Research Title:
Interactive Music Technology for Distraction, Entertainment and Well-being for Hospitalised Young People
Proposed Supervisors
Dr Garth Paine
Professor Michael Atherton
Dr Amanda Third
Project Concept
The project will investigate the ways in which patients within a hospital environment can be distracted from boredom and contribute to there overall well-being during their hospital stay. This will be achieved through an interactive digital music-making device. Interactive music devices will be developed within the context of distraction therapy, which aim to augment current regimes, thereby increasing the potential to normalize an adolescent’s stay in hospital. This HDR project aims to find new ways of approaching system design and development to more effectively marry the rich benefits of creative expression, new sensing technologies, and normalising a patients stay in hospital.
Background
My severely disabled brother, and my own personal love of music therapy has led me on this path. As a volunteer at the Nordolff- Robbins Music Therapy Centre, my interest in therapeutic practices within music, combined with my previous work with interactive light and motion installations to further extended my skills and knowledge of the myriad possible applications within the music/technological/therapy field.
Key issues and the themes.
This project, consisting of creative work and an exegesis will extend my 2010 honours project titled A pilot study into interactive music systems for distraction and play techniques for adolescents. Due to the time restrictions of the Honours year, the extension of the 2010 Honours project into PhD is a logical step. The PhD project will expand my Honours project (hereafter referred to as ‘the pilot study’) to include additional technological development in consultation with the Adolescent Medicine Department Art Therapists at The Children’s Hospital Westmead and will include a 3-year longitudinal study to gauge client interest over an extended period of exposure. The purpose of the research is to address the paucity of options available as distraction therapy to long stay adolescents.
Scope and Focus
The creative work seeks to offer innovative play and entertainment through the use of interactive music systems. The interactive music system(s) consist of a digital interface device, designed for teenagers to interact with to make music. The device can be used solo or in a group.
It is intended that this interactive system be made available to patients during their free time, as per their hospital schedule.
Discussion
The potential of electronic toys for use in medical settings has held interest in the hospital environment for some time. Recently Recreational therapists from Sydney’s Royal Rehabilitation centre used Wii Motes[1] (Nintento Australia, 2010) with burns victims to help distract the patient from their pain and encourage physical movement through interactive games (Stack Games, 2009). This illustrates one of the benefits of entertainment technology in the medical field, combining not only entertainment but also encouraging the physical movement required by the medical treatment regime.
Presently, the technology available for distraction from boredom, for patients within the Adolescent Medical Unit at The Children’s Hospital Westmead is limited. Often teenagers are given activities and devices that are known in their everyday lives and less likely to distract them from their medical predicament. This can best be seen in the Distraction Techniques chart (see Table 1). The technology available to the adolescent age group include devices such as iPod (Apple Inc, 2010) music players and PlayStation consoles (Sony Computer Entertainment, 2010). These devices often promote reclusive activities (Anderson, 2010), rather than social. The objective of the department is to normalise the patient’s stay and make them feel at home, which includes encouraging socialisation and group activities (Anderson, 2010). This objective is difficult to achieve with the available technologies, as most are designed for a single user. The objective of the proposed interactive music device(s) is to facilitate for both the independent user and group participants with the objective of contributing to normalising a patient’s stay.
In summary, the aim of this project is to extend and create an interactive music-making device for patients within the Department of Adolescent Medicine, promoting innovative stimulation that promotes wellbeing.
The Department of Adolescent Medicine caters for teenagers between the ages of 12-18, both long and short term stay. The patients illnesses can include complex symptoms, chronic illness, eating disorders, weight management concerns, drug and alcohol misuse. The patients that participated within the pilot study were a mix of male and female teenagers from the age of 12-18. The majority of the participants were long-term patients,
with a range of different illnesses such as eating disorders and chronic illness.
The pilot study was developed around the Percussa Audio Cubes (Percussa, 2010). This was a successful project yet limited by time and resourses. The plan is that via a doctoral length study, the project will develop further and become a permanent fixture within the Children’s Hospital Westmead.
Artistic Precedents
The pilot study was inspired by numerous different projects and creative works such as Dr. Garth Paine and Dr. Alan Lem’s project A Dynamic Sonification Device in Creative Music Therapy (Paine and Lem, 2008) which is also an interactive musical project. It builds upon similar ideas concerning music acting as a therapeutic tool that increases social, physical and mental well-being. It differs to the proposed Phd project in that the Paine and Lem project was designed specifically for a Communicative Music Therapy context, which is a session with a specific clinical outcome between a client and therapist. The proposed PhD project will run the project without a therapist or staff facilitation, much like a Play Station (Sony Computer Entertainment, 2010) game session.
