamwork, cooperation, sense of belonging,
companionship and social development (Brown, 1980). Adderley
and colleagues (2003) investigated the meaning and value that music
ensembles engendered for their participants, and the social climate of
the music classroom. Structured interviews were conducted with 60
students, 20 each from band, choir and orchestra. Ensemble participation
400 The Power of Music

yielded musical, academic, psychological and social benefits. The

social climate emerged as an important element, as students noted
the importance of relationships for their wellbeing and growth. In the
UK, reflecting on previous and current group music-making activities,
university music students reported benefits in terms of pride in being
an active contributor to a group outcome, developing a strong sense of
belonging, gaining popularity, making friends with like-minded people
and the enhancement of social skills (Kokosaki and Hallam, 2007; 2011).
Similarly, a study of 84 members of a college choral society showed
that 87 percent believed that they had benefited socially, 75 percent
emotionally, and 49 percent spiritually from participation. Meeting new
people, feeling more positive and being uplifted spiritually were all
referred to (Clift and Hancox, 2001).

School Climate
Some research has focused on the way that the collaborative and non-
competitive elements of ensemble music-making can enhance school
climate and social interactions within school contexts (Bastian, 2000;
Gouzouasis and Henderson, 2012). In Finland, Eerola and Eerola
(2014) explored whether music education could create social benefits
in the school environment in ten schools which had an extended music
curricular class. The quality of school life was assessed by a representative
sample of 735 pupils aged nine to twelve years old. The results showed
that extended music education enhanced the quality of school life,
particularly in areas related to general satisfaction about the school, and
sense of achievement and opportunities for students. A follow-up study
examined whether the increase in critical quality of school-life variables
was related to music. This analysis utilised data from other classes, with
an extended curriculum in sports or visual arts. These classes did not
confer similar benefits. Overall, the results suggested that extended
music education had a positive effect on the social aspects of schooling.
In a major study in Switzerland, Spychiger and colleagues 1993) found
that increasing the amount of classroom music within the curriculum
increased social cohesion within class and led to greater self-reliance,
better social adjustment and more positive attitudes, particularly in low-
ability, disaffected pupils.
 13. Personal, Social and Physical Development  401

Sistema Programmes
Evaluations of individual El Sistema or Sistema-inspired programmes,
where children experience intensive and prolonged engagement in an
orchestral community, have reported the strengthening of children’s
sense of individual and group identity, of children taking pride in their
accomplishments, and of enhancement in determination and persistence.
Children valued their participation as a social activity, a way to enjoy
music with others and strengthen friendships with peers, working in
teams and acquiring musical skills. Many of the evaluations of Sistema-
inspired programmes in the USA refer to enhanced peer relationships,
demonstrating respect and having consideration for others. Because of
their experiences in orchestras and ensembles, participants understood
the importance of working cooperatively (Creech et al., 2013; 2016).
Intensive ensemble activities are seen as a rich opportunity for nurturing
positive citizenship skills, including respect, equality, sharing, cohesion,
teamwork and the enhancement of listening as a major constituent of
understanding and cooperation (Majno, 2012). Slevin and Slevin (2013)
suggested that the programmes offered a safe and nurturing space where
children learned what it meant to pursue an ideal. They argued that
this type of teamwork, where the goal depended on individual effort,
enabled personal development. Similarly, Lewis and colleagues (2011)
revealed improvements in social skills and the development of positive
group identity in an ElSistema-inspired programme. Pupil surveys
administered two years apart indicated statistically significant change
in relation to social skills and relationships. Children reported how they
tried to help others and take turns. Interviews with parents and teachers
reinforced these findings. The parents suggested that this was because
the children were proud of their musical achievements and because
the programme offered opportunities for developing social skills and
discipline. Teachers also indicated that pupils had a greater sense of
purpose and self-confidence. Smithhurst (2011) and Burns and Berwick
(2012) found enhanced confidence and social skills to be outcomes, while
programmes in Scotland showed enhanced confidence, happiness and
teamworking skills (GEN, 2011a; 2011b). In Ireland, after three years, a
Sistema-inspired programme was found to foster a strong positive group
identity. When asked to design a new school crest, every child produced
402 The Power of Music

a design that included a musical symbol (Kenny and Moore, 2011).

Parents and others in evaluations by Campe and Kaufman (2013) and
Savoie (2012) indicated that playing in Sistema-inspired musical groups
supported students in their social development, providing an important
scaffold for developing collaborative skills. These skills transferred to
other school and home settings. Galarce and colleagues (2012), based
on findings from focus group data, found that students participating in
a Sistema-inspired programme in the Caribbean demonstrated improved
social skills, cooperation, teamwork, communication and a protective
social network after only six months of participation. Quantitative data
showed that students were significantly less likely to get angry and be
aggressive, and be less involved in teasing, shoving, hitting, kicking or
fighting. Similarly, Bergerson and Motto (2013) found that students
experienced greater empathy for others who shared their interests.
In Argentina, Wald (2011a; 2011b), researching two Sistema-inspired
programmes, found evidence of enhanced self-esteem, self-worth, self-
confidence, pride, motivation, commitment, social responsibility and
socialisation. Comparing programmes in Venezuela and the USA, Uy
(2010) reported improvements in relaxation and coping, communication,
the ability to work with others and self-esteem. Osborne and colleagues
(2015) explored the academic and psychosocial impact of El-Sistema-
inspired music programmes in two low socioeconomic schools, where
students experienced generational poverty or had current or first-
generation immigrant or refugee status. Ninety-two students in Years
3 to 6 completed audiovisual assessments of psychosocial wellbeing.
Comparisons by school and programme participation over a period of 12
months indicated improved psychosocial wellbeing for students in one
school. Overall, many positive social outcomes of Sistema programmes
have been reported internationally (Creech et al., 2013; 2016), although
there are exceptions: for instance, Villalba (2010) found that some
students did not feel completely integrated and others were bored. This
suggests that the nature of the musical activities in these programmes
plays an important role in mediating any wider non-musical outcomes.
 13. Personal, Social and Physical Development  403

Prosocial Skills and Empathy

One of the most frequently cited benefits of group music-making is
its impact on prosocial behaviour. From an evolutionary perspective,
Hagen and Bryant (2003) have argued that group music-making and
dancing evolved as ways of demonstrating internal stability in the
group and the ability to act collectively in establishing meaningful
relationships with other groups. Music and dance can also act as
effective tools to maintain bonds within social groups, increasing
cooperation and prosocial behaviour (Huron, 2001; 2003). Members of
musical groups have to pay attention to the actions and intentions of
the other players, and their physical and emotional states (Cross et al.,
2012). This promotes states of togetherness (Huron, 2001; 2003; Cross,
2009). Understanding the emotional state of others is key to developing
empathy—the ability to produce appropriate responses to the situation
of others that approximate their responses and experiences, as well as
an awareness and identification of their emotions (Lieberman, 2007).
Cross and colleagues (2012) suggest that music has empathy-promoting
components which can lead to shared intentionality, understanding of
the intentions of others, the adoption of a common object of attention
(Tomasello et al., 2005) and intersubjectivity (Rabinowitch et al., 2012).
There is evidence that engagement in making music can enhance
children’s prosocial behaviour and empathy. Ritblatt and colleagues
(2013) examined the effects of a school readiness music programme
on preschool children’s socioemotional readiness to transition to
kindergarten. They found that those participating in musical activities
improved on a range of social skills, including social cooperation, social
interaction and social independence.
In other research, preschool and primary-school children who
participated in a special music empathy programme—which highlighted
the importance of empathy through singing and composing songs
about empathy, as well as discussing how children empathise—also
demonstrated high empathy levels (Kalliopuska and Ruokonen, 1986;
1993; Kalliopuska and Tiitinen, 1991). Schellenberg and Corrigall (2015)
investigated whether group music training in childhood was associated
with prosocial skills. Children in third and fourth grade who attended
ten months of music lessons taught in groups were compared to a control
404 The Power of Music

group of children matched for socioeconomic status. All children were

administered tests of prosocial skills near the beginning and end of
the ten-month period. Compared to the control group, children in the
music group had larger increases in sympathy and prosocial behaviour,
but this effect was limited to children who had poor prosocial skills
before the lessons began. The effect was evident even when the
lessons were compulsory, which minimised the role of self-selection.
Rabinowitch and colleagues (2013) studied 52 children aged eight to
eleven years old who were randomly assigned to musical activities,
games or acted as a control group. The musical intervention consisted
of a range of musical games which were designed to encourage musical
interactions and working together creatively. Entrainment games were
designed to encourage rhythmic coordination, and imitation games to
highlight imitative and gestural encounters, shared intentionality and
intersubjectivity. The children took a battery of tests at the beginning and
end of the study, which included three measures of emotional empathy.
Two out of three of the empathy measures increased in the children in
the music group. Similarly, Hietolahtiansten and Kalliopuska (1991)
surveyed 12-year-old children who had been musically active for about
six years and same-age control children with no musical activity, and
found that the musically trained children scored significantly higher on
scores of empathy.
Related to empathy is the concept of emotional sensitivity. As music
is closely linked with the emotions, it is possible that active music-
making has the capacity to increase emotional sensitivity (Hunter and
Schellenberg, 2010). For instance, Resnicow and colleagues (2004) found
that there was a relationship between the ability to recognise emotions
in performances of classical piano music and measures of emotional
intelligence, which required individuals to identify, understand, reason
with and manage emotions using hypothetical scenarios. The two were
significantly correlated, which suggests that identification of emotion
in music performance draws on some of the same skills that make up
everyday emotional intelligence. There is also evidence that music
training enhances sensitivity to emotions in speech (Thompson et
al., 2004). Similarly, Schellenberg and Mankarious (2012) studied the
relationship between understanding emotions and music training in 60
seven- to eight-year-olds. The musically trained children had at least
 13. Personal, Social and Physical Development  405

eight months of formal musical training out of school, mainly through

private individual lessons. The findings showed a positive association
between music training and emotional ability.
Comparing the effects of different musical interventions, Rose
and Colleagues (2019) investigated the effects of musical instrument
learning on the development of 38 seven- to nine-year-old children. Pre-
and post-test measures of socioemotional behaviour were compared
in children who received either extracurricular musical training or
statutory school music lessons. There were no statistically significant
differences in socioemotional behaviour between the groups. In a
retrospective study, Theorell and colleagues (2014) assessed whether
musical creative achievement and musical practice were associated
with emotional competence. Eight thousand Swedish twins aged 27
to 54 were studied. Musical achievement and musical practice were
related to higher emotional competence, although the effect sizes were
small. Focusing on the impact of listening and observation, Haner and
colleagues (2010) studied the effects of a children’s opera about bullying
presented to five classrooms in three schools. Data were available for
104 children in Grades four and five. Knowledge of bullying increased
significantly after participation and there was a significant decrease in
self-reported victimisation.

Interventions for Children with Special

Educational Needs and Disabilities
One strand of research has focused on children with a range of special
educational needs and disabilities. For instance, music therapy studies
with young autistic children have shown enhanced social, verbal and
communication skills and emotional development (Oldfield, 2006).
Dezfoolian and colleagues (2013) studied five children with autism who
had no previous experience in music or play therapy. Social interaction,
verbal communication and repetitive behaviour of the participants were
scored before and after the Orff music therapy. All participants improved
significantly in their social interactions and verbal communication.
Similarly, Kim and colleagues (2009) studied improvisational music
therapy and toy-playing sessions using DVD analysis of sessions with
children on the autistic spectrum. Improvisational music therapy
406 The Power of Music

produced markedly more and longer events of emotional synchronicity

and initiation of engagement behaviours in the children than toy-
playing sessions. In response to the therapist’s interpersonal demands,
compliant positive responses were observed more in music therapy
than in toy-playing sessions. No responses were twice as frequent in
toy-playing sessions as in music therapy. The findings supported the
value of music therapy in promoting social, emotional and motivational
development in children on the autistic spectrum. Hillier and colleagues
(2012) reported the findings of a pilot music programme for adolescents
and young adults with Autism Spectrum Disorder. Evaluation of the
programme focused on self-esteem, anxiety and attitudes toward/
relationships with peers. Pre- and post-outcome measures showed a
significant increase in self-esteem, reduced self-reported anxiety and
more positive attitudes toward peers.
Zyga and colleagues (2017) focused on children with intellectual
disabilities, as these can cause a child to have significant deficits in
social skills and emotional regulation abilities. They investigated the
feasibility of delivering a school-based musical theatre programme to
students with intellectual disability across a range of school settings.
Video recordings were coded for socioemotional ability across each of
the 47 participants. The findings showed significant gains across all
domains, although these gains related to school- and individual-level
student factors such as grade level, severity of disability and baseline
social-skill level.
One project explored the impact of musical engagement as part of the
National Orchestra for All on 35 young people with special educational
needs following a summer residential programme. There were
statistically significant increases with a large effect size for self-esteem,
emotional wellbeing, resilience and life satisfaction. Participating girls
seemed to benefit more than boys (Hay, 2013; NPC, 2012).

Physical Development
As we saw in Chapter 2, research in the field of neuroscience has
shown that intensive instrumental music training affects the anatomy
of the brain, with greater grey-matter volume seen in motor-related
areas (Elbert et al., 1995; Hyde et al., 2009; Pascual-Leone, 2001) and
 13. Personal, Social and Physical Development  407

greater white-matter volume in motor tracts (Bengtsson et al., 2005),

with differences emerging after one year of music training (Hyde et al.,
2009; Schlaug et al., 2005). There are also very specific differences in
relation to the instruments played (Bangert and Schlaug, 2006). Despite
this, there is relatively little research exploring the impact of active
engagement with making music on physical development, although
children and adults frequently respond to music with movement. For
instance, Overy (2014) studied the impact of beat on children’s natural
responses to music and showed that four-year-old children showed
spontaneous, energetic movement responses which were highly periodic
and repetitive—such as jumping, swaying and twisting—often in close
synchrony with the auditory beat pattern, although not always in time.
She concluded that the human motor system responds powerfully to
an auditory beat pattern, but that there are large individual differences
in preferred movements. Also, individuals frequently use music as
a motivator when they are exercising. Research related to this will be
discussed fully in Chapter 17.
There is evidence that learning to play an instrument improves fine
motor skills (Schlaug et al., 2005). Early training may be important, as
Watanabe and colleagues (2007) showed that musicians who trained
before the age of seven had better performance in a timed motor
sequence task than musicians who began training later. Early- and
late-trained musicians were matched for years of musical experience,
years of formal training and hours of current practice. The early-trained
musicians performed better than the late-trained musicians. This
advantage persisted after five days of practice. Performance differences
were greatest for a measure of response synchronisation, suggesting
that early training has its greatest effect on neural systems involved in
sensorimotor integration and timing.
Some research has focused on fine motor abilities. For instance,
Costa-Giomi (2005a) compared the fine motor abilities of children who
participated in two years of piano instruction and those who had never
received formal music training. A significant improvement in fine motor
skills was found only for the children who received the music lessons.
There was also a significant difference in the speed of response between
the two groups at the end of the two years of instruction. Similarly, James
and colleagues (2019) carried out a cluster randomised controlled trial
408 The Power of Music

which provided evidence that focused musical instrumental practice,

in comparison to traditional sensitisation to music, provoked multiple
transfer effects in the sensorimotor domain. Over the last two years
of primary school, 69 ten- to twelve-year-old children received group
music instruction by professional musicians twice a week as part of the
regular school curriculum. The intervention group learned to play string
instruments, whereas the control group (peers in parallel classes) were
sensitised to music through listening, theory and some practice. There
were benefits for the intervention group as compared to the control group
for sensorimotor hand function and bimanual coordination. Learning
to play a complex instrument in a dynamic group setting appears to
impact development more strongly than classical sensitisation to music.
Martins and colleagues (2018) conducted a longitudinal training
study to examine if collective, Orff-based music training enhanced fine
motor abilities when compared to a homogeneous training programme
in basketball, or to no specific training. The training programmes in music
and sport had the same duration, 24 weeks, and were homogeneous in
structure. A design including tests prior to training, post-training and
a follow-up was adopted. Seventy-four children attending the third
grade, aged eight years old, were pseudo-randomly divided into three
groups—music, sport and control—that were matched on demographic
and intellectual characteristics. Fine motor abilities relating to hand-
eye coordination and motor speed subsumed under manual dexterity,
bimanual coordination and manipulative dexterity were tested. All
groups improved in manipulative dexterity but the children engaged
in the music programme showed an advantage in relation to bimanual
coordination and manual dexterity. This persisted for four months after
the programme ended.

Music, Locomotor Performance and

Coordinated Motor Skills
Some research has explored whether rhythmic accompaniment can
improve performance in physical education programmes. In early
research, Anshel and Marisi (1978) observed positive results in
performance accuracy and endurance when music was rhythmically
synchronised with motor performance. Painter (1966) found similar
 13. Personal, Social and Physical Development  409

results. Beisman (1967) showed that throwing, catching, jumping and

leaping improved when children participated in a programme involving
rhythm. Brown and colleagues (1981) studied two approaches to
facilitating perceptual motor development in children, aged four to six
years old. The experimental group, with 15 children, received 24 sessions
of integrated physical education and music instruction, based on the
methods developed by Kodaly and Dalcroze. The control group of 15
children received 24 sessions of movement exploration and self-testing
instruction. The experimental group showed significant improvement,
with changes in motor, auditory, and language aspects of perceptual
motor performance, as well as a total score.
Derri and colleagues (2001) investigated the effect of a ten-week music
and movement programme on the quality of locomotor performance in
68 four- to six-year-old children. The children were assessed on running,
skipping, galloping, hopping, leaping, sliding and horizontal jumping.
Thirty-five children participated in the exercise programme twice a week,
while the control group did not participate in any organised physical
activity programme. The findings showed that the experimental group
improved on galloping, leaping, horizontal jumping and skipping. A
later study showed that the programme compared favourably with
free-play activities (Deli et al., 2006). Similarly, Zachopoupou and
colleagues (2004) compared the effect of a developmentally appropriate
music and movement programme and a developmentally appropriate
physical education programme on the development of jumping and
dynamic balance in children aged four to six years old. Ninety children
participated. Fifty followed the music and movement programme which
lasted for two months. The remainder served as the control group
and followed a physical education programme for the same period
of time. The results showed that the experimental group improved
significantly in jumping and dynamic balance. Rose and Colleagues
(2019) investigated the effects of musical instrument learning on the
development of 38 seven- to nine-year-old children. Pre- and post-test
measures of motor ability and visual motor integration were compared
in children who received either extracurricular musical training or
statutory school music lessons. The children receiving extracurricular
lessons showed a significant increase in visual motor integration and
in gross motor ability for aiming and catching measures. It seems
410 The Power of Music

that musical activities may support development in a child’s ability to

judge distance, consider velocity, focus, and use their proprioceptive,
interoceptive and exteroceptive nervous system.

Overview
There is clear evidence that music plays an important role in the
development and maintenance of identity, although the extent to which
this applies may vary among individuals depending on their hobbies and
interests. Musicians as a group have been shown to be more open to new
experiences than the general population. Beyond this, there are no clear
personality differences between musicians and the general population,
or between those playing different instruments. However, differences
have emerged with more clarity in relation to the genre of music with
which musicians are engaged. This suggests that the context in which
music is rehearsed and performed influences personality development.
There is strong evidence across genres that professional musicians and
those training to become professional musicians experience performance
anxiety and may experience perfectionistic work tendencies. The latter
can have positive benefits in terms of motivation and conscientiousness
but may be detrimental when the musician becomes focused on
imperfect performances. Music can have a positive impact on self-esteem
in children and young people, providing that feedback from peers,
teachers and families is positive. This is particularly evident in those
from disadvantaged backgrounds or those with special educational
needs or disabilities. If feedback on performance, even practising at
home, is negative rather than constructive, the impact on self-esteem
can be detrimental.
In children and young people, group music-making in large and small
groups generally promotes the development of social skills, teamwork
and empathy, although there may be exceptions to this (for instance,
if a group member does not contribute equitably). Issues can arise in
the working of small groups of professional musicians, although the
need to prepare for public performance may support the development
of skills which help to resolve any challenges—for instance, compromise
and leadership skills—in order that the group can perform well.
Synchronisation of movement plays a role in supporting group working
and may have evolved in order to enhance group cohesion.
 13. Personal, Social and Physical Development  411

Learning to play a musical instrument which requires coordinated

complex movements enhances fine motor skills in young children.
When children are able to engage in movement to music, this impacts
positively on a range of athletic skills including jumping, skipping,
throwing and catching.
 14. Psychological Wellbeing

Psychological wellbeing is typically viewed as comprising hedonic

(feeling good) and eudaimonic (functioning well) components. The
emphasis given to each of these varies between conceptualisations.
Seligman (2002) proposed the concept of ‘authentic happiness’,
which consists of pleasure, engagement and meaning. More recently,
the concepts of relationships and accomplishment have been added
(Forgeard et al., 2011; Seligman, 2010; 2011,) leading to the acronym
‘PERMA’, which stands for positive emotion, engagement, relationships,
meaning and accomplishment. Others have argued that positive human
experience is only related to hedonic wellbeing, positive emotion, the
absence of negative emotions and an evaluative component termed ‘life
satisfaction’ (Diener et al., 1999). More recently, Diener and colleagues
(2010) added the concept of ‘flourishing’, which includes purpose
in life, positive relationships, engagement, competence, self-esteem,
optimism and contribution to the wellbeing of others. Despite these
different conceptualisations, there is agreement that wellbeing is multi-
dimensional. Approaching the conceptualisation of wellbeing from
a different perspective, Huppert and So (2013) equated high levels
of wellbeing with positive mental health. They argue that wellbeing
lies at the opposite end of the spectrum to common mental disorders,
depression and anxiety. By examining internationally agreed criteria
for depression and anxiety and defining the opposite of each symptom,
they identified features of positive wellbeing which combined feeling
and functioning. The elements that emerged were:
• competence, concentration, attention, decision-making,
general competence;
• emotional stability, feeling calm, relaxed, even-tempered;
• engagement, interest, pleasure, enjoyment;

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.14

414 The Power of Music

• meaning, purpose, worth, value in life;

• positive relationships, social relationships, positive affirmation;
• optimism, hopeful for the future;
• positive emotion, positive mood, happy, cheerful and
contented;
• resilience, managing anxiety and worry, emotional resilience;
• Self-esteem, feelings of self-worth, confidence;
• vitality, feeling energetic, not fatigued or lethargic;
• life satisfaction, positive appraisal of life in general.

Previous chapters have set out the role that music can play in relation
to many of these elements, including competence, engagement,
positive relationships, self-esteem and (to a lesser extent) resilience
and optimism. Some elements can be met by active engagement with
music, and others through listening to music, although there is overlap
between these. Actively making music offers the most opportunities
for supporting competence, self-esteem and resilience, while listening
to music is more likely to support emotional stability and positive
emotions. Both can support engagement, meaning, optimism, positive
relationships and vitality.
There is an ever-increasing body of research on the benefits of
engaging with music in relation to psychological wellbeing. This chapter
will consider the impact of listening to and actively engaging with
music through the different phases of the lifespan. Positive associations
between engaging with music and wellbeing have been demonstrated
in early childhood (Linnavalli et al., 2018; Trainor et al., 2012), in
terms of children’s educational outcomes (Guhn et al., 2019), sense of
social inclusion (Welch et al., 2014) and social cohesion (Elvers et al.,
2016), in adolescence (McFerran et al., 2019), adulthood (Greasley and
Lamont, 2006), older age (Laukka, 2007; Lindblad and de Boise, 2020)
and overall development (Biasutti et al., 2020). Drawing conclusions
about the research is not without its difficulties. For instance, in a
recent review, Daykin and colleagues (2018) pointed out that there was
a lack of consistency in how wellbeing was assessed and in the range
of musical interventions implemented. Overall, they reported that
music was associated with reduced anxiety in young adults, enhanced
 14. Psychological Wellbeing  415

mood and purpose in adults, and mental wellbeing, quality of life,

self-awareness and coping in people with diagnosed health conditions.
Music listening and singing were shown to be effective in enhancing
morale and reducing risk of depression in older people, while a few
studies addressed wellbeing in individuals with dementia. Sheppard
and Broughton (2020) also reviewed the literature and showed that
music and dance were related to key social determinants of health
from social, cultural, physical and mental health perspectives. Similarly,
O’Donnell and colleagues (2021), in a systematic review which
included 32 studies with 1,058 participants focusing on wellbeing in
adults over 18 years of age, showed that participatory arts interventions
benefited mental health through improved connectedness, emotional
regulation, meaning-making and redefining identity, personal growth
and empowerment. Benefits relating to wellbeing have been found,
whether individuals volunteer to participate or are referred by health
or social care professionals. Music has been recognised for its beneficial
effects on physical health (Fancourt and Finn, 2019; Hanser, 2010; Jones
et al., 2013; MacDonald et al., 2012; Pelletier, 2004; van den Elzen et
al., 2019). Research focusing on the way that music has been used in
medical contexts will be discussed in Chapter 15. The remainder of this
chapter will set out the way in which music can enhance wellbeing and
consider its role across the lifespan from infancy, through the school
years, adolescence, young adulthood, the adult years and into older
age, concluding with a section on music and wellbeing in the COVID-19
pandemic.
The impact of music on psychological wellbeing and good health is
largely, although not exclusively, through the emotions it evokes. Music
elicits emotions and changes moods through its stimulation of the
autonomic nervous system and limbic and related biological systems,
including endocrine and hormonal responses (Krout, 2007). Bodily
responses linked with emotion include changes in dopamine, serotonin,
cortisol, endorphin and oxytocin levels (Kreutz et al., 2012) and
cardiovascular indicators, blood pressure and pulse (Lee et al., 2016).
Some changes in response to music can occur without an individual’s
conscious awareness. In two multilevel meta-analyses of 104 studies
with 9,617 participants, de Witte and colleagues (2019) showed that
interventions using music had an overall significant positive effect on
416 The Power of Music

stress reduction, physiologically and psychologically, although greater

effects were found for heart rate when compared to blood pressure.
Overall, music can reduce stress and increase relaxation (Fukui and
Yamashita, 2003; Kreutz et al., 2004) but the outcomes depend on the
nature of the music (Kimberley et al., 1995). For instance, Gerra and
colleagues (1998) investigated emotional and endocrine changes in
response to listening to techno music. Sixteen young people were
exposed to techno or classical music for 30 minutes each. Concentrations
of plasma norepinephrine, epinephrine, growth hormone, prolactin,
adrenocorticotropic hormone, cortisol and β endorphin were assessed
before and after the listening activity. Techno music significantly
increased heart rate and systolic blood pressure, and led to changes
in the assessed neurotransmitters, peptides and hormones related to
mental state and emotional involvement. Classical music also enhanced
emotional state, but did not lead to significant changes in hormonal
concentrations. Similarly, Evers and Suhr (2000), working with adults,
investigated the short-term effects of listening to different musical
excerpts on serum concentrations of prolactin, adrenocorticotropic
hormone and serotonin, the latter contributing to feelings of wellbeing.
Some excerpts were characterised as pleasant—for instance, Brahms’
‘Symphony No. 3, Opus 90’—while others were perceived as unpleasant
(for instance, Penderecki’s ‘Threnos’, which is in part composed in
quarter tones to exaggerate the dissonance of the music). Listening to
Threnos led to a reduction in concentrations of serotonin, suggesting a
negative impact on wellbeing.
The most comprehensive attempt to outline the mechanisms that may
underpin music’s impact on the emotions is the BRECVEMA framework
(Juslin, 2013). This features eight mechanisms through which music
affects emotions:
• Brain stem reflex: a hard-wired attention response to simple
acoustic features such as extreme or increasing loudness or
speed (Juslin et al., 2014);
• Rhythmic entrainment: a gradual adjustment of an internal
body rhythm—for instance, heart rate—towards an external
rhythm in the music (Harrer & Harrer, 1977);
 14. Psychological Wellbeing  417

• Evaluative conditioning: a regular pairing of a piece of music

and other positive or negative stimuli leading to a conditioned
association (Blair and Shimp, 1992);
• Emotional contagion: perception of emotionally relevant
expressions in the music which is then copied (Juslin, 2000;
Lundqvist et al., 2009);
• Visual imagery: images with emotional qualities evoked by
the music (Osborne, 1981);
• Episodic memory: a conscious recollection of a particular event
from the listener’s past triggered by the music (Baumgartner,
1992);
• Musical expectancy: a reaction to the gradual unfolding of the
musical structure and its expected or unexpected continuation
(Meyer, 1956); and
• Aesthetic judgment: a subjective evaluation of the aesthetic
value of the music based on an individual set of weighted
criteria (Juslin and Sloboda, 2010).

The specific way in which emotions are invoked depends on complex

interactions between the nature of the music, the individual and the
context. Individual preferences play a major role. The more that the
individual is familiar with particular genres or pieces of music, the more
they are preferred (North and Hargreaves, 2008). This process begins in
early childhood. This explains why music that is pleasurable for some
individuals may be unpleasant for others. The greatest positive benefits
of music on wellbeing and health occur when individuals are able to
select the music that they are to listen to (Krause et al., 2015; Mitchell
et al. 2006a; 2006b). This is particularly important when music is being
used to reduce anxiety or pain (Bernatzky et al., 2012; Mitchell and
MacDonald, 2012). If individuals are exposed to music that they do not
like in contexts where they have no control, they may remove themselves
from the situation, but if that is not possible, the music can cause extreme
distress. Although individuals react to music in different ways, there are
some musical characteristics which tend to have a relatively consistent
effect on arousal levels (which are implicated in emotional responses).
418 The Power of Music

Quiet, slow music tends to lead to a lowering of arousal levels, while fast
and loud music tends to increase arousal (North and Hargreaves, 2008).
Music can engender intense, strong emotional experiences. These
generally occur when listening to music rather than performing
(Gabrielsson, 2001, 2002, 2011; Gabrielsson and Lindström Wik,
2003). Such experiences have overall general characteristics including
physical reactions and behaviours; perceptual and cognitive responses;
changes in feelings and emotions; existential and transcendental
aspects; and personal and social aspects. Individuals report sensations
of joy, happiness, rapture, euphoria, calm and peace which have high
significance and can lead to long-term benefits, with lives becoming
more fulfilling, spiritual and increasingly harmonious (Schäfer et
al., 2014) with a positive impact on wellbeing (Lamont, 2011; 2012).
Memories of such experiences can be used as sources for self-therapy,
inspiration and motivation, and provide insights into alternative ways
of being (Gabrielsson, 2011; Gabrielsson and Lindström, 1995). Most
occur in adolescence and early adulthood (Gabrielsson and Lindström
Wik, 2003).

The Use of Music to Support Emotional Stability and

Manage Moods
A key human ability is the capacity to regulate emotion, modifying
positive or negative aspects, intensity and time course (Barrett and
Gross, 2001; Cole et al., 2004), physiological processes, and emotion-
related behaviour (Eisenberg, 2004; Eisenberg and Spinrad, 2004;
Gross, 1998). Emotional self-regulation also includes the management
of moods which are generally differentiated from emotions in terms
of their longer duration, lack of specific cause and greater focus on
internal experiences rather than overt behaviour (Gross, 2015). Mood
regulation refers to the processes involved in modifying or maintaining
the occurrence, duration, and intensity of moods (Cole et al., 2004;
Eisenberg and Spinrad, 2004; Gross, 1998).
Music can promote subjective feelings of wellbeing, provide a means
of working through difficult emotions, and is often linked to spirituality
(Juslin and Sloboda, 2001). It is frequently used as a regulatory strategy
for maintaining or changing moods, emotions, arousal levels and to
 14. Psychological Wellbeing  419

reminisce (DeNora, 1999; Juslin and Laukka, 2004; Parker and Brown,
1982; Rippere, 1977; Schäfer et al., 2013; Silk, 2003; Thayer et al., 1994). It
can induce positive affective states (North et al., 2004), help to achieve
desired moods—whatever they may be (Vastfjall, 2002) and act as a
supporting strategy when coping with negative moods and emotions
(Miranda and Claes, 2009; Shifriss and Bodner, 2015). It may be that
this is one of the reasons why music plays such an important role in the
lives of most people (Sloboda et al., 2009). Certainly, mood regulation
is reported to be one of the most important reasons why people listen to
music (Christenson and Roberts, 1998; North et al., 2000; Sloboda and
O’Neill, 2001; Wells & Hakanen, 1991). Even adolescents who play an
instrument report that the best activity for mood regulation is listening
to music alone (Saarikallio, 2006). Music is used for self-regulation by
adolescents (Behne, 1997; Laiho, 2004; Roe, 1985), adults (Greasley and
Lamont, 2006), and the elderly (Davidson et al., 2008). It can be used
to maintain positive moods, for revival and energising, to create strong
sensations, as a diversion, as discharge, for mental work, for solace and
for psyching up (Saarikallio, 2011).
The extent to which music relates to wellbeing has been demonstrated
in several reviews. For instance, Schäfer and colleagues (2013) identified
129 functions of listening to music. Ratings by 834 respondents led
to the emergence of three underlying dimensions: listening to music
to regulate arousal and mood, achieving self-awareness, and as an
expression of social relatedness. Similarly, Krause and colleagues (2018)
identified 2,075 benefits of music based on a review of 97 published
articles. These were reduced to 562 benefits to wellbeing which were
perceived to be associated with musical participation. From these, five
dimensions were identified: mood and coping, self-esteem and worth,
socialisation, cognition and self-actualisation. Saarikallio and colleagues
(2018) collected data from 464 online participants and established that
the pleasure derived from music was based in part on sensations of
relaxation, power and passion, but also feelings of kinship relating to
social values and mental contemplation. Reminiscence is also a frequent
function of self-chosen music listening. This is particularly prevalent
in older adults (Hays and Minichiello, 2005; Juslin and Laukka, 2004),
although it is also found in young people (Tolfree and Hallam, 2016).
Overall, music is one form of attending to and reappraising emotional
420 The Power of Music

experiences (Ruud, 1998; Sloboda and O’Neill, 2001). Van Goethem

and Sloboda (2011) carried out diary studies alongside interviews and
established that music helped individuals through the use of several
regulation strategies. For instance, it could help to distract someone from
an emotion or a situation, or help to consider either in a rational way. It
plays a major role in assisting relaxation and promoting happiness.
Cognitive reappraisal seems to play an important role in the way that
music impacts on wellbeing. If listening to music, making music and
social engagement are coupled with a tendency to regulate emotions
and thoughts by suppressing emotion, there may be negative outcomes.
Suppressing outward expressions of emotions does not decrease negative
feelings and emotional arousal. High levels of engagement with music
through listening or participating have been associated with a greater
use of cognitive reappraisal. This may be because music provides a safe
platform for exploring and expressing emotions, positive and negative
(Huron, 2006). In this way, the process of emotion regulation may act
to mediate the relationship between musical engagement and wellbeing
(Chin and Rickard, 2012).
Thoma and colleagues (2012) demonstrated a clear preference for
music congruent with the specific emotional situation of the individual
at the time, while Randall and colleagues (2014) suggested that listeners
adopted particular regulation strategies based on their initial mood,
emotional wellbeing and health which would enable them to reach
their desired emotional goal. Similarly, Randall and Rickard (2017b),
in research with 327 young adults, concluded that music listening
was determined by initial mood and emotional health with the aim
of fulfilling specific emotional needs. Randall and Rickard (2017a),
based on data from research with 195 participants, demonstrated that
generally music returned moods to a neutral state, although sometimes
music was selected which was congruent with a current mood. Where
music was used to cope with very difficult situations or forget problems,
it tended to be associated with overall negative affective states and poor
emotional health and wellbeing. In a critical analysis, McFerran (2016)
suggested that the use of music to maintain negative moods by seriously
distressed individuals could lead to increasingly negative outcomes.
As research has developed over time, inconsistencies in terms
of conceptualisation and terminology have emerged (Baltazar and
 14. Psychological Wellbeing  421

Saarikallio, 2016). It has become clear that the impact of music on

wellbeing is not straightforward. For instance, Kantor-Martynuska
(2015) suggested that the way that individuals respond to music depends
on an interaction between the properties of the music, the relatively
stable traits of the listener, his or her current emotional state and their
current situation. A considerable body of research has focused on why
individuals choose to listen to sad music (Huron and Vuoskoski, 2020;
Tahlier et al., 2013; Van den Tol and Edwards, 2015). For instance, Sachs
and colleagues (2015) suggest that listening to sad music can bring
about positive change by correcting an ongoing homeostatic imbalance.
They argue that sadness evoked by music is pleasurable when it is
perceived as non-threatening, is aesthetically pleasing and produces
psychological benefits such as mood regulation and empathic feelings
caused, for instance, by recollection of and reflection on past events.
Garrido and colleagues, in several studies, also explored why people
listen to sad music (Garrido, 2017; Garrido and Schubert, 2013). Garrido
and Schubert (2015a) studied 335 participants who listened to a self-
selected piece of sad music. They found that participants’ depression
increased after listening. Similarly, Garrido and Schubert (2015b),
studying 175 university students who listened to a self-selected piece
of music on YouTube, found that listening could significantly increase
depressive feelings in those with depressive tendencies. In an online
survey of 137 participants, Garrido and Schubert (2013) showed that
listening to sad music could have adaptive or maladaptive uses. They
explained this by the dissociation theory of aesthetic enjoyment, where
participants with the capacity to enter states of absorption are able to
deactivate displeasure circuits and hence enjoy negative emotions in
music. Garrido and colleagues (2017) explored these issues further,
investigating whether listening to sad music in group settings provided
social benefits for emotionally vulnerable listeners, or whether it further
exaggerated depressive tendencies. Six hundred and ninety-seven
participants aged 16 to 74 years of age were recruited through online
depression groups and mental health websites in the USA, Australia,
the UK, South America, Africa, Asia and Europe. A survey of listening
habits revealed that participants with depression were more likely to
engage in group rumination (the process of continuously thinking the
same thoughts, usually sad and dark). Those with depressive tendencies
422 The Power of Music

seem to struggle to regulate their emotional responses in musical

contexts (McFerran, 2016) and group interactions focusing on sad
music exacerbated these difficulties (Miranda et al., 2012). Rose (2002)
described this extensive discussion and revisiting of problems among
friends as co-rumination. Conversely, the sharing of emotions through
music listening may provide individuals with depressive tendencies
with social support and thus increase their sense of connection with
others. Reflection as opposed to rumination can, it seems, be a useful
tool for processing negative emotions (Trapnell and Campbell, 1999).
Individuals who have already acquired adaptive coping strategies—
for instance, seeking social support—may use group music listening
positively to provide support and help them process negative feelings.
These findings are important for the use of music in healthcare settings
and wellbeing in everyday life (Garrido, 2017).
One strand of research has explored differences between individuals
in the ways that music impacts on wellbeing. For instance, Leipold
and Loepthien (2015), drawing on data from 521 participants aged 18
to 86 years old and 152 adolescents and young people aged 12 to 23
years old, studied the differences between attentive analytical listening
(which was defined as reflective and complex) and emotional listening,
and the relationships of these with coping with stress or rumination.
They showed that attentive analytical listening to music showed positive
relationships to accommodative coping, whereas emotional listening
had a positive relationship with rumination. No age differences were
found in the nature of listening in adulthood or for the younger age
group, although the transition from adolescence to adulthood was
important. A comparison between adolescents and young adults
revealed that attentive analytical listening was negatively associated
with age up to approximately 17 years old, after which the relationship
became positive, while adolescents demonstrated age increments in
emotional listening.
Similarly, Groarke and Hogan (2016) asked 24 younger people
and 19 older adults why they listened to music. The younger adults
emphasised affect regulation and social connection, whereas older
adults emphasised more eudaimonic (well-functioning) uses of music:
for instance, transcendence and personal growth. Saarikallio (2011)
found that older people were more aware of how music fitted particular
 14. Psychological Wellbeing  423

moods and situations. Women have been found to be more likely to use
music to regulate emotions and moods than men (Sloboda, 1999). There
is evidence that girls are more likely to engage with music to cope with
personal problems and interpersonal conflicts, whereas for boys, music
is a way of increasing energy levels and positive moods, and creating an
impression of being cool (Behne, 1997; Christenson and Roberts, 1998;
Larson, 1995; Larson et al., 1989. Music can be effective in decreasing
arousal due to stress, particularly for adolescents, females and musicians
(Pelletier, 2004). For instance, Lehmann (1997) reported that music
majors responded more strongly emotionally to their preferred music
than non-music majors, although some studies have reported that the
music-related emotional experiences of non-musicians and musicians
are broadly similar (Schubert, 2001).
The use of music to regulate moods is related to musical preferences.
Diversity in musical preference has been shown to be related to
emotionality in listening (Behne, 1997; Schwartz and Fouts, 2003).
Preference for harder forms of music has been found to be positively
related to emotional problems, including psychological turmoil and
behavioural problems (Took and Weiss, 1994) expression of anger
(Epstein et al., 1990), feelings of loneliness (Davis and Kraus, 1989) and
moodiness, pessimism and impulsiveness (Schwartz and Fouts, 2003).
Ter Bogt and colleagues (2020) addressed the potential link between
liking goth music and depressive symptoms in a four-year study of
10- to 15 –year-olds. They showed that goth music was liked by a small
minority of adolescents, who reported increased levels of depressive
symptoms as they grew older. In contrast, preference for upbeat and
conventional pop music has been found to be negatively related to
depression (Rentfrow and Gosling, 2003). Scheel and Westefeld (1999)
investigated the relationship between a preference for heavy-metal
music and vulnerability to suicide among 121 tenth- and twelfth-grade
high-school students. Participants completed a questionnaire relating to
reasons for living, risk of suicide and musical preferences. Heavy-metal
fans had less strong reasons for living, especially male fans, and had
more thoughts of suicide, especially female fans. For most, listening to
all types of music had a positive effect on mood. While preference for
heavy-metal music among adolescents may be an indication of increased
suicidal vulnerability, the research suggested that the source of the
424 The Power of Music

problem was more likely to lie in personal and familial characteristics

than in any direct effects of the music. However, group music therapy
can support young people at risk of mental health problems and can
reduce unhealthy uses of music (Gold et al., 2017).
Saarikallio and Erkkilä (2007), in a large study of 1515 participants
with an average age of 15 years old, found that the most preferred
musical styles for boys and girls across all age groups were rock, pop,
heavy metal and rap. Boys preferred heavy metal and techno music,
whereas girls preferred classical music, pop and gospel. Preferences for
classical, rock, jazz, folk and gospel music increased with age, while
the preference for pop music gradually decreased. Eclectic musical
preferences were related to the extent of the use of music to regulate
moods. Overall, Saarikallio and Erkkilä demonstrated how personal
factors were linked to differences in adolescents’ use of music. Those
preferring rock and heavy-metal music made greater use of music to
regulate their moods. Perhaps the intensity, volume and roughness
of these genres reflects the intense emotional experiences which are
characteristic of adolescence. In contrast, listening to pop, rap and
techno music tended to create positive, feel-good experiences
For many years now it has been possible to use a range of devices
to listen to music anywhere and at any time. Skånland (2011; 2013)
researching the use of the MP3 player suggested that such availability
could be valuable in supporting listeners in coping with crowded and
noisy environments, and promoting wellbeing and mental health.
Further developments in music technology have meant that people
can find expression through creating playlists. These can support the
maintenance of mood and recall of memories (Bull, 2005), while Hagen
(2015) observing students’ use of the playlist function concluded that
playlists based on moods, feelings, memories, or biographical, relational
representations helped users experience mastery over themselves.
Playlists may also support social cohesion as some of the pleasure of
creating them may come from owning, customising and trading them
(McCourt, 2005).
There are differences in the extent to which listeners are aware of
how music affects them. More engaged listeners are acutely aware of
how music can change or fit their moods (Greasley and Lamont, 2011).
Squirrel listeners (Lamont and Webb, 2010) are better able to access
 14. Psychological Wellbeing  425

and implement strategies to regulate their moods choosing music to

fit any given situation and their own physical, psychological and social
needs. Batt-Rawden and DeNora (2005) describe this as ‘lay therapeutic
practice’.

Singing
One strand of research examining the relationship between wellbeing and
music has focused on singing. Reviews of the research on participation
in choirs have identified many benefits, including:
• physical relaxation and release of physical tension;
• emotional release and reduction of feelings of stress;
• a sense of happiness, positive mood, joy, elation and feeling
high;
• a sense of greater personal, emotional and physical wellbeing;
• an increased sense of arousal and energy;
• stimulation of cognitive capacities, attention, concentration,
memory and learning;
• an increased sense of self-confidence and self-esteem;
• a sense of therapeutic benefit in relation to long-standing
psychological and social problems;
• a sense of exercising systems of the body through the physical
exertion involved, especially the lungs;
• a sense of disciplining of the skeletal-muscular system through
the adoption of good posture;
• being engaged in a valued, meaningful worthwhile activity
that gives a sense of purpose and motivation (Clift et al., 2008;
Clift, 2012; Stacey et al., 2002).

Group singing has been found to reduce anxiety and depression

(Houston et al., 1998; Lally, 2009; Wise et al., 1992; Zanini and Leao,
2006), as well as providing opportunities for developing social networks.
Singing has a variety of positive effects on both mental and physical
health (Fancourt et al., 2019; Irons et al., 2020; Kreutz et al., 2004; Moss
and O’Donoghue, 2020).
426 The Power of Music

Kreutz (2014) studied the psychobiological effects of amateur choral

singing with a mixed group of 21 novice and experienced singers who
completed questionnaires about their psychological wellbeing and gave
samples of saliva for measuring levels of salivary oxytocin, cortisol and
dehydroepiandrosterone at the beginning of two rehearsal sessions and
30 minutes later. The singing condition included warm-up vocal exercises
and repertoire pieces. In a control condition, dyads of participants
talked to each other about recent positive life experiences. The findings
showed patterns of change favouring singing over chatting. There were
no significant interactions for cortisol, dehydroepiandrosterone or the
cortisol dehydroepiandrosterone ratio. Overall, the findings suggested
that singing enhances individual psychological wellbeing, as well as
inducing a sociobiological bonding response.
Grape and colleagues (2003) also used a range of physical markers
to explore the possible beneficial effects of singing on wellbeing during
a singing lesson. Eight amateur singers aged 28 to 53 years old, and
eight professional singers aged 26 to 49 years who had been attending
singing lessons for at least six months, participated. Electrocardiogram
measures were recorded and computerised spectral analysis was
performed. Serum concentrations of TNF alpha, linked to autoimmune
systems, prolactin, cortisol and oxytocin were measured before and 30
minutes after the lesson. Five visual scales—sad joyful, anxious calm,
worried elated, listless energetic, and tense relaxed—were scored before
and after the lesson alongside a semi-structured interview. Heart rate
variability analyses showed significant changes over time in the two
groups. Power increased during singing for the professionals, whereas
there were no changes in the amateurs. This indicated an ability to
retain more heart-brain connection, more cardiophysiological fitness
for singing in professional singers, compared to amateur singers. Serum
concentration of TNF alpha increased in professionals after the singing
lesson, whereas the concentration in amateurs decreased. Serum
concentrations of prolactin and cortisol increased after the lesson in
the group of men and vice versa for women. Oxytocin concentrations
increased significantly in both groups after the singing lesson. Amateurs
reported increasing joy and elatedness, whereas professionals did not.
However, both groups felt more energetic and relaxed. The interviews
showed that the professionals were clearly achievement oriented, with a
 14. Psychological Wellbeing  427

focus on singing technique, vocal apparatus and body during the lesson.
In contrast, the amateurs used the singing lessons as a means of self-
actualisation and self-expression, as a way to release emotional tensions.
Overall, singing lessons seemed to promote wellbeing and reduce
arousal for amateurs compared to professional singers, who seemed to
experience the reverse.
In a study of young people who were members of a university choir,
Clift and Hancox (2001) identified six elements associated with the
benefits of singing: wellbeing and relaxation; enhanced breathing and
posture; social benefits; spiritual benefits; emotional benefits; and benefits
for the heart and immune system. In a later study, Clift and Hancox
(2010) surveyed 1124 choral singers drawn from choirs in Australia,
England and Germany. Participants completed a questionnaire which
measured physical, psychological, social and environmental wellbeing,
and a measure of the effects of choral singing. Open questions provided
more in-depth understanding. There was a high level of agreement
about the positive benefits of choral singing, with women significantly
more likely to endorse its value for wellbeing and health compared with
men. There was a small significant relationship between psychological
wellbeing and the effects of choral singing for women, but not for men.
Eighty-five participants with relatively low psychological wellbeing had
high scores on the singing scale. Four categories of significant personal
and health challenges were disclosed by members of this group: enduring
mental health problems; family and relationship problems; physical
health challenges and recent bereavement. Their accounts suggested six
ways that singing might impact on wellbeing and health: positive affect;
focused attention; deep breathing; social support; cognitive stimulation
and regular commitment. In a further study Clift and colleagues (2017)
studied four community singing groups which met weekly for people
with mental health issues. Evaluation took place over a six-month period
using two questionnaires. Twenty-six participants completed baseline
and follow-up questionnaires. The findings showed that clinical scores
reduced, and wellbeing scores increased significantly.
In a comparison of gender differences, Sandgren (2009) examined
how emotional states varied on measurements pre- and post- a regular
choral rehearsal in 212 participants from eleven choirs. Women reported
significantly more positive emotional states than men relating to
428 The Power of Music

participation in regular choir rehearsals, although the differences were

small. Men and women reported similar levels of negative emotions, but
varied more in the extent of positive change after the choir rehearsal.
Some research has focused on the impact of participation in a choir
on very specific groups of people. For instance, Bailey and Davidson
(2002; 2003) studied whether positive life transformations could occur
when homeless men joined a choir. Using semi-structured interviews
they found that group singing positively influenced emotional, social
and cognitive processes. They concluded that active participation in
singing may alleviate depression, increase self-esteem, improve social
interaction skills and induce cognitive stimulation. In a later study,
Baily and Davidson (2005) explored the effects of group singing and
performance with a second choir formed for homeless and other
marginalised individuals who had little or no music training or
group singing experience, and middle-class singers with low to high
levels of music training and choral singing experience. The findings
showed that the emotional effects of participation in group singing
were similar regardless of training or socioeconomic status, but the
interpersonal and cognitive components of the choral experience had
different meanings for the two groups. The marginalised individuals
appeared to embrace all aspects of the group singing experience, while
the middle-class choir members were inhibited by social expectations
of musicianship. Also working with a distinctive group, Southcott
and Nethsinghe (2019) explored the understandings and meanings
of shared music-making held by members of the Young Hearts Russian
choir in Melbourne, Australia and its impact on their quality of life. The
elderly participants were first-generation migrants who spoke most
strongly in their first language, Russian. Individual semi-structured
interviews were undertaken with nine choir members, while focus
group discussion included all 28 members. The interviews revealed two
broad themes: maintaining independence and resilience and learning,
rehearsing and performing music. Sub-themes included the importance
of participation, maintaining face, overcoming illness and disability, and
becoming a family. Singing together enhanced quality of life, combatted
social isolation, fostered resilience and sense of autonomy, and allowed
participants to access inner resources to face life challenges.
Considering issues relating to a range of disabilities, Dingle and
colleagues (2012) explored the personal experiences of choir members,
 14. Psychological Wellbeing  429

89 percent of whom experienced chronic mental health problems, 28

percent physical disabilities and 11 per cent intellectual disability. Semi-
structured interviews were carried out with twenty-one members of the
choir at three time points in the choir’s inaugural year, at the inception
of the choir, after six months, and after twelve months. Three themes
emerged:
• personal impact in terms of positive emotions, emotional
regulation, spiritual experience, self-perception, finding a
voice;
• social impact including connectedness within the choir,
connection with audience, social functioning; and
• functional outcomes including health benefits, employment
capacity and routine.

Overall, forming a new and valued group identity as a choir member

was associated with emotional and health benefits for participants.
Fancourt and colleagues (2019) focused on those who were recently
bereaved. Fifty-eight adults bereaved in the last five years who had
not received treatment of any kind for anxiety or depression in the last
month were recruited. Half participated in a choir or acted as a non-
intervention control group. Those joining the choir were engaged in
90-minute weekly singing and social sessions for 12 weeks, with a post-
intervention assessment after 24 weeks. Those who sang in a choir had
more stable symptoms of depression and levels of wellbeing, as well
as gradual improvements in their sense of self-efficacy and self-esteem.
In contrast, those in the control group showed gradual increases in
depressive symptoms, reductions in levels of wellbeing and self-esteem
and no improvement in their self-efficacy.
It is not only singing that can have positive benefits for wellbeing.
In a review, Perkins and colleagues (2020) identified 46 qualitative
studies reporting on participants’ subjective views of how participatory
music engagement supported their mental wellbeing. Thematic coding
revealed four themes: managing and expressing emotions, facilitating
self-development, providing respite and facilitating connections. The
outcomes of choral singing have also been compared with listening
to music. Boyd and colleagues (2020) examined the short-term effects
on mood and self-esteem of a novel group singing model that relied
430 The Power of Music

exclusively on oral methods of teaching songs to 59 community-recruited

adults and compared the effects with group listening. The findings
showed that participants’ positive emotions and mood improved after
singing but declined after listening. Self-esteem increased throughout
the sessions regardless of the activity, indicating the importance of the
social nature of the singing activities.

