Physical Disability Domain

 Why I Chose This Domain: 

I chose the disability domain of Physical/Medical, because I do not have any formal or personal experience with students with severe physical disabilities. I have witnessed a few encounters, and have experience with students with poor motor control, mild learning disabilities, and a student with epilepsy.

If I had a student with physical disabilities in private one-on-one lessons, I am 100% confident that I could find a unique pathway for them. In a classroom setting, I would need much more help. 

The reality is that there is far more research on autism and developmental disabilities than physical disabilities. 

I have one student who is epileptic and has had seizures in the past. She is bright and motivated, but is very slow in music class since that time is used to help her catch up in other classes. 

I have a young cellist who broke her finger. I love to separate left and right hands to work on different skills, but this is temporary. 

Other than these examples, my experience with physically disabled students is very limited. 

We all watched the video of Adrian Anantawan, and in the comments I also mentioned Augustin Hadelich (click for CBS Sunday Morning interview) and, of course, world renowned violinist Itzhak Perlman’s life-changing journey with a childhood polio diagnosis.

Additionally, I have been in contact with a personal friend and cellist who recently went through a horrible physical experience. She is a public music teacher and performer. Her story is really what sparked my interest to focus on physical disabilities.

25 MARCH: *I do not have any photos of the practical accommodations at this time, but I will continue our conversation and can update with photos at a later date.*

28 MARCH UPDATE: PICTURES and more CONTEXT ADDED

Brenda J Johnson

Cellist, Pianist, Studio Musician

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Brenda J Johnson

Performer

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"Hi Ben, I would be more than willing to share my journey. It was long and ugly, and my doctors and OT at Penn State Hershey said I am a walking miracle. I was facing amputation above the wrist from a , or if he could spare my hand/wrist, I should expect zero hand function. I didn’t know that until months later."

"The infection ate away at the pulley system at the base of may thumb so the tendon no longer is held on to the bone. In late May the infection started to spread rapidly and went from my thumb to my wrist, and then shot up into my fingers. My fingers are a little misshapen from the surgeries and tendon scrubbing during surgery." 

"I had the first big surgery in May 2023 and then two more big ones over the course of the 11 days I was in the hospital. The infection kept returning and they had to go in and clean it out. The doctor shot over 30 gallons of water through my fingers to remove the infection. He said he was working in places he had no business being. I had two more surgeries when the infection came back again."

"I was over medicated on the first infection surgery to the point that I should have no kidney function either. I decided the day after the first of my 5 major surgeries that failure was not an option. My husband developed an adapter that slides onto the frog of my bow and keeps my thumb from sliding off. I can’t hold a bow normally otherwise." 

 

"On an average day I have about 70% hand function. I have to work on it every day with stretching, guasha scraping, and a host of other things. It is truly by the grace of God that I can play."

(Gua Sha, also known as "scraping therapy," is an ancient healing practice in traditional Chinese medicine. It offers various heath benefits, including reducing stress, pain, and swelling.)

Brenda's right (bow) hand showing incision marks

"My infectious disease doctor wrote a paper about my case and it was published in August 2024 (I think). I was always referred to as “the cellist” both in the paper and in the academic network of infectious disease Drs who were weighing in on my case. The Dr. from Stanford was always so concerned about me and asked for updates long after they stopped talking about my case. I was truly fortunate that I found the Drs I did. Had I stayed in York. [PA],  I would not have a hand."

"When I play now, my hand moves differently than it did before. I had to relearn to play with open strings and I used a toilet paper tube with a mirror. When I started I couldn't play on the A or D string because of the wrist mobility. I played beginner bowing etudes to get the mobility back. I played the piano every day and couldn’t press down keys at first. I started with 30 seconds at a time and did it every hour. I built up from there. That kind of therapy saved my hand and gave me function I shouldn’t have, but the playing also saved me.  I needed the playing to keep me moving forward. I started documenting with videos so that I could see the progress. Otherwise I felt like I was getting nowhere. I started posting them too and that helped give me lots of encouragement. I would show videos at my Dr. appts and they loved it. On this side of it all, I am grateful beyond measure." 

"Do you know the violinist Adrian Anantawan? He was born without a fully formed right hand and plays the violin. Before everything really erupted with my hand I emailed him to ask about the “spatula” he calls it on his bow. He was so kind and sent me all kinds of pictures and info. I never contacted him on the other side of all of this, but he inspired me greatly. I figured if he could do it, I could figure out a way. He has a foundation in Boston for musicians with disabilities. I need to contact him with info about what Matt (my husband) developed as it could be helpful to someone else."

Truly amazing, and such a poignant and timely connection with Adrian. Perhaps she will reach out to him once again. Brenda and I are planning a ZOOM call soon.

Describe the Disability:

The following article shared in resources provides useful research and information about physical and medical disabilities:

Music Education for Students with Disabilities: A Guide for Teachers, Parents, and Students by Kaitilin A. Merck and Ryan M. Johnson. 

https://kb.gcsu.edu/thecorinthian/vol18/iss1/6/

Another helpful article is Adjustments of Elementary Music Instruction for Students with Disabilities: A Pilot Study by Kelly Jo Hollingsworth and Kaylee R. Smith.

https://files.eric.ed.gov/fulltext/EJ1392582.pdf

In education research, physical disabilities typically include:

Visual impairment, deafness, deaf-blindness, orthopedic impairment, or more rare cases of Cerebral palsy, Muscular dystrophy, Spina bifida, Limb differences/amputations, and traumatic injuries affecting motor function. 

Arthritis is a common disability that will not be found in young students, but there could easily be instances of older adult lessons or music therapy with accommodations being required. 

Other disabilities such as dyslexia, autism, and ADHD are far more prevalent and researched compared to physical disabilities.