The performance work of QFWFQ Duo, sound artists Andrea Pensado and digital artist Greg Kowalski, who build interactive installations such as Disconcertio (Qfwfq Duo, 2007) is another inspiration for the PhD. Disconcertio, is a light-tracking performance work, using a light to trigger sound and visual manipulation. It is an effective performance because it allows a person to perform freely without being overwhelmed with technology while still experiencing a high level of stimulation such as rich colours and visual aspects. The work produced by QFWFQ Duo is designed for artistic purposes; however, it could be appropriated for either people who are able-bodied or those with a disability[2]. It is often difficult to find music stimulation that is usable for a range of different persons, but Paine and Lem’s work achieves this through motion-tracking technology, in the same way my pilot study used the interactive music making device, the Music Cubes.
Another precedent for this project is the interactive work of video and sound artist George Poonkhin Khut's The Heart Library. The Heart Library invites visitors to St Vincent's Hospital to explore how their heart rates can become an artistic experience (Dunn, 2009). Khut’s work also draws upon Creative Music for example, “They are exploring how biofeedback art can help people suffering from anxiety and depression as they observe how their thoughts and feelings can be used to influence their heart rate”. Khut binds together technology and human interactivity to analyse the therapeutic benefits; much like the aim of my own work.
The PhD project will innovate in and extend existing practices such as the precedents above into a hospital environment, for a specific audience. It will seek to learn from the creative practices of the above precedents and contribute to an original project for the hospital specific environment.
Intended Audience
This project will be of interest to researchers and artists interested in methods of developing successful interactive systems that engage a wide audience of varying physical and cognitive ability. My pilot study looked at a target audience of 12-18+, within the Department of Adolescent Medicine. During the week-long study, 13 patients participated in the Music Cubes project, across a range of individual and group sessions. The overall results of the pilot study were positive. This was illustrated through feedback forms and observation checklists, examining the well-being scale[3] (R Tennant et al., 2007) of patients before and after use of the system.
For the PhD project, the interactive music device will target the same audience but using a more detailed approach that builds upon the strengths and addresses the weaknesses of the pilot study. On the basis of learning’s from the pilot study, the proposed PhD project will also be a longitudinal study to minimise the effect of fist use.
Like the pilot study, the interactive music-making device will be portable so it can be wheeled around to different wards within the hospital. In the future, it is hoped that it may be used in community environments, hospitals, therapy centres as well as schools or nursing homes as a permanent fixture.
Methods
This project will apply a practice-based research method rather than a controlled experimental approach.
Therefore, rather than evaluating the impact of a new interactive system on therapeutic outcomes for individuals, this project aims to assess the impact of the therapeutic environment and its practices on the creative development process itself. In this respect appropriate methods for evaluation include reflective practice writing (Bell, 2000) and specific feedback on the system and its iterative stages of development elicited from therapists and patients themselves.
The project will employ the software development environment MAX/MSP(Cycling 74, 2010) and Abelton Live (Abelton, 2010) to create a portable interactive system for use in therapeutic and community environments. I will be working closely with the staff from The Department of Adolescent Medicine, at The Children’s Hospital Westmead, and The Nordoff-Robbins Music Therapy Centre (Nordolf Robbins Music Therapy Centre, 2010) to observe and understand how their methods might influence the development and refinement of the project.
Study- Data collection and data analysis.
The project will seek to understand how and why participants engage with and are distracted and entertained by, the proposed interactive music-making device(s). To monitor and evaluate this level of engagement the project will employ observation techniques and feedback forms to determine the level of engagement and re/post session well-being. The analysis will consider the number of participants that engage with the interactive music system and how long they engage with it. A longitudinal study will gauge the degree to which interest is maintained in the system as a distraction therapy tool.
Significance (Value of Project)
In the future, it is hoped that interactive music systems as described above, could be integrated with existing play tools regimes to support educational, therapeutic, and assessment outcomes in the areas of communication, social and self-esteem development. This project proposes a solution, if merely a small one, towards the lack of innovative stimulation for teenage patients of the Adolescent Medicine Department at The Children’s Hospital Westmead.
The Children’s Hospital Westmead, involvement in the project is invaluable, especially because of the focus on adolescent heath, which was the age group targeted during the pilot study because of a perceived lack of options within existing regimes of practice. The pilot study sought to distract and entertain patients with new forms of interactive technology. The trial study contributed to original knowledge and has been a benefit to both the university and the hospital. This research collaboration between The Children’s Hospital Westmead and the University of Western Sydney will be of value to the hospital through the direct input to the developments in the field, and to the university through the valuable input and feedback staff will have throughout the research project. The project is not only of value to the community, to the hospital, and to the University, but to its patients by promoting wellbeing. Interactive music systems benefit original knowledge as technology such as the Percussa Audio Cubes (Percussa, 2010) are yet to be used within major hospitals. This project therefore, will focus on implementing a interactive music making device permanently into the Department of Adolescent Medicine, The Children’s Hospital Westmead.
[1] Wii-mote is the primary controller for Nintendo’s Wii console. The main features of a Wii-mote is monition sensing capabilities, an accelerometer and optical sensor technology.
[2] QFWFQ Duo’s work “Disconcertio” can be seen at http://www.qfwfqduo.com/qfwfqmovs.html
[3] Based upon The Warwick-Edinburgh Mental Well-being Scale