Wellbeing in Young Children

Much of the evidence relating to wellbeing in babies, infants and
children has been set out in previous chapters. In infancy and early
childhood, musical activity largely takes place through interactions
with caregivers. Ruud (1997) suggests that the first musical memories
often include feelings of being held by parents. Songs are frequently
more important than speech in bonding (Nakata and Trehub, 2004;
Shenfield et al., 2003). Cirelli and Trehub (2020a) examined the relative
efficacy of parents’ speech, and singing familiar and unfamiliar songs,
in alleviating the distress of 68 eight- and 68 ten-month-old infants.
Parent-infant dyads participated in three trials of a still-face procedure,
featuring a two-minute play phase, a still-face phase (where parents
were immobile and unresponsive for one minute or until infants became
visibly distressed), and a two-minute reunion phase in which caregivers
attempted to reverse infant distress by singing a highly familiar song, an
unfamiliar song, or talking expressively. In the reunion phase, talking
led to increased negative affect in both age groups, in contrast to singing
familiar or unfamiliar songs, which increased infant attention to parents
and decreased negative affect. The favourable consequences were
greatest for familiar songs, which also generated increased smiling. Skin
conductance recorded from a subset of infants revealed that arousal
levels were highest for the talking reunion, lowest for unfamiliar songs,
and intermediate for familiar songs. The arousal effects, considered in
conjunction with the behavioural effects, confirmed that songs were
more effective than speech at mitigating infant distress.
Krueger (2011) argued that, from birth, music is perceived as a
structure that offers the possibility of constructing and regulating
emotions, expressing and communicating, and shaping relationships
and situations. In children’s play, symbols, drawings and music can
 14. Psychological Wellbeing  431

be used thoughtfully but activities are mainly participatory, engaged

and active (Bonsdorff, 2017; Karlsen, 2011; Kuuse, 2018). From an
early age, using these resources, children develop a sense of agency
and self-efficacy. Informal learning of music is frequent in everyday
life (Batt-Rawden and DeNora, 2005). This creates memories, patterns,
meanings and opportunities for interaction between individuals and
their social surroundings. Learning how music can be used empowers
the individual to act on their own moods and emotions, wellbeing,
health and agency (DeNora, 2000; 2001; Skånland, 2013). Musicality
has been argued to be intrinsic to communication between parents and
infants (Malloch and Tervarthen, 2009). Parents use music to support
other activities and to create a calm and soothing environment prior
to sleep times, in addition to participating in child-centred musical
activities (Lamont, 2008). Child-parent interactions can be enhanced by
music therapy, as can impulse control and self-regulation skills (Pasiali,
2012) and social and communication skills (Mackenzie and Hamlett,
2005; Nicholson et al., 2010; Walworth, 2009). For instance, de Gratzer
(1999) showed in a ten-month action research project of group music-
making between parents and toddlers that non-verbal communication
between parent and child was enhanced. Williams and colleagues
(2012) examined the effectiveness of a short-term group music therapy
intervention for 201 parents of children with disabilities and found
that there were significant improvements for parental mental health,
child communication and social skills, parenting sensitivity, parental
engagement with and acceptance of their child, child responsiveness to
parent, and child interest and participation in programme activities.
As we saw in Chapter 13, moving in time together promotes social
bonding. This is important for the social development of infants, as it
promotes positive interactions with caregivers. Young infants seem to
enjoy listening to and moving to music. For instance, Cirelli and Trehub
(2020b) studied an infant who began moving rhythmically to music at
six months of age. Across nine sessions, beginning when she was almost
19 months of age and ending eight weeks later, she was video-recorded
by her mother during the presentation of 60-second excerpts from two
familiar and two unfamiliar songs presented at three tempos: the original
tempo and faster and slower versions. The child exhibited a number of
repeated dance movements such as head-bobbing, arm-pumping, torso
432 The Power of Music

twists and bouncing. She danced most to Metallica’s ‘Now that We’re
Dead’, a recording that her father played daily in her presence, often
dancing with her while it played. Its high pulse clarity, in conjunction with
familiarity, may have increased her propensity to dance, as reflected in
lesser dancing to familiar music with low pulse clarity and to unfamiliar
music with high pulse clarity. She moved faster to faster music but only
for unfamiliar music, perhaps because arousal drove her movement to
familiar music. Her movement to music was positively correlated with
smiling, highlighting the pleasurable nature of the experience. Rhythmic
movement to music may have enhanced her pleasure, although the joy
of listening may have promoted her movement.
More formal engagement with music may begin in early years
education. Certainly, early years educators have positive attitudes
towards music and value it, even if they have no formal qualifications
in music (Barrett et al., 2019). Parents, grandparents and former child
participants of early learning music programmes acknowledge that such
programmes enhance musical knowledge and skills (Barrett and Welch,
2020). Active group music-making also enhances pro-social behaviour
in young children. For instance, Kirschner and Tomasello (2009; 2010)
studied four-year-olds in tasks requiring identical skills in musical and
non-musical conditions. Joint music-making enhanced cooperation and
helpful behaviour.

Music and Wellbeing in School-Aged Participants

Previous chapters have shown that active engagement with music
can enhance intellectual functioning, spatial reasoning, mathematical
performance, phonological awareness, literacy, educational attainment
and personal, social and physical development. The extent to which
these benefits are realised depends on a wide range of factors, not least
the nature and quality of the musical education experienced, and the
level of commitment and engagement of the child. As musical skills are
acquired, a greater sense of purpose and self-confidence can develop
(Creech et al., 2013; 2016; Hallam et al., 2017). In this way, music
education can have an impact on wellbeing. For instance, Lage-Gómez
and Cremades-Andreu (2019) presented the results of a collaborative
action research study in Spanish secondary education. Data collected
 14. Psychological Wellbeing  433

included observations, interviews, classroom diaries, assessments,

questionnaires, and video and audio recordings. The findings showed
how group improvisation was influenced by:
• active student involvement and wellbeing;
• the students’ identification with the music;
• the emergence of group flow and positive emotions, including
a high level of motivation; and
• the musical experiences from the students’ roles as musicians.

Similarly, informal learning in small groups in the music classroom can

benefit wellbeing, leading to enhanced self-esteem, positive relationships,
competence and optimism (Hallam et al., 2016; 2017; 2018). Overall,
group music-making supports children in improving their social and
communication skills, cooperation and teamwork (Creech et al., 2013;
2016).
One strand of research has focused on children perceived as ‘at risk’.
The El Sistema programme and projects inspired by it—where children
experience intensive and prolonged engagement in an orchestral
community—facilitate pro-social behaviour, and the psychological
and physical wellbeing of their students. Evaluations of individual
programmes report strengthening children’s sense of individual and
group identity, causing children to take pride in their accomplishments,
enhancing determination and persistence, and making children better
able to cope with anger and express their emotions effectively. Children
value their participation as a social activity, a way to enjoy music with
others, to strengthen friendships with peers, work in teams and acquire
musical skills (Creech et al., 2013; 2016).
Some research has focused on children who are marginalised or at
risk. For instance, Cain and colleagues (2016) carried out a review of the
impact of participatory music programmes, which aimed to promote
positive mental and physical health, and wellbeing outcomes for
young people from culturally and linguistically diverse communities.
The majority of music participation programmes targeted toward
young people characterised as ‘at risk’ have had positive outcomes,
including a reduction in anxiety, depression, emotional alienation,
truancy and aggression. Participants showed an increase in attendance
434 The Power of Music

at school, enhanced self-esteem, cultural empathy, confidence, personal

empowerment and healthier nutrition. Similarly, Brown and colleagues
(2017) investigated the influence of the arts on cortisol levels in
economically disadvantaged children. Three hundred and ten children,
aged three to five years old, who attended a Head Start preschool were
randomly assigned to participate in different schedules of arts and
homeroom classes on different days of the week. Cortisol was sampled at
morning baseline and after arts and homeroom classes on two different
days at the start, middle and end of the year. For music, dance and visual
arts, grouped and separately, the findings showed that cortisol was
lower after an arts versus homeroom class at the middle and end of the
year, but not at the start of the year. A similar project, where professional
musicians worked with school-aged children (Ward et al., 2020) showed
through interviews with teachers, musicians, parents and observations
that pupils experiencing socioeconomic deprivation enjoyed the benefits
of fellowship through group-based music activities. Previously shy
pupils began to contribute more in class, and anxious children overcame
their fear of performing on stage. Teachers commented that the project
had developed pupils’ self-confidence.
One strand of research has focused on children’s wellbeing in terms of
the role that music can play in improving overt behaviour. For instance,
Fasano and colleagues (2020) explored whether short orchestral music
training could reduce impulsive behaviour. One hundred and thirteen
Italian children aged eight to ten years of age participated. Fifty-five
attended three months of orchestral training, which included a two-
hour lesson each week at school and a final concert. The 58 children in
the control group had no orchestral training. The children were assessed
in relation to inhibitory control and hyperactivity at the beginning and
end of the three-month training period. Children in the music group
showed a significant improvement in inhibitory control, while the
control group showed an increase in self-reported hyperactivity. This
suggests that even an intense and brief period of orchestral training can
facilitate the development of inhibitory control by modulating levels
of self-reported hyperactivity. Large-scale community-based music
programmes for children exposed to violence have also been found to
improve self-control and reduce behavioural difficulties. For instance,
Alemán and colleagues (2017) assessed the effects of an El Sistema music
 14. Psychological Wellbeing  435

programme on children’s developmental functioning in the context of

high rates of exposure to violence. The programme emphasised social
interactions through group instruction and performance. The research
was conducted in 16 music centres and included 2914 children aged six
to fourteen years old. Half were admitted to the programme earlier than
the remainder. Data collected at the end of the programme indicated
improved self-control and reduced behavioural problems. This was
particularly the case for children with less educated mothers, and for
boys, especially those exposed to violence. Overall, the programme
improved self-control and reduced behavioural difficulties.
English and colleagues (2021) explored the viability and effects of a
six-week digitally based music outreach programme using GarageBand
for children in a small rural town who were experiencing difficulties
in the upper-primary- and lower-secondary-school years. Focus groups,
observations and daily notes showed a significant positive impact on
the teachers and children involved. Similarly, Chao-Fernández and
colleagues (2020) analysed the benefits of music therapy for six students
with disruptive behaviours. A series of activities were designed based
on the use of the music video game Musichao. There were significant
improvements in the development of self-motivation, self-awareness,
self-control and social skills. Ye and colleagues (2021) undertook a meta-
analysis including ten studies on the effect of music-based interventions
on aggressive behaviour in children and adolescents. There was a
significant decrease in aggressive behaviour and a significant increase
in self-control in the music-based intervention group compared with
the control group.
Some research has focused on children experiencing internalised
problems. In South Korea, Kim (2017) investigated the effects of
community-based group music therapy in children aged seven to twelve
who were exposed to ongoing child maltreatment and poverty. Fourteen
children experienced music therapy, while twelve acted as controls.
Those in the music therapy group received twelve consecutive group
music therapy sessions once a week, whereas the control children had
no such opportunities. Teacher and child reports assessed behavioural
change and showed that children in the music therapy group were less
depressed, anxious and withdrawn, and had fewer attention problems
than those acting as controls.
436 The Power of Music

In New Zealand, since the 2010-2011 earthquakes, staff and learners

at Waitakiri School have participated in daily singing specifically to
promote wellbeing. Facilitation of the singing involved no pressure, but
rather democratic and participatory conditions, with teachers avoiding
judging learners’ progress and achievement, and a focus on being
together and having fun. Although some teachers lacked confidence
about leading singing and the focus was on having fun, learners still
developed key competencies and learned musical concepts (Rickson
and colleagues, 2018). In England, Chernaik (2021) reported the impact
on wellbeing in primary-school children aged eight to ten years old who
were exposed to live music provided by professional classical musicians
over the period of a school year. The project began with six classroom
workshops in each school, progressed to a chamber orchestra workshop
for groups of three or four schools in a local venue, and culminated
in a symphony orchestra concert. Questionnaires completed following
the concerts showed that a range of positive emotions were experienced
by the children including excitement, happiness, feeling calm, relaxed,
impressed and amazed. Focusing exclusively on extracurricular group
percussion activities, Burnard and Dragovic (2015) analysed data
from 14 rehearsals, 13 semi-structured interviews and 41 teachers’ and
pupils’ reflective diary entries. The findings showed the potential for
such activities to enhance pupil wellbeing by empowering them and
enhancing support and decision-making.
Croom (2015) reviewed studies on engagement with music within
the PERMA framework to support the claim that music practice and
participation could positively contribute to living a flourishing life
through positively influencing emotions, engagement, relationships,
meaning and accomplishment. Similarly, Lee and colleagues
(2017) identified 17 case studies that described successful music
programmes in schools in Australia. Content from these case studies
was aligned with the five categories of the PERMA wellbeing model.
The findings showed that the relationship element of the model was
most frequently mentioned. Collaboration and partnership between
students, teachers, staff in schools and local people in the community
including parents, local entrepreneurs and musicians were repeatedly
identified as a highly significant contributing factor to the success
of music programmes. Overall, the findings indicated that tailored
 14. Psychological Wellbeing  437

music and relationship-centred music programmes in schools not only

increased the skills and abilities of the students, but also improved their
psychosocial wellbeing and that of the community.

Music and Wellbeing in Adolescents and Young People

A great deal of research has been carried out with reference to music
and adolescence. As we saw earlier, music plays an important role in
teenagers’ lives (Bonneville-Roussy et al., 2013; Bosacki and O’Neill,
2013; Greasley and Lamont, 2011). Of all age groups, music seems to be
most important for young people (Christenson et al., 1985; Christenson
and Roberts, 1998; Gabrielsson and Lindström Wik, 2003; Roe, 1985;
Zillmann and Gan, 1997). Music—as it is engaged with in leisure time—
contributes to how an individual defines themselves (Hargreaves et
al., 2002; Hense and McFerran, 2017; North and Hargreaves, 1999). It
is seen to represent personality and is used in impression management,
as well as to judge the characteristics of others (Krause and Hargreaves,
2013). In the digital world, this is achieved by controlling what music
is shared with others and what is uploaded into personal collections
(Voida et al., 2006). By engaging in social comparisons, adolescents
are able to portray their own peer groups more positively than other
groups in their network, and are thus able to sustain positive self-
evaluations. Music facilitates this process (Tarrant et al., 2000). Tarrant
and colleagues (2001) investigated English male adolescents aged 14
to 15 years old’s perceptions of in-group and out-group. Participants
reported greater liking for the in-group and associated it more
positively with stereotyped music compared with the out-group. The
in-group was viewed as more fun, masculine and sporty and less
boring, snobbish and weird. Participants with lower levels of self-esteem
showed greater differentiation between groups and greater derogation
of the out-group. Van Zalk and colleagues (2009) examined the role of
similarity in music preferences in the formation and discontinuation of
friendships over a one-year period. Questionnaire data were gathered
from 283 Dutch same-sex mutual best friends of almost 13 years of age.
The findings showed consistent evidence for high similarity in specific
music dimensions among friends at the beginning and end of the year.
Moderate similarity was found in the overall patterning of preferences for
438 The Power of Music

music genres at both points in time, even after controlling for similarity
in social background. Specific music similarity in more non-mainstream
music dimensions, and overall music similarity at the beginning were
related to selecting a new friend at the end of the time period. However,
similarity in music preferences was not related to the discontinuation
of existing friendships. Similarity in music preferences seemed to be
related to friendship formation but not discontinuation.
Music plays a role in developing and retaining a sense of agency
(Saarikallio, 2019). Seeking and exploring a sense of agency through
music is particularly relevant for young people but also for those
experiencing a reduction in their ability to control their actions and/
or their environment due to illness or challenging personal situations
(Magee et al., 2017). Sense of agency is important for social-emotional
health and can be supported through musical engagement (Saarikallio,
2017; 2019; Saarikallio and Baltazar, 2018). Evaluating the impact of a
short music intervention with adolescents, McFerran and colleagues
(2018) observed that sense of agency was key. After participation,
young people reported an increased awareness of how they could utilise
music to reduce distress and promote their own development. Similarly,
Saarikallio and colleagues (2020) collected self-reports of personal
music listening and their impact on agency from 44 adolescents with
an average age of 14 who had received musical training. While there
was no general increase in agency over time, there were fluctuations.
These were determined by specific contextual factors: for instance, a
change in environment, or changes in moods and reasons for listening
to music. Elvers (2016; 2018) developed a framework which suggested
that increases in feelings of power and control were related to enhanced
self-esteem, which could be induced through musical experiences
that promoted positive affect, empathy, pleasure and social cohesion.
Similarly, music students’ wellbeing has been found to improve when
their teachers adopt autonomy-supporting strategies (Bonneville-
Roussy et al., 2020).
The emotional use of music may not differ according to the type of
musical activity, since adolescents’ reasons for listening and playing
have been shown to be quite similar to one another (North et al., 2000,
Saarikallio and Erkkilä, 2007). In a study of 38 adolescents divided
into two age groups—9 to 12 and 13 to 17, Tolfree and Hallam (2016)
 14. Psychological Wellbeing  439

established that, of the four main themes emerging from the data,
music in relation to emotions and moods was the strongest. Older
girls used music to express anger, stating that it provided a means of
acceptable rebelliousness when they were angry with their parents or
others in their family. Playing an instrument was not used in relation
to managing emotions. Indeed, for most people of any age, listening
is the preferred activity for regulating moods, mainly because music
is so readily available in the modern world. Lincoln (2005) explored
the dynamic relationship between young people, bedroom space and
music. Using the concept of zoning, she established that music was used
by teenagers spontaneously to create particular atmospheres in their
bedrooms, which depended on their age, mood, the time of day, other
concurrent activities and other occupants of the space (for instance,
friends or siblings). Music blurred the boundaries of public and private
space. Music played at a high volume spilled out of the bedroom zone
into other rooms in the house. Music was also used as a prequel and a
sequel, facilitating getting ready for nights out, setting the right tone
and atmosphere.
Teenagers report listening to music to pass time, alleviate boredom,
relieve tension and distract themselves from worries. Music is seen as
a source of support when they are feeling troubled or lonely, acting
as a mood regulator, helping them to maintain a sense of belonging
and community (Schwartz and Fouts, 2003; Zillman and Gan, 1997).
Music fosters their ability to cope with the challenges that they
face, including positive relationships with peers (Papinczak et al.,
2015; Selfhout et al., 2009; Ter Bogt et al., 2017), managing emotions
(McFerran and Saarikallio, 2014; Saarikallio and Erkkilä, 2007) and
developing self-determination (Laiho, 2004). Some have suggested
that it is because music plays an important part in these developments
that it is so important in adolescents’ lives (Laiho 2004; Miranda, 2013;
Schwartz and Fouts, 2003). Saarikallio (2019) argued that music is
the adolescent’s world, their playground and kingdom. They express
themselves through it, discover themselves and make their own choices.
Studying young adults, Gupta and Kumar (2020) examined the effects
of listening to instrumental music over a 20-day period and showed that
music listening significantly increased resilience, self-efficacy, optimism,
meaning in life and psychosocial flourishing. They concluded that
440 The Power of Music

music had the potential for generating positive schemas which could
enhance wellbeing and serve as a buffer against increasing negativity in
the modern world. Even quite young adolescents use music to manage
their moods. For instance, Behne (1997) carried out a longitudinal study
of 155 adolescents aged 11 to 17 years old and identified nine listening
styles including compensating, concentrated, emotional, distancing,
vegetative, sentimental, associative, stimulative and diffused. At ages
11 to 13, the most pronounced listening style was compensating,
demonstrating that even young adolescents know how to use music
for mood regulation. In general, different strategies for coping with
emotions are acquired with age (Seiffge-Krenke, 1995; Mullis and
Chapman, 2000).
In a series of studies, Saarikallio and colleagues (Saarikallio, 2006;
Saarikallio and Erkkilä, 2007) developed a theoretical model consisting
of seven regulatory strategies relating to music: entertainment, revival,
strong sensation, diversion, discharge, mental work and solace. They
surveyed 1515 adolescents, 652 boys and 820 girls, with an average age
of 15. The strategies used most often by boys and girls in all age groups
were the same: entertainment, revival and strong sensation. Overall,
girls used music for mood regulation more than boys. The use of music
for mood regulation increased with age for both sexes but the change
occurred later for boys. Singing or playing an instrument as a hobby,
valuing music and listening to it were positively related to using music
to regulate mood. Composing songs also led to increased regulatory
use of music, as did having a family member who sang or played an
instrument. Listening alone was chosen by over half of the respondents
in all age groups as an influencer of mood. The ways that music was
used to regulate mood involved elements that adolescents were often
not conscious of in their daily engagement with music (Saarikallio,
2006; Saarikallio and Erkkilä, 2007). Ongoing cognitive development
and an increased ability for abstract comprehension may help older
adolescents to be more conscious of how they use music to regulate
mood. Saarikallio and colleagues (2017) studied 55 adolescents with an
average age of 15 who listened to self-selected relaxation music for 20
minutes, once in a laboratory and once at home, and provided written
descriptions of their experience. Three major strategies—processing,
distraction and induction—and two mechanisms (musical and mental)
 14. Psychological Wellbeing  441

were identified. Processing was supported by both mechanisms,

while distraction and induction were supported predominantly by
music. Change from negative to positive mood was generally realised
through musical distraction, while the induction of positive emotion
was supported by all strategies and mechanisms. In a later study,
Baltazar and Saarikallio (2019) studied 571 participants and identified
six contrasting strategic uses of music: cognitive work, entertainment,
affective work, distraction, revival and focus on the situation. Clear
associations between strategies and mechanisms emerged, laying
the foundations for a model that integrated regulatory strategies and
mechanisms as intrinsic and interrelated components of behaviour
(Baltazar, 2019). In an experimental study, Baltazar and colleagues
(2019) manipulated the benefits of music and strategy use in reducing
stress. Overall, music had a greater impact on short-term outcomes of
self-regulation in comparison to strategy use, suggesting that successful
affective regulation depends on the adequacy of the chosen strategies
and the music, but that the music itself is key in the short term.
An increasing body of research has indicated that listening to
music can have very different purposes and outcomes. For instance,
McFerran and colleagues (2014) reported an investigation examining
how 111 Australian adolescents reported perceived changes in their
mood before and after listening to self-selected music. Most reported
using music to improve their mood, particularly when their initial state
was already positive. However, when feeling sad or stressed, some
reported a worsening mood. Those young people who were distressed
tended to prefer listening to heavy-metal music but did not report
more negative effects on mood for this than for any other genre. They
concluded that interpreting such findings was complex, and overly
simplistic interpretations needed to be avoided. Miranda (2013; 2019),
in two reviews, proposed that music could be both a protective factor
and a risk factor in relation to coping in adolescence. McFerran and
Saarikallio (2014) explored with 40 Australians aged 13 to 20 years old
the beliefs that they held about the power of music to support them
during challenging times. They were asked to recall times when music
had supported them and times when it had been unhelpful. They
considered why young people’s beliefs about the positive consequences
of music were so strong, even though for those with mental health
442 The Power of Music

problems this was not always the case. Miranda and Gaudreau (2011)
considered emotional reactions following listening to music, depending
on different levels of emotional wellbeing, and also the relationships
between social congruence in music tastes with friends or parents and
emotional wellbeing. Three hundred and sixteen adolescents with a
mean age of 15 years old participated. Three profiles were identified:
emotionally negative, limited or positive listeners. These were related
to emotional wellbeing, as was social congruence in musical tastes with
friends and parents. Also exploring differences between individuals,
Gibson and colleagues (2000) divided high-school students into high
and low loneliness groups in relation to romantic deprivation, and
rated their enjoyment of love-lamenting and love-celebrating videos
of popular romantic music. Loneliness proved inconsequential for
the enjoyment of love-lamenting songs, although highly lonely males
enjoyed love-celebrating songs markedly less than less lonely males.
In contrast, highly lonely females enjoyed love-celebrating songs more
than less lonely females.
Not all the effects of listening to music are positive. Adolescents
may use music as a distraction to avoid thinking about problems
(Saarikallio and Erkkilä, 2007). This can have a negative impact on
their psychological adjustment (Hutchinson et al., 2006). Listening to
music which explores negative themes—for instance, distress, suicide
or death—can increase depressive symptoms and suicidal thoughts
(Martin et al., 1993; Scheel and Westefeld, 1999). These negative
outcomes can be exacerbated through interactions with like-minded
peers through music subcultures. For instance, Stewart and colleagues
(2020) studied seven Australian young people with a tendency towards
depression, exploring their listening habits and their level of awareness
of the impact of their music-listening on mood and wellbeing. The
findings showed that, while music can have a positive effect on mood, it
can also intensify negative moods. They suggested that the relationship
between intentions and outcomes is mediated by differing levels of
self-awareness and insight into the mood regulation processes which
occur during listening to music. Some musical subcultures, such as
goth or emo, are focused on music with dark and depressing themes.
The blame for some suicides has been laid at the door of such music
(Young et al., 2014). In Australia, music therapy carried out over eight
 14. Psychological Wellbeing  443

weeks was compared with self-directed music-listening in a group of

100 students with self-reported unhealthy music use. There were no
differences in outcomes. Both groups showed small improvements over
time, although younger participants benefited more from the therapy,
and older participants from self-directed listening (Gold et al., 2017).
Specific aspects of music listening can impact on wellbeing. In a
small-scale study, Papinczak and colleagues (2015) analysed transcripts
from focus groups with 11 participants aged 15 to 25 years old. Four
ways in which listening to music linked with wellbeing were revealed:
relationship-building, modifying emotions, modifying cognition and
emotional immersion. A follow-up questionnaire study with 107 young
people showed that music-listening was significantly related to each of
these but not directly related to wellbeing. Ter Bogt and colleagues (2017)
studied whether adolescents and young adults used music as an agent
of consolation when dealing with sorrow and stress, and whether the
music itself, its lyrics or experiences of closeness to artists and fans were
experienced as comforting. Overall, 1,040 respondents (aged 13 to 30
years old) responded to items assessing listening hours, the importance
of music, music preferences, positive and negative effects elicited by
music, internalised and externalised problems, and consolation through
music. Slightly over 69 percent of respondents reported that they used
music as a source of consolation, particularly females and those with
higher levels of anxiety and depression. Music’s consoling effects were
reported as resulting mainly from the sound and texture of the music
itself, from attribution of personal meaning to the lyrics, and to a lesser
extent from perceptions of closeness to artists and other listeners.
Young people in the Western world spend a great deal of their
time listening to music but there is less research globally. Miranda and
colleagues (2015), focusing on cultural differences, argued that music
can be meaningful in similar and different ways for adolescents living
in diverse sociocultural contexts, in which local and global cultures
mix and hybridise (Larson et al., 2009). Boer and colleagues (Boer and
Fischer, 2012; Boer et al., 2012) proposed two overarching dimensions of
music: a contemplative or affective dimension, an individual dimension,
and an intrapersonal, interpersonal, a social dimension (collectivism).
Adolescents in more collectivist societies used music to convey cultural
identity more than those in individualistic societies. Research in six
444 The Power of Music

countries (Germany, Kenya, Mexico, New Zealand, the Philippines and

Turkey) revealed ten functions of listening to music in late adolescence:
as background, focused listening, for venting, related to emotions,
for dancing, related to friendship, family, politics, values and cultural
identity (Boer et al., 2012). Research in seven countries revealed seven
functions: music in the background, memories through music, music
as diversion, emotional experiences from music, self-regulation through
music, music as a reflection of the self and social bonding (Boer and
Fischer, 2012).

Actively Making Music

In addition to listening to music, actively making music can impact
on the wellbeing of young people. For instance, in the Netherlands,
Uhlig and colleagues (2018) worked with 139 adolescents in schools
and showed that engaging in rap and singing music therapy six times
a week for four months led to enhanced psychological wellbeing, self-
esteem and emotion regulation. Evaluating a similar rap and sing music
therapy with 52 adolescents, Uhlig and colleagues (2019) showed a
range of benefits for sleep compared with a control group. In the North
East of England, Mogro-Wilson and Tredinnick (2020) evaluated the
use of visual arts and music on 340 teenagers in a programme designed
to enhance social and emotional skill-building. The programme was
successful in meeting its aims, and demonstrated that art and music
could become a powerful presence in the lives of young people.
Underlying the complexity of the relationship between music and
wellbeing, Leung and Cheung (2020) used a process-oriented approach
to establish the association between listening to music, playing a musical
instrument, musical training and adolescents’ wellbeing. One thousand,
three hundred and eighteen Chinese adolescents between 12 to 15 years
of age from secondary schools in Hong Kong completed questionnaires.
Awareness of emotions and emotions themselves were found to mediate
between musical training and wellbeing. Positive and negative emotions
also mediated between listening to music and wellbeing, although
playing an instrument was not associated with emotional awareness,
positive or negative emotions, or wellbeing. The findings further
reinforce the problems of making direct links between music and
 14. Psychological Wellbeing  445

wellbeing. Similarly, Clarke and Basillo (2018) investigated the role of

the performing arts in 275 secondary-school pupils and demonstrated
that the opportunities for playfulness and developing interpersonal
relationships afforded by the activities predicted students’ wellbeing.
The importance of musical context in impacting on wellbeing emerged
from research by Baker and colleagues (2018), who studied an artist-
led group song-writing programme with 85 young people. They found
that contextual factors helped shape the song-writing environment.
The young people felt safe, had fun and pushed boundaries, and there
was direct and honest feedback, high energy rituals and an emphasis
on artistic excellence. Anthony and colleagues (2018), studying the
implementation of a music education programme with young people
in remote Aboriginal communities, found that the informal learning
frameworks (which incorporated music-making shared between
educators and community members) provided constructive ways of
engaging young people and empowering them in the management of
their health and wellbeing. Similarly, in research in Nigeria, Ojukwu
(2017) suggested that active engagement in music could promote
positive youth development.
Working with at-risk students, Van Rooyen and dos Santos (2020)
studied the experiences of teenagers in a children’s home who
participated in a choir in South Africa. Sixteen weekly choir sessions
were held, which included a variety of interactive vocal techniques. A
performance marked the end of the process, where songs selected by
the teenagers were performed. Qualitative data were collected through
14 semi-structured individual interviews at the end of the process.
The findings showed that participation in the choir offered teenagers
meaningful intra- and interpersonal experiences. At an intrapersonal
level, participants discovered their musical voices, increased their self-
awareness, self-esteem and self-confidence, and were able to express
and regulate emotions. In terms of interpersonal experiences, the
teenagers experienced growth in relationships, improved social skills
and greater connection with the broader community. Also working with
at-risk young people, Wilson and MacDonald (2020) reported on a ten-
week group music programme for young Scottish adults with learning
difficulties. Participants enjoyed the programme and participation
was generally maintained, with benefits evidenced in increased social
446 The Power of Music

engagement, interaction and communication. As we saw in Chapter

12, young people who are disaffected can be re-engaged with their
education through music. It can also enhance wellbeing in looked-after
children and those in the criminal justice system.
One strand of research has focused on young people presenting
issues with academic work. For instance, Sharma and Jagdev (2012)
studied 30 adolescents with low self-esteem and high academic stress
who engaged with music therapy for a period of 15 days. This reduced
anxiety and enhanced self-esteem. Similarly, Schiltz (2016) studied 93
highly gifted adolescents suffering from school failure. They engaged
with an integrated form of musical and verbal psychotherapy, musical
improvisation with story-writing or the production of drawings with
music, followed by verbal elaboration. Participants showed a significant
increase in concentration, the capacity for imaginary and symbolic
elaboration, pictorial and literary creativity, self-esteem and the quality
of coping strategies. There was a significant decrease in defensive
functioning and in embitterment and resignation. Music therapy can
clearly be beneficial in these circumstances.
Some research has focused on extracurricular school activities.
For instance, participating in a school production has been shown to
promote friendship groups and support musical, personal and social
development (Pitts, 2007; 2008). Kinnunen and colleagues (2020)
focused on the social sustainability of music events in adolescents’ lives,
through their perceptions and own words as they described live music
experiences. A web survey of over 1000 adolescents aged 15 to 18 years
old demonstrated that cultural content per se was not as meaningful
to them as the social networks at such events. Bonding and bridging,
as well as the sense of community, produced a range of benefits to
wellbeing. Similarly, a thematic analysis by Caleon (2019), including
13 studies aimed at fostering wellbeing in adolescents, identified that
music-based activities acted as catalysts for relationship-building, as
a means of self-expression and self-regulation, and as a resource for
self-transformation. Considering a heritage and related music project,
Clennon and Boehm (2014) examined how creative activities that were
embedded in a community could serve to enhance the cohesion and
wellbeing of the community through the work of its youth groups. In a
review, Zarobe and Bungay (2017) concluded that participating in arts
 14. Psychological Wellbeing  447

activities could have a positive effect on wellbeing through enhancing

self-confidence, self-esteem, relationship-building and a sense of
belonging.

Music and Wellbeing in Adults

For most people, adulthood is characterised by relative stability
and an increase in independence and responsibility, although there
are transitions in relation to choices concerning work and family
(Levinson, 1986; Levinson et al., 1978). Ageing and retirement bring
new challenges, including acceptance of the decline in physical and
psychological abilities and the loss of loved ones, while attempting to
maintain control over life and sustain interest and motivation (Atchley,
1975; Erikson, 1982). In general, older people report fewer negative
emotional experiences (Gross et al., 1997) and retain the ability to
regulate their emotions, alongside a desire to derive emotional meaning
from their lives (Carstensen et al., 2003). In relation to music, Sloboda
and colleagues (2009) have shown that most of music’s functions in the
everyday lives of adults are related to memories, moods and emotions.
Similarly, Greasley and Lamont (2006) reported that adults’ use of
music included a stress on personal choices, using music for emotional
self-regulation and reflection on internal experiences and memories,
while Van Goethem (2010) showed that the emotions most typically
regulated through music were happiness and calmness. Saarikallio
(2011) undertook a qualitative study with 21 participants aged 21 to 70
years old, and revealed that various regulatory goals and strategies were
similar throughout adulthood, but that there were also changes related
to age, particular events and retirement transition. All participants
used music to generate and maintain happy moods, for pleasure and
enjoyment. Moods were enhanced by listening to loud music, singing
along, starting to play an instrument or even dancing. In addition to
using music as a leisure activity, it was used to accompany all kinds of
activities, to relax after a working day but also energise to prepare for an
activity. When individuals are actively engaged with making music, its
effects are greater (Greasley and Lamont, 2006). In adult life, there are
many competing demands which affect participation and continuation
448 The Power of Music

with music-making. Personal determination and circumstances are key

to understanding this (Pitts and Robinson, (2016).
In a very large-scale study in Sweden, Bygren and colleagues
(1996) studied 15,198 individuals aged 16 to 74 years old. Of these,
85 percent were interviewed by trained non-medical interviewers
about their cultural activities. Eight confounding variables—age, sex,
education level, income, long-term disease, social networks, smoking
and physical exercise—were controlled for. These influenced survival
in the expected direction, except for social networks for men. Taking
these into account, the research revealed an influence on mortality in
people who rarely attended events compared with those attending
most frequently. In another large-scale population study, Cuypers and
colleagues (2011) analysed the association between cultural activity and
perceived health, anxiety, depression and life satisfaction based on data
from the third Nord-Trøndelag Health Study, which included 50,797
adult participants. The findings showed that participation in receptive
and creative cultural activities was significantly associated with good
health, positive satisfaction with life, and low anxiety and depression
scores, especially in men attending the receptive, rather than creative,
cultural activities. Similarly, Węziak-Białowolska and Białowolski (2016)
investigated the causative impact of attendance at cultural events on self-
reported and physical health in the Polish population. Four waves of the
biennial longitudinal Polish household panel study representative of
the Polish population aged over 16 were used. The findings confirmed
that there was a positive association between cultural attendance and
self-reported health, although it was not possible to establish a causal
link. In another large-scale study, Weinberg and Joseph (2017) explored
the connection between habitual music engagement and subjective
wellbeing. Data were gathered as part of the 31st survey of the Australian
Unity Wellbeing Index, to provide insight into the relationship between
music engagement and wellbeing. A sample of 1000 participants were
interviewed by telephone. The findings revealed that engaging with
music by dancing or attending musical events was associated with
higher wellbeing in comparison to those who did not engage with music.
The findings also emphasised the importance of engaging with music in
the company of others with regard to wellbeing, thus highlighting the
interpersonal features of music-making.
 14. Psychological Wellbeing  449

In the UK, Tymoszuk and colleagues (2021) explored trends in

participatory and receptive engagement with a broad range of arts in
5,338 adults. Over 97 percent of respondents reported engagement
in arts activities during 2018 and 2019, with reading and listening to
music being the most popular activities. Arts engagement was grouped
into three distinct clusters. Almost 20 percent constituted low engagers
whose main source of engagement was occasional reading; 44 percent
constituted receptive consumers who read and listened to music
frequently and engaged with popular receptive arts activities such as
going to the cinema, live music, theatre, exhibitions and museums;
while almost 36 percent constituted cultural omnivores who frequently
engaged in almost all arts activities. Greater engagement with the arts
was associated with higher levels of wellbeing, social connectedness
and a lower possibility of intense social loneliness, although there was
a positive association between greater arts engagement, depression and
intense emotional loneliness in the most highly engaged omnivores.

Participation in Musical Activities

Pitts (2005) found that musical participation was a potential source of
confirmation and confidence, providing opportunities to demonstrate
existing skills and acquire new ones. Music can also give a structure to
life and offer opportunities to perform with others, develop friendships,
engage in social interaction, get relief from family and work pressures
and provide spiritual fulfilment and pleasure. It can promote prosocial
behaviour, leading to feelings of belonging, social adjustment, trust
and cooperation (Anshel and Kipper, 1988; Odena, 2010). People
from a range of different backgrounds can experience benefits to their
emotional and physical wellbeing from making music, developing an
increased sense of self-worth, enhanced social skills and wider social
networks (Judd and Pooley, 2014). Lamont and Ranaweera (2020)
compared happiness and wellbeing in adults involved in knitting or
making music. Eight hundred and thirty-five amateur knitters and 122
amateur musicians completed a measure of happiness and questions
about past and current involvement. The knitters scored significantly
higher on happiness than the musicians, although no differences were
found in relation to subjective wellbeing. Older participants scored more
450 The Power of Music

highly on all wellbeing measures, with no effect of time participating

in the activity. Despite differences between the activities, participants
experienced broadly similar physical, psychological and social benefits.
In Australia, Krause and colleagues (2020 administered a questionnaire
to 192 residents aged 17 to 85 years old who were participating in a
musical activity at the time. The importance of music in individual’s lives
was positively related to perceived wellbeing including competency,
relatedness, autonomous motivation and the social, cognitive and
esteem dimensions of wellbeing. These findings were particularly
strong for female participants. Overall, there were positive associations
between musical activity and psychosocial wellbeing.
As we saw in earlier chapters, positive outcomes have been reported
from music interventions with adult offenders (Eastburn, 2003; Digard
et al., 2007; Henley et al., 2012). In these studies, participants enhanced
their communication and social skills, increased their confidence, were
better able to reflect on their situation, and believed that they could
change and attain their goals. Overall, their wellbeing was enhanced.
While there can be benefits to participating in music, it can also
be stressful. Pitts (2020) studied membership of leisure-time music
groups through an online survey of 559 participants in such groups.
While there were many benefits to wellbeing through being a member
of such groups, there were pressures for some groups as they struggled
to maintain their survival in the face of dwindling membership and lack
of funding. There can also be a negative impact on wellbeing for those
for whom music is a career or potential career. For instance, 126 college
students and amateur musicians in a joint Swiss-UK study were assessed
in relation to their wellbeing, quality of life and general health (Philippe
et al., 2019). Scores were high on general measures of quality of life for
both groups and on environment, social relationships, physical health
and psychological health. Differences between groups of musicians
emerged in terms of overall quality of life and general health, as well
as the physical health dimension, where college music students scored
lower than the amateur musicians, although the college music students
scored higher than the amateurs on social relationships. While music-
making can offer some health-protective effects, this may not be the
case among those aspiring to become professional musicians. Similarly,
MacRitchie and Garrido (2019) studied professional and amateur
 14. Psychological Wellbeing  451

orchestral musicians using questionnaires and interviews, and found

that intellectual stimulation was high for these groups and that there
was a balance between perceived challenge, effort and reward of the
musical tasks. Emotional engagement increased with age for amateur
players but decreased for professionals. Overall, social engagement was
high, with players reporting feeling connected as a group whilst making
music.
Some research has considered flow experiences in musical
participation and their relationship with wellbeing. For instance, Baker
and MacDonald (2013) studied flow in non-music-major university
students and retirees and their sense of self, achievement, identity,
satisfaction and ownership during the creation of personally meaningful
songs. There were strong experiences of flow during song-creation
when compared with sporting activities, dancing, yoga and performing
music. Habe and colleagues (2020) studied 452 elite musicians and
top athletes in their early twenties and found that flow was more often
experienced in group than individual performance settings, and that
life satisfaction was positively related to flow, particularly the challenge-
versus-skill balance.

Attendance at Music Festivals

Music festivals offer unique opportunities for engagement with music.
The excitement of physical proximity to the performers, social interaction
with other attendees and the music itself all contribute to the experience
(Oakes, 2003; Paleo and Wijnberg, 2006; Pitts, 2005). Engagement with
music in a festival context can contribute to the creation of a sense of
community, as it provides opportunities to engage in social activities
(Frith, 1996; Gibson and Connell, 2005). It also contributes to the
development of identity (Karlsen and Brändström, 2008; Matheson,
2005), although there can be negative outcomes and risks relating to
the use of alcohol or drugs, overcrowding, mob behaviour and other
public health issues (Earl et al., 2004). Pitts (2005) investigated audience
experiences at a chamber music festival, and showed that social and
musical enjoyment interacted to generate commitment and a sense of
involvement in the event. Similarly, Burland and Pitts (2010) studied the
roles that music played in the lives of jazz audiences at the Edinburgh
452 The Power of Music

festival. Analysis of a large-scale survey and in-depth interviews revealed

a sense of community and atmosphere, within which audience members
valued the opportunity to be amongst like-minded jazz enthusiasts.
Similarly, Pitts and Burland (2013) drew on evidence from nearly 800
jazz listeners, surveyed at the Edinburgh Jazz and Blues Festival and
in the Spin jazz club, Oxford. Questionnaires, diaries and interviews
were used to understand the experiences of listening for a wide range
of audience members. The findings illustrated how listening to live
jazz had a strongly social element, whereby listeners derived pleasure
from attending with others or meeting like-minded enthusiasts in the
audience, and welcomed opportunities for conversation and relaxation
within venues that helped to facilitate this. Within this social context,
live listening was (for some audience members) an intense, sometimes
draining experience, while for others it offered a source of relaxation
and absorption, through the opportunity to focus on good playing and
preferred repertoire. Overall, live listening constituted an individual
and social act which varied between listeners, venues and occasions.
Packer and Ballantyne (2010) established that a sense of connection
between participants and a separation from everyday life distinguished
festivals from other musical experiences, providing a sense of
disconnection that prompted festival attendees to reflect on their lives
and their understanding of themselves. They reported benefits in terms
of enhanced interpersonal relationships, a greater sense of belonging,
being valued, a deeper understanding of self and emotions, enhanced
self-perceptions, confidence, mastery, purpose in life, a greater sense
of agency, better strategies for coping with stress, a sense of making
a contribution, and being more hopeful. These benefits reflect those
reported by those engaged in making music.
Strong experiences of music most commonly occur in live settings
(Gabrielsson, 2011; Lamont, 2011). Experiences are enhanced if the
performers appear to be enjoying the experience and if they interact
with the audience (Brand et al., 2012; Pitts and Burland, 2013; Pitts
and Spencer, 2008; Radbourne et al., 2013). Physical proximity between
performers and audience can support this (Brand et al., 2012). The
quality of the experience is influenced by interactions between audience
members and the performers, which transform the experience from
being passive to active (Dobson and Sloboda, 2014). Technology has
 14. Psychological Wellbeing  453

enabled communities of fans to upload set lists and photos to online

forums and also use Twitter, which helps non-attending fans to feel
involved (Bennett, 2012).

Music and Wellbeing in the Older Generation

Across the world, life expectancy is increasing and there are growing
numbers of older people. Many live alone and are vulnerable to
experiencing depression. In recent years, there has been an increase in
research on the role of music in the lives of the older generation. Overall,
music becomes more important for the elderly (Gembris, 2008; Laukka,
2007). Participation in a wide range of musical activities provides a
source of enhanced social inclusion, enjoyment, personal development
and empowerment supporting group identity, collaborative learning,
friendship, social support, a sense of belonging, enhanced wellbeing,
and access to new social roles and relationships (Allison, 2008; Coffman,
2002; Coffman and Adamek, 2001; Langston, 2011; Sixsmith and Gibson,
2007; Wood, 2010). It is clear that older people gain cognitive, emotional
and social benefits from learning to play a musical instrument in a range
of different learning environments (Drummond, 2012; Veblen, 2012),
even over short periods of time (Bugos et al., 2016). Music-making
contributes to psychological wellbeing. It can alleviate loneliness
and offer support in coping with the challenges of ageing, providing
opportunities for musical progression and enjoyment, and thus adding
meaning to life (Forssen, 2007; Lehmberg and Fung, 2010; Saarikallio,
2011). It can provide contentment, satisfaction and feelings of peace, and
reduce anxiety and depression. It can reduce the decline in wellbeing so
often experienced by the older generation, and foster positive moods
and emotions (Lally, 2009; Livesey et al., 2012; Sandgren, 2009).
There are a number of large-scale studies examining the relationship
between wellbeing and musical activity in older people. For instance,
Jenkins (2011) derived data from the English Longitudinal Study of
Ageing—a large-scale, nationally representative survey of those aged 50
and above which contains several wellbeing measures and information
on three types of learning: formal courses, music/arts/evening classes
and gym/exercise classes. The key finding from this research was
that music, arts and evening classes were significantly associated
454 The Power of Music

with positive changes in wellbeing. There was no similar relationship

between formal courses, gym or exercise classes, and wellbeing. More
recently, also using the English Longitudinal Study of Ageing, Fancourt
and Steptoe (2018) analysed data from 2,548 adults aged over 55 during
a ten-year period, to explore whether membership of different kinds
of community groups was associated with wellbeing. Membership of
education, arts or music classes was longitudinally associated with
lower negative affect and more life satisfaction, while slightly different
positive outcomes were associated with membership of religious
groups. In a ten-day diary study of 1,042 people aged 13 to 82 years old
with music as a hobby, Koehler and Neubauer (2020) showed that need
satisfaction and positive affect were higher when participants reported
music-making. The satisfaction of basic psychological needs seemed to
act as a mediating mechanism between musical activities and wellbeing.
Since the 1980s, a considerable body of research has demonstrated the
relationship between actively making music and subjective wellbeing
(Lehmberg and Fung, 2010). Adults who participate in active music-
making report that it provides valued and worthwhile experiences,
while for those in older age it can provide structure and purpose to daily
living, enhancing motivation and providing meaning in life (Hallam
et al., 2012). It can reduce depression, promote positive emotions and
emotional regulation, and provide spiritual experiences (Creech et al.,
2014; Dingle et al., 2012). Those working with the older generation in
leading music-making have recognised that the older generation are not
a homogenous group. Even those who consider themselves to be novice
musicians bring to musical activities a mixture of skills, preferences
and cultural backgrounds. While they may have reduced capacity in
some areas, as musical groups they have a rich knowledge base, and
considerable experience and motivation (Dabback and Smith, 2012).
Older people tend to be independent learners who want to control their
learning, although the extent to which this applies to musical activities
varies across groups and the nature of the activities. Group dynamics are
important, as they are frequently key to sustaining motivation (Veblen,
2012). Internationally, music educators are increasingly recognising
that the social aspects of music-making are important to older adults
(Krause and Davidson, 2018) and that there needs to be a change from
pedagogy based on expertise training to pedagogy promoting cultural
connectedness and sharing.
 14. Psychological Wellbeing  455

Exploring a range of issues, Hays and Minichiello (2005) carried

out interviews with 52 older Australians to determine the role of
music in their lives. Participants were involved with music for much
of the time: for instance, listening to music, actively making music, or
volunteering (including working in community radio as broadcasters
and programmers, in music administration and concert development,
or teaching). Listening, performing or composing enabled expression
of their individuality and ways of defining themselves. Listening to
specific pieces of music led to the recall of events and experiences in
their life, along with the emotions associated with them. Music provided
a way for them to maintain positive self-esteem, to feel competent and
independent, avoid feelings of isolation or loneliness, be distracted
from health problems, feel uplifted physically and psychologically, and
feel rejuvenated. They used music as an accompaniment to their daily
activities, and reported that music helped them feel more competent
and motivated. When they were faced with challenging tasks, music
provided support and distraction. It reduced anxiety and stress levels,
and increased the threshold for pain endurance. Some indicated that
music provided them with inner happiness, contentment and peace. It
was therapeutic and made them feel more positive about life, as well
as more cheerful, hopeful, contented, relaxed and peaceful. Some were
moved to tears by music, and listened for the sheer joy and beauty of the
experience. Music was able to calm, excite, thrill and entertain them in
ways that other things were not able to. For some it became addictive,
a way of escaping reality and stimulating their imagination, while the
sense of beauty was spiritual in its effect. While this was associated with
specific religious beliefs for some, for others it was a personal feeling
of being at one with the world. Music provided many benefits which
all contributed to their wellbeing. Similarly, participants in the Music
for Life project reported engaging in a wide range of musical activities.
Questionnaire responses revealed that 96 percent reported listening
to recorded music, 81 percent to live music, 80 percent to playing
music in the background when they were completing other tasks,
79 percent singing at home, and 49 percent practising at home. They
played a wide range of instruments and had a wide range of musical
preferences (Creech et al., 2014; Hallam et al., 2012). Laukka (2007)
sent a questionnaire to a random sample of 500 community-living older
456 The Power of Music

adults aged 65 to 75 years of age in Sweden, to assess their use of music

in everyday life including frequency of listening, situations where music
was encountered, emotional responses to music and their motives for
listening. Different facets of psychological wellbeing were also assessed.
The findings showed that listening to music was a common leisure activity
and a frequent source of positive emotions. Participants reported using
a variety of listening strategies related to emotional functions including
pleasure, mood-regulation, and relaxation as well as issues of identity,
belonging and agency. Although health status and personality were the
most important predictors of wellbeing, some listening strategies were
significantly associated with psychological wellbeing.
One strand of research has considered the role of choral singing
in promoting wellbeing in older people. For instance, Lamont and
colleagues (2018) reported a case study of an older people’s choir over
a four-year period, using interviews, focus groups, observations and
participatory discussion. Choir members highlighted the individual
and interpersonal benefits of being part of the choir. They particularly
emphasised the importance of developing social relationships within a
supportive community, although musical achievement was also central
to the ongoing development of the choir. Five main themes emerged
from the data: personal investment and reward, an inclusive community,
an always evolving yet fundamentally unchanged environment, a desire
to connect, and leadership and organisation. Considering these with
reference to Seligman’s (2010; 2011) PERMA framework from positive
psychology, it was apparent that social relationships, meaning and
accomplishment were particularly important reasons for older people
finding singing in a community choir beneficial for wellbeing.
In Tasmania, Langston and Barrett (2008) explored how social capital
was manifested in a community choir. Interviews with 27 choir members
revealed that the choir provided shared norms and values, trust, civic and
community involvement, networks, knowledge resources, and contact
with families and friends. Fellowship was identified as a key component
in fostering group cohesion and social capital development. Similarly, in
England, Coulton and colleagues (2015) evaluated the effectiveness of
community-group-singing for a population of 258 older people aged 60
years old or over who either participated in singing or other activities.
After three months, significant differences were observed in relation to
 14. Psychological Wellbeing  457

the mental health components of quality of life, anxiety and depression.