It is important for music teachers to realize that we will encounter far fewer students with physical disabilities, but:

• Their needs are often more visible and require structural adaptation

• They may face greater barriers to participation in performance-based classes like music

Synopsis of the Article:

The article Music Education for Students with Disabilities explains how inclusion has become an important part of education and how it applies to the music classroom. It highlights that students with disabilities should have access to the same music experiences as their peers, supported by laws like IDEA and ESSA that promote learning in the least restrictive environment.

The authors focus on practical ways teachers can support students, including modifying musical parts, adapting instruments, and adjusting expectations so all students can participate. These changes are often subtle, allowing students to contribute without standing out. The article also emphasizes the social benefits of music, as ensemble work helps build relationships and teamwork skills. 

It is important to note that many of the accommodations that allow students with disabilities access ensemble classes also benefit students without disabilities.

Examples include:

• record the different parts individually and give them out to students who have trouble hearing their parts, reading music, or memorizing so that they can practice outside of class

• Students with visual and cognitive impairments use large-print and braille music, including braille notation

• students with limited motor skills to create the appropriate musical sounds can use electronic instruments like an ipad or other tablet with the right software 

 

• stringing instruments in reverse order can be an appropriate accommodation for students who have a physical disability with their left hand. The reversed format allows them to bow with their left hand and finger with their right hand. 

• String instruments are also a good choice for students suffering from disabilities like Cystic Fibrosis, cleft palate, or any breathing disability, because the mouth and breathing apparatus are not required for tone production.

What I found most useful is the focus on flexibility and creativity. Instead of lowering expectations, teachers can adapt how students participate. Examples like using technology, modifying instruments, and peer support show that all students can be successful in music with the right approach.

Recommended Activities:

• A strong activity for an inclusive music classroom is a layered ensemble, where students play the same piece at different levels. Some may play the melody, while others perform simple rhythms or a steady beat. This allows students with physical disabilities to participate meaningfully while keeping expectations high. 

I do this currently in all my classes. No matter what we are learning, I always provide 2-3 levels of difficulty so that everyone has an option. This also encourages student voice and choice, as they themselves determine what is the best fit for them.

Here is an example of a song that teaches the difficult skill of "hooked" bow on a string instrument. The BASSLINE uses only two open string notes in a simple, consistent rhythm. The HARMONY keeps the same two open string notes but adds the difficult "hooked" bow pattern, and the MELODY (Violin) incorporates all notes plus hooked bow. Even within these parts, there are other options that are discussed so that student have any and every opportunity for success. With or without disabilities, this approach is beneficial to all students as stated in bold above:

It is important to note that many of the accommodations that allow students with disabilities access ensemble classes also benefit students without disabilities.

If I had a student that is unable to hold or play a string instrument, hand drums, small percussion, or small xylophones would be great options.

• Another approach is using adaptive instruments and technology, like iPads or apps like GarageBand. These tools let students with limited mobility create and perform music with less physical demand, while still staying musically engaged.

I don’t know how effective this would be in my current classroom. I can visualize 2-3 students who could benefit from this, but it also may cause unwanted distractions since other students would also want to use tablets.

• Peer support is also effective. Pairing students can help with setup and participation, while building teamwork and inclusion.
• Teachers can also offer alternative roles like conducting, composing, or leading rhythms. This ensures all students can take part in meaningful ways.

Outside Resource: 

The following article is an extreme example of four children, ages 9-15, with severe physical disabilities and limited verbal communication. Although it is rare to have this level of disability in a music classroom, it shows what can be done and what is possible. This particular study utilizes a “Sound Forest” installation that occupies the entire room.

Frid, E., Panariello, C., & Núñez-Pacheco, C. (2022). Customizing and evaluating accessible multisensory music experiences with pre-verbal children–A case study on the perception of musical haptics using participatory design with proxies. Multimodal Technologies and Interaction, 6(7), Article 55. https://www.mdpi.com/2414-4088/6/7/55

This case study examines the design and evaluation of accessible multisensory music experiences. It specifically utilizes haptic feedback for children with profound and multiple learning disabilities and limited verbal communication. The authors used participatory design methods to evaluate how children perceive musical haptics and how accessibility can be built into interaction design. The findings suggest that haptic-based musical experiences enabled meaningful engagement and sensory interaction even among severely disabled students. It supports the idea that music can be experienced through tactile and movement-based modalities beyond verbal communication.

Figure 1. (a). The Sound Forest installation. (b). The Sound Forest installation when not active, showing strings and haptic platforms providing whole-body vibrations. 

Figure 2. Pages dedicated to music-related concepts in a PODD book. Figure 1 (left) describes the following concepts using both pictures and text fields (intended for the teachers, since the students do not read): top row: what, play, raise the volume, sing/song, go back to page; middle row: me/my/mine, hear, lower the volume, instrument, whoa; bottom row: you/yours, dance, turn off, album/song, go to categories. Figure 2 (right) shows picture representations of one of the student’s favorite music artists. 

Figure 3. The Haptic Music Players (HMPs) used in the study: HMP (1) a haptic pillow, HMP (2) a plush toy backpack with an embedded haptic strap, and HMP (3) a custom-built plush toy with an embedded tactile transducer and full-range speaker. 

Figure 4. PODD pictures used to describe haptic sensations (body locations and intensity of a vibration): leg, knee; belly; hand; raise the volume, louder; lower the volume, softer; foot, toe; bottom, hip; head, face; back; arm. 

Ultimately, effective music teaching is not about changing the music, but about adapting access so every student can participate meaningfully. 

Stories like my cellist friend remind me that with determination, creativity, and the right adaptations, music is always possible. It is our responsibility as teachers to help create that pathway for every student.