After six months, significant differences were observed in mental health
in favour of the group-singing. Similarly, Fung and Lehmberg (2016)
found that there was a positive impact on quality of life for people in a
retirement community who sang together. Joining a group with singing
activities as a new musical hobby in later life can provide mental and
physical stimulation, positive benefits to mood and increased social
interactions. Davidson and colleagues (2014) developed and evaluated
an eight-week singing programme with 26 participants aged 70 years
or older. There was little impact on health and wellbeing, although the
quality of the programme facilitators was an important factor in how the
programme was experienced. Pearce and colleagues (2015) followed
newly-formed singing and non-singing (crafts or creative writing) adult
education classes over seven months. Participants rated their closeness
to their group and their affect, and were given a proxy measure of
endorphin release, before and after classes at three timepoints: one,
three and seven months. The findings showed that, although singers
and non-singers felt equally connected by timepoint three, singers
experienced much faster bonding in the form of a significantly greater
increase in closeness at timepoint one. It seems that singing can have an
icebreaker effect in promoting fast social cohesion between unfamiliar
individuals. In a single case study, Southcott (2009) focused on a
small choir, the Happy Wanderers, formed by a group of older people
to perform to residents in care facilities and to sufferers of dementia.
Participation in the group enhanced the lives of the members and those
of their audiences. Costa and Ockelford (2019) specifically considered
the impact of music on audiences. They evaluated a programme of
regular concerts and teas for older people. Interview findings showed
that the concerts were effective in evoking positive emotions including
happiness, relaxation, inspiration, awe and gratitude, whilst negative
emotions (such as anxiety and worry) were lessened. These responses
were enhanced by the interaction between performers and audience,
the high standard of performance and an appropriate repertoire. The
opportunity for social contact and interaction relieved loneliness and
contributed to participants’ enjoyment.
In a series of studies in the UK, Creech and colleagues (2013; 2014),
Hallam and colleagues (2014; Hallam and Creech, 2016) and Varvarigou
458 The Power of Music

and colleagues (2012; 2013) researched the relationship between active

music-making and subjective wellbeing in older people’s lives. The
research comprised three UK case-study sites, each offering a wide
variety of musical activities including singing, ensemble participation
and song composition. At each site, a sample of people aged over 50, a total
of 398, some of whom had recently begun musical activities and others
who were more experienced, were recruited to complete questionnaires
that assessed quality of life. A control group of 100 completed the same
measures. In-depth interviews were carried out with a representative
sample, followed by observations of musical activities, focus groups and
interviews with the music facilitators. Comparisons were made between
older people participating in a wide range of musical and other activities
in relation to their questionnaire responses and psychological needs, as
well as those participating in the musical activities who were in the third
and fourth age groups. The factors that emerged from the analysis of
the data were: purpose (having a positive outlook on life), autonomy
and control, social affirmation, positive social relationships, competence
and a sense of recognised accomplishment. Those participating in the
music activities responded more positively than those engaged in other
activities. There was also no deterioration in responses in the music
groups between those in the third and fourth age groups, as might have
been expected with the exception of purpose in life. The interviews
revealed cognitive benefits including challenge, the acquisition of new
skills, a sense of achievement, and improvements in concentration and
memory. Health benefits included increased vitality, improved mental
health and mobility, and feelings of rejuvenation, while emotional
benefits included protection against stress and depression, support
following bereavement, a sense of purpose, positive feelings, confidence
and opportunities for creativity.
There is considerable evidence that older adults experience a myriad
of psychosocial benefits from learning to play a musical instrument,
even when starting to play as novices and when receiving training
over relatively short-term periods (Jutras, 2006; Roulston et al., 2015).
Older adults frequently cite the ensemble nature of musical activities
as a motivating factor to continuing engagement in learning to play
an instrument (Roulston et al., 2015). The social aspects of ensembles
offer wellbeing benefits through the development of new relationships
 14. Psychological Wellbeing  459

and decreasing isolation. Singing and playing seem to be important to

the elderly as they can enhance emotional self-regulation, emotional
expression and relaxation. They help to reduce loneliness and provide
experiences of togetherness, company and belonging, help to strengthen
self-concept and self-understanding, and provide enjoyment, beauty,
challenge and meaningful content to life. Focusing on the learning of
keyboard, guitar, recorder or djembe drums—taught individually or
in small groups—or creative musical activities over a ten-week period
with 98 individuals over the age of 50 with no or very little prior musical
experience, Perkins and Williamon (2014) concluded that engaging
in such activities offered significant wellbeing benefits, particularly
enhancing behaviours which promoted good health. Interviews with a
subgroup of 21 participants revealed that engaging with the musical
activities enhanced wellbeing through subjective experiences of
pleasure, enhanced social interactions, musically nuanced engagement
in day-to-day life, fulfilment of musical ambition, the ability to make
music, and self-satisfaction through making musical progress.
Learning to play a musical instrument may also be effective for
improving fine motor skills. Sensorimotor function generally declines
with age, and performance of the upper limbs in visuomotor tasks is
also subject to this decrease. The tasks required in musical instrument
training—employing sensory, motor and multimodal brain regions—
have been shown to stimulate brain plasticity (see Chapter 3; Altenmuller
and Schlaug, 2015; Rogenmoser et al., 2018). Piano-playing, in particular,
trains both coupled movements across the fingers and individuated
finger movement (Furuya and Altenmuller, 2013) but it is unclear if this
type of training is useful for maintenance or improvement in the context
of ageing. Preservation of domain-general fine motor skills may also
benefit healthy older adults, supporting the maintenance of the skills
required for numerous daily tasks involved in independent living.
In a series of studies, Bugos and colleagues (2007; 2016; Bugos and
Kochar, 2017) demonstrated that healthy older adults experienced
significant improvements in cognitive measures, particularly trail-
making tasks and digit-span tests, as a result of piano training
programmes. They also showed that the intense piano training of 17
healthy community-dwelling adults aged 60 to 85 years old enhanced
musical self-efficacy, although not general self-efficacy or cortisol levels.
460 The Power of Music

Bugos and Cooper (2019) examined the effects of music interventions

on bimanual coordination and cognitive performance in healthy older
adults aged 60 to 80 years old. One hundred and thirty-five participants
completed motor measures and a battery of standardised cognitive
measures, before and after a 16-week music training programme with
a three-hour practice requirement. Participants were allocated to either
piano, fine motor training or percussion instruction, gross motor training,
or music listening. There were significant enhancements in bimanual
synchronisation and visual scanning working memory abilities for fine-
and gross-motor training groups, as compared to listening to music.
Piano training significantly improved motor synchronisation skills as
compared to percussion instruction or music-listening. Reflecting on
the existing research, Bugos (2014) developed a model suggesting how
community music programmes and musical training could be integrated
to lead to successful ageing. Similarly, Seinfeld and colleagues (2013)
showed significant improvement in cognitive measures for a group
of older adults involved in piano training programmes as compared
to other leisure activities (for instance, exercise or painting). Thirteen
participants received piano lessons and undertook daily training for
four months, compared to 16 age-matched participants who acted as
a control group and participated in other types of leisure activities
(physical exercise, computer lessons or painting lessons). There was
a significant improvement in the piano training group in relation to
executive functions, inhibitory control and divided attention. There was
also a trend indicating an enhancement in visual scanning and motor
ability. Piano lessons also decreased depression, induced positive mood
states, and improved the psychological and physical quality of life.
Overall, playing the piano and learning to read music can be a useful
intervention in older adults to promote cognitive reserve and improve
subjective wellbeing. In an ongoing study, James and colleagues
(2020) explored the outcomes of piano instruction or musical listening
awareness on two sites in Hannover and Geneva with 155 retired healthy
adults aged 64 to 78 years old. Participants receive weekly training for
one hour over a 12-month period. The outcomes being assessed relate
to cognitive and perceptual motor aptitudes, as well as structural
neuroimaging and blood-sampling. MacRitchie and colleagues (2020)
examined the effects of a ten-week piano training programme on healthy
 14. Psychological Wellbeing  461

older adult novices’ cognitive and motor skills, in comparison to an

inactive waiting-list control group. Fifteen participants completed piano
training, led by a music facilitator in small groups. Quantitative data
from a battery of cognitive and motor tests was collected before and after
training, with further post-test data from the control group. Qualitative
data included weekly facilitator observations, participant practice
diaries, and an individual, semi-structured, post-experiment interview.
The findings demonstrated evidence of a strong positive impact of
training on a trail-making test, indicating improved visuomotor skills.
Moderate evidence for the negative impact of training on a different
section of the trail-making test was also found, suggesting no benefit of
cognitive switching. Qualitative results revealed that the group learning
environment motivated participants to play in musical ensembles and to
socialise. Motivation was optimal when all participants were happy with
the chosen repertoire. Participants reported that they were motivated by
learning to play familiar music and when the facilitator observed that
groups had formed cohesive bonds.
As we saw in Chapter 2, brain plasticity is possible in adulthood
and in the elderly, following relatively short-term musical training
(Herdener et al., 2010; Lappe et al., 2008; 2011). Training programmes
requiring intensive multisensory, cognitive and motor activities (for
instance, piano lessons) can improve working memory, perceptual
and motor skills, and delay age-related decline in speech perception
(Parbery-Clark et al., 2011; 2012), non-verbal memory, executive
processes (Hanna-Pladdy and MacKay, 2011) and dementia (Verghese
et al., 2003). Supporting this, comparisons of 42 professional, 45 amateur
and 38 non-musicians by Rogenmoser and colleagues (2018), using
brain imaging to calculate a brain age for each participant, found that
being a musician had a positive impact on brain-age scores. Musicians in
general exhibited lower brain-age scores than non-musicians, suggesting
a general age-decelerating effect of music-making on the brain. Further,
there was a stronger age-decelerating effect in the amateur musicians,
perhaps because the multisensory, motor and socioaffective experiences
of musical activity enriched their lives in addition to other activities.
For the professional musicians, brain plasticity may be maladaptive. The
extensively rehearsed and highly specialised repetitive sensorimotor
activities and stressful public performances may result in a less enriched
environment and lead to negative health effects.
462 The Power of Music

There has been a focus in some research on creative activities, usually

song composition. For instance, Waddington-Jones and colleagues
(2019) analysed video-recall interviews and questionnaires, to evaluate
the impact of participation in collaborative composition workshops on
the subjective and psychological wellbeing of older adults. The analysis
revealed that all of the dimensions of the PERMA framework for subjective
and psychological wellbeing were met. For older adults, collaborative
composition encouraged social interaction with others with shared
interests, increased positive affect, enhanced self-esteem and allowed
older people to express themselves. Similarly, Baker and Ballantyne
(2013) investigated whether group song-writing and performing
affected perceptions of quality of life and feelings of connectedness in a
community of retirees. Thematic analysis of data transcripts from focus
groups and written questionnaires from participants and the students
involved in the project indicated that the programme stimulated
enjoyment, positively affected emotions and improved wellbeing.
Participants experienced enhanced connection with one another, as well
as with others in the broader community, and a sense of accomplishment,
meaning and engagement in creating and performing their own songs.
In a similar project, where professional musicians worked with a small
group of older people to compose individual pieces of music, Habron and
colleagues (2013) demonstrated enhanced wellbeing through facilitated
control over musical materials, opportunities for creativity and the
development of identity, the validation of life experiences, and social
engagement with other participants and the professional musicians. The
results emphasised the importance of occupation as essential to health
and wellbeing in the later stages of life. Creech and colleagues (2020)
focused on the role of creativity in promoting wellbeing. In a review of
23 articles, they concluded that creativity in participatory music-making
was underpinned by social engagement, collaboration and inclusivity.
Opportunities for creative expression offered a range of benefits relating
to quality of life, including positive emotions, engagement, relationships,
a sense of meaning and accomplishment.
An innovative programme in rural Ontario was designed to address
social isolation among older people through matching participants
with trained volunteers. Both then worked together over ten sessions
in their home setting to create expressive art, which may have involved
 14. Psychological Wellbeing  463

music. Evaluating the programme using interviews, MacLeod and

colleagues (2016) found enhanced wellbeing in the older adults and the
volunteers, particularly in terms of relationships, personal development
and creating meaning. The impact of the intervention extended beyond
the programme’s duration. In an exclusively musical programme
which used similar methods, Dassa (2018) analysed 43 interviewers’
essays, documenting meetings between an interviewer and an elderly
person written over four years. The mutual musicking elicited remote
memories from childhood, adolescence and adulthood, and emotionally
impacted both parties. Mutual musicking revealed new and unfamiliar
facets of the participants. The findings suggested that creating a musical
autobiography interview through a process of music and reminiscence
strengthened the older person’s sense of self-identity, illuminated
hidden aspects and also changed attitudes toward the elderly. Also
studying the concept of reminiscence, Kruse (2021) explored the ways
that older adults reminisced about music participation over the course
of their lives. Six community musicians participated in the interviews
and worked with a life-review tool. Two hundred and twenty-five
reminiscences reflected healthy ageing and satisfaction, including
self-acceptance, valuable life lessons and the reconciliation of life
events, although some participants were troubled by strained parental
relationships and bittersweet associations with music.
Some research has focused more broadly on music-related activities:
for instance, dancing. Focusing on depression in the elderly, Rummy
and colleagues (2020) carried out a systematic review of 13 articles.
Some studies used individual therapy, while others combined music
therapy with other activities such as singing, dancing and lyric-writing.
The time spent varied from two weeks to six months, with one or
two sessions weekly, each with a duration of 30 to 60 minutes. They
concluded that music therapy was effective in reducing depression. Also
studying the impact of music indirectly through dance, Murrock and
Graor (2016) found that the 16 disadvantaged adult participants who
completed a 12-week dance intervention developed a sense of belonging
and group identity, which may have maintained group involvement and
contributed to reducing depression and social isolation.
There has been some interest in the way that music technology might
support wellbeing in the older generation. For instance, Engelbrecht
464 The Power of Music

and Shoemark (2015) carried out a mixed-method feasibility study

investigating the acceptability and efficacy of using iPads compared
to traditional musical instruments with older adults living privately in
the community. Five women aged 71 to 96 years of age were recruited
from a community-based day-respite centre in Brisbane, Australia.
Participants were randomly assigned to either a traditional musical
instrument or an iPad group, and engaged in five sessions of activity-
based music therapy. Participants completed journal entries following
each session to detail their experiences, and were assessed for levels of
perceived social isolation and global self-esteem before and after the
intervention. The use of iPads was acceptable to the group. Learning
was central to all sessions, but there were differences in mood outcomes
and emotional communications. Playing on an iPad resulted in greater
creativity and freedom. There were no significant differences in social
isolation or self-esteem between groups or over time. Both iPad and
traditional instrument interventions developed social cohesion group
identity and positive self-concept. Overall, the findings showed that
technology can be an acceptable and potentially successful tool for use
in music therapy with older people living in the community. Creech
(2019) supported these findings in a literature review of the intersection
between music, technology and ageing. Of the 144 papers screened, 18
were retained. Ten focused on using technology to support musicking
in the form of listening, reflecting and interpreting, while five explored
the utility of technology in promoting singing or playing instruments,
and a further three were focused on music and movement. Overall,
the literature suggested that older people, even those with complex
needs, were capable of and interested in using music technologies to
access and create personally meaningful music. Similarly, Poscia and
colleagues (2018) reviewed the effectiveness of existing interventions
for alleviating loneliness and social isolation among older people. The
findings from 15 quantitative and five qualitative studies suggested that
new technologies and community-engaged arts might be able to tackle
social isolation and loneliness among older individuals.
While the wellbeing of older people is important, it is also important
to consider the wellbeing of those caring for them. Considering the role
of carers and their patients, Ascenso and colleagues (2018) studied 39
participants in a series of community drumming programmes. The
 14. Psychological Wellbeing  465

outcomes were assessed through semi-structured interviews and focus

groups at the end of each programme. Emotional, psychological and
social dimensions of wellbeing emerged for both patients and carers.

Music, Wellbeing and the COVID-19 Pandemic

There have been a number of research projects which have considered
the role of music in offering support to people during the COVID-19
pandemic. One strand of research has explored the use of music in
families during lockdowns. For instance, in the USA, Cho and Ilari
(2021) studied how parents with young children used recorded music in
their everyday lives during the pandemic. Nineteen mothers of children
aged 18 months to five years strategically managed the sonic home
environment over a period of one week, based on resources provided
by the researchers in response to their children’s mood and state. A total
of 197 episodes were collected of children’s engagement with recorded
music. The findings showed that, while mothers utilised music to fulfil
various emotional needs, they tended to use it most to maintain or
reinforce their child’s positive mood, rather than to improve a negative
mood. Mothers reported various ways that their young children
engaged with music and stated that their strategic approaches to using
recorded music seemed to help their children feel less distressed and
more happy, thus reducing the stresses of parenting. Similarly, in the
USA and Canada, Steinberg and colleagues (2021) utilised an online
questionnaire to assess the use of music in the homes of young children
and their parents, and its relationship with parents’ attachment to their
child. Musical activity was high for both parents and children. Parents
reported using music for emotional regulation and to socially connect
with their children. The extent of parent-child musical engagement
was associated with attachment. Overall, music may be an effective
tool for building and maintaining parent-child relationships during
a period of uncertainty and change. In Brazil, Ribeiro and colleagues
(2021) explored how social distancing during the COVID-19 pandemic
altered families’ music-related behaviours with children aged three to
six years old, as well as caregivers’ levels of wellbeing and stress. One
hundred and eighty-eight caregivers participated in an online survey
which showed significant changes in families’ dynamics: parents,
466 The Power of Music

especially mothers, spent more time in childcare, with a substantial

decrease in caregivers’ wellbeing. There were changes in caregivers’ and
children’s musical activities at home during social distancing, including
an increase in child-only and shared caregiver-child musical activities.
Sociodemographic factors and the child’s disability status significantly
influenced musical engagement.
Through a transhistorical comparison of the musical activities of the
Milanese during an outbreak of plague in 1576 and the musical activities
observed during the COVID lockdowns in 2020 (including balcony-
singing and playlist-making), Chiu (2020) discussed how music fulfils
its functions of mood regulation and social cohesion in times of pandemic
and social isolation. There is much evidence from the internet and
news outlets of the important role that music, communicated through
social media, has played in supporting people during the COVID-19
pandemic. A number of research projects have also been undertaken,
typically through the use of online questionnaires. For instance,
Granot and colleagues (2021) administered an online questionnaire
in 11 countries: Argentina, Brazil, China, Colombia, Italy, Mexico, the
Netherlands, Norway, Spain, the UK and the USA. They received 5,619
responses. Participants rated the relevance of wellbeing goals during
the pandemic, and the effectiveness of different activities in obtaining
these goals: enjoyment, venting negative emotions and self-connection.
For diversion, music was as effective as entertainment, while it was
second best in creating a sense of togetherness, after socialisation. This
was evident across different countries and genders, with minor effects
of age on specific goals, and a clear effect of the importance of music in
people’s lives. Cultural effects were generally small and occurred mainly
in the use of music to obtain a sense of togetherness. Culture moderated
the use of negatively-valenced and nostalgic music for those with higher
levels of distress.
Carlson and colleagues (2021) also used an online survey with
a Likert scale and free-text responses, to establish how participants
were engaging with music during the first wave of the pandemic. The
findings showed that the extent of music-listening behaviours were
either unaffected or increased. This was especially true of listening to
self-selected music and watching live-streamed concerts. There was a
relationship between participants’ use of music for mood regulation,
 14. Psychological Wellbeing  467

their musical engagement, and their levels of anxiety and worry. A small
number of participants described having negative emotional responses
to music, the majority of whom also reported severe levels of anxiety.
In Spain, also using an online survey disseminated to the general
population and groups of musicians, Martinez-Castilla and colleagues
(2021) analysed the impact of personal and contextual factors on the
perceived efficacy of musical behaviours in fulfilling wellbeing-related
goals during lockdown. Responses were received from 507 people.
Personal factors had an impact on music’s efficacy, but not contextual
variables related to COVID-19 itself. The youngest respondents and
those with musical training reported the highest efficacy of music
for enhancing wellbeing, but overall, music’s importance was the
main predictor of its perceived efficacy. People who were emotionally
more vulnerable during lockdown, due to either a strong impact on
their daily lives or lower resilience, perceived greater benefits from
engagement with music. In Brazil, also using an online questionnaire,
Ribeiro and colleagues (2021) explored how music was used during
lockdowns and whether it helped individuals, especially those with
severe depression. Nearly 500 people aged 18 and over responded.
Four types of music-listening functions were identified: negative mood
management, cognitive functioning, positive mood management and
physical involvement. Those with severe depression were more likely
to use music for each of these functions—in particular, to manage
negative moods. Most respondents used music-listening to cope with
and regulate their moods. Again, using an online questionnaire, Gibbs
and Egermann (2021) explored the nature of music-induced nostalgia.
Five hundred and seventy participants listened to a self-selected piece
of music designed to induce nostalgia, which they had listened to
three months prior to lockdown. They reported the emotions and the
memories induced. There were significant differences in the affective
and narrative content of nostalgic music-listening in relation to which
emotional regulation strategy was used. Employing nostalgic music-
listening as a form of approaching difficult emotions was shown to have
a positive impact on wellbeing.
In Italy, Corvo and De Caro (2020) studied spontaneous singing
during the COVID-19 pandemic. Overall the Italians spent a great
deal of time in lockdown. From a mental wellbeing point of view, it
468 The Power of Music

was difficult to adapt to internment and movement controls. The lack

of freedom and opportunities to meet with friends and relatives had
a serious impact on wellbeing. Almost immediately after the first
lockdown began, the silence in Italian cities was broken by singing. It
was carried out in various ways. In some places, quite recent songs with
a strong emotional impact were sung, while in others, old songs strongly
connected to Italian culture (such as the national anthem) were chosen.
The balconies and windows in the streets of the cities were animated
with people of all ages enjoying these moments of social cohesion and
emotional exchange. Videos were made instinctively and shared through
social media by individuals, showing moments of strong union, in which
the sense of loneliness was (to some extent) forgotten. These singing
networks were completely spontaneous and showed singing used as a
coping strategy and to improve the sense of cohesion. The songs chosen
reflected individuals’ identities and helped avoid feelings of loneliness
and enhance mood. After two or three weeks, the number of people
singing reduced, but revived later. Music clearly provided a means of
demonstrating social solidarity which helped communities in a time of
crisis. Similarly, Calvo and Bejarano (2020) reported on music in Spain
during the crisis, where during the first weekend of confinement, a
growing number of individuals started to play music after the collective
applause to express gratitude towards health workers and doctors. This
involved professional musicians but also many amateurs. Performances
were posted on social media. Singalongs, balcony to balcony, classical
music duos or serenading with traditional instruments expressed a
social message that transcended the quality of the music performed.
They set up a database of 150 individuals who had played or sung on
their balconies at least twice. They identified performers in places with
strong regional identities, such as Galicia or the Basque Country, and
also with strong traditions of band music, such as Valencia. They also
undertook 51 telephone interviews. They asked about confinement, why
people played, the selection of repertoire and how neighbours reacted.
In many cases, performers reacted to informal or formal petitions to sing
or play by close relatives, next-door neighbours, or even by brass bands
and orchestras. A professional association of music teachers set up an
online challenge which invited music teachers to simultaneously play
a different score each day. Music teachers spoke about these challenges
 14. Psychological Wellbeing  469

as a very persuasive reason to keep on playing, perhaps through fear of

breaking relationships of trust and respect with peers in their profession.
Despite differences in professional background, respondents quoted
personal reasons for playing from balconies. They talked about the
need to provide a break to the tedious life of confinement. Musicking
provided children with activities and gave students a reason to continue
practising. Local media reported that a music teacher organised
balcony-to-balcony study sessions of txistu—a traditional instrument
popular in the Basque Country that resembles a flute—with students
who happened to live nearby. The dominant theme emerging from the
data was the need to create bonds with neighbours and also to help
others. Professional musicians saw this as their duty as artists. In other
cases, performers simply wanted to do something for other people. A
further theme was the presentation of music as a stress reliever, a way
to cope with anxiety, loneliness and the pain associated with not being
able to meet loved ones. Many musicians started playing on March 19th,
Father’s Day in Spain, as a way to express love and affection. Musicking
helped with the celebration of birthdays in an interesting process where
private rituals became a vehicle to connect with neighbours. Helping
others was the most common expression. Performers wanted to cheer
up people hospitalised in nearby mental health centres, to remind senior
neighbours that there was someone out there and to cheer children up.
The realisation that music had the potential to do good transformed
what was meant as a one-off act into a daily routine.
Also in Spain, Cabedo-Mas and colleagues (2021) carried out a
survey on the use of music during the pandemic. A total of 1868 Spanish
citizens responded. The findings indicated that, during lockdown,
respondents perceived an increase in the time they devoted to musical
activities such as listening, singing, dancing or playing an instrument.
They also reported using music to cope with the lockdown, finding that
it helped them to relax, escape, raise their mood or keep them company.
The findings suggested an improvement in their perception of the
value of music in personal and social wellbeing during the lockdown,
although there were significant differences in the use and perceptions of
music according to respondents’ personal situations. Age and feelings of
vulnerability may have led to more conservative uses of musical practice
and to more moderate perceptions of the positive values of music.
470 The Power of Music

Cabedo-Mas and colleagues also pointed out the importance of playlists

during isolation because of their social functions. As more and more
countries entered lockdown, Spotify reported on March 30th an increase
in collaborative playlist-making, which allowed people to connect
over shared music and have virtual jam sessions together. In the same
media release, Spotify also noted that their users were sharing more
content on their social networks than usual, so friends and followers
would know what they were doing. One group of songs that saw spikes
in streaming figures were those used in balcony performances, the
recordings of which circulated widely on social media. According to the
March 20th report by Spotify, streams of two of the songs sung by Italian
flash mobs Abbracciame and Azzurro had increased over 700 percent.
In Spain, streams of the song Resistiré increased by over 400 percent.
‘Abbracciame’ (‘Embrace Me’) by Andrea Sannino first released in
2015, has since earned the gold certification by Federazione Industria
Musicale Italiana in 2020, with 35,000 copies sold. At that time, it had
received over 41 million views on YouTube and seven million streams
on Spotify. Undoubtedly, balcony-singing had an immense impact on
musical culture during the lockdowns and will remain, for many, one of
the musical practices indelibly associated with that period.
During lockdowns, participants in musical activities such as flash
mobs or online ensembles, as well as their spectators, frequently
reported the alleviation of stress and the feeling of connectedness as a
result of their musical engagement. Erica Marino was a participant in
one of the earliest balcony flash mobs in Benevento, the video of which
went viral in early March (Cozzolino, 2020). When asked about the
messages flooding in from all over Italy after the video of the music-
making was widely shared on social media, Marino reported that
viewers expressed gratitude because they perceived a message of hope
and positivity from viewing it, as most social networks only contained
devastating news. Balcony-singing has deep roots in Italy. In 1576, when
the Milanese plague grew more deadly and public processions came to
an end, Borromeo relocated the ritual inside private homes, decreeing
that church bells across the city were to be rung seven times a day and,
while the bell was rung, litanies or supplications were to be sung or
recited at the direction of the bishop. This was to be performed in such a
way that one group sang from the windows or the doors of their homes,
 14. Psychological Wellbeing  471

and then another group sang and responded in turn. COVID-19 seems
to have revived this tradition. Mak and colleagues (2021) collected
data from 19,384 participants participating in the UK COVID-19 social
study at University College London to investigate who engaged with
the arts at home during lockdown, how this engagement differed from
patterns of arts engagement prior to COVID-19, and whether home-
based arts engagement was related to people’s ability to cope with their
emotions during lockdown. Demographic factors, socioeconomic status,
psychosocial wellbeing, health conditions, adverse events, worries
and coping styles were considered. Four types of home-based arts
engagement were identified: digital arts and writing, musical activities,
crafts and reading for pleasure. The strongest predictors of engagement
were age, educational attainment, social support, and emotion-focused
or supportive coping styles. Younger adults aged 18 to 29, non-key
workers, people with greater social support, people who had lost work,
those who were worried about catching the virus, and those with an
emotion-focused, problem-focused or supportive coping style were
more likely to have increased arts engagement during lockdown. Arts
activities were used as approach and avoidance strategies to help cope
with emotions, as well as to help improve self-development. Overall,
the findings suggested that, while some people who engaged in the arts
during the pandemic were those who typically engaged under normal
circumstances, the pandemic created new incentives and opportunities
for others to engage virtually. The research also highlighted the value of
the arts as coping tools during stressful situations.
Some research has explored how online music-making has developed
as a result of the lack of opportunities for live music-making during the
pandemic. For instance, MacDonald and colleagues (2021) studied the
Glasgow Improvisers Orchestra’s virtual, synchronous improvisation
sessions through interviews with 29 participants. Sessions included an
international, gender-balanced and cross-generational group of over 70
musicians, all of whom were living under conditions of social distancing.
The sessions were recorded using Zoom. The findings showed that the
sessions provided opportunities for artistic development, enhanced
mood, reduced feelings of isolation, and sustained and developed
community. Improvisation facilitated interaction and also allowed the
technological affordances of software and hardware to become part
472 The Power of Music

of the artistic collaboration. The domestic environment merged with

the technology to create what the authors described as ‘The Theatre
of Home’. Similarly, Daffern and colleagues (2021) studied virtual
choirs in the UK through an online survey of 3,948 choir members
and facilitators. The findings showed that three virtual choir models
were employed: multi-track, whereby individuals recorded a solo
which was mixed into a choral soundtrack; live-streamed, where
individuals took part in sessions streamed live over social media;
and live teleconferencing, for spoken interaction and or singing using
teleconferencing software. Responses to open questions revealed several
issues, including the practicalities of participation, the continuation of
the choir, the responsibility of maintaining the choir, how the choir
contributed to a sense of wellbeing, and social aspects reflecting a sense
of community and social identity. Musical elements were also reported,
particularly how the value of the musical experience changed with the
virtual models, the possibility of co-creation through singing, but also a
sense of loss of singing together in real time.
Sacred Harp singers from all over the world gather weekly to sing
a collection of shape-note songs first published in 1844, The Sacred
Harp (Morgan-Ellis, 2021). This tradition is highly ritualised, and
plays an important role in the lives of participants. As lockdowns were
implemented, groups of Sacred Harp singers independently devised a
variety of means by which they could sing together online using Zoom,
zinging, Jamulus, jamzinging, and Facebook Live stringing. These
developments were undertaken rapidly and creatively, indicating the
importance participants attached to singing. Twenty-two interviews were
conducted with participants and revealed that online singing practices
had reshaped the Sacred Harp community. Many singers who previously
did not have the opportunity to participate now did so, while others lost
access. As geographical barriers disintegrated, singing organisers had
to find ways to maintain local identity. The online community of singers
in the digital realm was stable but not identical to the community that
predated the pandemic. Online singing was meaningful to participants,
and provided continuity in their personal and communal practice. It
allowed participants to access and celebrate their collective memories of
the Sacred Harp community, carry out significant rituals and continue
to grow as singers. No single modality replicated the complete Sacred
 14. Psychological Wellbeing  473

Harp singing experience, but each allowed individual participants to

access many aspects that were most meaningful to them. Also focusing
on communal singing, Dowson and colleagues (2021) studied the
impact of the pandemic on existing dementia singing groups and
choirs. Over 50 examples of online musical activities were identified.
Sessions had to be adapted to the limitations of the technology rather
than technological difficulties being overcome. Accessibility, digital
safety and the wellbeing of participants were important considerations,
but overall the pandemic prompted innovative approaches to delivering
activities and interventions. People with dementia and their carers
adapted rapidly to the changes. Online music met a clear need for social
connection and cognitive stimulation. It also offered some advantages
which will remain even when COVID-19 restrictions are relaxed.
In a cross-sectional survey of 257 adults who participated in
instrumental, singing or dance groups, Draper and Dingle (2021)
explored the impact of face-to-face versus virtual music-making during
the pandemic. Participants rated the extent of their group identification
and the extent to which their psychological need satisfaction was met
retrospectively for their music group in face-to-face mode, and then
in adapted online mode, along with their mental health. The findings
showed that instrumental groups were less commonly adapted to
virtual mode than singing and dance groups. Group identification and
average psychological need satisfaction scores were significantly lower
for groups in virtual mode than in face-to-face mode. However, group
identification and psychological need satisfaction remained high, which
suggests that virtual music groups may be beneficial when face-to-face
music-making is not possible.
As concerts have been recorded rather than live during the pandemic,
Belfi and Colleagues (2021) investigated differences in aesthetic
judgments of live as opposed to recorded concerts, and whether these
responses varied based on congruence between the musical artist
and the piece. Thirty-two individuals made continuous ratings of the
pleasure that they experienced during a live concert or while viewing an
audiovisual recorded version of the same concert given by a university
band and a United States army band. Each band played two pieces:
a United States patriotic composition and a non-patriotic one. The
findings showed that, on average, participants reported more pleasure
474 The Power of Music

while listening to pieces that were congruent with the band playing
them (patriotic for the army band and non-patriotic for the university
band). These findings did not change whether the performance was
live or recorded. It seems that virtual concerts are a reasonable way to
elicit pleasure from audiences when live performances are not possible.
Focusing on the use of collaborative playlists, during the pandemic
Harris and Cross (2021) developed an experimental procedure to study
whether the perceived presence of a partner during playlist-making
could elicit the observable correlates of social processing. Preliminary
findings suggested that, for younger individuals, some of the social
processes involved in joint music-making were elicited even by an
assumption of a virtual co-presence.
One strand of research has focused on the way that undergraduates
used music during the pandemic. Hurwitz and Krumhansi (2021)
discussed the concept of listening-niche referrals to the contexts in
which people listen to music, including the music they are listening
to, with whom, when, where and with what media. They investigated
undergraduate students’ music-listening niches in the initial COVID-
19 lockdown period, four weeks immediately after the campus shut
down, and then when returning for a hybrid semester. Participants
provided a list of their most frequently listened to songs and identified
one that seemed most associated with that time period and why it was
relevant. Three clusters of themes emerged from the data: emotional
responses, memory associations and discovery of new music. Overall,
the pandemic led to more frequent listening in general and on Spotify,
with no differences between lockdown and the new normal. Listening
companions shifted from family members to significant others, and
finally to other friends and roommates. Overall, the implementation
of strategies to manage COVID-19 increased listening and changed its
context.
Vidas and colleagues (2021) surveyed 402 first-year Australian
university students, domestic and international, to examine the
effectiveness of music-listening during COVID-19. Songs that participants
were asked to nominate as helping them to cope with pandemic stress
tended to be negative in mood. Listening to music was among the most
effective coping strategies, and was as effective as exercise, sleep and
changing location. Its effectiveness was related to enhanced wellbeing
 14. Psychological Wellbeing  475

but not specifically to the level of stress caused by the pandemic.

International students experienced higher pandemic stress levels, but
similar levels of wellbeing to domestic students. Overall, listening to
music remained an effective strategy for maintaining wellbeing. Also in
Australia, Krause and colleagues (2021) assessed students’ media use
throughout the early stages of the COVID-19 pandemic and determined
whether media use was related to changes in life satisfaction. One
hundred and twenty-seven participants were asked to complete online
questionnaires, capturing pre- and during-pandemic experiences. The
findings indicated that media use varied substantially throughout
the study period, and at the within-person level. Life satisfaction
was positively associated with listening to music and negatively with
watching TV, videos or movies. The findings highlighted the potential
benefits of listening to music during periods of social isolation.

The Impact of the Pandemic on Music Professionals

A further strand of research has focused on the ways that musicians
have coped during the pandemic. For instance, Onderdijk and
colleagues (2021) collected responses from 234 musicians in Belgium
or the Netherlands. The findings showed a decrease of 79 percent of
live music-making in social settings during lockdown and an increase of
264 percent for online joint music-making. Respondents depending on
music-making as their main source of income explored online methods
significantly more than those relying on other income sources. Most
respondents were largely or even completely unaccustomed to using
specialised platforms for online joint music-making, and mainly used
video conferencing platforms such as Zoom and Skype when playing
together virtually. These were not often employed for synchronised
playing and were generally reported to be unable to deal with latency
issues. There was an increase of 93 percent in the use of alternative
remote joint music-making methods—for instance, recording parts
separately and subsequently circulating these digital recordings.
In the UK, Spiro and colleagues (2021) collected data from 385
performing-arts professionals. The pandemic led to a substantial
reduction in work and income, leading 53 percent to report financial
hardship. Eighty-five percent reported increased anxiety and 63 percent
476 The Power of Music

being lonelier than before the crisis. While 61 percent sought financial
support, only 45 percent asked for support for health and wellbeing.
Perceived financial hardship was associated with lower wellbeing and
higher depression and loneliness scores. There were positive associations
between self-rated health and wellbeing and lower depression scores.
Responses to open questions identified several overarching themes
characterising the effects of lockdown:
• loss of work and income, financial concerns, and uncertainties
for the future;
• the constraints of lockdown working, including challenges
of working at home, struggles with online work and skill
maintenance, and caring responsibilities;
• loss and vulnerability, including reduced social connections,
lack of support, feelings of loss and grief, and concern for
others;
• detrimental effects on health and wellbeing, including anxiety,
low or unstable mood, poorer physical health and lack of
motivation; and
• professional and personal opportunities, including coping
well or living more healthily, more time and less pressure,
new possibilities and activities, enhanced social connections
and new skills.

Overall, lockdown had profound negative effects on performing-arts

professionals, but also presented some opportunities. Also in the
UK, Cohen and Ginsborg (2021) studied the impact of COVID-19 on
professional freelance musicians, comparing those in the middle of
their performing careers (aged 35 to 45) with older players (aged 53
and over). Semi-structured interviews were carried out over Zoom with
24 freelance, self-employed orchestral musicians. Thematic analysis
identified common issues: the loss of a much-loved performing career,
missing music-making and colleagues, and anxiety about the future
of the music profession—although there were differences in relation
to identity as a musician, the extent of anxiety about finance, the
extent of emotional distress, attitudes toward practising and engaging
in collaborative music-making, and confusion over future career
 14. Psychological Wellbeing  477

plans. Music students seemed to be less affected by the pandemic

than professional musicians and showed no significant differences in
satisfaction with life, studying or the impact of the pandemic when
compared with students studying sports (Habe and colleagues, 2021).
Focusing on music teachers in Australia, De Bruin (2021) studied how
COVID-19 impacted on the way they taught, engaged and interacted
with students across online platforms. The findings from interviews
showed that the adopted teaching approaches fostered connection,
empathy and relationship-building, guiding students in slower and
deeper learner-centred approaches, using pedagogical practices that
reinforced and promoted interpersonal connectedness in and through
musical experience and discovery.
The COVID-19 pandemic has impacted on the way that music
therapists across the world have undertaken their work, particularly in
relation to the use of technology (Agres et al., 2021). Cole and colleagues
(2021) investigated the transition of neurological music therapy services
from in-person to telehealth. An online survey was distributed to
neurological music therapy affiliates worldwide. Sixty-nine therapists
fully participated in the survey. The findings showed that there was no
change in the overall number of clinical hours retained over telehealth,
and there was an association between more frequent telehealth usage
and the perceived likelihood of using telehealth in the future. All
types of therapy transferred to telehealth, although there were some
specific implementation changes. Overall, therapists spent fewer hours
working with telehealth compared to in-person therapy, regardless of
the employment setting. Technological challenges were drawbacks,
but major benefits included the ability to continue providing therapy
when in-person sessions were not possible, increased accessibility for
remote clients, and positive outcomes relating to increased caregiver
involvement.

Overview
The evidence set out in this and previous chapters shows clearly
that music can benefit the hedonic (feeling good) and eudaimonic
(functioning well) components of wellbeing throughout the lifespan,
although it has particular impact in adolescence and older age. Overall,
478 The Power of Music

there are many possible benefits to wellbeing and physical health from
engaging with music, either through listening to or actively making
music. These benefits occur through the impact of music on arousal
levels, moods and emotions, the social aspects of group music-making, its
role in personal development, and in some cases, directly through music
therapy. For the benefits of listening to be realised, the listener needs to
like the music. Music imposed by others, if not to an individuals’ taste,
can create tension and distress. For those prone to depression, engaging
deeply with music which is sad or focuses on negative life experiences,
particularly when shared with others, can have negative effects. For
the social and personal benefits of making music to be realised, the
quality of the interpersonal interactions between participants and those
facilitating the musical activities is crucial. The quality of the teaching,
the extent to which individuals are successful, and whether overall it is
a positive experience contribute to whether there are positive outcomes.
If the musical experience is negative in any respect, any possible positive
effects will be marginal or non-existent. The way that music has been
used in the COVID-19 pandemic illustrates clearly how important it is
in people’s lives and the extent to which it can support wellbeing in a
myriad of ways in stressful situations. Ongoing technological advances
continue to make listening to or making music more accessible to a
greater number of people, providing more opportunities for promoting
wellbeing.
 15. Music and Physical and
Mental Health

There is increasing evidence suggesting that mind-body interactions

play an important role in good physical health. Psychological factors
play a causal role in the onset, course and speed of recovery in many
illnesses, and non-medical interventions can sometimes be as effective
as medical ones (Pelletier, 1992). Emotions impact on health and
can play a role in clinical outcomes (Yael et al., 2000). They may also
indirectly influence health-related behaviours (Diefenbach et al., 2008).
Trudel-Fitzgerald and colleagues (2019) suggest that psychological
wellbeing is associated with lower disease and mortality risk, while
Diržytė and Perminas (2021) studied 1001 healthy and unhealthy
Lithuanian adults, and showed that those who were physically healthy
had significantly higher scores on measures of wellbeing. This does not
unequivocally demonstrate causality, although overall, there is strong
evidence that positive emotions are associated with better health and
health behaviours.
The role of stress in ill health has increasingly been acknowledged.
From an evolutionary perspective, the capacity to respond to
environmental threats is important for survival. In mammals, responses
to threats include changes in the delivery of oxygen and glucose to the
heart and the large skeletal muscles, providing physiological support
for fight or flight. Each of these carries the risk of injury and subsequent
infection, so immune system responses may also be included in adaptive
responses to help prevent infections from taking hold. While such threats
are rare in the modern world, the human physiological system continues
to respond in the same way. Threats that do not require physical action
(for instance, work pressures) can still have physical consequences,
including changes in the immune system. Segerstrom and Miller (2004)

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.15

480 The Power of Music

reviewed hundreds of studies and demonstrated that psychological

challenges could modify immune responses. They found that acute
stressors lasting for minutes were associated with changes in immunity.
Brief naturalistic stressors (for instance, taking an examination) tended
to suppress cellular immunity while preserving humoral immunity,
while chronic stressors are associated with the suppression of cellular
and humoral immunity. Picard and McEwen (2018) proposed that
chronic psychological stress induces metabolic and neuroendocrine
mediators that cause structural and functional changes in mitochondria,
leading to mitochondrial allostatic load which, in turn, affects the brain,
endocrine and immune systems. These play a role in psychosomatic
processes, suggesting shared underlying mechanisms. Many health
problems occur as a result of long-term stress, including depression,
cancer, anger and cardiovascular disease (Davidson et al., 2003, Steptoe
et al., 2001). Mroczek and colleagues (2015), in a diary study with 181
men aged 58 to 88 years old, showed that a decrease in positive emotions
in response to daily stressors increased the risk of mortality.

The Role of Music in Psychological and Physical Health

For many years, research has focused on trying to understand how and
to what extent music can impact physical health (MacDonald et al.,
2012). As we saw in Chapter 14, the impact of music on psychological
wellbeing and subsequently good health is largely, although not
exclusively, through the emotions it evokes (Juslin and Sloboda, 2010).
Music stimulates the cortical and subcortical neural networks in the
brain which are associated with activity in the autonomic nervous
system (Panksepp and Bernatzky, 2002). Responses related to emotion
include changes in dopamine, serotonin, cortisol, endorphin and
oxytocin levels (van Eck et al., 1996). These can all affect physical health.
Evidence from observational and experimental animal studies supports
this (Kubzansky, 2009). The physiological effects of music include
changes in heart rate, respiration, blood pressure, skin conductivity,
skin temperature, muscle tension and various biochemical responses
(Kreutz and Lotze, 2008). Finn and Fancourt (2018), in a review, found
that listening to music mainly displayed effects through stress responses,
irrespective of musical genre, self-selection of music or duration of
 15. Music and Physical and Mental Health  481

listening. Also in a review, Chanda and Levitin (2013) showed that

music improved health and wellbeing through the engagement of the
neurochemical systems for reward, motivation, pleasure, stress and
arousal, immunity and social affiliation.
Neuroscientific and clinical studies of music in the recent past have
substantially increased our understanding of how music supports
therapy. Music is able to influence complex neurobiological processes
in the brain and, through this, can play an important role in therapy
(Lin et al., 2011). Altenmüller and Schlaug (2015) argue that the power
of music to support mental and physical health lies in its potential to
support and facilitate neurorehabilitation. They point out that music
provides emotional, sensorimotor and cognitive experiences involving
listening, watching, feeling, moving, coordinating, remembering and
expecting musical elements. It is frequently accompanied by strong
emotions which in themselves can lead to physical reactions: for
instance, tears in the eyes or shivers down the spine. A large number of
cortical and subcortical regions of the brain are involved in all musical
activities (Altenmüller and McPherson, 2007; Tramo, 2001). Primary
and secondary regions in the cerebral cortex are involved in all sensory
perception including music, but music also impacts on multisensory and
motor integration in the frontal, parietal and temporo-occipital brain
regions. The frontal lobe is involved in controlling attention, planning
and motor preparation, in integrating auditory and motor information,
and in imitation and empathy. The multisensory integration regions in
the parietal lobe and temporo-occipital areas integrate sensory inputs
from auditory, visual and somatosensory systems into a combined
sensory impression. The multisensory brain activation of these different
systems is typical when we engage with music through listening to it or
actively making it. The cerebellum is important in motor coordination
and tasks which require timing. It is activated during the processing
of rhythm or keeping time rhythmically—for instance, in tapping in
time with an external stimulus. In addition, the emotional network in
the brain (which includes the cingulate gyrus and the older parts of
the brain such as the amygdala, hippocampus and midbrain) is crucial
to the way that music is perceived emotionally and, subsequently,
leading to motivation to engage with music. As we have seen in earlier
chapters, engaging in musical activities changes the brain. This has
482 The Power of Music

contributed to demonstrating the extent of neural plasticity (Bangert

and Altenmuller, 2003; Hyde et al., 2009; Wan and Schlaug, 2010).
As a result of this plasticity, music can assist in restoring damaged
sensorimotor brain networks, and have an impact on neurohormonal
status and cognitive and emotional processes. Overall, a wide range of
sensorimotor, coordination and emotional problems can be improved
with therapy that includes music. Overall, music has many functions,
roles, and psychological and physical applications. Participating in
making music can help to overcome issues relating to lung function,
language, mobility and fine motor coordination. Music can help to
decrease anxiety, enhance the immune system and alleviate depression
(Schäfer and colleagues, 2013). It can offer support to those with a range
of clinical problems, from Alzheimer’s disease to those on the autism
spectrum. Yap and colleagues (2017), in a review of 4,198 studies on
the impact of drumming and percussion music in promoting personal
and interpersonal wellbeing, found benefits for physical, psychological
and social health. Perceived health benefits identified by those singing
in choirs include stress reduction, therapeutic benefit in relation to long-
standing psychological and social problems, and the exercising of the
body through the physical exertion involved (especially the lungs) and
the disciplining of the skeletal-muscular system through the adoption
of good posture (Clift, 2012).
Although the healing powers of music have been acknowledged
for centuries, it was only after the 2nd World War that the American
Services recognised the power of music as capable of helping those with
physical and psychological injuries. This represented a major shift in the
relationship between music and medicine, and led to the development
of modern music therapy (Rorke, 1996). Since then, music therapists
have worked with a wide range of people across the lifespan, and have
developed many different strategies to support health and wellbeing.
As we have seen, listening to and making music engages multisensory
and motor networks in the brain, inducing change and fostering links
between them. These functions, alongside the ability of music to tap
into human emotion and reward systems, can be used to facilitate and
enhance therapeutic approaches which support the rehabilitation and
restoration of neurological functions and other neurological disorders
(Altenmüller and Schlaug, 2015). Music therapy contributes to the
 15. Music and Physical and Mental Health  483

treatment of a range of long-term psychiatric conditions including

anxiety, schizophrenia, sleep disorders, depression and dementia
(Boss et al., 2015; Wang and Agius, 2018). Kamioka and colleagues
(2014) summarised evidence from 21 studies, including those focused
on mental and behavioural disorders and diseases of the nervous,
respiratory, endocrine, nutritional, metabolic and circulatory systems,
as well as pregnancy, childbirth and the puerperium, while Stige and
colleagues (2010) focused on how music helped those struggling with
illness, disability, social and cultural disadvantage, or injustice. Clinical
studies have shown that music therapy can be used to treat depression,
autism, schizophrenia and dementia, as well as problems of agitation,
anxiety, sleeplessness and substance misuse. It can also delay age-
related decline in speech perception (Parbery-Clark et al., 2011), non-
verbal memory and executive processes (Hanna-Pladdy and MacKay,
2011). Detailed examples of music therapy research will be presented
later in the chapter.
Recently, there have been developments in what has become known
as ‘music medicine’, where music is used to promote good health and
support patients, particularly in reducing anxiety and pain. Performing-
arts medicine has a similar focus, with musicians going into hospitals to
entertain and engage patients of all ages in music-making to promote
their recovery and psychological wellbeing following treatment. As
we saw in Chapter 14, there has been considerable interest in the way
that music can promote wellbeing in everyday life, through listening
to or actively making music. The boundaries between these different
areas of work have become blurred and continue to change over time.
For instance, work with Alzheimer sufferers in care homes was initiated
by music therapists, but as its effectiveness was demonstrated and its
practice spread, it has tended to be delivered by community musicians.
They differ in the way that they apply music in therapy, perhaps including
musical composition, discussion of song lyrics or participation in joint
singing or musical games. There is no consensus as to which specific
approaches are more effective. Listening is the one constant among all
applications. This suggests that music itself is therapeutic.
Music has been used in a range of medical contexts (Le Roux et
al., 2007; Spintge, 2012). Listening to music can reduce the amount of
sedative drugs required in hospital (Conrad et al., 2007) and support
484 The Power of Music

recovery after surgery, in particular reducing the need for pain

medication (Nelson et al., 2017; Vollert et al., 2003), in some cases by up
to 50 percent (Spintge 2012; Spintge and Droh, 1992). This is particularly
the case when patients select the music themselves (Mitchell and
McDonald, 2006a; 2006b; 2012). Music can support improvement in
speech impairment following strokes (Kaser et al., 2017), support the
rehabilitation of motor movements in a range of conditions, and improve
the quality, range and speed of movement. There are benefits for stroke
patients (Särkämö et al., 2008) and those with neurodegenerative
disorders, such as Parkinson’s disease and dementia (Spaulding et al.,
2013; Verghese et al., 2003). Detailed examples of research in medical
contexts will be presented later in this chapter.

Music, Stress and the Immune System

Stress is a major worldwide health issue leading to exhaustion, burnout,
anxiety, a weak immune system and possibly organ damage. Creative-
arts interventions, including those based on musical activities, have been
suggested as ways to prevent stress and improve its management. In a
review of 37 studies on creative-arts interventions, Martin and colleagues
(2018) concluded that they were relatively effective in reducing stress.
Kreutz and colleagues (2012) developed a psychoneuroendocrine
approach to explore how musical activity was related to psychological
and physical health, using cortisol levels as a psychophysiological
measure of stress. Listening to particular types of music has been shown
to lead to significant reductions in cortisol, including classical choral
(Kreutz et al., 2004), meditative (Möckel, 1994) and folk music (Fukui
and Yamashita, 2003). However, not all music has this effect. Significant
increases in cortisol have been noted in listeners exposed to technomusic,
along with increased heart rate, systolic blood pressure and emotional
state (Gerra et al., 1998). Increases in cortisol have also been found in
those listening to upbeat pop and rock music (Brownley et al., 1995).
Singing and other participatory musical activities can bring
about positive changes in cortisol levels. Beck and colleagues (2000)
observed decreases of cortisol of 30 percent on average in members of a
professional choir during a rehearsal, although there was a 37 percent
increase during a performance. In an experimental study, Bittman and
 15. Music and Physical and Mental Health  485

colleagues (2005) exposed participants to a one-hour stress-induced

protocol, followed by a novel recreational music-making programme
which successfully modulated stress. Music also has an effect on cortisol
levels in the context of tango dancing. Murcia and colleagues (2009)
observed that the presence of music during dance led to decreases in
cortisol levels, although there was no impact on the presence or absence
of a dance partner. Keeler (2015) explored the neurochemistry and social
flow of group singing in four participants from a vocal jazz ensemble,
who sang together in two separate performances: one pre-composed,
the other improvised. Group singing reduced stress and arousal, and
induced social flow in both conditions.
Some research has focused on the impact of music on the immune
system. Making and listening to music can have a positive impact on
the immune system (Chida et al., 2008; Wilkinson and Marmot, 2003).
To assess immunity, samples of secretory immunoglobulin A in saliva
are measured. This is used as an indicator of the local immune system
in the upper respiratory tract, the first line of defence against bacterial
and viral infections. There have been reported increases in secretory
immunoglobulin A, suggesting enhanced immune system activity,
after singing (Beck et al., 2000; 2006; Kuhn, 2002; Kreutz et al., 2004).
No such increases have been found in those listening to choral music
(Kuhn, 2002). A study exploring active drumming or singing compared
with watching a live performance also found a more pronounced effect
on the immune system in those actively participating in making music.
In contrast, McCraty and colleagues (1996) found that listening to
relaxing music that created a positive emotional state led to increases
in secretory immunoglobulin A concentrations, while rock or new-age
music had no effect. Similarly, Hirokawa and Ohira (2003) examined the
impact of listening to more or less relaxing music on immune functions,
neuroendocrine responses and the emotional state of eighteen Japanese
college students after they had carried out a stressful task. The findings
were inconclusive in relation to the impact on the immune system. In
a review of 63 studies on the effects of music on neurotransmitters,
hormones, cytokines, lymphocytes, vital signs and immunoglobulins,
as well as psychological assessments, Fancourt and colleagues (2014)
indicated that there was a pivotal role for stress pathways in linking music
and immune responses, although there were a range of methodological
difficulties in the existing research.
486 The Power of Music

Active Music-Making and the Promotion of

General Good Health
There has been relatively little research focusing on the general physical-
health benefits of participation in musical activities. Early reviews of
research with adult singers concluded that there could be health and
wellbeing benefits of participating in a choir (Clift et al., 2008; Stacey et
al., 2002), although subsequent reviews have been more cautious (Clift,
2012). Perceived benefits include:
• physical relaxation and release of physical tension;
• emotional release and reduction of feelings of stress;
• a sense of happiness, positive mood, joy, elation and feeling
high;
• a sense of greater personal, emotional and physical wellbeing;
• an increased sense of arousal and energy;
• stimulation of cognitive capacities, attention, concentration,
memory and learning;
• an increased sense of self-confidence and self-esteem;
• a sense of therapeutic benefit in relation to long-standing
psychological and social problems;
• a sense of exercising systems of the body through the physical
exertion involved, especially the lungs;
• a sense of disciplining the skeletomuscular system through
the adoption of good posture; and
• being engaged in a valued, meaningful, worthwhile activity
that gives a sense of purpose and motivation.

In the UK, Hillman (2002) surveyed 75 participants who had participated

in a community singing project since reaching the statutory retirement
age. The long-term benefit attributed to participation in music was a
lack of deterioration in physical health. Reagon and colleagues (2016)
reviewed 18 papers studying the effect of group singing on health-
related quality of life. The patients included were suffering from chronic
respiratory disease, neurological conditions or mental ill-health. The
findings showed some evidence for improved quality of life, while
 15. Music and Physical and Mental Health  487

participants reported directly on their enhanced confidence, mood and

levels of social support. Also focusing on choral singing, Więch and
colleagues (2020) assessed the nutritional status and quality of life of
200 healthy adults aged 19 to 70 years old. Those involved in singing had
significantly lower body weight and body mass index in comparison
with a control group. They also had significantly lower basal metabolic
rate and metabolic age, and reported greater life quality. Drumming
has been the focus of some research. For instance, Smith and colleagues
(2014) examined the impact of djembe-drumming in a comparison
of middle-aged experienced drummers and a younger novice group
who each participated in 40-minute sessions, preceded and followed
by measurements of blood pressure, blood lactate, stress, anxiety
and ongoing measures of heart rate. Drumming decreased stress and
anxiety in both age groups, and blood pressure in the older participants.
Assessment of lactate and heart rate suggested that drumming can be
considered as low- to moderate-intensity exercise.
One strand of research has investigated the impact of creative song-
writing. For instance, Baker and MacDonald (2014) studied 13 students
and 13 retirees who engaged in song-writing activities. Each participant
created a song parody, original lyrics and an original song describing
a positive, negative or neutral experience. Positive outcomes included
listening to personal creations, exploring self, the relationship with
the therapist, the way that being fully immersed altered perception of
time, and the experience of balancing ability and effort. The younger
participants were more likely to continue to use their songs for further
therapeutic benefit.
The role of attendance at cultural events on health and wellbeing
has been studied. For instance, in Poland, Węziak-Białowolska and
Białowolski (2016) used data from the biennial longitudinal Polish
household study which represented the Polish population over the age
of 18, and found a positive association between cultural attendance
and self-reported health, although no causal link was established. In
Norway, Cuypers and colleagues (2011) examined the association
between cultural activity and perceived health, anxiety, depression
and satisfaction with life in 50,797 adult participants. Data on cultural
activities (receptive and creative), perceived health, anxiety, depression
and satisfaction with life were collected. The findings showed that
participation in receptive and creative cultural activities was significantly
488 The Power of Music

associated with good health, life satisfaction, and low anxiety and
depression. For men, attending receptive, rather than creative, cultural
activities was more strongly associated with all health-related outcomes.
Similarly, in the UK, Fancourt and Steptoe (2018) compared data from
2,548 adults aged over 55 years old—drawn from the English longitudinal
study of ag[i]ng modelling change over a ten-year period—in relation
to membership of different community groups, while controlling for
potential confounding variables. Membership of two types of community
groups was associated with enhanced wellbeing: attending education,
arts or music classes, and church or religious group membership.

Music, Health and the Older Generation

There are general health benefits of participating in making music for
older people, including lower mortality rates (Johansson et al., 2001).
Music-making contributes to perceived good health, quality of life
and mental wellbeing (Coffman and Adamek, 1999; 2001; Kahn, 1998;
Wise et al., 1992), while playing the piano exercises the heart as much
as a brisk walk (Parr, 1985), although studies on the impact of lung
function have had mixed outcomes (Clift, 2012). In the USA, Cohen
and colleagues (2006; 2007) carried out studies with 166 participants
with an average age of 80 who participated in 30 singing workshops
and ten performances over a one-year period. The choir group reported
a higher overall rating of physical health, fewer visits to the doctor,
less medication use, fewer falls, and fewer other health problems in
comparison with a control group, who had carried on with their usual
activities and did not participate in the choir. There was evidence of
higher morale, a reduction in loneliness and increased activity, while
the comparison group experienced a significant decline in activities.
Cohen and colleagues argued that sense of control, as well as social
engagement, were the most likely mechanisms responsible for the
positive outcomes. Coulton and colleagues (2015) studied the value of
community singing on the mental-health-related quality of life of older
people with 258 participants in five centres in the UK. Group singing
was compared with usual activities in those aged 60 years or over.
Significant differences were observed in mental-health-related quality
of life, anxiety and depression in favour of group singing. Similarly,
 15. Music and Physical and Mental Health  489

Zanini and Leao (2006) studied a therapeutic choir for the elderly and
found that singing provided a means of self-expression and fulfilment,
and instilled self-confidence in the participants’ expectations about the
future.
Depression in older adults has increased recently, and will continue
to rise as the number and proportion of older adults in the population
rises worldwide. Dunphy and colleagues (2019) carried out a review
of how art, dance movement, drama and music could help to alleviate
depression in the elderly, and established common mechanisms of
change. These included:
• physical changes, such as muscle strength;
• neurochemical effects, such as endorphin release;
• intrapersonal change, such as enhanced self-concept, sense of
agency and mastery;
• improved processing and communication of emotions;
• the provision of opportunities for creative expression and
aesthetic pleasure;
• cognitive stimulation, including memory; and
• social benefits, such as increased social skills and connection.

Each of these were considered to contribute to a reduction in depression.

Alzheimer’s patients can benefit from engagement with music, as
it encourages reminiscence and improves moods and behaviour,
although it does not have any long-term impact on underlying cognitive
deterioration (Creech et al., 2014). Despite this, some activities are
preserved and are relatively resistant to decline. One such activity is
engagement with music (Sacks, 2007). Baird and Thompson (2019)
point out that musical skills can be preserved in some people with
Alzheimer’s and dementia, including memory for familiar music and
the ability to produce music by singing or playing an instrument.
They studied a 77-year-old woman with severe Alzheimer’s disease
and her husband’s use of music in her care. Her behaviour and verbal
communication were observed when she read a newspaper article
or familiar song lyrics, or sang familiar song lyrics, or listened to the
original version of the familiar song. Over time, there was a gradual
490 The Power of Music

deterioration in her expressive language abilities, whereas her musical

skills were comparatively preserved.

Residents in Care Homes

Care homes support people with a range of difficulties who cannot live
independently. With the increase in the older population, many care
homes cater for those who need support or who may need additional
care following a stroke or other serious illness. Many residents in such
homes have dementia, a group of symptoms that typically includes
problems with memory, thinking, problem-solving, language and
perception. Dementia has a number of different causes, including
Alzheimer’s disease, vascular dementia and dementia with Lewy Body.
Anyone with dementia, whatever its underpinnings, can benefit from
engaging with music, as it encourages reminiscence and can improve
moods and behaviour. Much of the research on the impact of music in
relation to dementia has occurred in residential care or nursing homes
(Elliott and Gardner, 2018). Active participation in making music has
been found to have broadly positive effects. For instance, Biasutti and
Mangiacotti (2018) compared outcomes for older people with mild to
moderate cognitive impairment, who were either assigned to a group
receiving cognitive music training for 12 twice-weekly 70-minute music
sessions or acted as a control group who attended a similar number of
gymnastic sessions. A neuropsychological test battery, administered at
the beginning and end of treatment, showed a significant improvement
for the music group in relation to general mental state, verbal fluency
and a clock-drawing test, while the control group showed no significant
improvements. In a later study, Biasutti and Mangiacotti (2021) studied
the effectiveness of musical improvisation on depressed mood and
general cognitive function in 45 elderly care residents. The findings
revealed a significant improvement in cognition and a reduction in
depression and cognition for the music group, while the control group
showed no change in relation to depression and a deterioration in
cognition. Also focusing on depression, Werner and colleagues (2017)
examined the effect of interactive group music therapy, as opposed
to recreational group singing, on symptoms in elderly nursing-home
residents. A total of 117 participants from two German nursing
 15. Music and Physical and Mental Health  491

homes were allocated to 20 interactive group music therapy sessions

of 40 minutes each twice a week, or recreational group singing on ten
occasions for 90 minutes weekly. Levels of depressive symptoms were
assessed at baseline and follow-up in the sixth and twelfth weeks. The
level of depressive symptoms improved significantly more in those
assigned to music therapy than recreational singing.
In Australia, Brancatisano and colleagues (2020) reported the
outcomes of a music, mind and movement programme for 20 people in
their eighties with mild to moderate dementia. The programme involved
seven 45-minute weekly group sessions, and individual 15-minute
booster sessions. Assessments of global cognition, mood, identity and fine
motor skills were conducted at the start of the programme, immediately
following the intervention and one month after its close. The majority
of participants in the programme showed an improvement in overall
cognition, attention and verbal fluency, while the majority of those in
the control group showed a decline. Hämäläinen and colleagues (2021)
focused on the impact of yoik, a traditional vocal music of the indigenous
Sami people of Fennoscandia, with elderly and dementia residents in a
care home. In-depth interviews with close relatives of participants and
healthcare professionals revealed that they had observed positive effects
when yoik was introduced, even in persons unfamiliar with the genre.
Improvements in memory, orientation, depression and anxiety in both
mild and moderate cases of Alzheimer’s disease, and hallucinations,
agitation, irritability and language disorders in those with moderate
Alzheimer’s disease have been found in patients after six weeks of
music therapy. The effect on cognitive aspects was notable after only
four music therapy sessions (Gallego and García, 2017)
Focusing on agitation and anxiety in older people with dementia,
Cooke and colleagues (2010) investigated the impact of participation
in a 40-minute group music-making programme involving facilitated
engagement with singing songs and listening three times a week for
eight weeks. Forty-seven participants with mild to moderate dementia
from two care facilities in Australia participated. A sub-analysis of 24
participants who attended less than half of the music sessions found
a significant increase in the frequency of verbal aggression over time.
Participation in the music programme did not significantly reduce
agitation and anxiety, although music and reading group activities gave
492 The Power of Music

some participants a voice and increased their level of verbalisation. Also

focusing on agitation and anxiety, Sung and colleagues (2012) set up a
group music intervention using percussion instruments with familiar
music to reduce the anxiety and agitation of 60 institutionalised older
adults with dementia. The experimental group received a 30-minute
music intervention using percussion instruments with familiar music
in a group setting twice weekly for six weeks. In comparison with a
normal-care control group, those in the music group had significantly
lower levels of anxiety following the intervention, although there was
no difference between the groups in the reduction of agitation. Aiming
to reduce agitation, Vink and colleagues (2013) undertook a study of
94 residents with dementia who were allocated to either music therapy
or recreational activities twice weekly for four months. Data from 77
residents showed a decrease in agitated behaviours from one hour
before to four hours after each session. This decrease was greater in the
music therapy group but disappeared completely after adjustment for
general level of deterioration. There were no other reported benefits.
Castillejos and Godoy-Izquierdo (2021) explored the outcomes of a
music intervention which was integrated into the therapeutic activities
of institutionalised elderly people. Fifty residents in a care home
were studied at baseline, postintervention, and after two weeks. The
music intervention had a positive impact on physical health, cognitive
functioning, emotional wellbeing, pain and happiness compared with
stability in controls, although the benefits decreased progressively after
the discontinuation of the music programme. Similarly, Paolantonio
and colleagues (2020) examined the effects of group music-making
on the health and wellbeing of 22 nursing-home residents aged 72 to
95 years of age in Switzerland. Professional and student musicians
delivered ten weekly music sessions in four nursing homes, focusing
on singing, rhythm-based activities with percussion instruments and
listening to short, live performances. Being involved in musical activities
offered engagement and novelty, providing learning opportunities
and facilitating interpersonal relationships. Residents particularly
appreciated the opportunity to listen to live performances.
McDermott and colleagues (2014) undertook a qualitative study to
explore how care-home residents with dementia and their families, day-
hospital clients with dementia, care-home staff, and music therapists
 15. Music and Physical and Mental Health  493

perceived the role of music therapy. Music was viewed as being

accessible for people at all stages of dementia. There were perceived to
be close links between music, personal identity and life events, while
music was seen as being useful for building relationships. The effects
of music were viewed as going beyond the reduction of behavioural
and psychological symptoms, in part because individual preferences
for music were preserved in spite of dementia. This helped others to
value the dementia sufferer as a person and to support and maintain the
quality of their life.
In a case study, Giovagnoli and colleagues (2014) described the effects
of active music therapy on cognition and behaviour in one individual
with chronic vascular encephalopathy who suffered with memory,
attention and verbal fluency deficits. A four-month programme of 16
sessions was implemented based on creative and interactive music-
making, in addition to pharmacological therapy. At baseline, the patient
reported a tendency to feel tense, nervous and angry, and had difficulties
with memory and visuospatial performance, frequently accompanied
by loss of attention. Following music therapy, there were improvements
in attention, visuomotor coordination, verbal and spatial memory, an
increase in interpersonal interactions and a reduction in anxiety.
In an acute hospital setting, Cheong et al. (2016) evaluated the impact
of a creative music therapy programme on mood and engagement in
older patients with delirium and or dementia. Twenty-five patients of
approximately 80 years of age were observed before and after music
therapy, which included improvisation and playing songs of the patient’s
choice. There was a significant positive change in patients in relation to
constructive and passive engagement, pleasure and general alertness.
Also focusing on hospital stays for people with dementia, Daykin and
colleagues (2018) examined the effects of ten weeks of music sessions on
patients’ wellbeing and the environment in an acute elderly care service
in a UK hospital. Observational data, semi-structured interviews and
focus groups with patients, visitors, musicians and staff showed that
patients generally enjoyed the activity and that there was a reduction
in the prescription of antipsychotic drugs, enhanced patient and staff
experiences, and an improvement in care. Feeding difficulties can be
a problem as dementia progresses, resulting in malnutrition which,
in turn, can compromise physical and cognitive functioning. Fifteen
494 The Power of Music

participants in a care facility, who were not malnourished at the start,

participated in 12 music sessions lasting for 25 minutes just before
lunch, with songs likely to be known by residents. Unfortunately, there
were too many confounding variables for any conclusions to be drawn
(McHugh et al., 2012).
Some research has attempted to identify the most effective type of
music. For instance, Lem (2015) studied the levels of engagement with
music of 12 people with dementia who participated in 20 weekly music
therapy sessions, and found that engagement increased midway through
the programme when a more intuitive approach was adopted, with
more challenging musical experiences and less structure. An evaluation
of an intervention based on group singing activities—developed by the
Alzheimer’s Society for people with dementia and their carers—showed
that social inclusiveness and improvements in relationships, memory
and mood were particularly important to participants, who enjoyed
the sessions and found that they helped in accepting and coping with
dementia (Osman and colleagues, 2016). Pavlicevic and colleagues
(2015) explored music therapists’ strategies for creating musical
communities in dementia care settings. Six experienced music therapists
identified a ripple effect of music from person-to-person music-making
to that which continued beyond session time, within the care home and
beyond. Ongoing qualitative research by Skinner and colleagues (2018)
is examining the potential for dance to improve social inclusion for
people living with dementia in care facilities.
Some programmes have focused on training care-home staff to
deliver music sessions. For instance, Tapson and colleagues (2018)
evaluated an intervention comprising an 11-session interactive weekly
music programme in five care homes in the UK, which included training
for staff. The programme focused on singing and the use of voice, and
was led by pairs of trained professional musicians for 45 minutes each
week. The programme provided positive social experiences, creative
engagement, fun and a sense of achievement, and enhanced the working
and living environment for care-home residents and staff, playing a
crucial role in developing a sense of identity and empowerment for
residents, facilitated by musicians and care teams working together.
The role of those delivering such programmes cannot be overestimated.
Tuckett and colleagues (2015), in evaluating the effectiveness of a
 15. Music and Physical and Mental Health  495

group music therapy intervention, concluded that the impact was

mediated by the older person’s dementia state, its psychosomatic effect
on the participants and the nature of the session. The therapy evoked
memories and facilitated reminiscence, and acted as a diversion, but
the independent effects of the music and the therapist could not be
determined.
While most research has focused on active engagement with making
music, some has concentrated on the impact of listening to music. For
instance, Costa and colleagues (2018a) assessed the effect of listening
to preferred music on pain, depression and anxiety in older care-home
residents. One hundred and thirteen participants either continued
with their usual routine or listened to a daily 30-minute programme of
preferred music over a three-week period. Levels of pain, depression
and anxiety were assessed and showed decreases, although these were
less for pain. Those who regarded music as important listened most,
and those whose preferences were accommodated benefited most. In
a similar study, Costa and colleagues (2018b) studied the effects of
listening to preferred music on 117 participants from nine care homes.
In addition to their usual routine, each participant listened to a daily
30-minute programme of their preferred music for three weeks. Findings
showed that listening to preferred music resulted in relaxation, positive
reminiscence, reduced depression and boredom, and a range of physical
reactions including chills, tears or emotional arousal. Some reactions,
such as foot-tapping, were beneficial to the most disabled participants.
The use of preferred and favourite music was the principal factor in the
intervention’s effectiveness.
Some interventions have combined active music-making with
listening activities. For instance, Särkämö and colleagues (2014)
determined the efficacy of a novel music intervention based on coaching
the caregivers of patients with dementia to use either singing or music-
listening regularly as a part of everyday care. Eighty-nine patient
caregiver dyads were randomised to a ten-week singing coaching group,
a ten-week music-listening coaching group or a usual-care control
group. The coaching sessions consisted mainly of singing or listening
to familiar songs, with some vocal exercises and rhythmic movements
for the singing group, and reminiscence and discussions for the music-
listening group. The intervention also included regular musical exercises
496 The Power of Music

at home. The findings showed that, compared with usual care, singing
and music listening improved mood, orientation and remote episodic
memory, and to a lesser extent attention, executive function and general
cognition. Singing also enhanced short-term and working memory, and
caregiver wellbeing, whereas music-listening had a positive effect on
quality of life. Särkämö and colleagues (2014) concluded that regular
musical leisure activities could have long-term cognitive, emotional and
social benefits in those with mild to moderate dementia. Although music
can be considered as a leisure activity enjoyed for its own sake, there is
some evidence which highlights the benefits of prescribed therapy that
can be personalised to meet the needs and skill level of each individual
(Genoe and Dupuis, 2012). Menne and colleagues (2012) also point
out that, when designing interventions for people with dementia, it is
important to ensure that they enjoy the activities.
Live music performances have been shown to have a positive effect
on human contact, care relationships, positive emotions and negative
emotions in people with dementia in nursing homes (van der Vleuten
et al., 2012). Shibazaki and Marshall (2017) explored the effects of live
music concerts on dementia sufferers, their families, nursing staff and
caregivers. Interviews and researcher attendance at concerts in care
facilities showed that concerts were beneficial to patients and staff,
even when they did not attend the concerts. Those with mild to mid-
stage dementia showed increased levels of cooperation, interaction and
conversation, while those with more advanced forms exhibited decreased
levels of agitation and anti-social behaviour. Staff members reported
increased cooperation and opportunities for assessment, while family
members noted an increase in levels of wellbeing. The concerts revealed
that knowledge of music and its rules (as well as musical preferences)
remained when other cognitive skills and abilities had disappeared. De
Wit (2020) also explored the impact of live music-making on hospital
nurses and nursing-home caregivers working with vulnerable elderly
patients. The healthcare professionals collaborated with the musicians
to connect with residents, taking time to become engaged with them
in musical situations. This enabled new understandings to develop,
supporting the delivery of person-centred care.
 15. Music and Physical and Mental Health  497

Music, Dementia and Care in the Home

Most of the research relating to music and dementia has been undertaken
in residential, nursing and hospital settings despite estimates that, in the
UK, two thirds of those living with dementia continue to live in their own
homes (Wittenberg et al., 2019), a practice known as ‘ageing in place’
(Wiles et al., 2012). Those with Alzheimer’s and related dementias who
live at home have unique advantages in terms of being in a familiar place
with people they are close to, but carers and those cared for are at risk of
depression, isolation and decreased contact with peers and the networks
that normally help to maintain social, intellectual, physical, sensory and
spiritual needs. As memory declines, the person with dementia loses life
skills and sense of self, while their caregiver is increasingly burdened
physically and emotionally. Services are now developing to support
those who are ageing in place (Dawson et al., 2015). For instance, the
BUDI Orchestra was created as a music-based initiative for people with
dementia and their family carers living in the community. The initiative
comprised ten weekly sessions, facilitated by professional musicians
and supported by university students. At the end of the programme,
participants showcased their achievements at a public performance.
There were a range of positive outcomes, including enjoyment for
participants, a sense of social inclusion for musicians and participants
alike, and (for the dementia sufferers) increased engagement, a sense of
achievement, confidence and enhanced mood. Carers reported improved
mood, feelings of relaxation and improvements in their relationships
with the cared-for. Musicians’ preconceptions of musical learning were
challenged and they learnt more about themselves through facilitating
the sessions. In addition, the performance positively impacted
audience members’ perceptions of dementia. The findings challenged
assumptions of the capacity of people with dementia to learn new skills
and play instruments, and highlighted the power of performance to
challenge negative perceptions of dementia (BUDI Orchestra, 2015).
Similarly, Lee and colleagues (2020) explored how a community-based
group singing intervention impacted the wellbeing of people with early-
stage dementia and their family carers. Participants engaged in a six-
week group singing intervention facilitated by a music therapist in a
community arts centre. Semi-structured interviews revealed enhanced
498 The Power of Music

social connection, happiness and rejuvenation, reconnection with

the self and support for the relationship between carer and cared-for.
Overall, community-based music therapy can be effective in supporting
carers and those they care for (Rio, 2018).
Prattini (2016) examined music’s effects on levels of agitation in
people with Alzheimer’s disease or other dementias. The research
focused on those living at home who were cared for by an informal
caregiver. The participants either participated in active music-making
or listened to music. Only active participation had an impact on
agitation. Smith and colleagues (2021) arranged ten music-making
sessions for community-dwelling people living with dementia and
their care partners, once a month over a period of seven months.
Eighteen participants consented to take part, including seven people
living with dementia, five care partners and six former care partners.
Baseline semi-structured interviews explored the lived experience of
music, and expectations of the upcoming music-making cafés. Self-
report questionnaires captured the experiences of each music-making
café, while follow-up semi-structured interviews explored the impact
of music-making on participants’ self-reported wellbeing. The findings
demonstrated that participating in a music-making cafe benefited
the wellbeing of participants, providing a sense of camaraderie that
facilitated connections with others, creating opportunities to level
the playing field, drawing on a person’s strengths and abilities, and
providing meaningful musical experiences. Participating in music-
making promoted the wellbeing of community-dwelling people living
with dementia and their care partners, offering opportunities for peer
support and a reduction in feelings of isolation through a shared love
of music, as well as providing meaningful musical experiences in a
supportive, enabling environment.
In a home-based programme, participants with major or minor
depressive disorder learned how to use music to reduce stress. They
either received a weekly home visit by a music therapist, participated
in a self-administered programme where they applied the same
techniques with moderate therapist intervention, received a weekly
telephone call, or were part of a wait-list control group. Participants in
the music conditions performed significantly better than controls on
standardised tests of depression, distress, self-esteem and mood. These
 15. Music and Physical and Mental Health  499

improvements were maintained nine months after the end of the project
(Hanser and Thompson, 1994). In a community-based arts programme
in Canada, Moody and Phinney (2012) found that participating older
adults experienced enhanced capacity to connect to the community
and a stronger sense of community through collaboration as a group,
as they worked together on the project towards a final demonstration to
the larger community.

Reviews of the Relationship between Music Therapy

and Dementia
There has been little agreement between reviews of the literature
pertaining to the role of music therapy with the older generation and its
effectiveness. Some reviews have drawn relatively positive conclusions,
although sometimes with caveats. For instance, Abraha and colleagues
(2017) provided an overview of 142 non-pharmacological interventions
for behavioural and psychological symptoms in dementia, including
music therapy, and concluded that overall, music therapy and behavioural
management techniques were effective for reducing the behavioural and
psychological symptoms of dementia. Zeilig and colleagues (2014) also
reviewed a range of interventions and reported that music could generate
feelings of peace for patients with dementia. A range of arts projects
have been identified as promoting social engagement, but it has been
difficult to establish if the effects related to the role of the arts specifically
or could have been attained by any form of social engagement, although
the emphasis in the arts on creation and play may have supported
patients with dementia, as may the emphasis in the arts on emotion.
Istvandity (2017) reviewed intervention studies that utilised music and
reminiscence activities in elderly adult populations, and found positive
effects in four out of five studies, while Zhao and colleagues (2016) (in a
meta-analysis of 19 articles) suggested that music therapy plus standard
treatment reduced depressive symptoms to some extent.
Dowlen and colleagues (2018), in a review of 18 studies, identified
benefits in terms of taking part, being connected, affirming identity
and immersion in the moment, while Zhang and colleagues (2017)—
in a review of 34 studies with 1575 participants—showed that disease
subtype, intervention method, nature of the control or comparison
500 The Power of Music

group, participant location, trial design, trial period and outcome

measure instruments made little difference to outcomes. Overall, there
was positive evidence to support the use of music therapy to treat
disruptive behaviour and anxiety, and positive trends supporting the
use of music therapy for the treatment of cognitive function, depression
and quality of life. Raglio and colleagues (2012), reviewing clinically
controlled trials focusing on the use of music and music therapy in the
context of dementia, found that (with some limitations) the findings
were consistent in showing the efficacy of music therapy in impacting
positively on the behavioural and psychological symptoms of dementia.
However, the ability of the music therapist to directly interact with the
participants appeared to be crucial for success.
No difference was found in cognitive function between dementia
sufferers receiving interactive or receptive music therapy or usual care
in one review of 38 trials involving 1418 participants aged 75 to 90 years
old. Those receiving receptive therapy showed a significant decrease in
agitation and behavioural problems, although there was no significant
difference between those engaged in interactive music therapy and usual
care in relation to behavioural and psychiatric problems (Tsoi et al.,
2018). McDermott and colleagues (2012) found consistent improvement
in behavioural disturbance in the short term, in a review of 18 studies
adopting a diverse range of active music-making activities, with singing
often being used as a medium of change. However, the review did not
find any high-quality longitudinal studies that demonstrated long-term
benefits. Focusing on the impact of music therapy on anxiety in a review
of studies where the severity of dementia varied from mild to severe,
Ing-Randolph and colleagues (2015) found variation in the nature of the
interventions and the group sizes. While the findings seemed promising,
the small number of studies and the variability in methods made it
impossible to draw firm conclusions. Also taking account of variations
in the quality of the research and how it was reported, van der Steen and
colleagues (2018) reviewed 22 studies with 1097 dementia patients in
nursing homes or hospitals, and concluded that people with dementia in
institutional care participating in at least five sessions of a music-based
therapeutic intervention probably experienced reduced depression and
anxiety, improved overall behaviour and possible enhanced emotional
wellbeing and quality of life, although there was no impact on agitation,
 15. Music and Physical and Mental Health  501

aggression or cognition. The effect on social behaviour and the long-

term impact of the interventions was unclear.
In a scoping review, Elliott and Gardner (2018) summarised
what was known about the role and impact of music in the lives of
community-dwelling older adults with dementia, and reported that
music could reduce agitation, improve cognition and enhance social
wellbeing, while Bamford and Bowell (2018) also concluded that music
could promote a range of benefits for people with dementia when
used appropriately and in a meaningful way. In contrast, Vink and
colleagues (2003) reviewed ten music therapy interventions designed
to treat the behavioural, social, cognitive and emotional problems of
older people with dementia, criticised the methodological quality of
the research and reported that it was not possible to draw any firm
conclusions. In a later review, Vink and Hanser (2018) reported that
most descriptions of music therapy interventions lacked sufficient detail
to enable researchers to compare and replicate studies, or for clinicians
to apply the techniques. Definitions of music therapy and music-based
interventions were inconsistent, and practitioners varied in the extent
of their professional training and preparation for implementing music-
based clinical strategies. Fusar-Poli and colleagues (2018) carried out a
meta-analysis of six studies including 330 participants with an age range
of 79 to 86 years old, and found no significant effects of music therapy
on any outcomes. Similarly, Hui-Chi and colleagues (2015) conducted
a review of music therapy interventions with older people in nursing
homes, hospitals or communities, and indicated that (in the short-term)
music therapy did not improve the cognitive function of older people.
Considering the role of the arts in relation to dementia more broadly,
Schneider and colleagues (2018) included 11 relevant studies and
concluded that there was insufficient evidence demonstrating causality
to draw any firm conclusions.

Music, Public Health and Music on Prescription

Music has been used to communicate public health messages. For
instance, Cournoyer Lemaire (2020) report how the Quebec government
promoted adherence to COVID-19 measures through the use of music,
taking advantage of its capacity to reach a large population, capture the
502 The Power of Music

population’s attention quickly regardless of age, language or cultural

barriers, effectively communicate messages and thus change behaviour.
Clift and Camic (2016) provided an evidence base supporting the role
of the creative arts in public health, bringing together contributions from
practitioners and researchers to provide a comprehensive account of the
field and the approaches that had successfully led to improvements.
They showed that several countries had moved towards offering
a range of arts interventions on prescription. Similarly, Jensen and
colleagues (2016) reviewed current practice relating to arts and culture
on prescription in Sweden, Norway, Denmark and the UK, considering
the evidence supporting social prescription and potential barriers to its
implementation. In a later article, Jensen and Bonde (2018) illustrated
the variety and multitude of studies, showing that participation in arts
activities could be beneficial for those with mental and physical health
problems, and demonstrating the possible impact on reducing physical
symptoms and improving mental health.
Some research has focused on showing how arts on prescription can
be effective. For instance, Batt-Rawden and Tellnes (2011) explored the
role and significance of making music in the lives of men and women with
long-term illnesses in different life phases, facing different challenges.
In a longitudinal study that included eight interviews with each of the
22 participants, aged between 35 and 65, they found that music could
promote movement, release anger or aggression, and transcend pain.
Personal listening preferences were important. Crone and colleagues
(2018) presented findings from a longitudinal follow-up study of an
arts-on-referral programme in UK general practice over a seven-year
period, including 1,297 patients who were referred to an eight- or ten-
week intervention. Of all referrals, just over half completed their course
of prescribed art. Of those that attended, 75 percent were observed to be
engaged with the intervention. A significant increase in wellbeing was
observed from pre- to post-intervention for those that engaged with or
completed their programme. Some had multiple health issues. In the
main, this group completed the programme, were rated as engaged
and showed a significant increase in wellbeing. Poulos and colleagues
(2019) targeted community-dwelling older people with a wide range
of health and wellness needs who were referred to a programme by
their healthcare practitioner. The courses, led by professional artists in
 15. Music and Physical and Mental Health  503

a range of artistic activities, included dance, singing and music. Classes

were held weekly for eight to ten weeks with six to eight participants in
each group, culminating with a showing of work or a performance. Data
from 127 participants aged 65 years old and over showed that Arts on
Prescription had a positive impact on wellbeing, self-reported creativity
and the frequency of undertaking creative activities. The activities
on offer were challenging, created a sense of purpose and direction,
enabled personal growth and achievement, and empowered participants
in an environment which fostered the development of meaningful
relationships with others. Similarly, Murabayashi and colleagues (2019)
studied 115 frail elderly individuals aged between 65 and 89 years of
age, who were divided into two groups. The music therapy group
participated in group sessions of 45 to 50 minutes conducted by a music
therapist for 12 weeks. A control group waited for 12 weeks before
participation. Cognitive, physical and psychophysical functions were
assessed. Improvements were observed in physical function, depressive
mood and quality of life.
Overall, there is evidence that art interventions can be effective in the
promotion of wellbeing, whether individuals choose to participate or
are referred through social prescribing (Bungay and Clift, 2010; Jones
et al., 2013). Engaging with the arts can reduce loneliness and social
isolation (Poscia et al., 2017), particularly for those living in rural or
disadvantaged areas (MacLeod et al., 2016; Murrock and Graor, 2016;
Pearce and Lillyman, 2015).

The Role of Community Music and

Creative Workshops
In developed countries, there are high levels of mental and physical
illness associated with long-term health conditions, unhealthy lifestyles
and an ageing population. Community music activities can address
these issues (Jones et al., 2013). Increasing numbers of mental health
organisations are developing music-making interventions for patients.
To demonstrate whether such programmes could be effective, Fancourt
and colleagues (2016) studied a ten-week group drumming programme
and found significant decreases in depression and increases in social
resilience, anxiety and wellbeing. These changes were maintained three
504 The Power of Music

months later. Participants also provided saliva samples to test for immune
responses. These showed underlying biological effects, supporting
the programme’s potential for enhancing mental health. Similarly,
Ascenso and colleagues (2018) studied 39 participants engaged in a
community drumming programme. There were a range of benefits for
patients and carers, including enhanced emotions, initiative and sense
of control, accomplishment, redefinition of self and social wellbeing.
Perkins and colleagues (2016) researched group djembe-drumming and
found that the drumming itself was important as a form of non-verbal
communication, providing a connection with life through rhythm, and
generating and liberating energy. The group setting facilitated feelings
of acceptance, safety and care, and enabled new social interactions.
Inclusivity, musical freedom and the acceptance of making mistakes
supported by the music facilitator were important for learning. Solli and
colleagues (2013), in a review, explored service users’ experiences of
music therapy in the development of recovery-oriented provision. Key
factors were having a good time, being together, exploring feelings and
self-concept. Music therapy supported the development of strengths
and resources that contributed to the growth of positive identity and
hope.
Stickley and colleagues (2018) established that a range of arts
activities could support recovery through enhancing connectedness and
improving hope. Van Lith and colleagues (2013), in a review, concluded
that arts could play a substantial role in mental health recovery, while
Stevens and colleagues (2018) reported significant increases in self-
reported mental wellbeing, social inclusion and the ongoing use of skills
learned for some, but not all participants, depending on the in-course
experience of artistic growth. Community-based creative workshops
have supported those experiencing severe and persistent mental illness.
Workshops typically aim to build the skills and capacities of participants,
providing alternative ways to communicate identity and recovery stories
through visual arts, writing, dance and music, facilitated by practising
artists. Participants typically enjoy the workshops and being involved
in creative activities with others, which improves their confidence and
understanding of their illness (Stewart et al., 2018; Slatterly et al., 2020).
Bolger (2015) investigated the process of collaboration between a
music therapist and community participants in three music projects in
 15. Music and Physical and Mental Health  505

Australia. The projects were undertaken with three separate communities

which supported groups of marginalised young people. The findings
provided an understanding of the conditions required to optimise the
potential for positive growth in collaborators in participatory music
projects. MacGlone and colleagues (2020) investigated a community
music intervention for a population with varied disabilities—physical,
learning or both—who took part in weekly music workshops. Although
the findings showed improvements in individuals’ self-expression,
confidence, mood and social skills, there were differences in outcomes
in different centres. Participants in one centre improved their musical
skills; in another, some participated with enthusiasm but others chose
other art activities over music; while in another there was a lasting
positive impact. Despite this, all groups showed improvement in
communication, interaction with others and joint attention.

Music, Brain Plasticity and Movement

Motor skills tend to deteriorate with age. Activities which support
lifelong neuroplasticity, such as making music, can counteract these
processes and allow for the reacquisition of motor and cognitive skills
in the elderly following brain-tissue damage (for instance, after a
stroke). Playing a keyboard can improve fine motor functions through
neurophysiological changes in audiomotor networks. Rhythmic cueing
has a positive effect on gait disorders, improving stride length, speed
and overall mobility. Melodic intonation therapy can improve recovery
from non-fluent aphasia through the activation of right-hemisphere
networks. Importantly, the rewarding effects of music-making and
listening provoke neurochemical effects which, in combination with
music-induced brain plasticity, can facilitate neurorehabilitation
(Altenmüller and James, 2020). Much of the research on mobility
has focused on rhythm. Clinical evidence has shown that the use of
external rhythmic auditory cueing can aid in the rehabilitation of motor
movements such as gait in patients with Parkinson’s disease, traumatic
brain injury, spinal cord injury and Huntington’s disease (Thaut et al.,
2015). Neurological music therapy techniques can promote sensorimotor
rehabilitation (Mainka et al., 2016). Music can support improvement
in movement in a range of conditions, improving individuals’ quality,
506 The Power of Music

range and speed of movement. In acute medical settings or neurological

rehabilitation, music can facilitate and target specific therapeutic goals.
Making music can be beneficial for those who have partial paralysis
following a stroke (LaGasse and Thaut, 2012). While the motivational
aspects of music may account for some gains made, there is evidence
of increased activation of the motor cortex and improved cortical
connectivity (Altenmuller et al., 2009). Särkämö and colleagues (2014)
carried out a voxel-based morphometry analysis on acute and six-month
post-stroke patients. Structural magnetic resonance imaging data from
49 patients who listened to either their favourite music, verbal material
or no listening material during the six-month recovery period showed
that listening to music enhanced behavioural recovery and also induced
fine-grained neuroanatomical changes in the recovering brain.
Also working with stroke patients, Schneider and colleagues (2007)
evaluated a music-supported training programme designed to induce
an auditory sensorimotor co-representation of movements. Patients
without any previous musical experience participated in intensive
step-by-step training, first of the paretic extremity, followed by training
of both extremities. Training was given 15 times over three weeks in
addition to conventional treatment. Fine as well as gross motor skills
were addressed by using either a MIDI piano or electronic drum pads.
Pre- and post-treatment motor functions were monitored using a
computerised movement analysis system and established motor tests.
Patients showed significant improvement after treatment with respect
to speed, precision and smoothness of movement and motor control
in everyday activities. Similarly, Villeneuve and colleagues (2014)
engaged 13 stroke patients in three weeks of piano training comprising
nine 60-minute supervised sessions and home practice. Fine and
gross manual dexterity, movement coordination and functional use
of the upper extremity were assessed pre- and post-intervention at a
three-week follow-up. Significant improvements were observed for
all outcomes, particularly in those with a higher initial level of motor
recovery at the beginning of the intervention. Also working with stroke
patients, Särkämö and colleagues (2008) studied 60patients in the acute
recovery phase who were either assigned to a music, language or control
group. During the following two months, the music and language
groups listened daily to self-selected music or audiobooks respectively,
while the control group received no listening material. All patients
 15. Music and Physical and Mental Health  507

received standard medical care and rehabilitation. The findings showed

that recovery in the domains of verbal memory and focused attention
improved significantly more in the music group than the other groups.
The music group also experienced a less depressed and confused mood.
Working with patients with Parkinson’s disease, Pantelyat and
colleagues (2016) assessed the feasibility and effects of twice-weekly
group West African drum-circle classes for six weeks. Compared with
controls, those in the drumming group showed significantly improved
walking performance and quality of life. Studying patients with
cerebral palsy, Ghai and colleagues (2017) reviewed 547 records of the
effects of rhythmic auditory cueing on spatiotemporal and kinematic
parameters of gait in people with cerebral palsy, and concluded that
there was converging evidence towards the application of rhythmic
auditory cueing to enhance gait performance and stability. Alves-
Pinto and colleagues (2016) also reviewed the evidence supporting
the use of musical-instrument-playing for rehabilitation in cerebral
palsy. They proposed that active musical-instrument-playing could
be an efficient way of triggering the neuroplastic processes necessary
for the development of sensorimotor skills in patients with early brain
damage. In a later study, Alves-Pinto and colleagues (2017) studied
adolescents and adult patients with cerebral palsy, as well as a group
of typically developing children, who learned to play the piano for four
consecutive weeks, completing a total of eight hours of training. For
ten of the participants, learning was supported by a special technical
system aimed at helping people with sensorimotor deficits to better
discriminate fingers and orient themselves along the piano keyboard.
The potential effects of piano training were assessed with tests of
finger-tapping at the piano and perception of vibratory stimulation of
fingers, as well as neuronal correlates of motor learning in the absence
of and after piano training. Although the findings were highly variable,
there were significant effects of training on the ability to perceive the
localisation of vibrations over fingers, but there was no effect of training
on the performance of simple finger-tapping sequences at the piano or
on motor-associated brain responses.
Some work has focused on children. For instance, Marrades-Caballero
and colleagues (2018) studied 18 children between 4 and 16 years of age
with severe bilateral cerebral palsy, who received music therapy for 16
508 The Power of Music

weeks. Significant improvements were observed in overall and specific

arm and hand position, as well as activities from standard locomotor
stages. The improvements persisted at a four-month follow-up. Also
working with children, Peng and colleagues (2011) explored the
effects of patterned sensory enhancement music on muscle power and
movement control in children with spastic diplegia during loaded sit-to-
stands. Twenty-three children with spastic diplegia, aged five to twelve
years old, participated. Individual patterned sensory-enhanced music
was composed by a music therapist based on each participant’s sit-to-
stand movement, with 50 percent one repetition maximum load. Each
participant performed sit-to-stands continuously for eight repetitions
under randomly assigned music or no music conditions, while kinematic
and kinetic data were measured simultaneously. In the music condition,
the music was played only during the first five repetitions. The following
three repetitions were referred to as the ‘continuation condition’.
Compared to the control condition, greater peak knee extensor power,
greater total extensor power and better centre of mass smoothness, but
less movement time was found in the music condition. Significant effects
of the music were also found for the continuation condition.
Auditory stimulation has been shown to improve upper-extremity
skills. Ben-Pazi and colleagues (2018) studied nine matched pairs
of children aged 7.5 years old. The children listened to auditory
stimulation embedded in music or music alone for at least ten
minutes, four times a week for four weeks. The children with auditory
stimulation achieved more goals than children who listened to music
alone. Parents reported improved care and comfort in the children
in the intervention group, compared to a slight deterioration in the
control group. Bringas and colleagues (2015) tested the effectiveness
of a music therapy intervention for children with severe neurological
disorders. The control group received only a standard neurorestoration
programme, while the experimental group received an additional music
therapy auditory attention plus communication protocol immediately
before the usual occupational and speech therapy. Overall, the findings
showed improved attention and communication, as well as changes in
brain plasticity, in children with severe neurological impairments who
experienced adjunct music therapy.
 15. Music and Physical and Mental Health  509

Another strand of research has focused on individuals with

Huntingdon’s disease, a neurodegenerative condition that leads to
progressive loss of motor and cognitive functions. Metzler-Baddley and
colleagues (2014) devised an intervention involving drumming and
rhythm exercises to target early executive problems, such as difficulties
in sequence and reversal learning, response speed, timing and dual-
tasking. Five people completed the two-month music intervention. The
effects of rhythm exercises on executive function, basal ganglia volume
and white-matter microstructure in the anterior corpus callosum, the
anterior thalamic radiation and the corticospinal tract were assessed.
After two months of training, there were improvements in executive
function and white-matter microstructure, notably in the genus of
the corpus callosum (which connects the prefrontal cortices of both
hemispheres). There were no changes in basal ganglia volume.
Some research has focused on whether music therapy can support
those suffering from multiple sclerosis. Aldridge and colleagues (2005)
aimed to see which components of multiple sclerosis would respond
to music therapy. Twenty adult multiple sclerosis patients participated,
half receiving music therapy, over the course of one year. Measurements
were taken before therapy began and subsequently every three months,
then at a six-month follow-up without music therapy. Tests included
indicators of clinical depression and anxiety, a self-acceptance scale
and a life-quality assessment. Data were also collected on cognitive
and functional measures. Significant improvements were found for
the therapy group over time in relation to self-esteem, depression and
anxiety but these worsened when the therapy stopped.

Breathing
Several studies have investigated whether singing has a beneficial
effect on aspects of breathing. Overall, the findings are mixed (Clift,
2012). For instance, Schorr-Lesnick and colleagues (1985) compared
singers with instrumentalists and reported no difference between
participants aged 25 to 83 in choir, string, percussion or wind ensembles
in pulmonary function. Studies of patients with chronic pulmonary
disease have also had mixed results, with some research on singing
showing improvements compared with controls (Bonilha et al., 2009),
510 The Power of Music

while some has shown limited impact (Lord et al., 2010). Despite this,
those participating in singing activities frequently report that singing
has exercised body systems through the physical exertion involved,
especially the lungs (Clift et al., 2008; Stacey et al., 2002). Skingley and
colleagues (2018) established the views of participants with chronic
obstructive pulmonary disease who took part in a ten-month ‘singing
for better breathing’ programme. The findings showed that participants
learned about breath control, relaxation, exercises for breathing and
using singing as a means to deflect attention away from breathing
problems. The programme led to increased activity levels, was seen as
fun, provided friendship, increased motivation to participate in further
activities and offered support. For some, it was the highlight of the week.
The majority of participants reported improvements in respiratory
symptoms and mental and social wellbeing.

Speech Impairment
Music can play a therapeutic role in supporting improvement in speech
impairments. Rhythmic cueing has been used to reduce speech rate
and increase speech intelligibility in patients with severe dysarthria
and problems with the muscles that support speech due to traumatic
brain injury (for instance, as the result of a stroke; Pilon et al., 1998).
Similar results have been found for increasing the intelligibility of
the speech of patients with Parkinson’s disease (Thaut et al., 2001).
Hays and Minichiello (2005) found that music provided a means of
communication with spouses, friends or others, where language-based
communication was restricted due to Parkinson’s disease, dementia or
other illnesses affecting verbal communication.
Matthews (2018) compared two groups of people with Parkinson’s
disease who participated in voice and choral singing or a music
appreciation activity. Both groups attended once a week for nine weeks.
There was significant improvement for those in the choir for voice
volume and quality, maximum sustained phonation time and functional
symptom severity. At the end of the intervention, significant group
differences were observed in average and maximum voice volume, voice
quality and glottal function. Attendance for both groups was over 96
percent, suggesting that both groups found the nature and format of
the activities enjoyable and worthwhile. Quinn and colleagues (2021)
 15. Music and Physical and Mental Health  511

worked with post-verbal people with strokes, learning difficulties,

acquired brain injury, dementia or autism. The findings showed how
post-verbal people could use music to communicate and demonstrate
their capacities, and how those working with them used music to foster
a sense of inclusion and belonging.
The surgical removal of the larynx (i.e. the voice box) has a
profound psychosocial impact, often leading to depression and social
isolation. After laryngectomy, breathing, voicing, articulation and
tongue movement are important in restoring communication, and
require exercises which can be challenging motivationally. Moors and
colleagues (2020) explored the use of basic beatboxing techniques to
create a wide variety of fun and interactive exercises that maximised
the use of the structures important in alaryngeal phonation to maintain
motivation. An instructional online video was created to support
patients working on their own or with support from speech therapists.
For patients, the approach was engaging, useful, informative and
motivating. O’Donoghue and colleagues (2021) studied whether music
therapy—including song-writing, improvisation and singing—could
help adolescents who stuttered. The findings revealed participants’
experiences of living with stuttering, the importance of music in their
everyday lives and how music could help them.

Music in Hospital Settings

Music and Hospitalised Babies, Infants and Children
Babies born premature or underweight can benefit from the stimulation
of music in neonatal intensive care units. Music can enhance heart
rate, respiration, oxygen saturation, mean arterial pressure, sucking,
feeding ability and behavioural state. It has also been linked with overall
reductions in the length of stay in intensive care (Caine, 1991; Cassidy
and Standley, 1995; Keith et al., 2009; Standley, 2002; 2011; 2012). Music
can significantly reduce the frequency and duration of episodes of
inconsolable crying (Keith et al., 2009; Loewy, 2014) and have longer-
term benefits, reducing reactions to fear and anger at 12 and 24 months
(LeJeune et al., 2019). Some research has found reductions in the number
of negative critical events (Filippa et al., 2013) and the regulation of
512 The Power of Music

salivary cortisol levels (Shenfield et al., 2003). In a meta-analysis of 14

studies involving 964 infants and 266 parents, Bieleninik and colleagues
(2016) found significant large effects, indicating the positive effects of
music therapy on infant respiratory rate and maternal anxiety. There
was insufficient evidence to confirm or refute other effects. Walworth
(2009) examined the effect of music therapy on premature and full-term
infants’ developmental responses and the responsiveness of parents.
Sixty-five parent-infant dyads either attended music groups or a control
group. Infants participating in musical activities with their parents
demonstrated significantly more social toy-play than the control group.
Music therapy with hospitalised infants has shown positive effects
on infants’ capacity to self-regulate and engage in social interaction
with adults compared to controls (Malloch et al., 2012). Music has
been effective in promoting the wellbeing of young patients, enhancing
relaxation, providing distraction and helping them to cope with their
hospital experiences. In some cases, music-making can reduce or remove
the need for sedation. Listening to music can increase oxygenation
levels in the blood of long-term paediatric patients and have a positive
psychological impact on the chronically ill (Longhi and Pickett, 2008).
Patients react better to music therapy than other therapies (Hendon and
Bohon, 2008; Longhi and Pickett, 2008; Longhi et al., 2015), perhaps
because it is frequently perceived as fun (O’Callaghan et al., 2013).
Music is used in paediatric settings to enhance the wellbeing of
young patients (Klassen et al., 2008; Preti, 2013; Preti and McFerran,
2016). It can help children and young people relax (Daveson, 2001;
Longhi and Pickett, 2008; Malone, 1996), be used as a distraction
(Caprilli et al., 2007; Hendon and Bohon, 2008) and help children and
young people to talk about their hospital experiences and develop
coping strategies (Brodsky, 1989; Froehlich, 1984; Robb, 2000). Familiar
music can reduce anxiety associated with the hospital environment
(Preti and Welch, 2011) and can reduce children’s stress during painful
procedures (Caprilli et al., 2007; Klassen et al., 2008; Nguyen et al., 2010;
Vohra and Nilsson, 2011; Whitehead-Pleaux et al., 2006;). In some cases,
music-making can reduce or remove the need for sedation (DeLoach
Walworth, 2005). In a recent review of research with participants aged
0 to 21 years old, Johnson and colleagues (2021) showed consistent
and significant evidence that music could reduce anxiety before and
during medical procedures, although the findings relating to pain and
 15. Music and Physical and Mental Health  513

vital signs were mixed. Several studies have highlighted the importance
of patient preference in selecting music. This can be achieved easily
through the use of headphones. Group music-making can also benefit
teenagers in hospital (Bittman et al., 2001; Burns et al., 2005; Nicholson
et al., 2008).
Nguyen and colleagues (2010) studied whether music interventions
could influence pain and anxiety in children undergoing lumbar
punctures. Forty children aged seven to twelve years of age with
leukaemia participated, half experiencing a music intervention and half
acting as controls. Measures were taken before, during and after the
procedure. The findings showed lower anxiety, pain scores and heart
and respiratory rate in the music group during and after the procedure.
Similarly, Giordano and colleagues (2020) found that music therapy
reduced preoperative anxiety in children affected by leukaemia when
undergoing invasive diagnostic procedures. Barrera and colleagues
(2002) studied the impact of music therapy on paediatric haematology
and oncology patients. Data from 65 children and parents showed a
significant improvement in children’s emotions and wellbeing, while
parents perceived improved play performance in preschoolers and
adolescents but not school-aged children. In a review of 19 music
therapy studies with 596 participants, Facchini and Ruini (2020)
noted a significant reduction in psychological distress and an increase
in wellbeing. Eight articles evaluated the effects on pain and other
biological parameters, but the findings were inconclusive.
Patients undergoing haematopoietic stem cell transplants are at risk
of developing post-traumatic stress disorder (PTSD). This may explain
the extent of music therapy research in this area. For instance, Uggla
and colleagues (2016) examined the effect of expressive and receptive
music therapy delivered twice weekly on 24 patients up to the age of
16 undergoing haematopoietic stem cell transplants. The music therapy
significantly reduced evening heart rate compared to controls, indicating
reduced stress, although there were no significant differences in
saturation or blood pressure between the groups. In a later study (Uggla
et al., 2018), 29 patients aged 0 to 17 years of age were studied, 14 of
whom received music therapy twice a week for four to six weeks during
hospitalisation. Those experiencing music therapy had higher estimated
physical function at the time of discharge and improved quality of life.
514 The Power of Music

In a further study, Uggla and colleagues (2019) explored six families’

experiences of music therapy and found that it became a significant and
helpful experience, an important element in coping with and managing
treatment. In 2020, Uggla and Bond studied 38 patients, aged from
two months to 17 years old, who were receiving haematopoietic stem
cell transplantation and who participated in expressive and receptive
music therapy. The sessions took place in the child’s hospital room,
and the child was invited to play different musical instruments, sing
and listen to music with the music therapist. Parents and siblings could
also participate. The increasing physical functioning reported by the
children at discharge and the overall increased quality of life at the six-
-month follow-up suggested that the music therapy intervention was
effective. Similarly, Robb and colleagues (2014) examined the efficacy
of a therapeutic music video intervention on adolescents and young
adults who were in the acute phase of having a haematopoietic stem
cell transplant. Participants were allocated to the video intervention or
an audiobook group for six sessions over a three-week period. After the
intervention, the music video group reported significantly better social
integration and family environment. Haase and colleagues (2020) also
reported adolescents’ and young adults’ experiences of a therapeutic
music video intervention during hospitalisation for haematopoietic stem
cell transplants. Fourteen participants were interviewed and revealed
that the video provided an opportunity for reflection, self-expression
and meaning-making: it helped them to tell their story and to overcome
the negative aspects of cancer. It supported participants in overcoming
distress and challenges by providing opportunities to reflect on what
was meaningful, connect with others, and explore and identify personal
strengths.
Other research has focused on the effect of listening to music in the
recovery period following a range of surgery. Preethy and Gurunathan
(2020) studied the effects on the vital signs and behaviour of 62 children,
and showed that those listening to music demonstrated more positive
behaviour, significantly lower pulse rate and diastolic and systolic blood
pressure, and significantly higher oxygen saturation. Focusing on burn
injuries, Eid and colleagues (2020) evaluated the effect of a physical
therapy rehabilitation programme combined with music therapy on
children with lower limb burns, compared with controls. Both groups
 15. Music and Physical and Mental Health  515

improved, but the music therapy group showed greater improvement in

terms of pain, range of motion and gait parameters.
There are benefits of music therapy for the families of children
in hospital (Preti and McFerran, 2016). Parents value being able to
participate in musical activities with their child. Music can open up
communication between family members (Lindenfelser et al., 2012). In
addition to supporting children during stressful procedures, parents
are indirectly supported by music, creating a more relaxed environment
(Preti and Welch, 2004; 2011). Music can also contribute to the overall
hospital environment, modulating patient and staff mood (Rossetti,
2020).

Music Therapy and Cancer

There are an increasing number of music interventions focused on
supporting those with cancer. For instance, Boldt (1996) assessed the
effects of music therapy on bone-marrow-transplant patients who
needed to exercise to prevent muscle atrophy (although this was
difficult due to treatment effects). The long-term findings indicated that
music was effective in increasing participants’ self-reported relaxation
and comfort. Endurance increased, as did cooperative behaviour and
participation levels. Robb and colleagues (2003) examined the impact
of music therapy on anxiety and depression following bone-marrow
transplants. Three patients experienced music therapy for one hour a
week over six weeks, while three did not. Analysis of the content of
patient-generated songs revealed hope, positive coping, control and
appreciation. The findings provided insight into the individualised
experience of each patient and their coping strategies. Focusing on
Chinese female patients with breast cancer, Zhou and colleagues (2015)
examined the effects of music therapy and progressive muscle relaxation
on depression, anxiety and length of hospital stay following radical
mastectomy. A group of 170 patients either received music therapy
and muscle-relaxation training, or acted as controls who only received
nursing care. The 30-minute intervention was implemented twice a
day within 48 hours of surgery. Those participating showed significant
improvement in depression and anxiety, and spent less time in hospital.
A single session of patient-preferred live music has been shown to have
516 The Power of Music

a significantly positive impact on pain following surgery in patients in a

post-surgical oncology ward (Merry and Silverman, 2021).
Fancourt and colleagues (2016) carried out a multicentre study to
assess the impact of singing on mood, stress and immune response in
three groups affected by cancer: carers, bereaved carers and patients.
Participants sang regularly in five choirs across South Wales. Before and
after singing, mood and stress were assessed, and saliva samples were
taken to test for cortisol, beta-endorphin, oxytocin and cytokines. All
participants associated singing with reductions in negative affect and
increases in positive affect, alongside significant increases in cytokines.
Singing was associated with reductions in cortisol, beta-endorphin and
oxytocin levels. Overall, it improved mood and modulated elements
of the immune system. Köhler and colleagues (2020) synthesised the
evidence for the effectiveness of music therapy in different oncological
treatment phases with adult cancer patients. The narrative synthesis
included 30 studies and showed that, overall, music therapy had positive
effects on a broad range of outcomes, with techniques and effects
varying in different phases. During curative treatment, the results were
most promising with regard to anxiety, depression and pain-medication
intake, while in palliative settings, improvements with regard to quality
of life, spiritual wellbeing, pain and stress were reported. Twenty-one
studies were included in a meta-analysis, which showed small but
significant effects of music therapy on psychological wellbeing, physical
symptom distress and quality of life. In contrast, Daykin and colleagues
(2007) drew attention to the challenges and complexity of using music
with cancer patients because of the wide variation in responses. They
suggested that identity and creativity were key to understanding the
impact of music interventions.

Music and Surgery

Music has been used in a range of ways to support people who
are having surgery. Exposure to music has been shown to reduce
cortisol levels during medical treatment (Le Roux et al., 2007). For
instance, in pre-operative settings in hospitals, where patients are
often experiencing pain, anxiety, distress and even aggressive non-
compliance, meta-analytic analyses have demonstrated that music can
 15. Music and Physical and Mental Health  517

help to reduce anxiety (Spintge, 2012). Conrad and colleagues (2007)

played critically ill patients slow movements of Mozart’s piano sonatas
and found that the use of music significantly reduced the amount of
sedative drugs needed to achieve the degree of sedation, comparable to
controls who received standard treatment. In the music group, plasma
concentrations of growth hormone increased, whereas concentrations
of interleukin-6 (a component of the immune system) and adrenaline
decreased. Significantly lower levels of blood pressure and heart rate
also indicated reductions in stress. Overall, calming music activated
neurohumoral pathways associated with psychophysiological sedation.
In Sweden, Nilsson (2009) found that patients who had undergone
heart surgery and were allocated on the following day to 30 minutes
of uninterrupted bed rest with music, followed by 30 minutes of bed
rest——or alternatively 60 minutes of uninterrupted bed rest——
showed a difference in cortisol levels after the initial 3030 minutes
but not after 6060 minutes. The music was presented through a music
pillow connected to an MP3 player. There was no difference in heart
rate, respiratory rate, mean arterial pressure, arterial oxygen tension or
saturation, pain or anxiety levels.

Music and Pain

There has been considerable interest in the use of music to reduce pain.
Stress and anxiety exacerbate the experience of pain. Music therapy or
musical stimulation can reduce the perception of pain in post-surgical
patients, alone or as part of a pain management programme. Music
chosen by the patient is usually more effective than music chosen by
others. Patients also need to be able to control the volume at which the
music is played, when and for how long (Bernatzky et al., 2011; 2012).
Hole and colleagues (2015), in a review, reinforced these findings,
showing that music was effective in reducing pain and anxiety, even
when patients were under general anaesthetic. Pothoulaki and
colleagues (2008) investigated the effects of preferred-music-listening
on anxiety and pain perception in patients undergoing haemodialysis.
Sixty people diagnosed with end-stage renal failure and undergoing
haemodialysis treatment participated. Anxiety and pain were measured
pre- and post-intervention. The control group scored significantly
518 The Power of Music

higher on state anxiety than the experimental group and experienced

significantly higher pain intensity. In a study where pain was induced
experimentally, Basiński and colleagues (2018) showed that average
pain ratings were significantly lower when any music was played, but
increasingly so when the music selected was arousing or complex.
Focusing on pain and stress management in everyday life, Linnemann
and colleagues (2015) studied 30 women with fibromyalgia syndrome,
a condition characterised by chronic pain. Participants rated their pain
intensity, perceived control over pain, perceived stress level and music-
listening behaviour five times a day for 14 consecutive days. At each
assessment, participants provided a saliva sample for the analysis of
cortisol and alpha amylase, as biomarkers of stress response systems. The
findings showed that music-listening increased perceived control over
pain. Listening to music in combination with guided imagery has also
been found to lead to significant reductions of the β-endorphin, which
the body uses to numb or dull pain (McKinney et al., 1997), although
music-listening or guided imagery alone did not have this effect. Vollert
and colleagues (2003) used relaxing music with coronary patients
during rehabilitation and found significant decreases of β-endorphin
during physical exercise, suggesting that the music compensated for the
need for natural pain relief. In addition, systolic blood pressure, anxiety
and worry were reduced. These decreases were not found in patients
who performed the exercises without music. Gerra and colleagues
(1998) extended these observations, showing that listening to upbeat
techno music led to increases in β-endorphins, demonstrating that
upbeat music led to different outcomes.
Some research has focused on pain reduction in terms of active
engagement with music. For instance, Irons and colleagues (2020)
carried out a systematic review of 13 studies on the impact of group
singing on pain. There were psychological, physical and social benefits.
Most interventions reduced pain intensity. Overall, music does seem
to be able to contribute to the management of pain. This is gradually
being recognised and the processes involved more fully understood so
that treatment techniques can be refined to meet patients’ needs more
effectively (Mainka et al., 2016).
 15. Music and Physical and Mental Health  519

Music and Palliative Care

Coelho and colleagues (2017) carried out a scoping review to examine
and map non-pharmacological interventions implemented to provide
comfort in palliative care in home care, hospices and palliative care units.
Eighteen studies were included, covering ten non-pharmacological
interventions implemented in one to fourteen sessions which lasted for
five to sixty minutes. The most common were music and massage therapy.
The characteristics of these differed significantly across and within
interventions. They were mostly implemented in palliative care units
and hospices, and for patients with a cancer diagnosis. The use of music
as therapy in multidisciplinary end-of-life care dates back to the 1970s.
Music therapy is now one of the most frequently used complementary
therapies in palliative care in the USA. Schmid and colleagues (2018)
provided an overview of users’ and providers’ perspectives, and showed
that music therapy was viewed positively. Similarly, Nyashanu and
colleagues (2020) undertook a scoping review to explore the efficacy
of music interventions in palliative care. Music therapy supported the
management of pain, anxiety and depression, and promoted relaxation,
happiness and hope, enhanced spirituality and quality of life. Leow
and colleagues (2010) also reviewed terminally ill patients’ experiences
of using music therapy in a hospital, an inpatient hospice, a nursing
home or their own homes. They concluded that music therapy could
promote social interaction and communication with family, friends,
other patients and healthcare workers, and provide support for patients’
holistic needs. McConnell and Porter (2017), in a review of 51 articles
of music therapy in palliative care, found that music had a therapeutic
effect on the physical, psychological, emotional and spiritual suffering
of palliative-care patients and that group music therapy might be an
effective way to support staff caring for palliative-care patients.

Music and Mental Health: Stress, Anxiety

and Depression
Current levels of psychosocial distress in society are significant, as
evidenced by the number of prescribed antidepressants and working
days lost as a result of stress and anxiety. There is a growing body
520 The Power of Music

of evidence that active involvement in creative activities promotes

wellbeing, quality of life and health. In adults with a mental illness,
activities such as singing in a choir, creating art, expressive writing and
group drumming can reduce mental distress, depression and anxiety,
while simultaneously enhancing individual and social wellbeing. In
the UK, there are currently a number of projects that offer creative-arts
activities on prescription for those experiencing mental health issues
or social isolation. The projects adopt different approaches but all take
place in the community, are facilitated by professional artists and have
a referral process (Bungay and Clift, 2010). Engaging with music can
promote relaxation and reduce stress. Using a representative sample
of the Swedish population, Juslin and colleagues (2011) found that 78
percent reported that they listened to music at least once every day and
that one of the reasons for doing so was that it helped them to relax
(Juslin et al., 2011). Using music was reported as beneficial because
it was easily available at any time or place, and could be tailored to
personal taste. Linnemann and colleagues (2016) assessed whether the
presence of others while listening enhanced music’s stress-reducing
effect. Participants responded to questions on stress, the presence
of others and music-listening five times each day, 30 minutes after
waking and at 1100, 1400, 1800 and 2100 hours for seven consecutive
days. They also collected a saliva sample after each data collection to
enable a biological assessment of stress. Music had the greatest impact
on stress reduction when listening took place with others or when it
was deliberately listened to for relaxation. In a later study, Linnemann
and colleagues (2018) studied 60 participants aged eight to 34 years old,
who answered questions on music-listening and stress six times each
day for a week using an electronic diary device, which reported the time
and duration of listening. Self-reports of music-listening were associated
with lower reported stress levels but this was not corroborated by the
objective data. Participants had to listen for 20 minutes before stress was
reduced.
In an experimental study, Jiang and colleagues (2013) examined the
effects of sedative and stimulative music and music preference on stress
reduction, following induced stress. One hundred and forty-four female
music-education students performed a stressful mental arithmetic test,
and were then assigned to listen to preferred or non-preferred sedative
 15. Music and Physical and Mental Health  521

or stimulative music. Sedative music lowered tension and anxiety, but

there was no difference between preferred and non-preferred music.
Gold and colleagues (2013) researched the effectiveness of three months
of biweekly individual resource-oriented music therapy with 144 adults
with non-organic mental disorders in Norway, Austria and Australia.
The findings showed that music therapy was an effective addition to
usual care for those who were not motivated to engage with other
therapies.
Reviews relating to music and stress have had broadly positive
outcomes. For instance, Panteleeva and colleagues (2017) conducted a
meta-analysis of 19 trials on the effects of music on anxiety and showed an
overall decrease in self-reported anxiety, while music also had an impact
on blood pressure, cortisol level and heart rate. De Witte and colleagues
(2019), in a review of 104 trials with 9,617 participants, showed that
music interventions had a positive effect on stress reduction, with larger
effects for heart rate compared to blood pressure and hormone levels.
Also in a meta-analysis, Pelletier (2004) reviewed 22 articles which used
music to decrease arousal due to stress. Music alone and music-assisted
relaxation techniques significantly decreased arousal, but the extent of
reduction was mediated by age, type of stress, the relaxation technique
adopted, musical preference, previous musical experience and the type
of intervention. Leckey (2011), reviewing 11 studies, suggested that
creative activities could have a healing and protective effect on mental
wellbeing through promoting relaxation, providing a means of self-
expression and reducing blood pressure, while boosting the immune
system and reducing stress. Overall, however, the evidence was weak.
Williams and colleagues (2018) systematically reviewed 13 articles with
667 participants. The findings of seven longitudinal studies showed
that,, when people with mental health conditions participated in choral
singing, their mental health and wellbeing significantly improved,, with
moderate to large effect sizes. Qualitative studies showed that group
singing provided enjoyment, enhanced emotional states, a a developed
sense of belonging and enhanced self-confidence.
In the modern world, depression is common, leading to a loss
of social function, reduced quality of life and increased mortality.
Music interventions have been used as an alternative to therapy or
antidepressant drugs. Leubner and Hinterberger (2017) reviewed 28
522 The Power of Music

studies with 1,810 participants distinguishing between passive listening

to music and active singing, playing, or improvising with instruments.
In almost all studies, there was a significant reduction in depression
levels over time in response to musical activities, particularly in the
elderly. Group settings had slightly better outcomes than individual
sessions. There were improvements in participants’ confidence, self-
esteem and motivation. In a meta-analysis, Aalbers and colleagues
(2017) found that music therapy, in addition to usual treatment, reduced
depressive symptoms and anxiety, and helped to improve functioning,
including maintaining employment, activities and relationships. They
concluded that music therapy was likely to be effective for people by
decreasing symptoms of depression and anxiety and helping them to
function in everyday life, although they were reluctant to draw firm
conclusions because of the small number of studies and the lack of
detailed descriptions of the nature of the interventions. Fancourt and
colleagues (2016) studied the reaction of pro-inflammatory cytokines
to music interventions, as these decrease in individuals with depression
as they recover. The impact of group drumming on a broad array of
inflammatory measures was assessed over a six-week intervention.
Thirty-one participants with mild or moderate depression completed
psychological scales related to depression, anxiety, wellbeing, social
resilience and social inclusion before and after participation. The
drumming sessions lasted for 90 minutes over a period of six weeks,
with groups of 15 to 20 playing together. The sessions consisted of call-
and-response exercises and the learning of drumming patterns that
were built up into larger pieces. Significant improvements were found
for depression, wellbeing and social resilience. Stress and tiredness
levels decreased from the beginning to the end of each session, while
happiness, relaxation and energy levels increased. There was no impact
on blood pressure, but a decrease in heart rate. Overall, the drumming
had a positive impact on mental and physical health.
Postnatal depression can be reduced when mothers sing to their
babies on a daily basis or listen to music (Fancourt and Perkins, 2017). In
comparison with other mother-infant interactions, singing is associated
with greater increases in emotional closeness, positive emotions and
decreases in psychological and biological markers of anxiety (Fancourt
and Perkins, 2018). Music therapy can also be used to support those who
are grieving. Smeijsters and van den Hurk (1999) described a single case
 15. Music and Physical and Mental Health  523

study of the treatment of a woman experiencing grief after the death of

her husband. They described how she was able to express a part of her
personality which she had been suppressing since childhood through
playing the piano and vocalising during improvisational music therapy.
People with depression are more likely to engage in group rumination
related to music, which can amplify negative emotions (Garrido et
al., 2017), although Sakka and Juslin (2018)—in a comparison of the
everyday use of music for mood regulation in depressed and non-
depressed individuals aged 19 to 65 years of age—found few differences
between depressed and non-depressed participants.

Mental Health Care in Children, Adolescents and

Young People
Children and young people can experience mental illness, and music can
sometimes act to support them. McFerran and colleagues (2018) studied
whether involvement in a brief music-based intervention engaged
young people, was appropriate, decreased distress and increased their
understanding of ways to use music positively. The findings showed
that at least some of the measurable decreases in distress were related to
participation in the music sessions. Similarly, arts engagement, including
music therapy and dance, can reduce internalising symptoms such as
anxiety and depression in children and adolescents (Geipel et al., 2018).
Henderson (1983) studied 13 hospitalised young people, diagnosed
with adjustment reactions to adolescence, who either received 18
one-hour sessions of music therapy or acted as controls. The music
sessions involved discussion about emotions in music, expression, the
identification of body language, story composition to recorded music and
drawing to music. Participants showed greater emotional awareness and
felt a greater sense of inclusion. In Hong Kong, Kwok (2019) examined
the effectiveness of an intervention integrating positive psychology
and elements of music therapy in increasing sense of hope, emotional
competence and happiness, and decreasing anxiety in 106 students in
Grades Eight to Nine who were suffering from anxiety. There was an
improvement, with changes in hope acting as a significant mediator in
the relationship between the intervention, a decrease in anxiety and an
increase in subjective happiness.
524 The Power of Music

In Northern Ireland, Porter and colleagues (2017) examined the

efficacy of active music therapy with 251 children aged eight to sixteen
years old—who had social, emotional, behavioural and developmental
difficulties—and their parents. They either participated in usual care
or had an additional 12 sessions of music therapy delivered weekly.
Those in the music group showed improvements in communication,
social skills, social functioning, self-esteem, depression and family-
functioning. In Austria, Grebosz-Haring and Thun-Hohenstein (2018)
assessed the potential neuroendocrine, immune and psychological
efficacy of group singing and group music-listening in children and
adolescents with mental disorders. Seventeen patients aged 11 to 18
in a department for child and adolescent psychiatry participated in a
singing or music-listening programme in five daily, 45-minute sessions
in one week. Saliva samples were taken to assess cortisol. Mood was
also measured before and after the music activities. Singing led to a
significantly higher reduction in cortisol than music-listening, while
listening led to significantly higher positive change in feelings of
calmness and wellbeing. Group music therapy also positively affected
the mood states of 352 adolescents aged 12 to 21 who were inpatients in
a psychiatric hospital (Shuman et al., 2016). Individual music therapy
has also been found to slightly improve the quality of life for some
children with psychopathology in an outpatient department, although
the impact on symptoms depended on the severity of comorbid medical
conditions (Gold et al., 2007b). Promoting positive identities and social
participation has been shown to help recovery from mental illness in a
range of studies (Hense and McFerran, 2017).
Some interventions have used music through the medium of dance.
For instance, Jeong and colleagues (2005) assessed psychological health
and changes in the neurohormones of adolescents with mild depression
after 12 weeks of dance movement therapy. Forty middle-school seniors
participated and were randomly assigned to a dance movement group
or acted as controls. Following treatment there was a reduction in
psychological distress. Plasma serotonin concentration increased and
dopamine concentration decreased. It seems that dance movement
therapy can stabilise the sympathetic nervous system. Similarly, Gandhi
and colleagues (2021) are studying 36 institutionalised adolescents with
depression who will either engage in a therapeutic listening programme
 15. Music and Physical and Mental Health  525

or traditional music therapy for 30 minutes a day, two days each week
for eight weeks, while participants in a dance group will perform for 30
minutes a day, three days each week for six weeks.
Music has been found to help alleviate depression in university
students. For instance, Wu (2002) studied the effect of 20 hours of music
therapy on the anxiety, depression and self-esteem of 24 Taiwanese
undergraduates. There were positive outcomes in relation to anxiety
immediately following music therapy and after a two-month follow-up.
The effects on depression were less positive, although the music
therapy did lead to enhanced confidence, ability to relax and decreased
negative emotions. Also studying university students, Thomson and
colleagues (2014) explored how the use of music to regulate moods was
associated with depression, anxiety and stress. One hundred and forty-
six university students aged between 17 and 24 years of age completed
an online questionnaire addressing levels of psychopathology, music-
related mood regulation behaviours, and personal music-related
information. Overall, music-related mood regulation predicted levels
of psychopathology. High use of music for the venting of negative
emotions predicted high levels of depression, anxiety and stress.
Diversion (distraction from worries and stress) predicted high levels
of anxiety and stress, while music for entertainment or maintaining
or enhancing a happy mood predicted low levels of depression. For
some individuals, using music to regulate mood may be maladaptive,
although it may be that young people experiencing psychopathology
are more likely to use music to help to reduce their symptoms. Indeed,
Miranda and colleagues (2012) suggested that music-listening might
influence internalising psychopathology because of its role in emotion
regulation and coping.

Insomnia
Losing sleep is a widespread problem which can have serious physical
and economic consequences. Music’s impact on physical, psychological
and emotional states may explain why it has helped people with
sleeping disorders. Music can improve sleep quality, sleep efficiency
and time-to-sleep onset, with greater effectiveness than a range of other
interventions, including acupuncture and medication. Trahan and
526 The Power of Music

colleagues (2018) investigated music as a sleep aid amongst the general

public using an online survey that assessed musicality, sleep habits
and which music helped sleep (and why). Of the 651 responses, 62
percent of respondents stated that they used music to help them sleep.
Fourteen musical genres and 545 different artists were reported to be
used as sleep aids. Stress, age and music use were significant predictors
of sleep quality. Younger people with higher musical engagement were
significantly more likely to use music to aid sleep. Respondents reported
that music helped them sleep because of its unique sleep-inducing
properties, its role as part of their normal sleep routine, and the way it
blocked internal or external stimuli that would otherwise disrupt sleep.
Jespersen and Vuust (2012) studied the use of relaxing music at bedtime
with 15 traumatised refugees experiencing difficulties in sleeping. The
intervention group heard relaxing music played at night through a
music player nested in a pillow. There was a significant improvement
in sleep quality and wellbeing but no changes in trauma symptoms. In
a later study, Jespersen and colleagues (2019) studied 57 people with
insomnia who either listened to music or were given audiobooks to
listen to. The severity of insomnia decreased and participants perceived
an improvement in sleep and quality of life, but there were no changes
in objective measures of sleep.
Reviews of the role of music in supporting sleep have had broadly
positive results. Feng and colleagues (2018) reviewed 20 studies
involving 1339 patients and 12 interventions. All interventions were
statistically more effective than usual care, but patients ranked listening
to music as the best method for overall sleep quality. In terms of sleep
onset latency, music-associated relaxation and listening to music had
significant advantages. Listening to music and music with exercise
also tended to improve sleep efficiency. Wang and colleagues (2014)
reviewed ten studies involving 557 participants, and showed that sleep
quality was improved significantly by music and that there was a
cumulative effect for chronic sleep disorders. Jespersen and colleagues
(2015) reviewed six publications involving 314 participants across
a variety of settings including the participant’s own home, a sleep
laboratory and an inpatient rehabilitation facility. Sample sizes varied
between 15 to 65 participants aged from 19 to 83 years of age. Some
trials used music only, others music with relaxation. The music included
 15. Music and Physical and Mental Health  527

Eastern and Chinese classical music, new age, electric, popular oldies,
and jazz. The music was played for 25 to 60 minutes once a day over
three to 35 days. Sleep quality improved with music-listening in almost
all studies. Similarly, De Niet and colleagues (2009) conducted a meta-
analysis with data from 170 adults, including older people, to evaluate
the efficacy of music-assisted relaxation to improve sleep quality. Music
had a moderate effect. In ongoing research, Lund and colleagues (2020)
are trialling how music might help people with depression who suffer
from insomnia by asking them to listen to music for a minimum of 30
minutes at bedtime for four weeks.

Music, Trauma and Abuse

Music therapists around the world work in a wide range of settings with
those who are traumatised or abused (Pavlicevic and Ansdell, 2004).
Music has been shown to be cost-effective and powerful in supporting
sustainable community development, mental and physical health, and
peace initiatives (Hesser and Heinemann, 2010). It can help to reduce
symptoms and improve general functioning among those exposed to
trauma (McFerran et al., 2020), acting as an adjunct to conventional
therapy and promoting emotional regulation, increased pleasure and
anxiety reduction. It can be particularly helpful when individuals
struggle with the stigma associated with asking for professional help
(Landis-Shack et al., 2017), or when cognitive behavioural therapy
has had limited success. Rhythm may be particularly important in
supporting recovery. Research in neurobiology has shown that rhythmic
music has a specific impact on the brain. Therapy models using rhythm
have been used since 2003 in centres for young people at risk, in refugee
trauma centres, forensic psychiatric wards in prisons, and child and
adult mental health services. Its benefits include increased levels of social
integration, improvements in affect and mood stabilisation, reductions
in anxiety and depression, and increases in self-esteem (Faulkner, 2017).

Post-Traumatic Stress Disorder

Post-traumatic stress disorder can be caused by a wide range of incidents,
the most common following engagement in severe combat-related
528 The Power of Music

emotional trauma. Symptoms include distressing memory intrusions,

avoidance, emotional disturbance and hyperarousal, and lead to a
significantly reduced quality of life. In recent years, there has been
increasing demand for music therapy services within military treatment
facilities, partly due to the increased research output, but also the
increased prevalence of injuries—including traumatic brain injury and
post-traumatic stress disorder—for which interdisciplinary patient-
centred care is required. The complexity of traumatic brain injury
and post-traumatic stress in the context of military service presents
particular challenges for music therapists as they try to develop
effective interventions (Bronson et al., 2018). Pezzin and colleagues
(2018) examined the feasibility and potential effectiveness of an active
music-instruction intervention in improving psychological health
and social functioning among veterans suffering from moderate to
severe post-traumatic stress disorder. Sixty-eight veterans were self-
or provider-referred to the programme. Participants were aged 22 to
76 years old, mainly male, African-American or black. Almost a third
were in employment, while almost half were retired due to disability.
The research assessed symptomatology, depression, perceptions of
cognitive failure, social functioning, isolation and health-related quality
of life. Participation led to a significant reduction in post-traumatic
stress symptoms and depression, with a trend towards improvement in
the other assessed areas. Carr and colleagues (2012) assessed whether
group music therapy had an effect on post-traumatic stress disorder
symptoms and depression in 17 patients who had already participated
in cognitive behavioural therapy. Participants received ten weeks of
group music therapy, following which there was a significant reduction
in the severity of symptoms and a reduction in depression. Participants
reported the group music therapy as helpful. Vaudreuil and colleagues
(2020) used public performance to support the social transformation
and reintegration of US military service members. Two case studies of
service members who received music therapy as part of their treatment
for post-traumatic stress disorder, brain injury and other psychological
health concerns were presented. The participants wrote, learned and
refined songs over a number of sessions, and created songs to perform
to audiences. Interviews showed evidence of beneficial psychological
effects of this procedure. Similarly, Bensimon and colleagues (2012)
 15. Music and Physical and Mental Health  529

studied six soldiers who had been diagnosed as suffering from combat-
or terror-related post-traumatic stress disorder, who participated in a
series of 90-minute weekly sessions of music therapy. The sessions were
filmed and in-depth interviews were undertaken with participants.
Analysis of musical and verbal content revealed the importance of group
engagement with issues related to trauma and non-trauma matters,
decreasing reflection on traumatic emotions and increasing expressions
of non-traumatic feelings. In a single case study of a 36-year-old army
veteran, Wellman and Pinkerton (2015) described how a ten-week music
therapy intervention enhanced motivation, decreased stress, anxiety
and depression, and led to reported feelings of wholeness. Medication
was reduced, which led to increased reengagement with previously
enjoyed activities and enhanced quality of life following four years of
medical disability and significant social phobias. The use of music for
therapeutic purposes can also occur in more informal ways. For instance,
one US soldier rapped about his experiences in Iraq to cope with the
aftermath of his deployment there, while in Uganda, one young man
constantly played a stringed instrument but was too traumatised to talk
about his role as a resistance army commander (Bergh and Sloboda,
2010). Military sexual trauma is an issue for some returning veterans.
Story and Beck (2017) studied five veteran women who participated in
up to ten music and imagery sessions and a post-session focus group
over the course of three months. Participants reported using music and
imagery to manage and reduce their symptoms.
Civilians can also experience post-traumatic stress after being subject
to combat events. Following the 2014 Israel Gaza conflict, Bensimon and
colleagues (2017) examined the emotional effects of listening to happy
and sad national songs on young and older adults and the relationship
to exposure to missile attacks, post-traumatic stress symptoms and
negative emotions. In young adults with low post-traumatic stress
symptoms, sad national songs were related to higher negative emotions,
whereas in older adults it was those with higher post-traumatic stress
disorder symptoms that exhibited higher negative emotions in response
to sad national songs.
530 The Power of Music

Music, Asylum Seekers, Refugees and Survivors

Music therapists have become increasingly interested in the role of
music in relation to war, peace, refugees and trauma (Akombo,, 2000;
Edwards,, 2005; Hunt,, 2005; Kennedy,, 2001; Lopez,, 2008; Ng,, 2005).
Following the attack on the USA in September 2001, many have been—
and continue to be—traumatised by war, acts of terrorism and violence
worldwide. Some music therapists have sought to respond actively
to these events and the resulting trauma, by reaching out to trauma
survivors.
Refugees have to move involuntarily from their country of residence,
often having witnessed disasters, wars and the deaths of immediate
family members prior to leaving. These traumatic situations provoke
strong reactions and emotions. often exacerbated by challenging
refugee-processing system,—for instance, detention and waiting in
refugee camps—which make migration and resettlement processes for
refugees and asylum-seekers much more challenging than for other
migrants. The psychological effects of trauma experienced by refugees
tend to be long-lasting. Multicultural arts programmes can allow for
sensitivity to different identities, heritage and experience, and can be
important in healing and promoting wellbeing (Gopalkrishnan, 2016).
In refugee camps, the arts can support the preservation of religious
identity through the celebration of festivals and events, help to alleviate
psychosocial distress and trauma, and reduce stigmatisation.
Among children who have experienced trauma, including sexual
abuse, terrorism, war and domestic violence, there have been promising
findings for the value of the arts in supporting grief, depression and
post-traumatic stress disorder, as well as supporting the communication
of experiences (Andemicael, 2011). Clini and colleagues (2019)
assessed the impact of arts interventions on forcibly displaced people,
and identified several key issues concerning the perceived benefits of
such programmes. The findings showed that participants reported the
impact of creative activities in relation to skills, social engagement and
personal emotions. Artistic and cultural activities impacted positively
by helping participants to find a voice, creating support networks and
providing opportunities to learn practical skills which were useful
in gaining employment. In a review, Lenette and Sunderland (2016)
 15. Music and Physical and Mental Health  531

mapped the potential for participatory music practices to support the

health and wellbeing of asylum-seekers and refugees in three contexts:
conflict settings, refugee camps and resettlement settings. The review
highlighted the different roles that music could have in people’s lives
as they moved away from their home countries towards resettlement.
Overall, they found that the growing body of research on music
and wellbeing for asylum-seekers provided a strong foundation for
investment in music as a key positive social and cultural determinant
of health for this group of people. Music can reduce the symptoms of
post-traumatic stress disorder through reducing anxiety and depressive
symptoms, increasing pleasure, helping with emotional regulation,
and supporting the building of communities and support networks,
thus enhancing resilience, reducing stigma and improving general
functioning (Sutton, 2002). This has been demonstrated in community
arts projects in Sri Lanka following the civil war and the tsunami. The
arts can help people to regain control of their lives (Huss et al., 2016).
Beck and colleagues (2018) researched the impact of guided imagery
with music alongside standard medication with 16 adult refugees who
completed 16 one-hour individual sessions. Pre- and post-measures
of post-traumatic stress symptoms, sleep quality, wellbeing and social
function demonstrated significant positive changes with large effect
sizes. Evaluation of single sessions showed that participants found
the therapy acceptable and helpful. All of the participants used music-
listening for self-care in their homes between sessions and responded
positively to the intervention overall. In Australia, Lenette and
colleagues (2016) studied music facilitators who regularly attended an
immigration transit accommodation facility to share music and singing
activities with detained asylum-seekers, to ameliorate significant
mental and emotional distress resulting from indefinite detention.
Drawing on the facilitators’ monthly written observations, a number of
key themes emerged which linked music and singing to the health and
wellbeing of detained asylum-seekers. Overall, it was clear that there
was the potential for participatory music-making to counter the impact
of traumatic experiences and detention on asylum-seekers’ health and
wellbeing. Similarly, Hesser and Heinemann (2010) provided examples
of music projects which supported the social inclusion of refugees and
others who had experienced severe trauma. The Rwandan Genocide of
532 The Power of Music

1994 killed over a million people and led to enormous distress for those
who survived. D’Ardenne and Kiyendeye (2015) used focus-group
interviews with 13 survivors who participated in a music programme
and found that the music had changed their past, given them a safe
place in the present, fellowship and prayer, and provided them with
the personal resources to face the future. Research looking at the lasting
impact of trauma (for example, in Holocaust survivors after 70 years)
has found higher levels of resilience among those who have engaged
in the arts over the course of their lives relative to those who have not,
suggesting the value of the arts both in the immediate aftermath of
trauma and in the decades that follow (Diamond and Shrira, 2018).
There is also evidence that music can support victims of torture.
Alanne (2010) studied three traumatised men from Central Africa,
South Asia and the Middle East who lived as asylum-seekers or refugees
in Finland. They received weekly or bimonthly music therapy sessions
over one to two years as part of their rehabilitation, using projective
listening, guided imagery and free association within a psychoanalytic
frame of reference. Analysis of data from the sessions revealed that music
therapy approaches were effective in promoting verbalisation as well
as the regulation and expression of emotions. Participants responded
positively and demonstrated some improvement, although with
varying degrees of satisfaction. The therapy increased the consciousness
of patients regarding their traumatic experiences, and was perceived
as supporting calm and relaxation. The findings suggested that music
psychotherapy methods may be effective in treating patients who are
survivors of torture and related traumatic experiences. Music can
support the healing of children who have been traumatised through
war, those forced to fight, serve as spies, soldier wives or camp followers,
and who are now refugees. Using their own cultural music and creative
compositions can help young people to overcome their fears and
challenges, promote healing and the development of self-esteem, trust
and identity. Osborne (2012) provided examples of the way that music
neuroscience can provide a means of evaluating the success of music
therapy with traumatised children in post-conflict societies including
North Uganda, Palestine and South Thailand. Felsenstein (2013)
studied the impact of a short-term music therapy intervention on three
groups of preschool children in the aftermath of a forced evacuation
 15. Music and Physical and Mental Health  533

from their homes during the unilateral Israeli disengagement from the
Gaza Strip in 2005, and the post-trauma treatment of the evacuees. The
findings suggested that music could build post-trauma resilience and
reduce the vulnerability of preschoolers to traumatic events, although
community and family could also strengthen the way that individual
children coped.
Several authors have documented the benefits of creative musical
activity for children who have experienced war (Bergmann, 2002;
Heidenrich, 2005; Osborne, 2009; Sutton, 2002) as a means of developing
self-esteem, trust, identity and social cohesion in a range of countries
including Bosnia-Herzegovina, Georgia, Sierra Leone, Rwanda and
Palestine. These projects have enabled reflection and the expression of
feelings. Some programmes supporting refugees or displaced young
people in Sierra Leone, Ghana and Slovenia have included dance.
These programmes supported the development of communication,
empowered young people, gave them a sense of belonging and relief,
and supported identity development (Harris, 2007; Jones et al., 2004;
Lederach and Lederach, 2010; Pesek, 2009).
Zharinova-Sanderson (2004) reported work with traumatised
refugees in Berlin at the Centre for the Treatment of Torture Victims.
Music therapy in this context helped young people to use their own
cultural music to adjust to their new culture, while performance
opportunities allowed audience members to see beyond traumatised
refugees to real people. In Sierra Leone, Gonsalves (2010) worked
with traumatised young girls who had been forced to fight and serve
as spies, soldier wives and camp followers. Through song, the girls
communicated their emotional and material needs, histories, fears and
current difficulties. Creative musical interaction supported increased
understanding, reengagement and connections with others, and
promoted healing, thus empowering the participants. In post-conflict
Kosovo, Gerber and colleagues (2014) evaluated the work of a charity
which aimed to promote a culture of peace and unity, as well as the
development and recovery of children. Groups of non-participating
students were compared with new programme participants, those
participating for twelve months and those who had graduated from the
programme. Overall, children who participated in the programme for at
least one year had fewer emotional and cognitive problems than recently
534 The Power of Music

enrolled children. In Ireland, Kenny (2018) examined the musical lives

of the children of asylum-seekers living in a state system of communal
housing while they waited for their refugee applications to be processed.
Data were collected through six participatory music workshops, video
observations, a reflective log and focus-group interviews. Eleven
children aged seven to twelve years old, of six different nationalities,
participated. The findings revealed the importance and relevance of
the contexts of music-making in temporary accommodation settings,
as well as the broader national and international contexts for children
living in asylum-seeking systems.
A review of 21 school- and community-based interventions for
approximately 1800 refugee and asylum-seeking children, carried out
in high-income countries or refugee camps, with a focus on verbal
processing of past experiences or a range of creative arts activities,
suggested that interventions delivered within the school setting could
be successful in helping children overcome difficulties associated with
forced migration. Feelings of powerlessness, humiliation and anger
were reduced and social inclusion, mental health, social acceptance and
belonging were enhanced (Tyrer and Fazel, 2014).

Music and Victims of Abuse

Child sexual exploitation is a major international problem and victims
need to be rehabilitated and reintegrated into society. They can be
supported through the creative arts. Schrader and Wendland (2012)
described how music therapists working in Phnom Penh, Cambodia—in
a centre that provided care for young girls rescued from sexual violence
or commercial sexual exploitation—trained staff in the centre, teaching
them to play instruments, participate in ensembles and lead large group
music activities so that they could support the girls. Rogers (1992)
highlighted a number of factors that appear to be common to sexually
abused individuals, including the participants’ manipulation of music
therapy, the symbolic use of instruments, the preoccupation with mess
and containers, the use of boundaries, and the power of secrets. Material
from case studies illuminated these points.
In the USA, there are over five million crimes involving violence to
partners annually. Victims experience a lifetime of increased risk for
 15. Music and Physical and Mental Health  535

depression, anxiety, addiction, suicide attempts and post-traumatic stress

disorder. Additionally, women’s experience of abuse is a risk factor for
incarceration. Palidofsky and Stolbach (2012) describe the therapeutic
benefits to incarcerated adolescent girls of working collaboratively with
theatre professionals to create, develop and perform musicals based
on their own traumatic experiences. Similarly, Neupane and Taylor
(2011) described how a gender-sensitive music intervention was able
to facilitate healing and recovery in incarcerated abused women. Also
working with victims of abuse, Slotoroff (1994) developed a technique
in an inpatient short-term psychiatric setting using improvisational
drumming and cognitive behavioural methods to address issues of
power. A middle-aged woman and an eleven-year-old boy participated,
and increased their sense of power and self-control, leading to long-
term positive behavioural, cognitive and emotional changes. Flores and
colleagues (2016) used African drumming to enhance the emotional
and social wellbeing of 16 children in residential care, most of whom
had been exposed to some form of neglect or abuse and displayed high
levels of anger, anxiety, depression or disruptive behaviour. Participants
attended weekly sessions of African djembe-drumming over a period
of four months. The intervention did not appear to significantly impact
the participants’ long-term self-concept or levels of depression, anger
or disruptive behaviour, while anxiety increased. Despite this, findings
from interviews and observations suggested that the workshops did
enhance the children’s emotional and social functioning in terms of
their self-esteem and self-confidence, prosocial behaviour, enjoyment,
concentration and manifestation of musical capacity, even though these
did not transfer to the children’s everyday functioning. This may have
been because of the severity of their socioemotional difficulties, as well as
the limitations of the intervention itself. Hannigan and McBride (2011)
investigated therapists’ perspectives on the value of using drumming,
along with other percussion instruments, as therapeutic tools in family
violence treatment groups. Overall, drumming was perceived as useful
in fostering group cohesion and cooperation, helping clients with a
passive communication style become more involved in groupwork,
facilitating emotional expression and offering participants a way to
experience active relaxation and engagement in the group process.
536 The Power of Music

Another approach to supporting trauma victims has been through

song-writing. For instance, Fairchild and McFerran (2019) studied
15 children aged eight to fourteen years old who had experienced
homelessness and family violence. Participants collaborated in writing a
song about what music meant to them. Throughout the process of song-
writing, the children described how music provided an escape from
what was happening in their lives and offered hope for a better future.
Similarly, Clendenon-Wallen (1991) studied 11 adolescents who had
been sexually abused who participated in a music group where activities
included song- or rap-writing, rhythm-playing, improvisation, lyric
analysis and creative movement. The adolescents also designed record-
album covers. The music-based activities increased participants’ sense of
self-worth and self-confidence. Not only did the music ease their anxiety,
but it was also useful in the process of socialisation and verbalisation,
and served as a starting point for discussing personal matters. Group
improvisation also enhanced group cohesion and cooperation.
Christenbury (2017) combined song-writing and art to promote healing
in a child who had been traumatised. The child controlled the process, as
the therapist composed songs in response to the child’s drawings. Both
related to the emotions that the child chose as being important for her
healing. This increased self-esteem and provided a healthy emotional
outlet. Also using song-writing, along with improvisational instrument-
playing, lyric analysis and musical games where participants were asked
to encode and decode various emotions, Graham (2011) determined
the effects of music on the emotional expressivity of children and
adolescents who had experienced abuse or neglect. All 22 participants
had been removed from their homes and placed in group foster homes.
The findings showed an increase in emotional expressivity and in the
degree and appropriateness of the emotions expressed by participants.
Rudstam and colleagues (2017) employed group music and imagery
with ten women who had been exposed to physical, psychological or
sexual abuse—often with a history of childhood abuse and neglect—
who were suffering from post-traumatic stress disorder. All participants
completed the treatment, indicated that it was helpful and showed a
decrease in post-traumatic stress and dissociative symptoms, alongside
an increase in quality of life. These changes were maintained when the
programme ended. Adopting a different approach, Strehlow (2009)
 15. Music and Physical and Mental Health  537

focused on the use of analytical music therapy to treat sexually abused

children, showing how an eight-year-old rebellious girl who had
suppressed her feelings after being sexually abused by her mother’s
partner responded positively. Similarly, Sutton and De Backer (2009)
drew on case material from work with a young boy and an adult
attending a psychiatric outpatient department, to show how a form
of musical listening and thinking could help to understand the issues
faced by those who are traumatised.
Fairchild (2018) highlighted the creative resources that children
experiencing homelessness and family violence can bring to research,
as well as the range of resources that they can draw upon in the face of
adversity. The research challenged the view of such children as being
at risk, and explored their resources and what helped them to do well.
Fairchild and colleagues (2017) used song-writing and interviews
to collaborate with children, focusing on what music meant to them.
Music offered an escape from the outside world and provided hope that
the future would be better. The children described a range of support
from friends, family, sport, pets, writing a journal and creativity. They
wanted to feel safe and cared for, and protect themselves and others,
and exhibited considerable self-determination. A collaborative article
written with one 11-year-old revealed that he believed that learning to
play the drums through music therapy had changed his life.
Music therapy has been used to support parenting. For instance, Day
and colleagues (2009) reported the reflections of five women who had
experienced childhood abuse as they participated in a group parenting
programme that incorporated song-writing. Three years after completion
of the programme, all participants reflected positively on the process of
creating their songs, and most reported that they continued to engage
with their song creations. Parents who have experienced childhood
trauma often experience challenges when parenting an adolescent
as this can trigger memories of abuse, which can intensify conflict,
resulting in negative relationship cycles. Colegrove and colleagues
(2018) devised a dyadic music therapy for parents and adolescents
which increased responsive parent-adolescent interactions and parental
emotion coaching, while reducing conflict and adolescent mental health
difficulties.
538 The Power of Music

Children who have been exposed to ongoing maltreatment and

poverty frequently experience behaviour problems. In South Korea, Kim
(2013) used music therapy for 15 weeks with four such children. There
was a reduction in externalising and internalising behavioural problems
overall, although there was considerable individual variation. In a later
study, Kim (2017) showed that, although children in the music therapy
group were less depressed, anxious and withdrawn, and had less
attention problems than children in standard-care waiting groups, there
were many confounding factors. The El Sistema programme, a large-scale
community-based music programme which includes children exposed
to violence, showed in research conducted in 16 music centres with 2914
children aged six to fourteen years old that participating children had
improved self-control and reduced behavioural difficulties (Alemán et
al., 2017).

Severe Mental Ill-Health

The following sections provide examples of the way that music
can be used to support recovery from severe mental ill-health,
providing supplementary support to traditional pharmacological and
psychological approaches. For patients with psychosis, music therapy
and music-listening have both been reported to improve symptoms
of general psychopathology, psychoticism, aggressiveness and
interpersonal hostility, paranoid ideation, phobic anxiety, somatisation,
anxiety and depression, as well as catatonic symptoms such as lack of
participation, cooperation, relaxation, interaction and psychosocial
functioning (Silverman, 2003). However, not all of the research has
confirmed these findings (Attard and Larkin, 2016). An interesting
line of enquiry has focused on the use of music individually tailored
to match patients’ brain rhythms. For instance, Müller and colleagues
(2014) examined whether long-term exposure of psychiatric patients
to music that was individually adapted to brain rhythm disorders
associated with psychoticism could act to ameliorate symptoms. A total
of 50 patients with various psychiatric diagnoses were randomised
to listen to CDs either containing music adapted to brain-rhythm
anomalies associated with psychoticism as measured by specific spectral
analysis, or standard classical music. Participants were instructed to
 15. Music and Physical and Mental Health  539

listen to the CDs for 18 months. Psychiatric symptoms were assessed

at the start of the intervention and at four, eight and eighteen months.
Patients in the experimental group showed significantly decreased
symptoms compared to control patients for psychoticism, paranoia,
anxiety, phobic anxiety and somatisation. These changes may have
resulted from the modulation of neurochemical interactions which
improved brain function and enhanced neuroplasticity. Feng and
colleagues (2019) explored whether music therapy could improve the
brain function of patients with major depressive disorder using near-
infrared spectroscopy. Fifteen mild or moderate major depressive
disorder patients were compared with healthy controls, who were all
treated with continuous music therapy for ten days. Verbal fluency
task performance of the participants yielded significantly higher scores
after music therapy. The near-infrared spectroscopy data showed
increases in some channels which were significant for both groups. The
major depressive disorder group showed significant activation in the
dorsolateral prefrontal cortex, orbitofrontal cortex and ventromedial
prefrontal cortex after music therapy, suggesting that the music therapy
had been effective.
One strand of research has considered the impact of music on
acute mental health. For instance, Silverman (2017) explored the
effects of different levels of structure within educational music therapy
interventions on knowledge of illness management, and recovery
and affect in adult acute-care mental health inpatients. One hundred
and fifteen participants were randomly assigned to either high- or
low-structured educational music therapy or a waiting-list control.
There were significant differences in relation to knowledge of illness
management and recovery between the high-structure condition and
the other groups. Overall, highly structured music therapy seemed to
be best for efficiently and effectively imparting knowledge concerning
illness management and recovery in acute mental health settings.
Stefani and Biasutti (2016) studied the impact of group music therapy
alongside drug care in comparison with drug care alone, in addition
to other non-expressive group activities in the treatment of psychiatric
outpatients. Twenty-seven patients with diagnoses of schizophrenia,
schizoaffective disorders, bipolar affective disorder, depressive episode
and specific personality disorders were allocated to receive group
music therapy and standard care in 48 weekly sessions of two hours,
540 The Power of Music

or standard care only. Those participating in the group music therapy

demonstrated improvement in neuroleptic drug dosage. Although
antidepressant drug usage increased for both groups, the difference
was only significant for the control group. Benzodiazepines and mood
stabilisers showed no significant change in either group. Overall, group
music therapy combined with standard drug care was effective for
controlling neuroleptic drug dosage in adult psychiatric outpatients
Grocke and colleagues (2014) studied 99 individuals with severe
mental illness who experienced weekly group music therapy, including
singing familiar songs and composing original songs in a professional
studio. Focus group interviews and lyric analyses, along with
quantitative data, were collected at 13, 26 and 39 weeks. Music therapy
improved the quality of life and self-esteem of participants, with those
participating in a greater number of sessions experiencing the greatest
benefits. Focusing on singing, Williams and colleagues (2018) reviewed
13 articles including 667 participants on the efficacy of group singing
as a mental health intervention for individuals living with a mental
health condition in a community setting. The findings showed that,
when people with mental health conditions participated in a choir, their
mental health and wellbeing significantly improved, with moderate
to large effect sizes. Group singing provided enjoyment, improved
emotional states, developed a sense of belonging and enhanced self-
confidence. Working with young people in a youth mental health service
in Australia, Hense and McFerran (2017) showed that promoting young
people’s musical identities could facilitate their recovery from mental
illness.
Reviews of the evidence for the effectiveness of music therapy for
those with psychopathology across a range of different age groups
have had mixed findings. Silverman (2003) carried out a meta-analysis
including 19 studies, and showed that music could effectively suppress
and combat psychotic symptoms. There were no differences between live
and recorded music, structured music therapy and passive listening, or
between preferred versus therapist-selected music. However, classical
music was less effective than popular music. Gold and colleagues
(2004) reviewed the overall efficacy of music therapy for children and
adolescents with psychopathology, and examined how the size of the
effect of music therapy was influenced by the nature of the pathology,
 15. Music and Physical and Mental Health  541

the client’s age, the music therapy approach adopted, and the way that
outcomes were assessed. Of the 11 studies included, with a total of
188 participants, music therapy had a medium to large positive effect
on clinically relevant outcomes. The effects tended to be greater for
behavioural and developmental disorders than for emotional disorders,
social skills or self-concept, particularly when eclectic, psychodynamic or
humanistic approaches, rather than behavioural models, were adopted.
In a later review focusing on adults, Gold and colleagues (2009) found
that music therapy, when supplementing standard care, had a strong
and significant effect on global state, general and negative symptoms,
depression, anxiety and general functioning. Small effect sizes were
achieved after three to ten sessions, while 16 to 51 sessions were needed to
achieve large effects. Overall, the findings suggested that music therapy
was an effective treatment which could help people with psychotic and
non-psychotic severe mental disorders to improve their functioning.
In a review of 35 studies focusing on acute psychiatric disorders, Carr
and colleagues (2013) found that drawing firm conclusions was limited
by methodological shortcomings and small sample sizes. Studies with
significant positive effects used active, structured musical participation
and were delivered in four or more sessions. No clearly defined effective
model emerged but greater frequency of therapy, actively structured
music-making with verbal discussion, consistency of contact, clear
boundaries and an emphasis on building a therapeutic relationship
and building patient resources seemed to be of particular importance.
Yinger and Gooding (2014) summarised the research on music therapy
for children and adolescents, including disorders usually diagnosed in
childhood (for instance, substance abuse, mood and anxiety difficulties,
and eating disorders). They outlined a range of music therapy techniques
and their strengths and weaknesses. Some research has considered how
music might support those having electroconvulsive therapy. Graff
and colleagues (2016) examined 30 patients’ preferences for music
prior to treatment. Most enjoyed listening to music through speakers
or headphones, although 17 percent preferred no music. Gleadhill
and Ferris (2010) developed a framework for evaluating the impact
of music therapy on people with dissociative identity disorder. This
debilitating disorder, acquired due to severe ongoing neglect or abuse,
is characterised by the presence of two or more identities that frequently
542 The Power of Music

control the individual’s behaviour. The framework suggested that

symptom relief, destigmatisation, increased self-esteem and prevention
of future abuse were important outcomes.

Eating Disorders
The role of music in ameliorating eating disorders has been examined
in a number of studies and reviews. Free and structured improvisation,
song-writing and listening to pre-composed music can all be used to help
sufferers to address specific aspects of their eating disorder, including
being able to recognise and tolerate their feelings, connect with others,
and make links between thoughts, feelings and their body. Music can
support the development of a sense of self and facilitate understanding
of the symbolic functions of the illness. Robarts and Sloboda (1994)
explored the process of music therapy in the treatment of people
suffering from anorexia nervosa. Individual cases have illustrated
the ways in which music therapy can support the individual while
addressing frequently deeply rooted problems: for instance, issues with
identity, negative self-image, distorted body image, autonomy, control,
avoiding facing difficult emotions and difficulty in relationships. There
is a relationship between listening to music for cathartic purposes
and emotional eating. Van den Tol and colleagues (2018) argued that
enjoyment of food and music share similar neural activations in the brain
and are both used to regulate feelings. They investigated the associations
between emotional eating, disordered mood and music-related mood
regulation, and found associations with depression, anxiety and stress.
Music-listening for releasing anger or sadness and emotional eating
were positively associated. Other music-listening strategies—including
entertainment, diversion or mental work—were associated in people
who had low levels of disordered mood. High levels of disordered mood
were associated with high levels of emotional eating but not with music-
listening strategies. This suggests that some music-listening strategies
might be able to be used as healthier alternatives to emotional eating. In
a retrospective analysis of songs written by adolescents with anorexia
nervosa, McFerran and colleagues (2006) revealed identity as the most
common theme. Mealtime is an anxious time for people with anorexia,
 15. Music and Physical and Mental Health  543

and music therapy has been used successfully to significantly reduce

post-meal-related anxiety (Bibb et al., 2015).

Addiction
Chronic drug abuse leads to a dopamine-deficient state in the
mesolimbic system, causing dysphoria in abstinence, leading to craving
and, subsequently, a return to drug use. Functional imaging studies
have shown that listening to personally pleasing music activates the
mesolimbic reward system in a fashion similar to that of drug abuse.
Such activation could therefore ameliorate dysphoria and the craving
of the hypodopaminergic state. Mathis and Han (2017) found that
listening to personally pleasing or moving music could reduce craving in
abstinent alcoholics. Twelve participants with alcohol-use disorder in a
residential substance rehabilitation unit reported on their level of craving
before and after listening to either a participant-selected song or white
noise. The music intervention had a significant advantage in reducing
craving compared to noise. Other studies on addiction have reported
that music therapy can improve perceived control, thus reducing
cravings. Silverman (2011) researched the effect of music therapy on
readiness to change and craving in patients in a detoxification unit. One
hundred and forty-one participants were allocated to a rockumentary
music therapy intervention, verbal therapy or a recreational music
therapy condition. There were significant differences between groups in
readiness to change, contemplation and action, with participants in both
music conditions having higher scores than those in the verbal therapy
condition. They also tended to have lower mean craving scores, and
perceived the intervention as helpful and enjoyable.
Group music-making activities such as choirs can enhance social
connections and provide a positive diversion for people overcoming
addiction. For instance, Liebowitz and colleagues (2015) investigated
how participation in a music-based performance and instruction
programme influenced the sense of engagement experienced by
participants in a residential setting for at-risk veterans. Participants had
opportunities to connect with others through shared interests, and the
connections forged with other residents extended beyond relationships
established in the choir through increased recognition associated with
performances. The choir provided a diversion from other concerns and
544 The Power of Music

may have served as a means of facilitating adjustment to change at a

measured speed.
Reviews of the impact of music therapy in relation to addiction report
a lack of consistency in research outcomes (Hohmann et al., 2017; Mays
et al., 2008). A scoping review of 3697 articles on the impact of music
in the lives of young adult drug users found that they valued music for
meeting emotional, psychological and social needs, particularly when
they were homeless. However, the research included in the review was
limited to considering the harmful consequences of music rather than
considering potential benefits (Lemaire et al., 2021).

Obsessive-Compulsive Disorder and Social Anxiety Disorder

Music can play a role in ameliorating the symptoms of obsessive-
compulsive disorder alongside pharmacotherapy and cognitive
behavioural therapy. In Iraq, Abdulah and colleagues (2018) evaluated
the impact of passive music-listening as an adjunct therapy with 36
patients aged from 19 to 65 years old. The experimental group received
seven 50-minute relaxing music tracks to listen to daily, in addition to
regular pharmacological treatment for a three-month period. Controls
received regular treatment only. The findings showed improvement in
the severity of the behaviours for the experimental group. Similarly,
Shiranibidabadi and Mehryar (2015) randomly assigned 30 patients with
obsessive-compulsive disorder to standard treatment, pharmacotherapy
and cognitive behaviour therapy, in addition to 12 sessions of individual
music therapy or standard treatment for one month. Music therapy
resulted in a greater decrease in checking and slowness but not for
washing or responsibility. Overall, music therapy as an adjunct to
standard care was effective in reducing obsessions, as well as comorbid
anxiety and depressive symptoms.
Listening to music has been found to reduce time spent dwelling
on threats in people experiencing social anxiety disorder. Lazarov and
colleagues (2017) examined the efficacy of a gaze-contingent music
reward therapy for social anxiety disorder, designed to reduce the extent
of dwelling on threats. Forty patients were randomly assigned to eight
sessions of either gaze-contingent music reward therapy (designed to
divert patients’ gaze toward neutral stimuli rather than threat stimuli)
 15. Music and Physical and Mental Health  545

or to a control condition. The music therapy yielded greater reductions

in symptoms than the control condition. These effects were maintained
after the intervention, which also revealed reduced time spent dwelling
on threats and socially threatening faces which had not been used in
training, suggesting that the outcomes transferred to other situations.

Schizophrenia
Music therapy can reduce some of the symptoms of mild schizophrenia,
including hostility, hallucinations, suspiciousness, emotional
withdrawal, poor rapport and difficulty in abstract thinking. Compared
with controls, those with schizophrenia receiving adjunct music
therapy have shown improvement regardless of the duration, frequency
or number of therapy sessions (Tseng et al., 2016). In a review of 18
studies with a total of 1,215 participants, undertaken during 7 to 240
sessions, Geretsegger and colleagues (2017) showed that in the medium
term, there were positive effects for adjunct music therapy on a range of
negative symptoms, social functioning and quality of life, although the
effects were inconsistent across studies and depended on the number of
sessions and the quality of the therapy. Working in a hospital emergency
psychiatric ward with 61 patients with psychosis, Volpe and colleagues
(2018) found that structured music therapy led to a decrease in anxiety,
depression and affective symptoms.
Liao and colleagues (2020) explored the factors which were important
for the effectiveness of group singing when social robots interacted with
individuals with schizophrenia. Nine participants aged 28 to 62 years old
participated in four group singing therapy sessions provided by a social
robot and an occupational therapist. Group cohesiveness, universality
and altruism were the most important factors related to the efficacy of
the programme. Similarly, Odell-Miller (2016) considered how music
therapists could use the music created by patients to better understand
their emotions and how they interacted with others.
546 The Power of Music

Music Therapy for Those with Autistic Spectrum Disorder or

Severe Learning Difficulties
Music therapists have worked with children on the autistic spectrum
disorder for many years, typically as a means to improve verbal and
non-verbal communication. Music can be particularly effective in
supporting the development of communication, as in itself it is a kind
of language (Ockelford, 2012). Using functional magnetic resonance
imaging, Sharda and colleagues (2015) showed that those with autistic
spectrum disorder had alternate mechanisms for speech and music
processing, and established that song could overcome the structural
deficit for speech. In a later study, Sharda and colleagues (2018)
evaluated the neurobehavioural outcomes of an eight- to twelve-week
music intervention with 51 autistic children aged six to twelve years
old. Song and rhythm improvisation improved communication and
the resting state brain functional connectivity between auditory and
subcortical regions and auditory and frontomotor regions, although
connectivity was lower between the auditory and visual regions, areas
known to be overconnected in those with autistic spectrum disorder.
Some children with autistic spectrum disorder excel at creative
activities, particularly music, having superior memory for pitch and
timbre and a high-level capacity for processing melodic and rhythmic
complexity (Janzen and Thaut, 2018). A survey of adults with autistic
spectrum disorder studied their special interests, the intensity of and
motivation for those interests, and their impact on quality of life.
Approximately two thirds of the sample reported having a special
interest, including computers, music, nature and gardening. Most
engaged with more than one. Having such interests was associated with
enhanced wellbeing, including social contact and leisure. However, very
high intensity of engagement with special interests was negatively related
to wellbeing (Grove et al., 2018). Even those on the autistic spectrum
without special musical skills can benefit from music therapy as a means
of enhancing social interaction, sensory perception, language and eye
contact (LaGasse, 2017). Musically enriched interactions can reduce
anxiety and aggressive behaviour and improve listening, attention span
and social interaction (Campbell, 2010), while auditory motor rhythmic
training can improve language acquisition and processing, as well as
 15. Music and Physical and Mental Health  547

speech control (Janzen and Thaut, 2018). However, not all interventions
have successful long-term outcomes. For instance, Dvir and colleagues
(2020) videoed the synchrony of body rhythms between four-to-six-year-
old children with autistic spectrum disorder and their music therapists
over a 20-week period. Higher levels of synchrony were found when
repetitive rhythmicity that occurred twice or more times per second was
used, but there was no long-term impact.
Although individuals with autistic spectrum disorder commonly have
deficits in processing complex emotional cues, the ability to identify the
emotional content of music is generally preserved. In Sweden, Theorell
and colleagues (2014) established that playing a musical instrument,
particularly in an ensemble, was associated with higher emotional
competence. There is further support for this from a review conducted
by Molnar‐Szakacs and Heaton (2012), who pointed out that many
individuals with autistic spectrum disorder showed an early preference
for music and were able to understand simple and complex musical
emotions in childhood and adulthood, despite the difficulties that
they experienced with communication and understanding of emotions
within the social domain. One study has even suggested that antenatal
music training and maternal talk could reduce the risk of children
developing autistic-like behaviours. In China, a study of 34,749 parents
of kindergarten children completed questionnaires which revealed that
antenatal music training and maternal talk to the foetus was associated
with a reduction in autistic-like behaviours (Ruan et al., 2018). Parent-
child integrated music activities can support the relationships between
children with autistic spectrum disorder and their parents or caregivers
(Lense et al., 2020), as can music-based parent coaching (Hernandez-
Ruiz, 2020), while musical activities which include children with autistic
spectrum disorder can reduce their being victimised by neurotypical
peers (Cook et al., 2018).
Some research has considered how music might help children
with learning difficulties more broadly. For instance, Mendelson and
colleagues (2016) studied a classroom-based music intervention for
improving communication skills in children with autistic spectrum
disorder or other intellectual disabilities in four elementary school
special education classrooms. The findings showed that 45-minute
weekly music therapy sessions promoted improvements in verbal
responsiveness. Working with young adults with severe learning
548 The Power of Music

difficulties, Pavlicevic and colleagues (2014) found that long-term

music-making provided them with ongoing opportunities for gaining
confidence and enhancing self-esteem, with feelings of shared
acceptance and success. In a case study of an individual with profound
learning difficulties, McFerran and Shoemark (2013) found that the
success of the therapy lay in a combination of attentive, responsive and
creative behaviour over time, with the music therapist listening and
taking responsibility for the structure of the activities, and the young
person spontaneously initiating activities—withboth participants
building a relationship over time. Biological markers of stress have
also shown a reduction following music therapy in individuals with
intellectual disabilities and autistic spectrum disorder (Poquérusse et
al., 2018). Community music activities can also benefit those with mild
to profound learning difficulties, increasing their self-confidence and
enabling wider recognition of their musicality (Wilson and MacDonald,
2019).
Reviews of the impact of music on individuals with autistic
spectrum disorder have generally shown positive outcomes, including
improved non-verbal and verbal communication, motor development,
coordination, body awareness, sensory perception, social emotional
reciprocity and a wide range of social skills (Geretsegger et al., 2014;
Janzen and Thaut, 2018; Shi et al., 2016; Srinivasan and Bhat, 2013;
Vaiouli and Andreou, 2018). In addition to the impact on these functions,
De Vries and colleagues (2015) showed that music reduced anxiety and
improved cognitive skills, attention to task, enhanced body awareness,
self-care skills, and the expression, recognition, understanding and
processing of emotions. Ragone and colleagues (2021), focusing on the
use of technology with children with autistic spectrum disorder, showed
a relationship between sound-based activities and improvement of
motor and social skills. The reviews all point out the limitations of the
research, particularly in terms of the small sample sizes and variation in
the kinds of therapy and outcome measures, while still acknowledging
the benefits. In contrast, Simpson and Keen (2011) gave limited support
for the use of song-writing or improvisational therapy to facilitate social,
communicative and behavioural skills in young children with autism
spectrum disorder. Music has been successful in increasing exercise
intensity and important in reducing the risk of obesity, sleep disorders
 15. Music and Physical and Mental Health  549

and stereotypical behaviours common in children with autism spectrum

disorder, although the effects are mediated by the extent to which the
exercise is structured, the nature of the music and the characteristics of
the child (Woodman et al., 2018).
Some research has focused on the nature of effective music teaching
for children with a range of learning difficulties and autism. Gerrity and
colleagues (2013) showed that the use of repetition, giving students
choice and allowing for longer response time were important teaching
strategies, while children themselves found it important to have clear
directions and expectations, a behaviour plan, and fostering a positive
atmosphere that was free of distractions. Thompson and colleagues
(2020) gathered the perspectives of autistic individuals aged 18 to 25
years old to inform the design of music-making workshops using an
online survey and structured interviews, and showed that participants
expected a welcoming atmosphere and an acceptance of diversity.

Overview
Psychological wellbeing and physical health are closely linked. The
former can enhance recovery from illness and limit its occurrence,
while stress and anxiety can contribute to ill health. Music can enhance
wellbeing, but equally it can contribute negatively to psychological health
(if depressing or aggressive music is listened to constantly, particularly
in the presence of others). Music-making in ensembles activates many
regions of the brain, enhancing the connections between them, while
listening to music—which constitutes an aspect of making music—
impacts on brain regions associated with arousal, the emotions, reward
and pleasure. The rhythmic aspects of music impact on movement, while
whether music is slow, fast, quiet or loud affects arousal, mood and
emotion. Musical preferences have a major influence on whether music
therapy is effective. In these different ways, music can influence mental
and physical health positively or negatively. In addition to the direct
effects of music, therapy interventions typically involve interactions with
other people, the therapist and other participants. The social interactions
involved in music-making and listening with others are important in the
impact of music on mental and physical health, and can be more or less
positive. The therapist or facilitator and the approaches that they adopt
550 The Power of Music

are also important mediators. It is not possible for research to untangle

the differential impact of music itself and the social interactions with
others that may accompany it. Overall, predicting the outcome of any
musical intervention on mental or physical health is complex because of
the interaction of these factors. This complexity can also account for the
different research outcomes.
 16. Music, Inclusion and
Social Cohesion

Music has a wide range of functions. These were set out in detail in
Chapter 1. One of the most important functions is the role of actively
making music in encouraging social bonding. This function has
been argued to have an evolutionary basis (Huron, 2001). Harvey
(2018) suggests that music and music-related behaviours, along with
language and speech, were important for early evolution in helping to
promote emotional synergy and social bonding, and foster group-level
cooperation and coordination. Savage and colleagues (2020) argue that
the evolution of musicality involved gene and cultural coevolution,
where proto-musical behaviours that began as cultural inventions had
effects on biological evolution through their impact on social bonding.
Repetition, synchronisation and the combination of harmony, rhythm
and pitch provided social rewards through linking brain networks,
physiological systems and behaviours. Cross (2003) argues that
music may be particularly suited for supporting social bonding, as it
is generally free of risk and its meaning can be interpreted in different
ways, allowing humans to interact and share experiences, even though
each participating individual may have different perspectives, goals
and relationships. Music can promote survival through the way it
synchronises the moods of many individuals, who can then collectively
take action to protect and defend themselves from attack (Dowling and
Harwood, 1986). Moving together rhythmically seems to reinforce this
process (Hove and Risen, 2009; Kogan, 1997; Trainor, 2014). Further
support for the role of music in social bonding is the fact that music
occurs in every human culture and subculture, unless it is deliberately
suppressed. It is the most universal human behaviour on record (Merker
et al., 2015). Mehr and colleagues (2020) support the evolutionary role

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.16

552 The Power of Music

of music in relation to coalitional interactions, but also emphasise its

importance in infant care.
Humans, as a species, face considerable challenges compared with
primates as to how to maintain social bonds with groups much larger
than those of primates. Music might provide a way of achieving this
(Freeman, 2000). Rhythmic activities induced by drum beats or music
can lead to altered states of consciousness, through which mutual trust
among members of societies can be engendered. This proposition has
been supported by empirical research. For instance, Weinstein and
colleagues (2016) recruited individuals from a community choir that
met in small groups (20 to 80 people) and large groups (232 people).
Feelings of inclusion, connectivity and positive affect increased
after each 90-minute singing rehearsal in the small choir, but greater
increases were reported for those in the large choir, suggesting that
singing together fosters social closeness—even in large group contexts
where individuals are not known to each other. Similarly, Pearce and
colleagues (2015) followed newly-formed singing and non-singing adult
education classes over a period of seven months. Participants rated their
closeness to their group before and after classes at three timepoints: one,
three and seven months. Singers and non-singers felt equally connected
after seven months, but much faster bonding occurred in the singing
group after only one month. Singing may have evolved specifically to
bond together large human groups of relative strangers quickly, their
willingness to coordinate with others supported by the way that music
generates positive emotions.
All group music-making involves a strong element of sociability
(Finnegan, 1989). The links between music, social bonding (Cross,
2009; Hagen and Bryant, 2003) and emotion (Juslin and Sloboda,
2001) may explain why group music-making enhances wellbeing.
Sloboda (1985) suggests that music-making is rewarding, in part
because it generates social bonding and cultural coherence. Its role in
a range of ceremonies supports this (Roederer, 1984). Social networks
developed through music-making support group identity, collective
thinking, collaborative learning, friendship, social support, a sense of
belonging, synchronisation, catharsis, and the collective expression
and experience of emotion (Brown, 1991; Faulkner and Davidson, 2004;
Coffman, 2002; Creech et al., 2013a; Lehmberg and Fung, 2010). In a
 16. Music, Inclusion and Social Cohesion  553

recent example, Arditi (2020) suggests that when musicians in popular

bands perceive their performance identity as linked to the identity of
the band, the group has greater solidarity and is more likely to remain
together. While music can support the formation and maintenance
of group identity, and promote cooperative behaviour, conversely it
can create the potential for hostility towards outgroups. For children
and young people, group music-making offers the opportunity to
engage in wide cultural experiences, explore new ideas, places and
perspectives, and support social cohesion (Israel, 2012). This not only
benefits participants but also increases the involvement of parents and
carers, and their attendance at cultural events and exposure to culture
more generally (Creech et al., 2013).
The biological underpinnings of social bonding in primates involve
endorphins and the endogenous opioid system. These are released
during synchronised exertion (Tarr et al, 2014) and are associated
with several human behaviours, including laughing and synchronised
sports, as well as singing and dancing. Passively listening to music also
engages the endogenous opioid system. Identifying self as part of a
group, combined with the activity of the endogenous opioid system,
may be important in the way that music promotes social bonding.
Endorphins are released during synchronised movements which also
have an effect on social bonding, social behaviours and oxytocin levels
(Weinstein et al., 2016). Kreutz (2014), studying the psychobiological
effects of amateur choral singing in comparison with dyads chatting to
each other, showed patterns of change favouring singing over chatting,
suggesting that singing enhanced individual psychological wellbeing,
as well as inducing a sociobiological response. Similarly, Grape and
colleagues (2003) observed significant increases of oxytocin—which
plays a fundamental role in social behaviours—in both professional and
amateur singers after a singing lesson.
Participating in musical groups requires attention to be paid to the
actions and intentions of other group members and their physical and
emotional states, in addition to being able to communicate emotions
and respond to those of others (Cross et al., 2012). Group music-making
promotes the activity of neural networks that connect areas of the brain
associated with social cognition and music production (Sanger et al.,
2012). This is key to the development of empathy. Musical participation
554 The Power of Music

can enhance empathy in children (Rabinowitch et al., 2013) and may

also increase emotional sensitivity (Resnicow et al., 2004). In young
people, music preferences can indicate similar or different values, with
similarity contributing to social attraction, explaining how musical
bonding can occur in a range of different cultures (Boer et al., 2011).
Human interactions sometimes require that behaviour is coordinated
(Keller et al., 2014). Such synchrony promotes positive social behaviour.
For instance, infants who were bounced in synchrony with an
experimenter were subsequently more likely to help the experimenter
when they dropped objects which were needed to complete a task than
those bounced out of synchrony (Trainor and Cirelli, 2015). The pleasure
of performing in temporal synchrony with others may also have wide-
ranging consequences for wellbeing and overall functioning (McNeill,
1995). For instance, Hove and Risen (2009) showed that degree of
synchrony in tapping tasks predicted subsequent affiliation ratings.
One of the most frequently cited benefits of group music-making
is its impact on prosocial behaviour. Young children have shown
enhanced cooperation and helpful behaviour in musical as opposed
to non-musical conditions (Kirschner and Tomasello, 2009; 2010). The
El Sistema programme and projects inspired by it facilitate prosocial
behaviour (Creech et al., 2013; 2016). Intensive ensemble activities
are seen as providing opportunities for nurturing positive citizenship,
including respect, equality, sharing, cohesion, teamwork, and the
enhancement of listening skills as an important element in promoting
understanding and cooperation (Majno, 2012). Research in the USA has
shown that involvement in group music activities in high school helps
individuals learn to support each other, maintain commitment and
bond together to achieve group goals (Sward, 1989). Band participation
has positive benefits on maturing relationships, teamwork, cooperation,
sense of belonging, companionship and social development (Brown,
1980). In adolescence and young adulthood, music-listening in families
and peer groups contributes to family and peer cohesion. This applies
across a range of cultures including Kenya, the Philippines, New
Zealand and Germany (Boer and Abubakar, 2014). In a large study of
30,476 people in the UK, Van de Vyver and Abrams (2018) found that
greater engagement with the arts, including musical activities, predicted
greater prosociality, volunteering and charitable giving.
 16. Music, Inclusion and Social Cohesion  555

Joint music-making provides opportunities for developing skills

relating to citizenship. It can encourage tolerance and the development
of social ethics, increase acceptance of children with intellectual
impairments (Humpal, 1991; Jellison et al., 1984) and enhance concern
with wider community issues (Miksza, 2010). Wiltermutt and Heath
(2009) showed that students in the USA scored higher on a coordination
exercise and a public-good game after singing along with a song played
on headphones compared to no singing or forced asynchronous singing.
Music-making can also be used to teach leadership skills to children
in primary and secondary schools (Hallam, 2017), where they learn to
communicate verbally and musically with other children.

Music and Conflict

There can be no greater illustration of the power of music than its role
in conflict situations. The relationship between music and conflict is
complex. Music has not always been used to promote peace. It can be—
and has been used by—those who desire to create or maintain conflict.
Bergh and Sloboda (2010), in a review of the literature, outlined the ways
in which music can support conflict. They give examples of how music
has been used to support preparations for war. For instance, in Nazi
Germany, music was used to accompany large rallies, with the purpose
of developing a sense of cohesion (Reinert, 1997). In Croatia, music was
used to develop nationalist feelings before the start of the war (Pettan,
1998), while Serbians used folk music to bolster the concept of Serbian
uniqueness (Hudson, 2003; Bohlman, 2003). Similarly, Albanians used
music videos to attempt to create a national identity in preparation for
war (Sugarman, 2006). For centuries, music has been used to support
militia as they face battle, drums offering rhythm to support marching
together, while drums, bugles and bagpipes have been used to bolster
courage (McNeill, 1995). More recently, in Iraq, American soldiers played
loud, aggressive music while engaging in dangerous activities (Gittoes,
2006). In some countries, music has been used to promote revolution.
Songs can be used as calls for action. For instance, congregational music
represents solidarity and a sense of collective identity in the civil rights
movement (Ward, 1998). Boulanger Martel (2020), drawing on data
relating to the production of music between 1988 to 2019 of the Fuerzas
556 The Power of Music

Armadas Revolucionarias de Colombia, argued that cultural production

was employed to bolster rebel-group legitimacy: internally by justifying
the existing hierarchical relationships between leaders and fighters, and
externally by identifying the rebel group as a legitimate alternative to
the existing establishment and a rightful representative of the people.
Typically, in conflict situations, music is employed with multiple
purposes. For instance, in the 2nd World War, in the ghettos and
concentration camps, music played a complex role in daily life. It was
used to help to alleviate distress among those who were incarcerated
(Gilbert, 2005) but at the same time to intimidate and demonstrate
power (Pettan, 1998). Moreno (1999) reviewed the meaning and
sometimes therapeutic role of music for victims and perpetrators during
the Holocaust, demonstrating the importance of music in times of stress.
Music was used for humiliation and torment. Musical censorship was
applied and music was used for deception, distraction and masking.
The prisoner orchestras demonstrate how musically induced humane
feelings were separated out, with sentiment and nostalgia coexisting
alongside denial and indifference to the way that others were suffering.
Recently, loud noise and music have been used as a means of torture,
to challenge beliefs (Cloonan and Johnson, 2002), or to torment and
humiliate prisoners of war (Cusick, 2006). Bayoumi (2005) reported
how detainees have been subjected to music at high volume which has
been designed to destroy their minds. In Guantánamo Bay, Eminem,
Britney Spears, Limp Bizkit, Rage Against the Machine, Metallica and
Bruce Springsteen have been played at excessive volume for long periods
of time. Detainees indicated that music was used as a weapon designed
to deprive them of sleep, cause overstimulation and be psychologically
intolerable.
In contrast to promoting conflict and causing distress, music has
been used over many years in attempts to resolve conflict and support
peace. For instance, the Buwaya Kalingga people established peace
pacts that were consolidated through feasts and the use of specific
songs (Prudente, 1984). Bergh and Sloboda (2010), in a review, point
out that since the early 1990s there has been increasing use of music and
arts to reduce conflict. In the Balkans and between Israel and Palestine,
music and the arts have frequently been used in mediation efforts. In
the Sudan, music was used as a meeting place between 29 different
 16. Music, Inclusion and Social Cohesion  557

ethnic groups who had been displaced as a result of the 22-year civil
war (Bergh, 2007). Other initiatives have included the recording of
joint Israeli-Palestinian CDs, music therapy with children (Ng, 2005)
and brass-band performances for children from different ethnic groups
(Veledar, 2008). Bornstein (2008) has researched artistic and religious
contributions to peace building in Indonesia, while music and poetry
have been used to attempt to resolve conflict in Cyprus (Ungerleider,
1999) and elsewhere (Epskamp, 1999). Bang (2016), in a review of
the literature, investigated how artistic engagement could facilitate
transformative learning and the development of skills and capacities for
more constructive engagement with conflict, fostering new perspectives
and, ultimately, cooperative relationships. Zelizer (2003; 2004), working
in Bosnia, Herzegovina, focused on the process of artistic interventions,
suggesting that conflict could be resolved by expanding the identity of
participants beyond current group identities. Also focusing on process,
Weaver (2001) argued that reconciliation between parties in conflict
should be viewed as a creative process, while Zelizer (2003; 2004)
suggested that changing emotions, not rational thought, was necessary
to achieve reconciliation after civil war.
Much of the research on conflict reduction has been criticised because
outcomes have been based on the perceptions of those organising
the programmes and the musicians delivering them, rather than the
participants (Cohen, 2005a). This may have distorted the reported
effectiveness of programmes. For instance, Fock (2004) found that
teachers in a Danish multicultural music project were more cautious
when reporting change in pupils than they were in responses given
in questionnaires which had to be returned to the organisers. Cohen
(2005a) suggested that, to be effective, projects should connect with other
conflict resolution interventions and take greater account of the context.
Lederach (2005) also considered how artists could contribute to peace-
building, while in a review (but also using empirical data collected from
conflict transformation projects in Sudan and Norway—Bergh, 2007;
Bergh, 2008; Bergh, 2011), Bergh and Sloboda (2010) concluded that
most interventions were ineffective in the long term because they did
not relate to participants’ daily lives. It seems that, to be effective and
make sustainable changes, programmes need to take place over many
years. Some multicultural projects, where music from other cultures
558 The Power of Music

is shared, can emphasise differences between groups rather than

the similarities. This can exacerbate the issues which the programme
intended to address. The imbalance in power between organisers, those
delivering the programme and participants can also be a problem in
establishing efficacy (Zelizer, 2004). Haskell (2005) suggests that issues
of power and control need to be taken into account in all interventions,
as weaker parties may agree to avoid future negative consequences.
Academic research in this area has been criticised for sometimes having
too great an emphasis on theory rather than practice (Robertson, 2006).
Despite these difficulties, there continue to be discussions about how
music might help in supporting the resolution of conflict (Lopez, 2008;
Urbain, 2007). As considered in Chapter 15, there has been increasing
interest from music therapists in developing interventions to support
those traumatised by conflict (Edwards, 2005; Ng, 2005).
Some research has focused on the relationship between social
cohesion and patriotism. Hamzah and colleagues (2021) studied the
impact of music in Malaysia, which became independent in 1957.
The national anthem and patriotic songs were mobilised by the state
to foster a sense of national cohesion and collective identity. These
songs were popular and accepted by Malaysian citizens from diverse
backgrounds as a part of their national identity. This was supported by
their repetition on national radio, television and social media platforms.
Group discussions were conducted and revealed that patriotic songs,
rather than commercial popular songs, were more popular and wide-
reaching in appeal across different professions, ethnicities, religions
and geographic locations. Patriotic music provided a means for social
cohesion through the personal, intimate and affective associations that
such songs solicited from individual citizens. Johan (2020)—drawing
on cases of intercultural intimacy found in the production, performance
and studio recordings of Malaysian artists and groups—revealed how
Malaysian popular music, specifically from the stage of maturing
nationhood during the 1970s and 1980s, provided an important means
of intercultural cohesion among citizens from a range of ethnicities,
religions and social classes. It offered intimate, creative expression that
facilitated the process of everyday social cohesion.
In the same way that music can be used to promote conflict, it can
also be used to increase prejudice. For instance, Corte and Edwards
 16. Music, Inclusion and Social Cohesion  559

(2008) researched the use of punk music by white power activists. At

the end of the 1970s, a racist rock music movement known as White
Power music emerged in Great Britain connected to political parties of
the extreme right. Throughout the 1990s, it expanded significantly into
a multi-million-dollar international enterprise, promoting White Power
musicians performing in a wide range of musical genres. The music
had a particular role in recruiting new adherents, especially young
people. The authors concluded that White Power music continued to
play a significant role in the mobilisation of racist political and social
movements by drawing in new recruits, cultivating a racist collective
identity, and generating substantial sums of money to finance a range
of racist endeavours. In contrast, Roberts (2009) provided examples of
punk involvement in left-wing social movements, including the Rock
Against Racism movement in the UK and the Peace movement in the
US. The punk ethic of independent media construction at the centre of
the punk movement made it possible for punks to make connections to
various social movements, in addition to altering the dynamics of those
social movements. Eyerman (2002), drawing on research on the Civil
Rights movement in the United States, the memory of slavery in the
formation of African-American identity and the place of white-power
music in contemporary neo-fascist movements, outlined how music can
act as a political mediator.
Some research has focused specifically on using music to reduce
prejudice. For instance, in Northern Ireland, Odena (2010) studied the
perceptions of 14 practitioners engaged in musical activities in cross-
community settings, working with Protestant and Catholic groups.
Interview data showed that cross-community music education projects
were an effective means of addressing prejudice amongst young people,
but the specific contexts of each setting put limits on what could
be achieved. Similarly, folk songs have been used in Israel to bring
Palestinian and Jewish children and their families together during cross-
community school visits (Lichman, 2006; Lichman and Sullivan, 2000).
Songs promoting social inclusion can reduce prejudice, discrimination
and aggression between groups and promote cultural understanding.
For instance, Greitemeyer and Schwab (2014), in a series of experiments,
showed that participants who had listened to songs with pro-integration
relative to neutral lyrics expressed less prejudice and were less aggressive
560 The Power of Music

and more helpful towards an outgroup member. These effects were

unaffected by liking the song or the mood and arousal properties of the
songs employed, suggesting that it was the pro-integration content of the
lyrics that achieved the effects. Clarke and colleagues (2015) reported
the outcome of an empirical study demonstrating that passive listening
to music of an unfamiliar culture could significantly change the cultural
attitudes of listeners who had high levels of empathy. Research in other
areas relating to the way that music can bring about change has shown
that sustainable change tends to occur where participation is active and
involves participants in the regular use of musical skills over a period of
months as opposed to days (Spychiger et al., 1993; Harland et al., 2000).

Music and Refugees

For many years, Australia has been one of the most multicultural
countries in the world, although globalisation increased the number
of people arriving from countries with vastly different backgrounds,
experiences, ideologies, values and belief systems. Gifford and colleagues
(2009) carried out a longitudinal study to explore the experiences of
120 newly arrived young people with refugee backgrounds. In their first
year at a school focused on developing their English language skills,
with the exception of instances of teasing and bullying, their experience
was positive, but on transition to mainstream school they felt that they
had inadequate English language skills to engage fully with educational
requirements. They felt less supported by teachers, their academic work
declined, as did their feelings of belonging and safety, and there was
a significant increase in experiences of discrimination. Most did not
complete secondary education, instead seeking further technical training
or employment. Many were not part of an intact family, and family
instability was a feature of their lives, with family support weakening
over time. This may be why they valued their wider ethnic community.
Most experienced discrimination or violence because of their ethnicity,
religion or colour. Despite their often traumatic lives prior to arrival, they
exhibited considerable personal strengths, but nevertheless faced many
challenges. This, coupled with the burdens shouldered by their families,
had an impact on their ability to reach their full potential in the early
years of settlement in Australia. Perhaps because of the large number
 16. Music, Inclusion and Social Cohesion  561

of immigrants, there has been considerable research in Australia about

the possible impact of music in supporting their integration. For young
children, playground games provide a mechanism through which they
can be included in the school environment while retaining connections
with their home cultures (Marsh and Dieckmann, 2016; 2017). Marsh
(2016) explored how music participation, specifically participation in
musical play, could contribute to the wellbeing of newly-arrived refugee
and migrant children, providing new musical and social beginnings.
Specific reference was made to children from Iraq, South Sudan and
Sierra Leone in Australia, Punjabi children in the UK and newly arrived
Central and South American immigrants in the USA. In a school catering
for newly-arrived immigrants, music was used to support acculturation
and integration (Marsh, 2012a; 2012b). Young people aged 12 to 18 years
old participated in musical activities designed to provide opportunities
for cultural maintenance, cross-cultural transmission and verbal and
non-verbal communication, with a view to developing interpersonal
connections, social cohesion and empowerment through varied
learning, teaching and performance opportunities. Participation in
performance in a major school concert was important in achieving these
aims. The key outcomes for students included feelings of belonging to
the school community, the wider Australian community, as well as to a
global music community, reached through various technological media
(Marsh, 2012a; 2012b). Marsh (2015) focused on the collaborative
music and dance activities of a Sierra Leone youth group attending
an intensive English language centre for newly arrived students. For
these marginalised young people, the music and dance activities,
conceived within a socially just framework, provided opportunities
for participatory parity, cultural justice and social inclusion within
communities from both the home and host cultures.
Also in Australia, Crawford (2017; 2019) reported the findings of a
case study that investigated the impact of music education on students
in a school in Victoria. Music education was used as a vehicle to engage
young people with a refugee background. The findings indicated that
classroom music which fostered socially inclusive practices resulted
in a positive transcultural learning space, which supported young
refugees, fostering a sense of wellbeing and belonging and an enhanced
engagement with learning. While some of these benefits were not always
562 The Power of Music

clearly distinguished from the more general experience of school, the

students did identify some elements of music-learning and teaching that
they linked to these outcomes. In a multiple case study of three schools
in Victoria, Crawford (2020) explored the perceptions, experiences
and practices of teachers directly or indirectly involved with music
education in schools that had a high percentage of young people with
a refugee background. Intercultural competence and socially inclusive
behaviours were seamlessly embedded in the music learning activities
on offer. These were student-centred, active, practical, experiential and
authentic.
Also in Australia, Lenette and colleagues studied a group of music
facilitators who regularly attended an immigration transit accommodation
facility to share music and singing activities with detained asylum
seekers. The monthly written observations of the facilitators were
analysed and revealed links between music and singing and the health
and wellbeing of detained asylum-seekers related to humanisation,
community, resilience and agency. Sunderland and colleagues (2015)
reported the outcomes of an exploratory narrative study on the impact
of participatory music-making on the social determinants of health and
wellbeing of refugees in Brisbane. They mapped reported outcomes for
five refugee and asylum-seeker members of a participatory Brisbane-
based music initiative, the Scattered People. Three key aspects were
critical for wellbeing: cultural expression, music-making, and the
consolidation of personal and social identity. Cain and colleagues
(2020), using qualitative methods, explored how participatory music-
making within immigrant communities could influence wellbeing. Three
broadly defined cultural groups living in the region participated: people
of Baltic origin, from Latin American and Caribbean backgrounds, and
newly arrived immigrants and refugees. Individual interviews were
analysed and showed how musical involvement affected mental, social
and emotional wellbeing. Focusing on the staff of a refugee and asylum-
seeker music programme, Sunderland and colleagues (2016) showed
that they shared a common concern for promoting social justice using
music participation, creation and dissemination.
Some research in Australia has been concerned with the experiences
of migrant musicians. Mani (2020) investigated the multiple and often
marginalised ways of being, knowing, educating and performing
 16. Music, Inclusion and Social Cohesion  563

in migrant musicians in South East Queensland. The wide range of

activities that they undertook in their new homes not only built their
capacity but also added culturally derived value to their lives and the
lives of those that they encountered. Three key features were central to
their lives and livelihoods: connectedness, self-identity, and wellbeing.
Magowan (2019) considered how complex emotional dynamics
emerged between music facilitators, music producers and asylum-
seekers as they variously navigated experiences of dislocation and
replacement. The recounting of painful journeys immersed singers and
music producers in reciprocal recognition and reimagining of events
in an empathic process, empowering asylum-seekers and Aboriginal
Australians through their songs.
As in Australia, a considerable body of research has been undertaken
in Norway. In 2020 just over four percent (238,291) of the Norwegian
population had a refugee background. In the region of 21,000 of these
refugees were children between six and fifteen years of age (Statistics
Norway, 2020). In 1989, the Norwegian concert agency initiated a
three-year programme of introducing multicultural music-teaching in
Norwegian primary schools. Eighteen schools in and around the capital
took part in a research project to determine the effects of immigrant
musicians introducing the music of their countries of origin to fourth-
grade children. Positive results emerged, particularly with regard to
reduced harassment and ethnic tension. Multicultural music is now
regularly on the school concert agenda, with a total of 3,000 such
concerts having been presented to more than a quarter of the total
Norwegian school population (Skyllstad (1995; 1997). Skyllstad (2000)
initiated a three-year research project aimed at understanding the
cultural traditions of immigrant communities in Oslo, and preventing
discriminatory attitudes. The project also aimed at releasing and
promoting the artistic talents and resources in immigrant communities
through cooperation with leading artists from countries of origin in
the fields of music and dance. Participating schools benefited from the
programme through improved interethnic relationships, a reduction
in incidents of harassment and the enhanced self-image of immigrant
children, who were more easily accepted. Other intercultural initiatives
followed. A multicultural music centre was founded, which arranged a
yearly world music festival. Similar projects have been established—for
564 The Power of Music

instance, Einarsen (1998) and Fock (2004)—but have generally had

less positive outcomes than those reported by Skyllstad (1995; 1997).
Bergh (2007) followed up the performances of traditional folk and
classical music by musicians from the home countries of immigrant
groups 13 years later and found that, although participants recalled the
programme and enjoyed it at the time, it had had little impact on their
daily lives and their relationships with other groups as they did not see
any connections between the musical performances, the musicians or
the populations of these countries. In contrast, Enge and Stige (2021)
explored music therapy in a public primary school in a rural area of
Western Norway which focused on refugee children’s social wellbeing,
with an emphasis on their peer community. The children who were
offered music therapy faced various challenges, including living in
difficult home situations or struggling academically or socially. The
music therapy had a participatory and exploratory character, and
successfully nurtured the children’s capacity to regulate their emotions
and engage in social participation.
Studying a refugee camp in Greece where people from Iraq and
Syria had been living for up to a year, Millar and Warwick (2018) aimed
to improve understanding of the relationship between music and the
wellbeing of young refugees aged 11 to 18. Data were collected over a
five-week period through observation of individual music lessons and
group music workshops involving between three to twelve participants
and semi-structured interviews. The findings showed that actively
making music could impact positively on young people’s wellbeing,
enabling the development of emotional expression, improved social
relations, self-knowledge, positive self-identification and a sense of
agency. In London, Clini and colleagues (2019) undertook a collaborative
study using focus groups and in-depth semi-structured interviews with
asylum-seekers and refugees, and showed that participants articulated
the impact of creative activities around three main themes: skills, social
engagement and personal emotions. The activities helped participants
to find a voice, create support networks and learn practical skills useful
in the labour market.
In Wales, Vougioukalou and colleagues (2019), using observations
and interviews, explored the effect of participating in weekly structured
musical activities and improvisation, as well as at public performances.
 16. Music, Inclusion and Social Cohesion  565

They observed that improvisation encouraged individual unscripted

performances, instilled confidence in solo performance, gave individuals
who had experienced displacement and marginalisation a chance to lead
in a safe, performative space, gave other participants a chance to follow
and accompany these compositions instrumentally or vocally (drawing
on their own cultural traditions, thus creating innovative cross-cultural
pieces), and provided participants and audience members with a unique
and irreplicable experience that triggered their imaginations, prompting
questions and further discussion between participants. These findings
suggest that the combination of structured and improvisational musical
activity can help to foster a sense of wellbeing and social inclusion,
change power dynamics, create opportunities for cross-cultural dialogue
and create a community out of people from different locations and
situations. The Welsh choral tradition and arts in the local community
provided a receptive environment for this diverse group of performers,
connecting them to the wider local community arts scene that led to
individual, collective and wider societal benefits. In the USA, Muriithi
(2020), using interviews and observations of performances, explored
the lived experience of six refugee musicians who had been involved in
music prior to entering the USA. Traumatic experiences resulted in their
fleeing from their homes to seek refuge elsewhere. After being resettled
in the United States, they continued to suffer from the experience of
loss, the need to adapt and change, and the struggle with trauma and
negative emotions. Music was their method of healing trauma and
facilitating integration. It supported healing, enabling them to forget
problems, communicate a message of hope and integrate, thus reducing
isolation and loneliness.
In a review, Henderson and colleagues (2017) identified the possible
positive health and wellbeing outcomes of participatory music activities
for culturally and linguistically diverse people who could be described as
vulnerable or at risk in particular migrant populations. They concluded
that there was insufficient evidence from the existing research to draw
clear conclusions. Similarly, Lennette and Sunderland (2016) mapped
the potential for participatory music practices to support health and
wellbeing outcomes for asylum-seekers and refugees in conflict settings,
refugee camps and resettlement contexts. The findings highlighted the
different roles that music had in people’s lives as they moved towards
566 The Power of Music

resettlement, and how music might support health and wellbeing in this
population.

Social Inclusion
There have been several approaches to defining social inclusion. An
overarching approach considers it in terms of the interaction between
psychological and sociological factors, including:
• motivation;
• loneliness;
• self-efficacy;
• anxiety;
• self-esteem;
• self-regulation;
• identity;
• development;
• feelings of contentment and belonging;
• social relationships and networks;
• group coherence and dynamics;
• marginalisation;
• integration;
• interaction;
• social sharing; and
• enabling social relations (Baumeister et al., 2005).

As considered in earlier chapters, music can play a role in enhancing

social inclusion in many everyday situations rather than being limited
to those relating to large-scale conflict. Music-making has been used to
support children and young people who are at risk through poverty,
prejudice, disaffection or involvement with the judicial system. For
instance, Ho and colleagues (2011) reported positive changes in
wellbeing and mental health following a drumming intervention
with low-income children, while Barrett and Bond (2015) found that
 16. Music, Inclusion and Social Cohesion  567

participation in a music programme enhanced the musical, academic

and social competence and confidence, connection, character and
caring of students in four socioeconomically disadvantaged school
settings. Similarly, Fanian and colleagues (2015) evaluated a creative
arts workshop for Tłįchǫ youth in circumpolar, arctic and subarctic
regions which enabled young people perceived as ‘at risk’ to explore
critical community issues and find solutions together using the arts.
Observations, focus groups, questionnaires and reflective practice
were adopted. Participating young people reported gaining confidence
and new skills, artistic and personal. Many found the workshops to
be engaging, enjoyable and culturally relevant, and they expressed an
interest in continuing their involvement with the arts and spreading
their messages through art to other young people and others in their
communities. However, the short-term nature of some programmes
makes drawing conclusions about their efficacy difficult. For instance,
Millar and colleagues (2020) reported on a project involving 16 sessions
of participatory music-making with 32 hard-to-reach young people aged
12 to 17, which aimed to engage them on their own terms through music
that resonated with their lived experience, but their need for stability
required more long-term engagement.
In the UK, positive benefits for self-efficacy and self-esteem have been
found for looked-after children (Dillon, 2010) and those in the criminal
justice system (Daykin et al., 2012). Programmes for juvenile offenders
have successfully addressed complex mental health symptoms and
behavioural regulation difficulties, and increased academic performance
and family functioning (Bittman et al., 2009; Rapp-Paglicci et al., 2012)
Coutinho and colleagues (2015a; 2015b), in two reviews, showed the
possible benefits of a range of music interventions with adult offenders,
while in Norway, Waakter and colleagues (2004) researched the impact
of music on young people who had experienced serious and multiple
life stresses. Cain and colleagues (2016) carried out a review to explore
whether participatory music activities could promote positive outcomes
for young people from culturally and linguistically diverse communities
characterised as ‘at risk’, and reported a range of positive wellbeing and
health outcomes, in addition to enhanced cultural empathy.
Delgado (2018) argued that the performing arts can be implemented
effectively to attract young people in schools, out-of-school settings, or
568 The Power of Music

what has been referred to as the ‘third area’ between school and family.
The latter are non-stigmatising, community-based venues that can
supplement or enhance formal education, providing a counter-narrative
for young people to enable them to resist the labels placed on them,
serving as a vehicle for reactivity and self-expression. The performing
arts can support creative expression that can be transformative
for individuals and communities. Group music-making offers the
opportunity to engage in wider cultural experiences and explore new
ideas, places and perspectives; it supports social cohesion through
broadening experiences (Israel, 2012). Benefits can extend beyond those
for participants to include families and whole communities (Creech et
al., 2016)
Some research has been undertaken in the context of school music
education. Early research in Switzerland showed that increasing the
amount of class music within the curriculum did not have a detrimental
effect on language and reading skills, despite a reduction in time in these
lessons (Spychiger, et al., 1993; Zulauf, 1993), but led to increased social
cohesion within class, greater self-reliance, better social adjustment
and more positive attitudes. These effects were particularly marked in
low-ability, disaffected pupils (Spychiger et al., 1993). In Finland, Eerola
and Eerola (2013) studied 735 children, some of whom participated in
extended music education classes from age nine for four hours each
week, compared with just over 80 minutes for the remaining children.
By the end of the programme, the children receiving additional classes
reported a more positive classroom climate and more satisfaction with
school life. However, those attending the additional classes were selected
because of their strong musical skills. This may have influenced the
outcomes, although other factors may have been important, including
shared musical interests, positive feedback from public performance,
intense emotional experiences, feelings of affiliation and the prosocial
effects of joint musical activities.
In a national study of 2000 children in the UK, Sing Up, those who
were relatively more musically skilled were more likely to report
themselves as being more socially included (Welch et al., 2010). Later
analysis (Welch et al., 2014) matched data from 6087 participants
following three years of the Sing Up project, and suggested that
engagement in musical activities impacted on sense of self and sense
 16. Music, Inclusion and Social Cohesion  569

of social integration irrespective of age, sex and ethnicity. Similarly,

Rinta and colleagues (2011) explored the connections between
children’s musical backgrounds and their feelings of social inclusion.
Data were gathered from 110 eight- to eleven-year-old children in the
UK and Finland. The findings showed that those children who played
a musical instrument or sang with their family or friends regularly felt
more socially included.
In Spain, Almau (2005) found that extracurricular musical activities
contributed towards increased school attendance and social inclusion in
Roma children. Also in Spain, Musicalizatech (a project that promoted
musical creativity in secondary and high-school students) showed a
clear impact on participants in relation to the development of social
and emotional skills, problem-solving and teamwork, the development
of technological skills, and creative processes (Cuadrado et al., 2017).
In contrast, in the USA, Gerrard (2021) found through interviews with
students, band leaders, teachers, parents and administrators that a
middle-school band programme with Latinx students did not meet their
needs as they were uncomfortable with the band model and wanted
more creative work with music that was familiar to them.
Music teachers face a range of challenges related to social inclusion.
They have to decide whether it is part of their role to address such
issues. For instance, Evron (2007), working as an art educator in
Israel, considered whether teachers of the arts should ignore the
violent experiences of their students, relate the curriculum to address
such problems, or simply expect creative activities to enable students
to express their fears and life experiences, avoiding political issues.
A further issue is whether teachers of the arts should respond to the
challenges of re-engaging disaffected young people through inclusive
teaching practices or go beyond this in some way (Burnard, 2008).
In a review, Karlsen and Westerlund (2010) argued that the musical
education of immigrant students could be seen as a healthy test for any
educational context in terms of how democracy is enacted. Bates (2012)
considered issues relating to social class in school music, and concluded
that there is a need to provide free and equitable music education for all
students, understand and respect their cultural backgrounds, and also
recognise the social forces that perpetuate poverty. Several authors have
commented on the lack of equity in opportunities for different groups.
570 The Power of Music

In England, Griffiths (2020) found that female, black and minority-

ethnic students were well represented in elite music education, but
were very poorly represented in the professional repertoire, where 99
percent of performed pieces were by white composers and 98 percent by
men. Treacy (2020) found that the challenges female musician teachers
encountered in pursuit of their careers in Nepal were not addressed
in shared visions of music education. In the USA, Palmer (2017)
considered how music educators could address issues of discrimination
that appeared to be beyond their control. Also in the USA, Baird (2001)
interviewed nine teachers to investigate how they engaged preschool-
and elementary-aged children in singing and talking about social justice
issues, the barriers that they perceived to this practice in schools and
society, and how parents, educators and song-makers could bring about
changes that would improve the ability of children to sing for social
justice in American schools and the wider society.
In the relatively recent past, the arts in general have been used to
attempt to address social inequality, the uneven distribution of wealth or
resources and inequity, unfair differences in society, and the environment
in wealthy and poor countries around the world (Parkinson et al., 2013).
For instance, in Ireland, a study in a deprived area of Cork explored
the impact of a wide music education project on the feelings of social
inclusion exhibited by local residents. The findings indicated that
music could be used as a tool to tackle social exclusion and educational
disadvantage (Minguella and Buchanan, 2009). In Tasmania, Langston
and Barrett (2008) examined social capital in a community choir using a
survey, field notes and semi-structured interviews. Many social capital
indicators were evident in the choir: shared norms and values, trust,
civic and community involvement, networks, knowledge resources,
and contact with families and friends. Fellowship was identified as a
key component in fostering group cohesion and the development of
social capital. Laing and Mair (2015) studied the role of music festivals
in helping to build strong and cohesive communities and found that
the organisation of festivals might contribute to social inclusion
through providing opportunities for local participation, learning new
skills, and access to education about social justice, although organisers
tended to direct their social inclusion efforts towards attendees rather
than reaching out to local residents, limiting the impact on the local
community and social inclusion more generally.
 16. Music, Inclusion and Social Cohesion  571

Overview
The evidence relating to the role of music in social cohesion demonstrates
only too clearly the power of music. It has been successfully used to
promote prejudice and enhance national identities for political purposes.
It has been used to bolster the morale of those engaged in warfare and
to humiliate and terrorise opponents. Attempts to use music positively
to promote social cohesion in those already or previously engaged in
conflict have had limited success and, in some cases, have highlighted
differences between groups, exacerbating problems. Active music-
making may offer some support in breaking down barriers between
different ethnic or religious groups, but its effectiveness in any given
situation depends on the depth and strength of existing prejudices and
the current political climate. As we have seen in Chapters 14 and 15,
music therapy can offer support to those traumatised by conflict and
can enhance the self-beliefs of members of marginalised groups. Those
engaged in music education are faced with challenges in deciding
whether they should overtly address issues relating to prejudice in their
classes, consistently adopt inclusive teaching strategies, or narrowly
focus their teaching on musical issues.
 17. Music in Everyday Life

The development of the electronic media in the latter part of the 20th
century revolutionised access to and the use of music in our everyday
lives. In the Western world, music pervades every aspect of our lives
(Clarke et al., 2010). Music is played in supermarkets, shopping precincts,
restaurants, places of worship, schools, on the radio and television, and
through the medium of recordings. Music plays an important role in
the theatre, TV, films, video and advertising. Music is now available
in a wide variety of formats, not only through radio and recordings
but through smartphones and computers, which can stream music on
demand. These new technologies have changed the way that people
are able to interact with music (Nill and Geipel, 2010) making music
easily accessible at any time and in a wide variety of contexts (Heye and
Lamont, 2010; Juslin et al., 2008). Individuals are able to control what,
when and how they listen to music. This has led to complex patterns of
everyday music usage and storage, leading to the highly personalised
categorisation of music (Greasley and Lamont, 2006). Users adopt
different ways of managing playlists which fuse new ways of collecting
music with practices from pre-digital collecting (Hagen, 2015). Digital
music has facilitated greater interactivity between user, device, and
music (Kibby, 2009) and moved from collecting music being a tangible
experience to a more ephemeral one (McCourt, 2005).
A reflection of the extent to which people engage with music is
the size of the music industry. In the UK and the USA, it is amongst
the top generators of income. Prior to these developments, music was
only accessible for most people if they made it themselves or attended
religious or social events. Alongside the increased availability of music
for listening, there are also greater opportunities for actively making
music. Many more people of all ages now learn to play instruments
or sing and participate in musical groups, although the degree of

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.17

574 The Power of Music

participation to some extent depends on financial resources (ABRSM,

2014).

Music and Leisure

Listening to music is a top leisure activity for many people (Rentfrow
and Gosling, 2003). Engaging in leisure activities has a long history,
going back to at least the fourth century BCE, when Aristotle referred
to it as constituting an important element in the life of the citizens of
Athens (including the experience of melody, drama, poetry and dance).
These were perceived as important in supporting happiness (Hallam
et al., 2017). More recently, Stebbins (1992) has distinguished between
casual leisure—which mainly includes enjoyable social interactions
and self-gratification behaviours—and serious leisure, which requires
significant effort. Those participating in serious leisure fall into three
groups: amateurs, hobbyists and volunteers. Amateurs share similar
expectations with professionals and rely on the general public to
appreciate and support their activities. Hobbyists are dedicated, but to a
lesser extent. Their activities are frequently undertaken alone. Volunteers
provide help, formally or informally, while dabblers or dilettantes only
participate in any specific leisure activity for a brief period of time or to
a limited extent. Amateur musicians can engage in musical activities for
personal amusement or as a serious leisure activity. Many of the activities
that they engage with are indistinguishable from those undertaken by
professional musicians. Music constitutes a key part of their identity, and
they invest much time and energy in it. At the start of active engagement
with music, motivations may vary. Dabblers or dilettantes have no great
commitment and spend little time practising, which limits their musical
development and the benefits that they may derive from it, while others
may be totally committed and aspire to amateur or professional status.
Hobbyists (Stebbins, 1992) or enthusiasts (Keown, 2015) tend to focus
on listening, have large music collections and high-quality equipment,
and invest considerable time in learning about and adding to their
collections. Regular attenders at concerts or festivals tend to have higher
levels of musical experience and rate music as important in their lives.
Less committed listeners, dabblers, dilettantes and recreationists enjoy
music, but it is not a major focus in their lives, although it is important
to them.
 17. Music in Everyday Life  575

Relatively little research attention has been given to understanding

the behaviours of music enthusiasts and sound-recording collectors
(Keown, 2015). They, mainly men, may actively participate in
collecting sound-recording albums to fulfil multiple motivational
desires including love of music, obsessive-compulsive behaviour,
accumulation and completism, selectivity and discrimination or self-
education and scholarship (Shuker, 2004). Lacher and Mizerski (1994)
describe their behaviour in terms of affective responses, experiential
responses, the ability to be swept up in the music, and the need to
re-experience the music. Other influential factors include perceived
knowledge (an illusion of knowing), objective knowledge (knowing
based on data-supported information), opinion leadership (allowing
other individuals’ opinions to influence purchasing behaviours), and
enduring involvement (relating to a product in support of self-image).
These are better predictors of motivation to purchase particular
recordings than demographic variables such as age, social class and
marital status (Flynn et al., 1995), although record-collecting in general
has been identified as a male characteristic (Straw, 1997). Technological
developments have led to further distinctions in terms of technology
users and technology consumers, and different downloading profiles:
occasional downloaders, online listeners, explorer pioneers, curious and
duplicators (Molteni and Ordanini, 2003).
Related to the concept of enthusiasts is that of fandom, which has
been conceptualised as a psychological symptom of a presumed social
dysfunction (Jenson, 1992) although also as a logical consumer strategy
focusing on pleasure and identity development in association with an
identifiable capital (Stevens, 2010). Fandom is also related to seeking
out interpersonal relationships with other music fans (Duffett, 2013).
Whatever the musical activity, the level of commitment and time spent
engaging with music impacts on the benefits which can be derived from
it. To be a dedicated fan requires having sufficient finance to attend
concerts and pay for recordings and, for the really dedicated, travel to
distant performances. Higher incomes are required for this (Bennett et
al., 2009).
576 The Power of Music

Listening to Music
Listening to music is a key leisure activity for many people (Rentfrow
and Gosling, 2003). The easy availability of music nowadays means
that people are able to interact with music at any time and in a variety
of contexts. Listening can be motivated by the desire for aesthetic
experience, the regulation of moods and emotions (Groake and Hogan,
2018), to promote wellbeing in those with long-term illness (Batt-
Rawden et al., 2005) or to help in accessing new ways of being (Krueger,
2018). As considered in depth in Chapter 14, music is frequently used
as a regulatory strategy for maintaining or changing moods (Silk,
2003; Thayer et al., 1994). This is one of the most common reasons for
listening to music. While people generally use music to enhance positive
emotions, it can be used to explore negative themes: for instance,
distress, suicide and death. This can subsequently increase depressive
symptoms and suicidal thoughts (Scheel and Westefeld, 1999). These
negative outcomes can be exacerbated through interactions with like-
minded others. Music can also have a negative impact when individuals
are exposed to music that they dislike in contexts where they have no
control and are unable to remove themselves from the situation. This
can cause extreme distress.
There is variation in the extent to which listeners are aware of the
impact of music on their moods. Typically, older people and women
are more aware while, amongst young people, girls are more likely to
use music to cope with personal problems as a kind of lay-therapeutic
practice (Batt-Rawden and DeNora, 2005), while boys tend to use it
to increase energy and promote their image (North et al., 2000; Wells
and Hakanen, 1991). Open and intellectually engaged individuals and
those with higher levels of intelligence tend to use music in a rational
cognitive way, while neurotic, introverted and non-conscientious
individuals are more likely to use music for emotional regulation.
Extroverts tend to adopt an emotional approach to listening and to use it
as a background to other activities (Chamorro-Premuzic and Furnham,
2007; Chamorro-Premuzic et al., 2009). The use of music to regulate
moods may be related to musical preferences. For instance, eclectic
preferences have been shown to correlate with emotionality in listening
(Behne, 1997; Wells and Hakanen, 1991) and flexibility in using music
 17. Music in Everyday Life  577

for mood-related needs (Schwartz and Fouts, 2003). Arnett (1995)

discusses how individuals set about selecting and using music to serve
their needs, wants and purposes.
For many years now there has been controversy over the extent to
which engaging with depictions of violence in a range of media—or
listening to music which has violent lyrics—impacts on behaviour.
Violent media exposure is a risk factor for aggression and there are
short- and long-term harmful effects, including increases in aggressive
thoughts and behaviour, desensitisation to violence, and a decrease in
prosocial behaviour and empathy. However, it is the accumulation of
risk factors and the relative lack of protective factors which leads to
violence rather than one single factor (Anderson et al., 2017; Bender et
al., 2018; Browne and Hamilton-Giachritsis, 2005). In the case of music,
there are relationships between certain types of music (for instance, hard
rock, heavy metal, hip hop, rap and punk) and alcohol and substance
abuse, violent behaviour and delinquency (Lozon and Bensimon, 2014).
An experimental study has shown that when misogynous aggressive
song lyrics are played, male and females respond more negatively to
the opposite sex and recall more of their negative attributes than when
neutral lyrics are played (Fischer and Greitmeyer, 2006). Teenage sexual
attitudes, norms, desires and intentions are impacted by the kind of
music that they prefer to listen to (Agbo-Quaye, 2006), while sexual
and violent slang and expressions of Nigerian hip hop are reflected in
Nigerian higher-education students’ linguistic expressions of sexuality
and violence (Onanuga and Onanuga, 2020). Appreciation of the
rhythmic flow, melodic structure and particular artists of some genres,
but revulsion at the misogynistic and sexist messages can lead to internal
conflict in young women (Zichermann, 2009). Overall, the lyrics of some
music may be a risk factor for violent or misogynistic behaviour, but
other factors determine whether this translates into actual behaviour,
although it is clear that its influence on language and attitudes has a
more subtle effect, which may impact on behaviour in everyday life.

Attending Live Musical Events

Attendance at a live music event indicates a greater level of commitment
to music than listening to recorded music and typically is motivated
578 The Power of Music

by hearing a particular artist or style of music, learning about new

music, or personal and social reasons (for example, going with
friends or being part of a community; Pitts and Burland, 2013). Strong
experiences of music most commonly occur in live settings. These tend
to be enhanced if the performers interact with the audience and appear
to be enjoying the experience. This transforms the experience from
being passive to active. Music festivals offer unique opportunities for
intense musical experiences, the physical proximity to the performers,
social interactions and the music itself all making a contribution. The
festival context can provide a sense of community and help support the
development of identity, although there can be risks associated with
alcohol or drug abuse, and other negative behaviours. The sense of
separation from everyday life distinguishes festivals from other musical
experiences, leading participants to reflect on their lives. Clubbing also
creates a distinctive musical environment where mobile phones play an
important role in managing the experience, helping to develop clubbing
friendships and supporting the friendly vibe of club culture (Bull, 2006).

Actively Making Music

Many more people of all ages learn to play instruments, sing and
participate in musical groups than in the past, although the extent and
types of opportunity vary and participation frequently depends on
financial resources (ABRSM, 2014). In some cultures, music-making is
a central activity. The Mekranoti Indians, primarily hunter-gatherers,
living in the Amazon rainforest in Brazil spend up to two hours each
day making music. The women sing for up to two hours in the morning
and evening, while the men sing very early each day and frequently
for half an hour before sunset. Historically this activity related to the
need for vigilance in case of attack but nowadays it continues probably
because it is intrinsically rewarding (Werner, 1984). In Western cultures,
music-making does not play a central role in everyday life for most
people. Listening to music is the most common way of engaging with
music. The reasons for adults’ participation in music have been grouped
into three broad categories: music-making as a musical act, deepening
musical knowledge and understanding; as a social act, developing
a sense of belonging, making friends with like-minded people; and
 17. Music in Everyday Life  579

for personal reasons, skill development, self-esteem and satisfaction

(Kokotsaki and Hallam, 2007). Music-making is generally pleasurable
and relaxing, and provides opportunities for self-expression and the
opportunity to demonstrate musical skills. It can give structure to life
and offer opportunities to develop friendships, get relief from family
and work pressures, and provide spiritual fulfilment. Being a member
of a musical group can also lead to feelings of belonging, trust and
cooperation. Adult participation in music-making is frequently an
extension of engagement with active music-making in childhood in
the home or at school. The pattern of engagement generally changes
over the course of life, diminishing in the middle years and increasing
in retirement. Life-changing events sometimes provide an impetus for
re-engagement.

Socioeconomic Status
Bennett and colleagues (2009) examined the relationships between
class, gender and ethnicity and a range of activities including music,
film, television, literary and arts consumption. They also considered the
organisation of sporting and culinary practices and self-maintenance.
They found that social class was the most powerful indicator of the
nature of cultural consumption, but other factors such as age and
gender were important. The primary distinction was not between high
or popular, legitimate or ordinary cultural forms but rather between
participation and non-participation, although there were some very
subtle differences related to class: for instance, the distinction between
jazz and Dixieland jazz, and Radio Three and Classic FM. North and
Hargreaves (2007a; b; c), in an examination of the relationships between
musical preferences and factors relating to the lifestyles of different
social groups, found numerous associations showing that fans of high-
or low-art musical styles demonstrated a preference for other high- or
low-art media (for instance, in reading, TV, radio and leisure activities).
In relation to interpersonal relationships, living arrangements, moral
and political beliefs, and criminal behaviour there tended to be an
association between a commonly accepted liberal conservative divide
and musical preferences. Social class aspects of lifestyle (for instance,
travel, personal finances, education, employment, health, drinking and
580 The Power of Music

smoking) indicated that liking for high-art music was indicative of the
upper-middle and upper classes, whereas liking for low-art music was
indicative of a lifestyle of the lower-middle and lower classes.
The Audience Agency (2013) studied the impact of socioeconomic
status and geographical location on engagement with cultural activities,
and identified ten distinct groups based on cultural values:
• metroculturals—prosperous, liberal, urbanites interested in a
very wide cultural spectrum;
• commuterland culture buffs—affluent and professional
consumers of culture;
• experience seekers—highly active, diverse, social and
ambitious, engaging with arts on a regular basis;
• dormitory dependables—from suburban and small towns
with an interest in heritage activities and mainstream arts;
• trips and treats—enjoy mainstream arts and popular culture
influenced by children, family and friends;
• home and heritage—from rural areas and small towns,
engaging in daytime activities and historic events;
• up our street—modest in habits and means with occasional
engagement in popular arts, entertainment and museums;
• Facebook families—younger suburban and semi-urban who
enjoy live music, eating out and popular entertainment such
as pantomime;
• Kaleidoscope creativity—mix of backgrounds and ages,
occasional visitors or participants, particularly in community-
based events and festivals;
• Heydays—older, often limited by mobility to engage with arts
and cultural events.

These categorisations highlight the issues that people face in accessing

live music related to finance and geographical location.
 17. Music in Everyday Life  581

Music in the Arts

Music plays a major role in film and other media. Without it, drama
would be much less interesting. For instance, the shower scene in
Psycho, which is disturbing without music, is much more terrifying
with it. Music contributes to our enjoyment of films or TV programmes
in many ways. Most film music is designed to influence our emotions
subconsciously. If the action is ambiguous, the music can provide clues as
to what is going on. When there is no other information, music can help
to define characters, sometimes with a character being given a theme. It
is frequently more effective than dialogue in providing information to
the audience: for instance, indicating the time when the action is taking
place. It can indicate urgency, building up tension when something
frightening is going to happen, while increasing volume creates the
impression of fast-moving sequences. Music can give certain passages
continuity or divide a film into segments. If music accompanies actions,
the mood of the event will be better remembered, as the music deepens
the emotional experience. Some messages are culturally specific: for
instance, the music that indicates bravery in one culture might indicate
evil in another (Cohen, 2016).

Listening to Support Everyday Activities

People rarely listen to music as a specific activity. It more usually
accompanies other activities, although at the same time it can induce
feelings of being more alert, positive and focused, particularly when the
music is self-selected (Sloboda et al., 2001). Although in everyday life
much music-listening takes place alongside other activities, this does not
mean that it is not listened to with full attention (Lamont et al., 2016).
People listen to music when travelling, carrying out boring tasks (for
instance, housework) or routine intellectual tasks, or when engaged in
physical activity. Music can distract, energise, facilitate moving in time
and enhance meaning. It has the greatest impact on behaviour when
it is selected for a particular purpose (Lamont et al., 2016). The most
common use of music is when travelling, where it helps the individual
to isolate themselves from other travellers, pass the time and make
preparation for whatever activity is to be engaged with on arrival at the
destination (Bull, 2005; Lamont et al., 2016).
582 The Power of Music

Music and Driving

The effects of music on driving vary depending on the type of music,
the context and the characteristics of the driver. A survey of 1,780 British
drivers revealed that approximately two thirds listened to recorded
music or music on the radio while driving. Reasons for listening included
relaxation and concentration. Music was seen as less distracting than
conversation. There were associations between possession of a motor
insurance no-claims bonus and a preference for silence, although the
genre of music affected driving performance. Driver age may have been
a mediating factor, as older drivers who listened to classical music may
have been less likely to be involved in a road accident, simply because
they were safer drivers with lower levels of sensation-seeking, risk-
taking or drink-driving. For the youngest age group, house and dance
music were associated with a higher incidence of accidents, but this may
have been associated with times when groups of friends were travelling
together and driving at night, introducing other potential distractions
and challenges (for instance, poor visibility, driver drowsiness,
distractions from passengers, or the influence of drugs or alcohol—
Dibben and Williamson, 2007). However, it is possible that different
genres may affect driving safety because of their musical characteristics.
Dance and house music tend to be characterised by fast tempo, high
volume, complex rhythmic patterns and layered textures. These are
highly arousing and can increase alertness or, alternatively, divert
attention away from driving (Brodsky, 2002; Recarte and Nunes, 2002).
They may also result in greater aggression at the wheel (Wiesenthal et
al., 2003). Using a driving simulator, Catalina and colleagues (2020)
investigated the extent to which listening to music could affect young
drivers’ emotions and their driving performance. They found that
driving with music increased the tendency to increase speed level,
particularly if happy music was playing. Relaxing music or no music
reduced the probability of speeding. Also using simulated driving,
Navarro and colleagues (2018) manipulated musical background
using preferred and researcher-selected music played at different tempi.
Listening to music influenced drivers’ performance but its tempo did
not. Arousing music improved drivers’ responsiveness to changes in the
speed of the vehicle that they were following, but this was cancelled out
 17. Music in Everyday Life  583

by a reduction in intervehicle safety margin. Also simulating driving,

Arafat and colleagues (2017) investigated the effects of natural sounds,
classical music and hard rock on driving performance. Driving was
most efficient with natural sounds and most inaccurate with hard rock.
Participants’ perceptions of the impact of the music on their driving
reflected these findings.
Studying young adults in a broader travelling context, Heye and
Lamont (2008) showed that listeners consciously chose their music,
depending on current goals which may have been linked to their
destination. Listeners created an auditory bubble which enhanced their
awareness of their surroundings, although it was partly permeable.
DeNora (2013) also suggested that personal listening created an
environment of asylum which provided space to explore inner reality,
but at the same time removed connection with other human beings.

Music at Work and to Accompany Mental Activity

Music has always played a major part in work activities and continues
to do so. It has been used to coordinate movement, alleviate boredom,
develop team spirit and speed up the pace of work. Nowadays, singing
to accompany work is uncommon in the developed world, but in the
office environment, those who listen to recorded music report improved
mood, providing that they are able to select the music themselves.
When tasks are routine and solitary music can improve concentration
and focus, relieve boredom, reduce stress and block out unwanted noise
(Lamont et al., 2016). Increasing access to music has contributed to
changes in listening to music in offices, where employees can listen to
music through personal listening devices. A survey of music-listening
in office settings in the UK found that employees listened to music for a
third of their working week. They listened to a wide variety of styles and
artists. Music helped them to both engage in and escape from work, and
they often used it to seal themselves off from the office environment.
They managed listening so that they did not disturb colleagues or appear
unprofessional in front of clients (Haake, 2011). Companies have come
to recognise that music can support job performance and foster ethical
conduct (Meyer, 2019).
Generally, cognitive work is enhanced with the playing of calming,
relaxing music, although if a task is very boring, more stimulating music
584 The Power of Music

may be required to maintain concentration. However, tasks involving

rote memorisation tend to be disrupted by music, although it can act as
a mnemonic to support memory for factual information (Hallam and
MacDonald, 2016; Hallam and Rogers, 2016). As we saw in Chapter 11,
schoolchildren and students frequently play music when completing
academic work. As with driving, the effect of the music depends on a
range of factors which interact together, including the complexity of the
task and the nature of the music. Children with behavioural difficulties
who may have particular difficulties with concentration can be helped
by calming music playing in the background (Hallam and MacDonald,
2016).

Music and Exercise

Regular physical activity has benefits for physical and mental health.
Music is a common accompaniment to exercise, whether in the gym or
outside in the park or on the streets. Music played before exercise has been
shown to optimise arousal, facilitate task-relevant imagery and improve
performance in simple motoric tasks. During repetitive endurance
activities, preferred motivational, stimulative music reduces levels of
perceived exertion, improves energy efficiency and leads to increased
work output. In high-intensity exercise, carefully selected music can
promote ergogenic and psychological benefits, although it does not
appear to help in reducing perceptions of exertion beyond the anaerobic
threshold. Medium-tempo music can enhance positive feelings during
high-intensity exercise and in recovery periods, while medium and fast
music can increase zoning out, enjoyment and remembered pleasure
(Karageorghis et al., 2021). In high humidity and high temperature
conditions, time to exhaustion when music is playing is longer and
perceived exhaustion lower (Nikol et al., 2019). Music is most effective
when it accompanies self-paced exercise or when it is selected as being
motivational (Karageorghis and Priest, 2012). Schneider and colleagues
(2010) also showed that an adequate choice of music during exercise-
enhanced performance output and mood, while Potteiger and colleagues
(2000) found that different types of music acted as distractors during
exercise and were associated with lower ratings of perceived exertion.
Differences in musical preferences while exercising are most influenced
 17. Music in Everyday Life  585

by age. When working out in gyms, older people prefer quieter, slower
and less stimulative motivational music (Priest et al., 2004). In a review,
Terry and colleagues (2020) concluded that music was associated with
significant beneficial effects on affect, physical performance, perceived
exertion and oxygen consumption, but not heart rate. The effects were
moderated by context, exercise as opposed to sport, and the tempo of
the music.

Music, Commerce and Consumption

Recorded music is played extensively in workplaces, shops, airports,
restaurants and hotels. The commercial and industrial uses of music
constitute major industries. As a general rule, people tend to avoid
music that they do not like, and are attracted to places where they find
the music appealing. This has led various authorities to use music to
persuade people they consider undesirable to relocate from specific
public places. Typically, opera or other classical music is used for this
purpose. The police have also used music to try to reduce aggressive
behaviour in groups of people who have been drinking heavily by
playing children’s songs or other calming, pleasant music. In everyday
life, music is used to manipulate what is purchased through advertising
and create an appropriate ambience in retail settings. Music achieves
this through its capacity to change arousal and emotions, and the way
that it is associated with particular events or items.
One strand of research has focused on the role of music in store
ambience. For instance, Ishar and colleagues (2017) studied consumer
purchasing behaviour at self-service convenience stores in Sri Lanka
and found that music was one of several factors that influenced
purchasing, along with scent and light. Singh and colleagues (2014)
found that appropriate background music helped retailers to create a
desirable store atmosphere, which contributed to the image of the store
and allied with consumer preferences. Playing the right kind of music
has a direct impact on consumer behaviour within a store (Farias et al.,
2014). When preferred music is played, customers stay longer, are more
comfortable and relaxed, and likely to purchase more. If background
music is fast, loud and causing discomfort, less time is spent shopping.
An appropriate level of arousal induced by music increases pleasure,
586 The Power of Music

which positively influences satisfaction with the shopping experience

(Moran et al., 2013). Music can also affect perceptions of the atmosphere
in banks and bars (North et al., 2000). The speed at which people shop
is positively related to the tempo and volume of background music.
Milliman (1982) found that slow music led to supermarket customers
shopping more slowly and spending more money, perhaps because they
took more time to browse available products, while Smith and Curnow
(1966) found that customers spent less time in store when loud music
was playing, although there was no difference in the amount of money
spent.
The type of music can influence what is bought. In one study,
stereotypical French or German music was played in a store and
influenced whether French or German wine was purchased, although
customers were unaware of the influence of the music (North et al.,
1997; 1999a). Similarly, a soundtrack depicting nature-influenced
perceptions of the country of origin of orange juice, its cost, whether the
oranges were genetically modified and beliefs about the health benefits
of drinking it (North et al., 2016). Lacher and Mizerski (1994) examined
the purchasing of new rock music and found that sensorial, emotional,
imaginal and analytical responses to the music all had direct effects
on responses to it, which in turn influenced purchase intention. The
strongest indicator of purchase intention was the need to re-experience
the music. The COVID-19 pandemic has led to a major increase in online
purchasing. Within this context, Hwang and colleagues (2020) found
that interactive (as opposed to static) background or no music enhanced
the experiential value of e-commerce for consumers.
Music is used to entice people into retail establishments. North and
Hargreaves (1996a) demonstrated this by setting up an advice stall in
a café on a university campus, which offered leaflets with advice to
students on a range of issues. Pop music was played at three levels of
complexity. Moderately complex music positively influenced approach
towards the stall, although not actually visiting it. Preferred music was
better at attracting students to the stall than no music, although disliked
music acted as a deterrent.
Different kinds of music not only have an impact on perceptions of
ambience but can also affect the amount of money spent. For instance,
North and Hargreaves (1998) played pop, classical, easy listening or no
 17. Music in Everyday Life  587

music in a café for four days. Customers rated the ambience of the café
and also indicated how much they were prepared to spend on typical
items: for instance, a slice of pizza or a canned drink. When popular
music was playing, the café was seen as lively and youthful; classical
music led to perceptions of it being upmarket and sophisticated, while
stereotypical piped music led to perceptions of it being downmarket.
Customers were prepared to pay more money when any kind of music
was playing in contrast to silence, but classical music led to customers
being prepared to pay the most. Areni and Kim (1993) played classical
or pop music in a wine cellar and found that, although the two different
types of music did not lead to customers buying any more wine, classical
music led to customers buying more expensive wine. They suggested
that the classical music primed customers to feel more affluent and to
act accordingly. In a restaurant setting, North and colleagues (2003)
also found that customers spent more money when classical music was
played as opposed to pop or no music. The positive effects of classical
music on spending were particularly marked for non-essential items,
such as a starter or coffee afterwards.
The sounds made in consuming food can affect how it is perceived.
For instance, potato crisps are perceived as tasting fresher when
the sound of biting into them is louder (Zampini and Spence, 2004),
while discontinuous or uneven sounds influence perceptions of how
crispy they are (Vickers and Wasserman, 1979). Music can influence
perceptions of flavour. Music selected to reflect the descriptors often
used to describe wine (for instance, heavy, subtle and refined, zingy and
refreshing, or mellow and soft) influenced the perceived taste of the
wine in the direction of the emotions symbolised by the music (North,
2012).
Some research has focused on the impact of music on the speed of the
consumption of food and drink. For instance, Milliman (1986) studied
restaurant customers and found that slow music led to customers eating
more slowly, completing their meal in just under an hour on average,
compared with three quarters of an hour when fast music was played.
In a café setting, Roballey and colleagues (1985) found that fast music
led to customers eating at more bites per minute than when slow music
was playing. Spending may also be affected, with slow music leading
to greater spending on drinks (Milliman, 1986). In a student cafe,
588 The Power of Music

diners were asked to say how much they liked the music (North and
Hargreaves, 1996b), with data showing that moderately complex music
was most popular. It was also clear that the more music was disliked,
the more noticeable it became.
Music plays a key role in advertising. To persuade customers to buy
particular products, the music needs to be appropriate. Customers need
to understand the advertising message but also be able to relate to the
emotional elements of the music. The most successful advertisements
are those that provide information and have emotional power. The
attitudes of potential customers can be changed if music conforms to
their conception of the nature of the product: for instance, exciting
classical music might be used to advertise an expensive sports car.
Food adverts tend to be accompanied by cheerful songs, which may
include the product name in their lyrics. North and colleagues (2004)
prepared radio adverts for five brands: an online bank, a people carrier,
a bathroom cleaner, a chocolate bar and a high sugar drink. In addition
to the voiceover, music was played that did or did not fit with the
characteristics of the brand. Recall of the product was higher when
the adverts featured music that fitted the advertised product. When
music is well-matched with the product, it is better remembered. Audio
branding in the form of jingles or signature tunes can support memory
for a brand. Overall, music is effective in helping to enhance the appeal
of products and promote memory for them (Çupi and Morma, 2020;
Deaville et al., 2020; North et al., 2016; Rathee and Pallavi, 2020).

The Economics of Music

Music makes a major contribution to economies locally, nationally
and internationally, including recordings, radio, live-music venues,
production and distribution, applications including ringtones, computer
games, films, children’s toys, as background in business environments
and through the employment of musicians. The music economy is
spread across most categories of economic activity: construction,
manufacturing, wholesaling, retailing, consumer services, and the
public sector. Musicians work as employees and in self-employment, the
largest groups in music and dance, education, broadcasting, software
and computer services (Beyers et al., 2008; UK Music, 2020). The
 17. Music in Everyday Life  589

introduction of streaming services presented particular challenges to

the industry (Molteni and Ordanini, 2003). Musicians and the music
industries are generally concentrated in a relatively small number of
large regional centres (or at least this is the case in the USA and the
UK;Florida et al., 2010), although music festivals of all kinds can have a
major impact on local economies. Even when entrance to events is free,
there are considerable benefits to the local economy more generally
(Bracalente et al., 2011; Tohmo, 2005). In the USA, the music industry
recently accounted for $514 billion (Music Market Research, 2021),
while in the UK it accounted for £5.8 billion, employed almost 200,000
people and accounted for £2.9 billion of exports and £4.7 billion in music
tourism (UK Music, 2020).

Music and Non-Human Species

Music can have an impact on animals and plants. Music as part of an
enriched environment has been shown to have a positive impact on many
non-human species, including domestic animals, those reared on farms
and those in captivity in zoos and wildlife parks. The aim of playing
music is generally to enhance wellbeing, although there has been some
research exploring the benefits to cognition. For instance, music has
been shown to have a positive effect on rats’ maze-learning capacity.
Rauscher (1998) reported that, when rats were exposed to Mozart’s
sonata K448 they completed a maze faster and with fewer errors than
if minimalist music, white noise or silence was in the background,
suggesting that repeated exposure to complex music improved spatial-
temporal reasoning. Similarly, Tonon do Amaral and colleagues (2020)
assessed the effect of both classical and heavy-metal music on short- and
long-term memory of rats exposed to music for eight hours a day for 61
days. After exposure, the rats were familiarised with two objects, and
their memory for them was tested after ninety minutes and 28 days.
Rats exposed to either type of music performed better than controls
with regard to short-term memory, although there was no impact on
long-term memory, suggesting a temporary effect.
Within an agricultural context, one strand of research has focused
on the impact of playing music to cows when they are being milked.
For instance, North and MacKenzie (2001) found that dairy cows
590 The Power of Music

increased their milk production by three quarters of a litre a day when

listening to slow rather than fast or no music over a nine-week period.
Exposure to a pleasant auditory environment alleviated stress and
encouraged relaxation, which resulted in greater milk yields. Similarly,
Mallick and colleagues (2020) studied the amount of milk produced
by aged crossbred cows following instrumental music playing in the
background during milking. Milk production increased particularly in
the evening, which may have been a more stressful time for the cows
prior to exposure to the music. Also in an agricultural context, Jiafang
and colleagues (2021) found that repeated sound stimulation, Mozart, a
mechanical noise or natural sound background affected the behaviour,
physiology and immunity of 72 hybrid piglets who were exposed to six
hours of sound stimulation per day. In the short term, the music reduced
stress responses and, in the long term, enhanced immune responses,
while noise increased aggressive behaviour and reduced immunity.
Music can also benefit domestic animals, particularly dogs and cats,
when they are hospitalised, receiving veterinary care or in a rescue
centre. Wells and colleagues (2002) explored the influence of five types of
auditory stimulation—human conversation, classical, heavy metal, pop
or no music—on the behaviour of 50 dogs living in a rescue shelter. The
dogs were exposed to each type of auditory stimulation for four hours,
with one day between conditions. Classical music led to more time spent
resting, while heavy metal encouraged barking. The other stimuli had
no effects. In a review, McDonald and Zaki (2020) showed that classical
music could influence behaviour and physiological measures associated
with canine stress responses such as heart rate variability, level of
vocalisation and time spent resting in animal hospital settings, while
Boone and Quelch (2003) showed that harp therapy decreased restless
behaviour, anxiety and respiration rate in hospitalised dogs or those
in post-surgical care. In research focusing on domestic cats, Hampton
and colleagues (2020) found that music reduced stress in a veterinary
context. The most effective music was that designed specifically for cats,
not classical music.
In relation to music and plants, Retallack (1973) claimed that plants
exposed to soothing music showed better growth and were healthier
than those without music, while Ramekar and Gurjar (2016) showed
that vedic chanting had a positive effect on plant growth, leaf size and
 17. Music in Everyday Life  591

internodes (the parts of the plant carrying water, hormones and food
between nodes). Chowdhury and Gupta (2015) studied the effects
of different types of sound on the health and growth of marigolds
using light Indian and meditative music, as well as noise. They also
monitored the germination of chickpea exposed to light Indian music.
Music promoted the growth and development of the plants, including
germination, whereas noise hindered it. Focusing on the role of sound on
the germination of okra and zucchini seeds, Creath and Schwartz (2004)
used musical sound, pink noise and healing energy. Musical sound had
a highly significant effect on the number of seeds which germinated,
compared to an untreated control. This effect was independent of
temperature, seed type, position in room, specific petri dish and the
person doing the scoring.

Overview
Music plays a major role in everyday life. It is a major leisure activity
but also supports the undertaking of many everyday tasks, including
travelling, exercise and intellectual work. People listen to music for
pleasure but also to manipulate or consolidate their moods. In some
cases, this can have negative effects. There are individual differences
in the extent to which people are aware of the effects of music. Fewer
people are actively engaged in making music or attending live events,
perhaps because of lack of opportunity or financial constraints. The
types of music listened to and the musical activities engaged with
depend broadly on economic factors, age and individual dispositions.
Music plays a crucial role in all of the arts and in commerce, purchasing
and advertising. It also makes a major contribution to local and national
economies. The benefits of music can also be seen in non-human species,
including the growth and productivity of animals in the agricultural
sector, and the growth and germination process in plants.
 Reflections on an Exploration
of the Evidence for the
Power of Music

Perhaps the most surprising aspect of this exploration of the evidence

relating to the power of music is the fact that there is so much research.
Related to this, a very wide range of methods have been adopted to
study the impact of many different musical activities. Most people do
not need scientific evidence to demonstrate the power of music. They
recognise its power in their everyday activities and use it to manage
their moods and emotions, although they may not be consciously aware
of the extent of its power—for instance, in influencing what they buy,
their consumption of food and drink, or the way it is used in advertising,
drama and films. Certainly, those engaged in commerce are aware of
music’s impact as they use it to manipulate our behaviour, as are some
who hold political power, who have deliberately used music to generate
prejudice or violence, or approved its application in torture. At the other
extreme, some have recognised the power of music by controlling or
banning it.
The possible benefits of listening to and making music for health and
wellbeing have broadly been recognised, although often in conjunction
with other more conventional treatments and, even then, not for all
conditions. It can be particularly helpful in reducing stress, anxiety and
pain through the way it directly affects opioid systems in the brain.
However, at the individual level, we should not only think of the power
of music in terms of its benefits to health and wellbeing, as for some
individuals it may reinforce existing negative emotions, exacerbating
mental ill health. This is not a reflection of its lack of power: quite the
reverse. It demonstrates that it can have powerful negative effects.

© 2022 S. Hallam & E. Himonides, CC BY-NC-ND 4.0 https://doi.org/10.11647/OBP.0292.18

594 The Power of Music

Assessing the impact of actively making music or music therapy

is challenging, because the effects of the music itself cannot easily be
disentangled from its social elements. This does not necessarily mean
that the music itself does not make a contribution, as clearly in many
cases it does, but there may be exceptions; for instance, if individuals
do not like particular musical genres or specific musical activities.
Relationships with those facilitating musical activities play a key role
in bringing about change, as does the quality of the facilitation. In some
cases, such relationships and the quality of the musical experience
may be more important than the actual musical activities. Making or
creating music with others is a social event, and its social nature is an
important factor in its success or failure. The impact of any activity on
self-efficacy, self-esteem and overall self-beliefs depends on feedback
from others. Musical activity leads to feedback being given, but it
may not always be positive. If feedback is negative, it is likely to have
negative effects and lead to the individual looking for more rewarding
ways to spend their time.
The major controversies in relation to the research, which have
not lessened but escalated over time, concern the impact of music on
various aspects of cognition, particularly in children and young people,
but also in older age. The evidence from neuroscience has clearly shown
that learning to play a musical instrument leads to changes in the brain.
The extent to which these changes transfer to other activities is hotly
debated, although the evidence for the impact on a range of aural skills
is strong, as might be expected from activities which require high levels
of aural perception and the analysis of sound. These skills in turn are
important for the development of language. The evidence for transfer
to other skills—for instance, spatiotemporal reasoning, executive
functioning, literacy, mathematics, intelligence, aspects of memory and
academic attainment—is mixed. Some of the possible causes for this
have been outlined above. Some have argued that the gold standard in
research requires the random allocation of participants to intervention
and control groups, the latter being an alternative activity rather than
no activity. This paradigm has gained its credibility from its routine
use in medical research. However, medical research does not typically
take account of individual differences or involve human interaction
at any level, which is likely to affect the outcomes. This is not the case
 Reflections on an Exploration of the Evidence for the Power of Music
 595

with research involving musical activity. The outcomes of listening to

music depend on many individual differences including personality,
gender, musical preferences and musical experience, and also vary
depending on whether listening is undertaken alone or with others.
When considering actively making music, the possible confounding
factors are even greater. While the research evidence might be stronger
when control groups participate in alternative activities, there is no
reason why other activities should not be equally successful in bringing
about positive change. The fact that sport or visual art (for instance)
may generate positive change does not undermine the possible impact
of music. Some types of musical engagement may have advantages over
other interventions because of the complex demands that they make on
participating individuals aurally, emotionally, intellectually, physically
and socially. As the evidence stands at the moment, it is not clear which
musical activities might be beneficial for promoting any particular
outcome. Currently, much of the evidence is mixed, to some extent
explicable in terms of the different musical activities studied and the
research methods used. As research into the wider benefits of music is
not a high priority for research funders, it may be many years before it
is possible to provide clear guidance on which musical interventions
might lead to particular outcomes, and what qualities in the delivery of
those interventions are key to success.
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 Index

β-endorphin 518 affirmation 12, 414, 458

Africa 7, 421, 445, 507, 532, 535
ABRSM 574, 578
African-American 250, 528, 559
abuse 527, 530, 534–537, 541–542,
after-school 35, 118, 155, 188, 388, 398
577–578
age-decelerating 461
accommodation 164, 531, 533, 562
ageing 61, 159–160, 162, 191, 193, 196,
accompaniment 31, 92–93, 164, 408,
447, 453–454, 459–460, 463–464, 497,
455, 584
503
accuracy 20, 23, 32, 42, 51, 57, 70, 73,
age-matched 73, 96, 118, 460
80, 89, 92–93, 97–98, 104, 395, 408
agency 376, 384, 391, 431, 438, 452, 456,
acoustic 21, 30, 33, 45, 48, 50, 52, 61, 64,
489, 562, 564
72, 104, 126, 142, 156, 416
organisation 563, 580
activation 20, 22, 24, 26–31, 36, 38–39, 41
age-related 23, 36, 160, 167, 184–185,
active 15, 18–20, 24, 28, 33, 36, 42
201, 218, 461, 483
acute 424, 480, 493, 505–506, 514, 539,
aggression 217, 303, 340, 342, 345, 366,
541
373, 390, 402, 433, 435, 491, 500, 502,
adaptive 4, 421–422, 479 516, 538, 546, 549, 555, 559, 577, 582,
addiction 180, 383, 455, 534, 543 590
ADHD 180, 270, 301–303, 317 aggressive 585
adolescence 3, 5–6, 70, 75, 156, 171, agitation 483, 491–492, 496, 498, 500–501
241, 251, 257, 396, 414–415, 418, 422, agreeableness 378, 380–382
424, 437, 441, 444, 463, 477, 523, 554.
agricultural 589–591
See adolescent
aims 444, 561
adolescent 419, 422–424, 435, 437–444,
alcohol 167, 451, 577–578, 582
446. See adolescence
alcoholics 543
adrenocorticotropic hormone 416
alertness 493, 582
adulthood 19, 75, 160, 252, 394, 396,
414–415, 418, 422, 447, 461, 463, 547, alexithymia 215–216
554 Toronto Alexithymia Scale 215
advantage 21, 56–57, 60, 65, 80, 87, 123, altruism 2, 395, 397, 545
126, 136, 138–139, 142–144, 146, 148, Alzheimer’s disease 163, 165–166, 304,
150–151, 157–159, 167, 169, 175, 177, 482–483, 489–491, 494, 497–498
185, 194, 197, 203, 209, 220–221, 243 Alzheimer’s disease 163, 165–166,
aesthetic 417, 421, 473 304–305, 308, 482, 489–491, 498
affective 5, 47, 50, 81, 114, 376, 419–420, amateur 12, 21–22, 34, 57, 149, 151, 175,
441, 443, 461, 467, 539, 545, 558, 575 180, 191, 204–205, 380–381, 426–427,
449–451, 461, 468, 553, 574
806 The Power of Music

America 112, 199, 214, 421, 482, 528, artistic 16, 27, 211, 224, 227, 445, 471–472,
555, 561–562, 570 502, 504, 530, 557, 563, 567
amplitude 20, 32, 52, 68, 75, 95, 98–100 arts-based 233, 387
amusement 12, 574 Asia 145, 377, 421, 532
amusia 37, 97 assessment 10, 17, 67, 88, 102, 113, 154–
congenital 37, 97 155, 159, 162–163, 166, 176–179, 189,
amygdala 226, 481 197, 211, 214, 217–218, 240, 243–244,
analogue scale 166 249, 388, 402, 429, 433, 485, 487, 491,
anatomical 21, 25–26, 31, 37, 47–48, 496, 509, 518, 520
181, 202, 506 assignment 63, 86, 196
anger 59, 215, 326, 331, 336, 342, 344, 347, associative 139
350, 353–354, 357–358, 364, 366–367, asylum-seeker 530–534, 562–565
373, 402, 423, 433, 439, 480, 493, 502, asymmetry 25, 36, 58, 152
511, 534–535, 542 leftward 25, 36
anorexia 542 athlete 240–241, 451
antenatal 393, 547 athletic 240, 411
anterior 17, 21, 32, 35, 60, 153, 175, 202, atmosphere 439, 452, 548, 585–586
227, 509 atonal 153
anthem 468, 558 at-risk 89, 117–118, 389, 445, 543
antidepressant 519, 521, 539 attention 135–138, 142–143, 146–147,
anxiety 162–163, 165, 217, 278, 298, 301, 150, 153–154, 156–157, 159, 164,
305, 307, 310, 354, 358, 365–366, 372, 173–174, 176–177, 181–182, 184–185,
380, 383–384, 406, 410, 413–414, 417, 189, 191–193, 195–196
425, 426, 429, 433–435, 443, 446, 448, attentional abilities 177
453, 455, 457, 467, 469, 475–476, 482– attentional processes 135–136, 146,
484, 487–488, 491–493, 495, 499–500, 154
503, 509, 511–513, 515–525, 527, 529, attentional system 176
531, 534–536, 538, 541–542, 544–546,
attentional control impairment 305
548–549, 566, 590, 593
attentive analytical listening 422
aphasia 74, 505
attitudes 7, 125, 326, 347, 350, 376, 400,
appreciation 11, 71, 148, 192, 510, 515,
406, 568, 588
577
cultural 560
aptitude 54, 58, 70, 82, 94, 102, 112,
discriminatory 563
121–122, 140, 154, 156–161, 167, 169,
189, 203, 213, 254, 460 towards learning 243, 323, 329, 338,
architecture 76, 164 356, 373
arithmetic 107–108, 115, 117–121, 124, towards music 432, 476
130, 200, 219, 520 towards offending 359
army 473–474, 529. See military towards prisoners 363
arterial 511, 517 towards self 386
articulation 47, 99, 164, 511 towards sex 577
articulatory 47–48, 157 towards the elderly 463
articulatory suppression 157 audiation 189, 207, 254, 257
artist 12, 167, 443, 445, 469, 473, 502, 504, audiobook 506, 514, 526
520, 525, 557–558, 563, 577–578, 583 audiovisual 57, 151, 402, 473
audition 47, 72, 95
 Index  807

auditory-motor 32, 38, 207 synchronisation 193, 460

aural 21, 42, 46, 55, 57, 61, 69, 76–77, training 137, 182
104–105, 116, 140–141, 169, 257, 260, biological 4, 58, 99, 142, 167, 194, 310,
279, 594–595 312, 415, 426, 481, 503, 513, 520, 522,
Australia 64, 113, 243, 335–336, 348, 547, 551, 553
353, 360, 362, 393, 421, 427–428, 436, birth 3, 45, 61, 74, 325, 392–393, 430, 511
441–442, 448, 450, 455, 464, 474–475, blending 50, 79, 83, 97, 101
477, 491, 504, 520, 531, 540, 560–563 blood flow 18, 25, 28, 311–312
Austria 520, 524 blood oxygenation 27–28, 153
authentic cadence 53 blood pressure 109, 303, 415–416, 480,
autism spectrum disorder 76, 335, 341, 484, 487, 513–514, 517–518, 521–522
405–406, 482–483, 510, 545–548 blues 278, 347, 352, 452
autobiographical memory 304–305 bonding 3–4, 6, 259, 344, 367–368, 374,
automation 392–393, 395, 399, 403, 426, 430–431,
of instruction 389 444, 446, 457, 461, 469, 551–554
of processes 26 boredom 5, 316–317, 319, 402, 439, 495,
of skills 7, 25, 42 583
autonomic nervous system 308, 415, 480 bottom-up processes 34, 49, 53, 195, 235
autonomy 354, 359, 378, 382, 428, 438, boundaries 100, 396, 439, 445, 483, 534,
458, 542 541
axial diffusivity 207 boy 103, 145, 209, 247, 298, 302–304,
319, 329, 333, 335, 343–344, 346, 385,
babies 43–45, 48, 368, 392–393, 430, 387, 389–390, 406, 423–424, 435, 440,
511, 522 535–536, 576
basal ganglia 29, 47, 99, 509 brain damage
basal metabolic rate 487 and music 46, 74, 482, 505, 507
baseline 41, 83, 109, 124, 156, 163, 166, brain injury 505, 510, 527–528
181, 193, 214, 272, 288, 304, 329, brainstem 16–17, 20, 32–33, 47, 57, 61,
365–366, 406, 427, 434, 491–493, 498 67, 156
Basque Country 468–469 bravery 6, 581
beat-making 128 Brazil 94, 465–467, 578
behavioural modelling 52 breathing 427, 509–511
behavioural problems 165–166, 269–270, British Columbia 245
301, 303, 317
bullying 405, 560
bereavement 427, 429, 458, 515
beta-endorphin 516 cadence 53
bias 10, 136, 144, 195, 253, 307 calmness 265, 279, 298–299, 301, 303,
Big Five personality test 230–231, 380 306, 314, 317, 334, 349–350, 367, 413,
bilateral 20, 23–24, 28, 30, 38, 48, 137, 418, 426, 431, 436, 447, 455, 517, 524,
153, 174, 188, 226–227, 283, 307, 507 532, 583–585
bilingualism 88, 151, 177–178 Canada 244–245, 249, 333, 336, 346,
bimanual 353, 465, 498
coordination 26, 29, 157, 185, 192, cancer 480, 514–516, 519
408, 460 Cantonese 145
movements 26–27, 29 cardiovascular 415, 480
patterns 148 career plans 328, 377, 476
808 The Power of Music

caregiver 62, 165–166, 169, 328, 331, chronic sleep disorder 526
352, 392, 430–431, 464–466, 473, 477, chronic stressors 109, 480
494–498, 504, 515, 547, 553 cingulate 22, 153, 175, 226–227, 481
care home 483, 490–492, 494–495 circuitry 29–30, 46–47, 49, 54, 312, 421
carer. See caregiver citizenship 238, 242, 250, 333, 401,
Caribbean 331, 402, 562 554–555
catharsis 3, 348, 542, 552 civil war 531, 557
cats 590 clapping 86, 92–93, 127, 148, 343
causality 9, 37–38, 61–62, 64, 83, 114, 121, classical 7, 19, 22, 30, 32, 58, 88, 157,
146, 159, 196, 202, 206–207, 210, 213, 167, 180, 213, 215, 226–228, 230–231,
232, 247–249, 259, 448, 479, 487, 501 234, 271–273, 275, 278–279, 287, 289,
CDs 1, 288, 345, 538, 557 297–298, 305, 311, 325, 334–335, 378,
cell 382–383, 404, 408, 416, 424, 436, 468,
nerve cell 18, 24 484, 526, 538, 540, 564, 582–583,
transplant 514 585–590
transplants 513–514 classroom-based training 86, 141, 214,
547
cell transplants 513–514
close relatives 411, 468, 491
cellular immunity 480
closure 112, 115, 143, 150, 178, 206
censorship 7, 357, 556
cluster analysis 124
cerebellum 16, 28–29, 31, 254, 481
cluster randomised controlled trial 157,
cerebral
213, 407
activation 27
coaching 164, 356, 495, 537, 547
areas 135
coarse temporal scales 69–70
cortex 15, 481
cochlea 20, 45, 73
functions 17
cochlear implant 73–74
hemispheres 23, 265
cognitive control 50, 142, 153, 159–160,
palsy 507 176, 178, 185, 188
processing 139 cognitive impairment 74, 163, 169, 180,
ceremonies 3, 6, 352, 552 193, 218, 267, 270, 306–307, 316, 490,
change readiness 543 555
chanting 86, 92–93, 343, 350, 590 cognitively unimpaired 218
chess 252 cognitive maturation 48
Chicago 327, 330 cognitive processing 7, 23, 26, 39, 44,
chills phenomenon 310–312, 495 50, 79, 134, 145, 154, 195, 197, 223,
China 2, 7, 13, 70, 81, 129, 139–141, 146, 254, 278, 310, 397, 428
179, 182, 238, 241, 281, 284, 288, 365, coherence 3, 151, 337, 552, 566
444, 466, 515, 526, 547 collaboration 323, 342, 344, 352, 354,
choir 4, 103, 160, 165, 209, 237–238, 240, 359, 362, 371, 396, 399–400, 402, 432,
244, 247, 256, 353, 361–363, 371, 380, 436, 453, 462, 470, 472, 474, 476, 496,
385, 399–400, 425–429, 445, 456–457, 499, 504, 534–535, 537, 552, 561, 564
472–473, 482, 484–489, 509–510, 516, college attainment 247
519, 521, 540, 543, 552–553, 565, 570 college students 109, 121, 139, 230,
chord 21, 32, 41, 390 261–263, 272–273, 287, 293–294,
chronic illness 163, 165, 429, 480, 486, 450, 485
493, 509, 512, 518 coloured blocks 111, 137
 Index  809

Columbia 333 consciousness 17, 532, 552

comfort 3, 283, 325, 352, 443, 508, 515, consonance 280, 312–314
518, 569, 585 consonant-based word discrimination
communication 65, 87, 146
and music 3–4, 6, 32–33, 43–44, 63, 73, contour 21, 26, 32, 40–41, 44, 53, 58–59,
76, 169, 328, 330, 335, 339, 341, 343, 61, 74, 92, 144
350–352, 354, 360–361, 364, 366, 374, contralateral 28, 39
378, 394, 397–398, 402, 405, 430–431, cooperation 433
433, 446, 450, 489, 501, 504–505, 508, and music 303, 336–337, 346, 356,
510, 515, 519, 523, 530, 533, 535, 545, 369, 371, 396, 399, 401–403, 432, 449,
547–548, 553, 555, 561, 565 496, 515, 535–536, 538, 551, 553–554,
communicative gestures 63, 393 557, 579
community-based 348, 363, 434–435, coordinated movement 395, 411, 583
464, 497–498, 504, 534, 538, 568, 580 coping
comorbidity 524, 544 and music 5, 191, 326, 330, 347, 355,
comparative study 69, 207, 209, 259 358–359, 362, 364, 366–368, 392, 402,
composers 258, 379, 570 415, 419–420, 422–424, 433, 439–441,
composite 178, 203, 244 446, 452–453, 467–469, 471, 474, 476,
composition 22–23, 149, 263–265, 280, 494, 512–513, 515, 525, 529, 576
350, 363, 381, 416, 462, 485, 508, 536, corpus callosum 16, 24, 35–36, 257, 509
541 correctional institution 359, 361, 372
comprehensive neuropsychological correlation 9, 24, 33, 36, 58, 70, 81–82, 88,
battery 162, 190 94, 102–103, 109, 113, 121–123, 137,
computer 158, 175, 195–197, 202–203, 205, 207,
music 234, 282, 340, 344, 350, 357 224, 226–227, 229, 237, 241, 248–249,
computerised 68, 152, 183, 186, 212, 259, 275, 311–313, 321, 386, 398
250, 358, 426, 506 cortical thickness maturation 19, 35,
concertos 109, 262, 286 174, 187
concerts 210, 242, 363, 369, 376, 434, cortices 25, 28–29, 37, 41, 202, 226, 509
436, 455, 457, 466, 473–474, 496, 561, corticospinal 24, 509
563, 574–575 cortisol 415–416, 426, 434, 459, 480,
conductor 30, 136, 363, 398 484–485, 511, 516–518, 521, 524
conflict 3, 180, 187, 194–195, 277, 321, courage 359, 555
353, 358, 398, 529–530, 532–533, 537, Circle of Courage 353
555–558, 565–566, 571, 577 covariate 179, 229, 245–246, 276, 295
conflict-monitoring abilities 180, 195 COVID-19 415, 465–467, 471, 473–478,
conformity to social norms 4, 6 501, 586
confounding factors 9, 125, 140, 163, cows 589–590
177, 197, 203–204, 208, 221, 248, 307, creative behaviour 226
448, 488, 494, 537, 595 creative thinking 224, 229–230, 232–233
confusion 128, 261, 476, 506 creativity 11, 14, 16, 223–235, 337, 357,
connectedness 342, 367, 415, 429, 449, 367, 374, 382, 446, 458, 462, 464, 503,
454, 462, 470, 477, 504, 563 516, 537, 569, 580
connectivity 29, 37, 108, 137, 226, 506, crime
545–546, 552
conscientiousness 258, 378, 380–383, 410
810 The Power of Music

and music 319, 325–326, 337, 348, 350, 534–535, 537–539, 541–542, 544–545,
353, 355–357, 364–365, 368–373, 387, 576
446, 534, 567, 579 detention centre 333, 356–357, 359–360
cross-community 559 determination 128, 326–327, 401, 433,
cross-cultural 43, 330, 561, 565 439, 448, 537
cross-domain 4, 47, 224–225 developmental difficulties / disabilities
cross-sectional 80 / delays 51, 64, 74–76, 94, 96, 270,
cross-sectional survey 36–37, 41, 64, 138, 304, 308, 348, 351, 390, 523, 540
144, 158, 196, 207, 218, 473 developmental functioning
cultural capital 247, 325 and music 333, 435
cultural omnivores 449 developmental responses
culture and music 512
adjustment and music 533 deviant stimuli 21, 32–33, 40, 59, 134,
and music interpretation 63, 98, 267, 150, 228, 268, 348
279, 296, 581 dexterity 104, 159, 191–192, 408, 506
and music-making 2, 6–7, 43, 63, 578 differential 28, 31, 79, 165, 194, 196, 264,
awareness and music 325, 338, 553, 268, 274, 549
557, 560 diffusivity 207
cross-communication and music 341, digit-span task 73, 149–151, 154–156,
356, 443, 554, 561 158, 165–166, 173, 175, 184, 188,
of music 57, 297, 335, 348, 354, 265–267, 305, 459
376–377, 382, 442, 470 disabilities 74–75, 166, 308, 341, 390,
culture-free intelligence test 143, 206 394, 405–406, 410, 428–429, 431, 466,
483, 505, 528–529, 547
cytokines 485, 516, 522
disadvantage 86, 103, 119, 129, 242,
dancing 163, 182, 388, 403, 432, 444, 251, 567, 570
447–448, 451, 463, 469, 485, 553 disaffection 319, 321–323, 326, 335–336,
deactivation 225–227 342, 377, 400, 446, 566, 568–569
deafness 72, 98 disorder
decision-making 22, 175, 338, 355, 413, behavioural 166, 342, 346, 483
436 brain 76
decoding 79–80, 82–84, 90, 97, 105, 174, eating 541–542
187 gait 505
dehydroepiandrosterone 426 language 51, 75, 491
dementia 163–167, 169, 217, 219, 304, mood 542
415, 457, 461, 473, 483–484, 489–501, neurodegenerative 484
510. See also Alzheimer’s disease; neurological 482, 508
See Alzheimer’s disease
obsessive-compulsive 180, 544
depression 161–162, 165, 215, 352, 354,
psychiatric 180, 413, 498, 513, 520,
358, 365–367, 372, 383–384, 413, 415,
524, 527–530, 534, 536, 538–539, 541
421–423, 425, 428–429, 433, 435,
442–443, 448–449, 453–454, 457–458, rhythm 538
460, 463, 467, 476, 478, 480, 482–483, schizophrenia 483, 539, 544–545
487–491, 495, 497–500, 503, 506, 509, sleep 483, 525–526, 548
511, 515–516, 519, 521–525, 527–531, social anxiety 544
disruptive behaviour 303, 360, 499, 535
 Index  811

dissociation 60, 311, 421 elderly 166, 197, 283, 304–305, 316, 419,
dissonance 311–312, 314, 416 428, 453, 459, 461, 463, 489–493, 496,
distractibility 34, 64, 272 499, 503, 505, 521
distraction 268, 272, 274, 276, 294, 296, electroencephalography 17, 39–40, 60,
302, 305–306, 314, 317, 440–442, 455, 69–70, 75, 109, 262, 281, 285, 288
512, 525, 548, 556, 582 electrophysiological 17, 33, 144, 275, 313
distress 13, 347, 383, 417, 420, 430, 438, elementary students 81, 89, 116, 125,
441–442, 465–466, 476, 478, 498, 129, 189, 216–217, 238–239, 247, 250,
513–514, 516, 519, 523–524, 530–531, 256, 298, 385, 388, 390, 547, 570
556, 576 elite 247, 451, 570
divergent thinking 223, 226–228, El Sistema 72, 118, 155, 247–248, 259,
230–231, 233–234 326–334, 387–388, 401–402, 433–434,
diversion 356, 419, 440, 444, 466, 495, 537, 554
525, 542–543 emission tomography 311
diversity 12, 61, 69–70, 217, 224–225, 228, emotional listening 422–423
255, 268, 341, 377, 388, 423, 433, 443, emotional self-regulation 64, 182, 330,
500, 548, 558, 565, 567, 580 387, 406, 415, 418, 422, 429, 447, 454,
doctoral theses 241, 249 459, 465, 467, 527, 531, 576
dogs 590 emotional stability 362, 380, 413–414
domain-general 47, 51–54, 168, 176, 194, empathy 175, 201, 348, 360, 394–395, 397,
224, 230–231, 459 402–404, 410, 421, 434, 438, 477, 481,
domain-specific 4, 52, 69–70, 224, 231, 553–554, 560, 563, 567, 577
257 empirical study 189, 224, 251–253, 308,
dopamine 291–292, 310, 312, 415, 480, 372, 552, 557, 560
524, 542 empowerment 338, 415, 434, 453, 494,
dorsal 25, 28, 38, 41, 47–48, 99, 153 503, 533, 561
dorsolateral 23, 58, 174, 225–227, endocrine 415–416, 480, 483–485, 524
283–284, 307, 539 endogenous opioid system 553
dorsomedial 312 endorphin 6, 415–416, 457, 480, 489,
drama 129, 211, 214–215, 221, 251, 516, 518, 553
348–349, 359, 489, 574, 581, 593 England 239, 251, 326, 329, 332, 337,
drawing 111, 118, 137–138, 140, 164, 385–386, 427, 436, 444, 456, 570
193, 228, 251, 263, 297, 341, 430, 446, enjoyment 4–5, 33, 110, 126, 197–198,
490, 523, 536 263–264, 267, 310, 320–321, 335, 340,
driving 290, 582–584 342–343, 356, 359, 362, 364, 373, 401,
drug dosage 539 413, 421, 431, 433–434, 442, 445, 447,
drugs 483, 493, 516, 521, 539 451–453, 457, 459, 462, 466, 468,
drumming 127, 160, 336, 343, 358, 389, 493–494, 496–497, 504, 510, 521,
395, 464, 482, 485, 487, 503–504, 529, 535, 540–543, 564, 567, 574, 578,
507–508, 519, 522, 535, 566 580–581, 584
dysphoria 542–543 ensemble 11, 30, 83, 114, 116, 136,
173–174, 186, 197–198, 215, 238, 242,
economically disadvantaged 103, 129, 244, 250, 255, 257, 356, 380, 389–390,
434, 567 397–401, 458, 461, 470, 485, 509, 534,
educated mothers 333, 435 546, 549, 554
812 The Power of Music

entertainment 4, 98, 440–441, 466, 525, festival 391, 451–452, 530, 563, 570, 574,
542, 580 578, 580, 589
entrainment 50–53, 75, 83, 92, 98–99, fibromyalgia syndrome 518
195, 252, 404, 416 financial hardship 369, 475, 476. See
envelope tracking 52 also economically disadvantaged
episodic memory 133, 191, 204, 218, finger flexor 39
268, 281, 283–284, 306–307, 417, 495 flash mobs 470
ethnicity 117, 319, 337, 339, 376–377, fMRI 18, 22, 28, 36, 38, 226
386, 557–558, 560, 563, 569–571, 579 foetus 3, 43, 547
eudaimonic 413, 422, 477 folk 32, 57, 164, 230–231, 379, 382, 424,
Europe 297, 340, 377, 421 484, 555, 559, 564
event-related potential 17–18, 38–39, folk fiddlers 379
59, 65, 70, 180, 306 food 312, 370, 542, 587, 591, 593
evolution 2, 4, 50, 403, 479, 551 fraction computation 126
exhaustion 484, 584 France 69–70, 144, 187, 199, 586
ex-offenders 358, 364–367, 370, 373 Frank Sinatra 271
expert 6, 9–10, 19, 21, 23, 25, 32–33, freedom 321, 327, 365, 371, 464, 468, 504
42, 57–60, 70, 83, 111, 144, 149–151, freelance 231, 476
154, 167–169, 175, 177–178, 194, 197, friendship 244, 327, 335, 337–339, 369,
203–205, 208, 224–225, 227–229, 235, 376, 388, 398–401, 422, 433, 437–439,
255, 258, 270, 290–291, 317, 454 442, 444, 446, 449, 453, 456, 468, 470,
expressivity 50, 536 474, 510, 519, 537, 552, 569–570,
ex-prisoners. See ex-offenders 578–580, 582
extensor 39, 508 frontal 16, 20, 22–23, 25, 32, 38, 48, 55,
extensor muscles 39 153, 162, 181, 186, 193–194, 202,
extroverts 231, 274, 292–295, 315, 378, 226–227, 257, 275, 313, 481
380, 576 frontocentral 194, 313
frontoparietal 30, 137, 185
familiarity 22, 30, 48, 55, 59–60, 136,
frustration 303, 342, 353–354, 385, 391
142, 144, 164, 182, 199, 263, 267, 270,
276–277, 288–289, 293, 295, 298, 304, gamelan 363–364
316–317, 350, 355, 417, 430–432, 461, gamma-band activity 17, 31, 34, 41, 65
489, 491–492, 495, 497, 540, 569
gangs 350, 354–355
fasciculus 207
gender 138, 144, 152, 180, 203, 229, 242,
fear 215, 311, 350, 434, 469, 511, 532–533, 268, 270, 288, 290, 292, 314, 383, 427,
569 466, 471, 534, 579, 595
feelings of belonging 5, 14, 337, 353, gene 201–202, 551
373, 376, 387, 399–400, 439, 447,
generalisability 10, 224, 230
449, 452–453, 456, 459, 463, 510, 521,
genetic 37–38, 42, 61, 76, 171, 201–202
533–534, 540, 552, 554, 560–561, 566,
578–579 genre 21, 32, 77, 164, 255, 271, 273,
277–278, 282, 311, 314, 316, 325, 347,
female 3, 43, 109, 121, 139, 161, 167,
352, 355, 376–378, 381–383, 391, 410,
250, 265, 268, 271, 273, 278, 292–294,
417, 424, 438, 441, 480, 491, 525, 559,
300, 306, 343, 359, 368, 379, 398, 423,
577, 582, 594
442–443, 450, 515, 520, 570, 577. See
also girls
 Index  813

Germany 7, 61, 89, 97, 103, 155, 233, hemisphere 16, 23, 31, 36, 46, 48, 58–59,
244, 340–341, 381, 427, 444, 490, 69, 74, 136–137, 147, 152–153, 226,
554–555, 586 265, 283, 505, 509
germination 591 heritability 201
gifted 251, 446 heritage 377, 446, 530, 580
girls 116, 247, 298, 329, 385, 387, 406, high-functioning 57, 203, 268
423–424, 439–440, 533–534, 536, 576 high risk 335, 352–353, 398
Glasgow 333, 471 high school 71, 87, 114, 122–124, 128,
Glenn Miller 271 130, 229, 239, 241, 243–244, 246, 300,
glucose 24, 479 327, 346, 380, 391, 399, 423, 442, 554,
gospel 424 569
government 7, 207, 336, 340–341, 501 hip hop 272–273, 337–338, 347–348, 352,
Greece 13, 296, 564 354, 357, 376, 577
grey matter 21–23, 35, 37, 139, 155, 194, hippocampus 22, 312, 481
202, 254, 406 hobby 12, 66, 410, 440, 454, 457
grief 337, 358, 476, 522, 530 hobbyists 574
growth hormone 416, 517 holistic 126, 195, 519
gyrus 20–21, 23–25, 31, 36, 38, 153, 181, Holocaust 531, 556
186, 254, 257, 481 homelessness 428, 535, 537, 543
Hong Kong 139, 238, 444, 523
haematopoietic 513–514 hormonal 415–416
haemodynamic 18, 27, 29 hormones 416, 485, 517, 521, 524, 591
Haiti 331 hospices 518–519
hallucinations 491, 544 hospital 13, 74, 392, 469, 483, 492–493,
happiness 59, 234, 297, 327, 329–330, 362, 496, 500–501, 512–516, 519, 523–524,
389, 401, 413–414, 418, 420, 425, 436, 545, 590
447, 449, 455, 457, 461, 465, 486, 492, hostility 360, 538, 544, 553
497, 519, 522–523, 525, 529, 574, 582
human capital 247
harmonic 40–41, 50, 53–54, 56, 60, 81,
humoral immunity 480
83, 142
hyperactivity 180, 301, 335, 338, 345,
harmony 21, 55, 59, 139, 194, 551
360, 434
healing 13, 337, 357, 482, 521, 530,
hyperconnectivity 24
532–534, 536, 565, 591
healthcare professionals 491, 496, 502, identification
519 emotion 215–216, 404
hearing language unit 56, 69, 77, 80, 84, 87,
in noise 141 100, 141
spatial 176 logo 91, 104
hearing music 6, 20, 43 music 20, 40, 49, 68, 70, 97, 100, 287,
hearing speech 141–142, 167 355
heart rate 270, 310, 312, 416, 426, 480, self 553, 564
484, 487, 511, 513, 517, 521–522, 585, identity 1, 3, 5–6, 314, 320–321, 326, 337,
590 344, 347–348, 353, 355–356, 358, 360,
heavy metal 382, 423–424, 441, 577, 364, 367–368, 375–377, 384, 387–388,
589–590 391, 396, 401, 410, 415, 429, 433,
hedonic 4, 413, 477 443–444, 451, 453, 456, 462–464, 468,
814 The Power of Music

472, 476, 491–492, 494, 499, 504, 516, In Harmony 326–330, 332
524, 530, 532–533, 540–542, 552–553, inhibitory control 85, 92–93, 151, 171,
555, 557–559, 562–563, 566, 571, 173, 175, 179–180, 182–184, 186, 189,
574–575, 578 195, 434, 460
illness 163, 428, 438, 479, 483, 486, 490, insomnia 526–527
502–504, 510, 519, 523–524, 538–540, institutionalised 304, 365, 492, 524
542, 549, 576 instrumentalists 31, 207, 239, 379–381,
imagery 509
and music 107, 135, 417, 518, 529, intensive care 74, 511
531–532, 536, 584 intensive training 84, 89, 95, 104, 141,
imagination 232, 344, 378, 455 157, 185, 333, 406, 506
imaging 18, 22, 25–27, 30, 32, 35–36, 41, intercultural 356, 558, 562–563
46, 138, 149–150, 155, 167, 174–175, interference 144, 149, 162, 180, 194, 272,
181, 185, 188, 202, 226, 283–284, 278, 280, 287, 293, 296, 310, 315
460–461, 506, 542, 545 interpersonal intelligence 3, 200, 208,
imitation 3, 34, 54, 154, 395, 404, 481 443, 445, 448
immersion 281–282, 443, 487, 499, 563 interval 21, 26, 29, 59, 61, 100, 150, 296,
immigrant 341, 346, 367, 377, 402, 428, 351, 370, 374
530, 561–565, 569 intonation 59, 74, 100, 144, 505
immigration 201, 531, 562 therapy 74, 505
immunity 480–481, 485, 590 intrapersonal intelligence 200, 208,
immunoglobulin 485 443, 445
immunty 427, 479–480, 482, 484–485, introverts 274, 292–294, 315, 378, 576
503, 515–517, 521, 524, 590 iPad 464
improvisation 42, 86, 129, 161, 173, 182, Iran 7, 212, 279, 289–290, 345
189–190, 193, 204, 225–229, 231–233, Iraq 529, 544, 555, 561, 564
235, 251, 256, 335, 340–341, 344, 351,
Ireland 156, 328, 352, 401, 523, 533,
354, 367, 388, 405, 433, 446, 471, 485,
559, 570
490, 493, 511, 521–522, 535–536, 541,
Israel 118, 213, 529, 532, 556–557, 559,
545, 548, 564–565
569
incarceration 353, 362–363, 534, 556
Italy 144, 339–340, 434, 466–468, 470
inclusion 10, 143, 179, 325, 335–336,
414, 453, 456, 462, 494, 497, 504, 510, Jamaica 331
522–523, 531, 534, 552, 559, 561–562, jamming 349, 358, 388, 470
565–566, 569–571 joy 418, 425–426, 432, 455, 486
India 13, 207–208, 238, 279, 591 judgement 54, 56, 76, 80, 187, 191, 306,
infant 3, 33, 43–45, 48, 62–63, 71, 74–75, 326, 369, 371, 373
98, 114, 197, 342, 392–393, 395, 430–
431, 511–512, 522, 552, 554. See babies Kalamazoo Kids 327, 332
infant-directed 44–45, 71 kinaesthetic 200, 208
informal musical activities 11, 33–34, kindergarten 84, 88, 90–91, 115–116,
63, 77, 81, 84, 173, 231, 338, 399, 431, 118–119, 129, 146, 154, 182, 212, 242,
433, 445, 468, 529 249, 403, 547
infrared spectroscopy 226–227, 283–284, kinematic 507–508
307, 539 kinetic 327, 508
infrequent deviant stimuli 134, 150 Korea 216–217, 360, 435, 537
 Index  815

language impairment 75–76, 94–96, 99 maladaptive 421, 461, 525

latency 137, 152, 475, 526 Malaysia 558
lateralisation 58, 60, 137 male 3, 23–24, 109, 112, 121, 139, 167,
late-trained 407 273, 292, 294, 300, 360, 365, 368, 372,
leadership 323, 334, 336, 354, 398, 410, 379, 423, 437, 528, 575, 577
456, 555, 575 manipulative dexterity 408
learning climate 259, 323, 400, 568 manual dexterity 408, 506
leukaemia 513 marginalised 336–337, 350, 358, 366,
life satisfaction 329, 406, 413–414, 448, 428, 433, 504, 561–562, 571
451, 454, 475, 488 mastery 4, 13, 258, 322, 344, 353, 363,
limbic 225, 415 424, 452, 489
linguistically diverse 433, 565, 567 maternal 44, 187, 511, 547
Liverpool 328, 332 maturation 19, 23, 35–36, 48, 71, 87, 174,
lobe 16, 20, 24, 48, 55, 148, 202, 257, 481 182, 184, 187, 207
localisation 26, 36, 112, 139, 148, 507 mean arterial pressure 511, 517
lockdown 465–472, 474–476 meaning 4, 6, 48, 50, 54–55, 310, 314, 337,
locomotor 409, 507 344, 367, 399, 413–415, 428, 431, 436,
439, 443, 447, 453–454, 456, 462–463,
loneliness 5, 376, 423, 439, 442, 449, 453,
514, 551, 556, 581
455, 457, 459, 464, 468–469, 476, 488,
503, 565–566 medication 484, 488, 516, 525, 531
longitudinal study 9, 35, 64–66, 68–69, medicine 327, 345, 482–483
72, 75, 86, 88, 121, 154, 156, 182–183, Mekranoti Indians 578
187, 207, 211, 213, 219, 240, 244, 259, melodic 21–22, 34, 36, 44, 50, 53, 66,
408, 440, 448, 487–488, 500, 502, 521, 74, 76, 83, 100–101, 147, 164, 203,
560 216, 546, 577
Los Angeles 71, 88, 330 melodies 22, 33, 38, 41, 43, 53–55, 59–60,
loudness 272–274, 314–315, 416, 418, 74, 150, 175, 233, 271
447, 549, 555–556, 585–586 memories 16, 22, 133, 169, 278, 311,
love 6, 12, 33, 368, 442, 469, 498, 575 314, 424, 430–431, 444, 447, 463, 467,
low-arousal music 274, 280 472, 495, 537
low-frequency oscillations 275, 313 working memory 23, 26, 34, 36, 54, 67,
73, 81–82, 86–87, 101, 120, 133–135,
low-income 88, 104, 118, 128, 182, 216,
388, 566. See also  economically 138, 141, 144–146, 148–162, 164–169,
disadvantaged 171, 173–179, 182, 184–187, 191–197,
200, 204–205, 210, 214, 217–219,
lullabies 3, 367, 393
252–253, 257, 264–267, 269, 272, 288,
lungs 425, 482, 486, 488, 509
292, 295, 306, 309, 460–461, 496
lyrical 226, 277, 279, 287, 300
memorisation 8, 55, 59, 139, 149, 153,
lyric-writing 338, 350, 463 157, 267, 279, 282–284, 584
magnetic resonance 18, 22–23, 25–28, memory impairment 305
30, 35–36, 149, 174–175, 181, 185, memory performance 146, 150, 152–153,
188, 226–227, 506, 545 159, 161, 165, 167, 169, 192, 217, 265,
magnetoencephalography 18, 20, 31, 267, 275, 278, 280, 282, 284, 295, 305,
33, 44, 64, 147 307, 313
mainstream education 337, 340–342, men 275–276, 337, 363, 369, 423, 426–428,
346–347, 560 448, 480, 488, 502, 532, 570, 575, 578
816 The Power of Music

mental health 13, 337, 341–342, 347, 351, 521–522, 529, 546, 566, 575–577,
353–354, 366, 372, 394, 413, 415, 421, 584–585
424, 427, 429, 431, 441, 457–458, 469, motoric 249, 584
473, 502–504, 520–521, 527, 534, 537, Mozart effect 8, 110, 261–262, 264–266,
539–540, 566–567, 584 307–308
mental rotation 111, 121, 268 Mozart, W. 8, 109–110, 261–266, 268,
mentor 326, 354, 356, 373 273, 275, 279, 281, 286–287, 289–290,
mesolimbic 542 298, 301, 303, 307–308, 516, 589–590
meta-analytic analyses 10, 253, 516 MP3 player 424, 517
metabolic 480, 483, 487 multicultural 126, 530, 557, 560, 563
metabolism 24, 202, 303 multimodal 16, 37, 39–40, 62, 76, 459
metacognition 270, 290, 296, 317 multiple sclerosis 509
metal music 273, 277, 382, 423–424, 441, muscles 22, 24, 39, 479–480, 489, 508,
577, 589–590 510, 515
methylphenidate 302 musicality 2–3, 112, 299, 525, 547, 551
Mexico 339, 444, 466 musicianship 6, 112, 123, 176–177, 190,
midbrain 312, 481 232, 428
middle-aged 178, 487, 535 myelination 15, 24, 137, 172
middle-class 250, 428
national anthem. See anthem
middle school 189, 213, 237, 246–247,
Nazi Germany 7, 555
346, 386, 388, 524, 569
negativity
Milanese 466, 470
brain activity 17–18, 21, 32, 34, 60
military 6, 527–528
military service 528 feeling 440
mirror neurons 73 negligible 188, 209, 211, 240
misogynism 577 neighbourhood 118, 245–246, 388
mobility 458, 482, 505, 580 neocortical 65, 225, 311
Modern Language Association 112 neonatal 44–45, 511
modulation 39, 51, 57, 75, 150, 280, 283, nerve impulses 15
285–286, 307, 397, 485, 516, 538 nervous system 72, 135, 156, 308, 311,
monolingual 69, 151, 177 410, 415, 480, 524
morale 415, 488, 571 neurocognitive 60, 74
morphometry 18, 23, 25, 181, 506 neurodegenerative 167, 484, 508
mortality 167, 448, 479–480, 488, 521 neuroimaging investigations 35, 155
motherese 44, 48 neuroleptic drug 539
mothers 3, 43–44, 48, 83, 212, 333, 342, neurological 25, 33, 38, 42, 44, 75, 87,
367, 392–393, 431, 435, 465–466, 522, 99, 180–181, 225, 256, 260, 262, 269,
536 392, 477, 482, 486, 505, 508
motivation 6, 8, 77, 101, 110, 119, 125, neurological impairment 49, 508
128, 140, 157, 197, 200, 221, 225–226, neuron 15, 17–19, 21–22, 24–25, 27–31,
240, 243, 252, 254, 256, 258–260, 263, 40–41, 44, 50–53, 73, 75, 153, 176,
282, 312, 316, 319–324, 327–328, 202, 312, 507
331–332, 338–339, 342, 357, 368–370, neuroplasticity 21, 31, 37, 40, 505, 507,
373, 381–383, 385–386, 402, 406, 410, 538
418, 425, 433, 435, 447, 450, 454–455,
458, 461, 476, 481, 486, 505, 510–511,
 Index  817

neuropsychological 135, 138, 155, 162, openness 82, 208, 230–232, 235, 258,
181, 183, 190–191, 193, 196–197, 212, 378, 380–381, 388
217–218, 490 opera 405, 585
neurorehabilitation 481, 505 optimism 253, 389, 413–414, 433, 439
neuroscience 9–10, 15–17, 46, 104, 108, Opus Project 327, 332
110, 148, 193, 202, 255, 274, 283, 286, orbitofrontal 174, 312, 539
311, 406, 481, 532, 594 orchestra 23, 111, 113, 118, 135, 139–140,
neuroticism 379–381, 576 186, 191, 244, 250, 255, 303, 326,
neurotransmitter 172, 312, 416, 485 329–331, 334, 367–368, 379–381, 388,
New Zealand 333, 436, 444, 554 391, 398–399, 401, 406, 433–434, 436,
Nigeria 445, 577 451, 468, 471, 476, 497, 556
noise 20, 33–34, 45, 56–57, 60–61, 64, oscillation 34, 47, 50, 100, 148, 275, 313
67, 80, 101, 141–142, 147, 157–158, out-of-key 59–60
161, 167, 264, 266, 274–275, 280–281, out-of-tune 281
293–295, 299, 304–305, 326–327, overarousal 315
332–333, 543, 556, 583, 589–591 overstimulation 556
noisy 67, 72, 142, 424 oxygenation 27–28, 153, 174, 512
non-human species 589, 591 oxygen saturation 511, 514
non-medical interventions 479 oxytocin 415, 426, 480, 516, 553
non-musicians 9, 19–34, 37–40, 42, 46,
55–61, 65, 67, 70, 80–81, 110–112, paediatric 512–513
114, 134–145, 149–153, 157–158, palliative 516, 518–519
160–162, 168–169, 175–179, 186, parahippocampal 312
190–191, 193–194, 196–197, 204–206, parent 11, 33, 63–64, 75, 82, 113, 129, 181,
226–228, 231–232, 235, 240, 254–255, 189, 203, 208, 211, 214, 239, 243, 247,
257–258, 265–266, 272–273, 291–292, 249, 325–328, 330–331, 334–335, 345,
377, 379–380, 423, 461 356, 368, 378, 385, 388, 390, 393–394,
non-trained 67, 184–185 396, 401–402, 430–432, 434, 436, 439,
Northern Ireland 352, 523, 559 442, 465, 508, 511–515, 523, 537, 547,
Norway 337, 344, 366, 466, 487, 502, 553, 569–570
520, 557, 563–564, 567 parietal 16, 20, 27, 29, 41, 139, 153, 175,
Norwegian 231, 321, 386, 563 202, 481
nostalgia 164, 466–467, 556 Parkinson’s disease 76, 484, 505, 507, 510
novice 21, 426, 454, 458, 461, 487 participatory 33, 63, 335, 355, 371, 415,
numerical magnitude representations 429, 431, 433, 436, 449, 456, 462, 484,
121 504, 530–531, 533, 561–562, 564–565,
nursery 116, 190, 341 567
nurture 326, 387, 401, 554, 564 patriotism 6–7, 164, 473–474, 558
patterning 51, 98, 108, 120, 122, 437
occipital 16, 35, 155, 187, 313, 481 pattern-matching 36, 98
oculomotor 135 peace 358, 418, 453, 455, 499, 527, 529,
offender 348, 353–362, 364–366, 368, 533, 555–557
371–373, 450, 567 pedagogy 335, 381, 454
offending 339, 359, 366, 369–371 peer pressure 343, 353
Ohio 242, 250, 363
Ohio Proficiency Test 250
818 The Power of Music

percussion 84, 114, 129, 160, 193–194, playschool 33, 64, 73, 85, 182
214, 254, 335, 343, 358, 363, 378, 388, pleasure 4, 12, 14, 169, 263, 267, 274–275,
436, 460, 482, 491–492, 509, 535 292, 309–314, 331, 413, 416–417, 419,
perfectionism 382–383, 410 421, 424, 432, 438, 447, 449, 452, 456,
performance 12, 39, 123, 154, 215, 313, 459, 471, 473–474, 481, 489, 493, 527,
322, 369–370, 390, 404, 410, 461, 470, 531, 549, 554, 575, 579, 584–585,
474, 485, 488, 492, 496, 543, 557, 590–591
564–565, 575 poetry 283, 352, 557, 574
performer 31, 173, 316, 397–398, 410, Poland 383, 448, 487
451–452, 457, 468–469, 565, 578 police 354, 585
perseverance 101, 119, 258, 359, 386, 389 pop 58, 110, 263, 271–272, 295, 323, 327,
persistence 69, 95, 138–139, 143, 163, 195, 335, 352, 382–383, 399, 423–424, 484,
238, 242, 321, 326, 396, 401, 407–408, 540, 558, 586–587, 590
433, 504, 507 posterior 20, 22, 25, 36, 58, 60, 153, 275,
personal development 1, 330, 372, 375, 313
377, 385, 401, 453, 463, 478 post-traumatic stress disorder 513,
personality 9, 157, 200, 203, 224, 230– 527–528, 530–531, 534, 536
231, 235, 254, 257–258, 260, 270, 290, poverty 352, 402, 435, 537, 566, 569
293–294, 317, 348, 360, 375–383, 410, pre-attentive 33, 66, 69, 76, 96
437, 456, 522, 539, 595 precentral gyrus 31
pharmacological 292, 493, 499, 518, predictive 45, 50–51, 53, 75, 121, 191
538, 544 predictive coding 50, 53
pharmacotherapy 544 predictor 70, 80, 82, 98, 114, 121, 210,
Philippines 444, 554 240, 258, 287, 378, 391, 396, 456, 467,
phobic 538 471, 525, 575
phonation 510–511 predisposition 37–38, 42, 159, 201
phoneme 45, 52, 79–80, 84–85, 89, 94 preference 43, 221, 264, 266, 268, 270,
phonemic awareness 81, 84–86, 95, 207 276, 279, 293, 295, 301, 316, 348, 391,
phonetic 54, 56, 61, 72–73, 80, 154 420, 423–424, 512, 520–521, 546, 579,
phonetic contrasts 56, 80 582
physical development 407, 432 pregnancy 43–44, 393, 483
physiological 13, 21, 50, 60–61, 72, 134, prejudice 558–559, 566, 571, 593
142, 150, 267, 278, 303, 310, 313–314, prelinguistic 63, 393
316, 416, 418, 479–480, 505, 551, 590 pre-literacy 91, 103
pitch 8, 20, 24–25, 29–30, 32–33, 36, premotor 26–29, 36, 38, 41
39–41, 44, 48–49, 56–59, 62–63, 65, prepotent 177, 194
67–68, 71, 81, 85, 90, 93–94, 96–98, preschool 62–63, 80–81, 84–85, 89, 97,
100, 102, 139, 144–145, 180, 183, 115, 117, 124–125, 127, 154, 182,
205–206, 282, 314, 546, 551 189–190, 210, 212, 214, 232, 249, 403,
pitch impairment 97 434, 513, 532, 570
planum temporale 25, 36, 58, 254 pride 326, 328, 332, 338, 364, 369–370,
plasma 416, 516, 524 374, 385, 388, 400–402, 433
plasticity 16–17, 28, 32, 36, 40, 42, 47, priming 262, 266, 269, 307, 309, 587
49, 171, 183, 185, 195, 202, 212, 459, prison 356, 361–372, 527
461, 482, 505, 508 prisoners 319, 361, 363–367, 369–370,
playlist 1, 424, 466, 470, 474, 573 372, 556
 Index  819

problem-solving 120, 134, 173, 262, 354, race 358, 377

369, 399, 490, 569 racism 559
procrastination 328, 331 randomised controlled trial 10, 71,
proficiency 104, 113, 153, 289–290 94–95, 157, 165–166, 169, 213–214,
prolactin 416, 426 219, 366, 407
proneness 258, 316 rap 225–226, 340, 347–354, 357–359, 376,
prosocial 6, 64, 338, 360, 363, 367, 393, 424, 444, 536, 577
395, 397, 403–404, 449, 535, 554, 568, rapport 12, 544
577 rats 589
prosodic 47–48, 50–53, 59, 74–75, 92, receptive activities 2, 63, 73, 76, 83,
97, 100, 215 100, 189, 204, 214, 249, 352, 448–449,
prosody 50 487–488, 500, 513–514, 565
protective factors/effects 167, 387, 441, refugee 325, 345–346, 367, 377, 402,
521, 577 526–527, 529–534, 560–565
protein 24, 202 regression analysis 9, 23, 52, 64, 73,
proximity 451–452, 578 97, 113, 155, 176, 190, 205, 210, 218,
pseudo-words 93, 95, 144, 281 239–240, 243
psychiatric 180, 483, 500, 524, 527, rehabilitation 73–74, 159, 284, 319, 326,
535–536, 538–539, 541, 545 333, 353, 366–367, 482, 484, 505–507,
psychiatry 524 514, 518, 526, 532, 534, 543
psychodynamic 251, 540 rehearsal 6, 136, 151, 157, 369–370,
397–399, 426–428, 436, 484, 552
psychometric 143, 178, 206
reintegration 319, 356, 363, 371–372, 528
psychopathology 524–525, 538, 540
relationship-building 443, 446–447, 477
psychophysical 144, 503
relaxation 426
psychophysiological 484, 517
relaxing 1, 5, 11–12, 27, 109, 261–262,
psychosis 538, 545
265, 271, 306, 330, 402, 413, 416,
psychosocial 214, 350, 402, 437, 439, 450,
419–420, 425–427, 436, 440, 447, 452,
458, 471, 511, 519, 530, 538
455–457, 459, 469, 473, 486, 495, 497,
psychosomatic 480, 494 510, 512, 515, 519–522, 525–526, 532,
psychotherapy 251, 341, 348, 446, 532 535, 538, 582, 585, 590
psychoticism 538, 540–541 relief 449, 469, 518, 533, 541, 579
pulmonary 509–510 religion 1, 5–6, 454–455, 488, 530,
punk 559, 577 557–558, 560, 571, 573
pupil referral units 342–343 reminiscence 419, 463, 489–490, 495, 499
putamen 47, 153 reoffend 354, 356, 358, 361, 369–370,
372–373
qualitative 123, 165, 327, 332, 336, 342,
repetition 15, 18, 27, 41, 48, 54, 62–64, 80,
350, 359–360, 371–372, 385, 390–391,
95, 109, 129, 144, 157, 173, 261–262,
393, 429, 447, 464, 492, 494, 562
265, 270, 278, 317, 322, 356, 363, 393,
quality of life 165–166, 172, 415, 428, 450,
405, 407, 431, 436, 461, 508, 546, 548,
457–458, 460, 462, 486–488, 496, 500,
551, 558, 584, 589–590
503, 507, 513–514, 516, 519, 521, 524,
reproduction of music 98, 161
526–529, 536, 540, 545–546
residential home 193, 346, 490. See care
quantitative 129, 211, 327, 336, 358,
home
464, 540
820 The Power of Music

resilience 329–330, 336–337, 353, 359– rock 7, 32, 58, 231, 258, 273, 276, 278,
360, 374, 376, 387, 406, 414, 428, 439, 287, 302, 358, 379, 382, 424, 484–485,
467, 503, 522, 531–532, 562 559, 577, 583, 586
resonance 18, 22, 25–28, 30, 35–36, 149, romantic music 442
164, 174–175, 181, 185, 188, 226–227, rostral 28
506, 545 rules 17, 42, 55, 59–60, 120, 173, 335,
respect 320, 330, 337–338, 340, 344, 356, 356, 496
367, 371, 373–374, 397–398, 401, 469,
554, 569 saccadic 135
respiration 310, 312, 480, 511, 590 sadness 215, 285, 297, 306, 421–422, 426,
respiratory 164, 483, 485–486, 510–511, 441, 478, 529, 542
513, 517 saliva 426, 485, 503, 511, 516, 518, 520
responsiveness 354, 369, 371, 431, 512, Salvation Army 379
537, 547, 582 San Diego 327, 332
retention 16, 23, 88, 107, 133–134, scanning 18, 27, 35, 138, 152, 159–160,
145–146, 150, 153, 180, 282–283, 339, 193, 460
426, 438, 447, 464, 477, 561 school readiness 83, 403
retirement 234, 447, 451, 457, 460, 462, secretory 485
486–487, 528, 579 sedation 278, 304, 483, 512, 516–517, 520
retrospective 210, 217, 239, 259, 361, segmentation 50, 69, 82–84, 88, 95,
405, 542 99–101
Rett syndrome 76 segregation 43, 45, 83, 141
rewarding 3, 14, 77, 278, 291, 310–312, self-acceptance 391, 509
374, 505, 552, 578, 594 self-actualisation 419, 427
rewards 5, 252, 259, 268, 278, 292, 306, self-affirmation 388
310–312, 321, 451, 456, 481–482, 542, self-awareness 386
544, 549, 551 self-belief 258, 321, 327, 331, 339, 375,
rhyme 79, 83, 86, 94, 97, 102, 117, 253, 377, 384, 387, 571, 594
265–266, 283, 340, 393–394 self-care 330, 531, 548
rhythm 30, 33–34, 36, 43, 47–48, 50–54, self-concept 259, 299, 320, 323, 353,
60, 66, 68, 70–71, 74–76, 81–87, 90, 357–359, 373, 384–389, 459, 464, 489,
92–102, 105, 107, 114, 116–118, 504, 535, 540
122–123, 126–127, 130–131, 144, 151,
self-confidence 13, 326, 329, 332, 335,
156, 158, 160–162, 164, 173, 175, 183,
339, 342, 353, 364, 370, 384–385,
193, 195, 203, 226, 252, 271, 347, 352,
390–391, 401–402, 425, 432, 434, 445,
388–389, 395–397, 404, 408–409, 416,
447, 486, 489, 521, 535–536, 540, 547
481, 492, 495, 504–505, 507–509, 527,
self-control 22, 333, 345, 355, 369,
536, 538, 545–546, 549, 551, 555, 577,
434–435, 535, 538
582
self-description 351, 388
cueing 505, 510
self-development 320, 429, 471
impairment 90
self-directed 443
prosodic cues 51, 75
self-discipline 258, 329–330, 337, 360,
rhythmic prosodic cues 51, 75
378, 399, 401
rituals 5–6, 362–363, 445, 469–470, 472
self-disclosure 352
self-efficacy 119, 128, 200, 258, 321–322,
330–332, 337, 353–354, 356, 373–374,
 Index  821

384, 390, 429, 431, 439, 459, 566–567, sensory 15–17, 22, 47, 50, 55, 74, 95,
594 99, 133, 151, 196, 459, 481, 497, 508,
self-esteem 6, 243, 258, 320–323, 329–332, 546, 548
335–336, 338, 342–343, 345–347, 351– sequencing 89, 99, 107, 147–148, 204,
353, 355–358, 360–361, 364–366, 369, 210, 357
372–373, 381, 384–393, 402, 406, 410, serotonin 415–416, 480, 524
413–414, 419, 425, 428–429, 433–434, set-shifting 172, 181, 184–185, 209
437–438, 444–447, 455, 462, 464, 486, sex 23, 69, 87, 112, 163, 212, 246, 278,
498, 509, 521, 524, 527, 532–533, 535– 312, 360, 386, 437, 440, 448, 569, 577
536, 540–541, 547, 566–567, 579, 594 sexism 357, 577
self-estimated 230 sexuality 3, 343, 358, 529–530, 534, 536,
self-evaluation 5, 299, 358, 437 577
self-expression 12, 337, 342–343, 346, sexually abused 358, 530, 534–536
356, 360–361, 364, 384, 427, 446, 489, Sierra Leone 533, 561
505, 514, 521, 568, 579
sight-reading 174, 197, 204
self-identity 5, 377, 391, 463, 563
Sing Up 335, 568
self-image 384, 386–387, 542, 563, 575
sleep 45, 180, 431, 444, 474, 483, 525–526,
self-knowledge 359, 564 531, 548, 556
self-monitoring 225, 251 smoking 448, 580
self-paced 27, 275, 584 sociability 362, 394, 552
self-perception 200, 321, 363, 377, 384, social capital 325, 456, 570
386, 429, 452
social climate 399–400
self-rated 230, 267, 349, 476
socialisation 402, 419, 466, 536
self-regulation 181, 188, 257, 322, 331,
social isolation 6, 428, 455, 459, 462–464,
342, 351, 418–419, 431, 440–441, 444,
466, 470–471, 475, 497–498, 503, 511,
446–447, 459, 566, 576
520, 528, 565
self-reliance 400, 568
social media 466, 468, 470, 472, 558
self-report 112, 158, 163, 180, 191–192,
socioeconomic status 69, 82, 87–88,
200, 231, 269, 286, 359, 381, 393,
113–114, 140, 157, 161, 188, 203, 205,
405–406, 434, 438, 443, 448, 487, 498,
207, 209, 237–238, 240, 242, 244, 246,
503–504, 515, 520–521
297, 345, 380, 404, 428, 471, 580
self-satisfaction 459
socioemotional 259, 403, 405–406, 535
self-select 9, 112, 183–184, 267, 310, 404,
sociomoral reflection 180
421, 440–441, 466–467, 480, 506, 581
software 94, 339–340, 349–350, 359,
self-system 377, 384
471–472, 588
self-taught 227–228
soldier 528–529, 532–533, 555
self-understanding 391, 459
solidarity 2, 330, 468, 553, 555
semantic 54, 59, 71, 133, 143, 160, 175,
solitude 258, 322, 378, 583
187, 266, 281, 287
somatisation 538
sensation-seeking 382, 582
somatosensory 19, 22, 24, 30, 95, 481
sensitisation 157, 185, 214, 408
sonata 109, 261–266, 268, 281, 289–290,
sensor 234
298, 307, 516, 589
sensorimotor 23, 26, 29, 31, 36–37,
song-writing 216, 234, 342–343, 350,
39–42, 76, 98, 157, 175, 185, 225, 397,
359, 362, 445, 462, 487, 511, 535–537,
407–408, 461, 481–482, 505–507
541, 548
822 The Power of Music

soothing 3, 431, 590 subculture 376, 551

sound discrimination 43, 45, 64, 86, 97, substance abuse 336, 357
100, 119, 154, 507 suicidal 354, 423, 442, 576
soundtrack 282, 472, 586 suicide 423, 442, 534, 576
South Africa 7, 328, 353–354, 356, 389, superior longitudinal fasciculus 207
445 surgery 484, 514–517
South America 330, 421, 561 survivor 530–532
Spain 67, 88, 213, 335, 432, 466–470, 569 Suzuki method 34, 146, 154
spatiotemporal 507, 594 Sweden 215, 405, 448, 456, 502, 517,
special educational needs 90, 248, 296, 520, 546
303, 319, 329, 340, 350, 389, 405–406, Switzerland 400, 450, 492, 568
410 syllable 45, 51–52, 56, 60–62, 69, 80, 82,
spectroscopy 226–227, 283–284, 307, 539 87, 92, 95–96, 98–99, 101, 147, 283
speech deficits 76 symbol 4, 6, 55, 85–86, 121, 123, 126–127,
speech impairment 484, 510 141, 159, 161, 192, 213, 263, 352, 363,
spinal cord 16, 505 402, 430, 446, 534, 542
spiritual fulfilment 449, 579 sympathetic nervous system 311, 524
spirituality 5, 329, 400, 418, 427, 429, synapse 15, 17, 24, 65, 172, 202
449, 454–455, 497, 516, 519, 579 synchronisation 3, 6, 17, 37, 50, 62, 93,
spontaneous 7, 98, 148, 154, 225–226, 98–99, 156, 160, 193, 262, 395–396,
288, 340, 364, 395–396, 407, 439, 407–408, 460, 475, 551–553
467–468, 547 synchrony 92, 265, 395–397, 407, 546, 554
Sri Lanka 531, 585 systematic 26, 72, 84, 101, 131, 182,
stem cell 513–514 188, 234, 242–243, 266, 308, 310–311,
stereotype 17, 379, 381, 437 313, 335, 346, 350, 353, 382, 415, 463,
stigma 527, 531 518, 521
stimulation 1, 5–6, 18, 39, 50, 67, 76, systematic review 10, 101, 131, 346, 350,
224, 268, 271, 278, 301–303, 307, 316, 353, 415, 463, 518
415, 425, 427–428, 440, 451, 457, 459, systolic blood pressure 416, 484, 514, 518
473, 486, 489, 507–508, 511, 517, 520,
584–585, 590 Taiwan 272–273, 298, 524
story development 164 task-switching 174, 177, 185, 195
stress 45, 51, 53, 73, 76, 147, 166, 301, 337, Tasmania 456, 570
358–359, 366–367, 416, 422–423, 425, taste 12, 133, 376, 442, 478, 520, 587
441, 443, 446–447, 450, 452, 455, 458, teamwork 329–330, 336, 353, 364, 397,
461, 465, 469–471, 474–475, 478–482, 399, 401–402, 410, 433, 554, 569
484–487, 498, 512–513, 515–522, 525, tears 455, 481, 495
527–531, 534, 536, 542, 547, 549, 556, technology 1, 7, 17, 44, 46, 281, 344–345,
567, 583, 590, 593 399, 424, 452, 463–464, 471–473,
striatum 291, 312 477–478, 548, 561, 569, 573, 575
stroke 484, 490, 505–506, 510 teenager 5, 341, 437, 439, 444–445, 512
Stroop test 172, 182, 193, 204, 274 tempi 88, 286, 582
stutter 76, 511 tempo 98, 114, 263–264, 271–273,
subcortical 19, 27, 29, 48, 57, 60, 71, 87, 275–276, 280, 282, 314, 363, 395, 431,
99, 142, 156, 480–481, 546 582, 584–586
consonant discrimination 57, 60 temporo-occipital 35, 155, 187, 481
 Index  823

tension 5, 265, 306, 314, 341, 425–426, unconscious awareness 11, 55, 77,
439, 478, 480, 486, 493, 517, 520, 563, 133–134, 415, 440, 593
581 undergraduate 109, 114, 143, 179,
terrorism 529–530 203–204, 206, 215–216, 225, 239, 258,
therapeutic 13, 76, 335, 341, 344, 348, 262–263, 265, 270–271, 273, 275–278,
350–351, 356, 358, 367, 371–372, 425, 280, 282, 290, 474, 525
455, 482–483, 486–487, 489, 492, 500, unhealthy 383, 424, 443, 479, 503
505, 510, 514, 519, 524, 529, 534–535, United States 13, 114, 243, 391, 473, 559,
541, 556, 576 565. See America
therapist 340–342, 347–348, 351, 360, 394, untrained 40, 64, 69, 95, 100, 127, 147,
406, 477, 482–483, 487, 492, 494–495, 156–157, 159, 161, 184–185, 188,
497–498, 500, 503–504, 508, 511, 514, 202–203, 208–209, 215–216, 238
527–529, 534–536, 540, 545–547, 549, urban 114, 237, 319, 336, 347, 358–359,
558 386, 580
thrash metal 277
threats 344, 421, 479, 544 valence 234, 274–275, 284, 313
timbre 8, 21, 32, 65, 100, 271, 314, 546 variability 10, 44, 98, 142, 153, 191, 251,
timing 8, 29, 32, 39, 50, 56, 58, 60, 62, 296, 426, 500, 590
94–95, 98–99, 142, 252, 407, 481, 509 variables 10, 26, 50, 95, 109, 129, 140,
tiredness 265, 306, 522 156, 160, 177, 180, 191, 203–204, 208,
241, 243–244, 252, 256, 282, 400, 448,
togetherness 403, 459, 466
467, 488, 494, 507, 575
tolerance 227, 330, 388, 555
variation 49, 54, 183, 229, 242, 256, 391,
tomography 311
500, 516, 537, 548, 576
tonality 63, 150, 314
vascular 163, 490, 493
tone 19–21, 24, 33–34, 37, 40–41, 49, 56,
ventral striatum 291, 312
58–59, 62–65, 80, 82, 97, 144–145,
verbalisation 491, 532, 536
147, 152–153, 225, 275, 298, 416, 439
veterans 528–529, 543
tone deaf 37, 82
victim 405, 532–535, 547, 556
top-down processes 34, 49, 52–53, 195,
235 vigilance 177, 285, 578
torment 556 violations 17, 59–60, 62, 286
torture 532, 556, 593 violence 333, 343, 354, 434–435, 529–530,
534–535, 537–538, 560, 569, 577, 593
Tower of Hanoi test 173, 186
virtual 41, 128, 281–282, 470–474
transcranial magnetic stimulation 18, 39
visual analogue scale 166
transferable 232, 321, 325, 334, 338,
341, 374 visual impairment 345
transformation 36, 121, 330, 336, 342, visual memory
428, 446, 528, 557 and behaviour 134
transformative 359, 361, 364, 557, 568 visuomotor 28, 136, 459, 461, 493
transplant 513–515 vital signs 485, 512, 514
trauma 180–181, 353, 505, 510, 513, Vivaldi 266, 286, 304–305
526–537, 558, 560, 565, 571 vocally expressed emotion 57, 59
trust 326, 337–338, 344, 370, 373, 397–398, voice 43, 58, 68–69, 76, 87, 96, 183, 194,
449, 456, 469, 532–533, 552, 570, 579 211, 350, 362, 364, 367, 392, 429, 491,
twins 163, 171, 202, 215, 405 494, 510–511, 530, 564
824 The Power of Music

volume 20–23, 25–26, 35, 155, 181, 187, Western 7, 19, 32–33, 63, 139, 267, 271,
202, 254, 271, 310, 316, 406–407, 424, 279, 336, 378, 443, 564, 573, 578
439, 509–510, 517, 556, 581–582, 586 white-matter microstructure 509
volunteer 31, 47, 164, 242, 273, 275, Williams syndrome 148
311, 313, 338, 362–363, 368, 415, 455, willingness 128, 327, 381, 552
462–463, 554, 574 womb 3, 43, 46
vowel 49, 56, 61, 65, 69–70, 87, 146, 164 women 275–276, 362, 366, 393, 426–428,
voxel 18, 22–23, 27, 36, 175, 181, 506 464, 502, 518, 529, 534, 536–537,
voxel-based morphometry 23, 506 576–578
vulnerability 325, 333, 421, 423, 453, word discrimination 65, 82, 87, 146
467, 469, 476, 496, 532, 565 working memory
and behaviour 148, 150
weapon
workshop 64, 251, 333, 358–359, 362–364,
of music 556
373, 388, 436, 462, 488, 504–505, 533,
Wechsler Adult Intelligence Scale 200,
535, 548, 564, 567
204
World War 482, 556
wellbeing 1, 5, 8, 11, 13, 92, 165, 167,
worry 5, 278, 414, 426, 439, 457, 467,
196, 234, 323, 325, 328–329, 338, 341,
471, 518, 525
347, 351, 353, 362, 367, 383, 393, 400,
402, 406, 413–422, 424–427, 429–434, youth 6, 121, 186, 244, 326, 328, 330–331,
436–438, 440, 442–451, 453–460, 333, 336–337, 339, 345, 347–348,
462–469, 471–483, 486–488, 492–493, 352–353, 355–357, 359–360, 445–446,
496–498, 500–504, 510, 512–513, 516, 540, 561, 567
519, 521–522, 524, 526, 530–531, 535,
540, 546, 549, 552–554, 561–567, 576,
589, 593
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THE POWER OF MUSIC
An Exploration of the Evidence
SUSAN HALLAM AND EVANGELOS HIMONIDES
Building on her earlier work, The Power of Music: A Research Synthesis of the Impact
of Actively Making Music on the Intellectual, Social and Personal Development of
Children and Young People, this volume by Susan Hallam and Evangelos Himonides
is an important new resource in the field of music educa�on, prac�ce, and
psychology.

A well signposted text with helpful subheadings, The Power of Music gathers and
synthesises research in neuroscience, psychology, and educa�on to develop our
understanding of the effects of listening to and ac�vely making music. Its chapters
address music’s rela�onship with literacy and numeracy, transferable skills, its
impact on social cohesion and personal wellbeing, as well as the roles that music
plays in our everyday lives.

Considering evidence from large popula�on samples to individual case studies and
across age groups, the authors also pose important methodological ques�ons to
the research community. The Power of Music defends qualita�ve research against
a requirement for randomised control trials that can obscure the diverse and o�en
fraught contexts in which people of all ages and backgrounds are exposed to, and
engage with, music.

This magnificent and comprehensive volume allows the evidence about the
power of music to speak for itself, thus providing an essen�al directory for those
researching music educa�on and its social, personal, and cogni�ve impact across
human ages and experiences. This is the author-approved edi�on of this Open
Access �tle. As with all Open Book publica�ons, this en�re book is available
to download for free on the publisher’s website. Printed and digital edi�ons,
together with supplementary digital material, can also be found at h�p://www.
openbookpublishers.com

Cover image by Tabitha Lincoln, all rights reserved Cover design by Anna Gatti

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