Patients who come to see child psychiatrists like Dr. Jim Hudziak at the Vermont Center for Children, Youth, and Families may leave with a prescription, but it often is not for a medication. As part of a model he developed called The Vermont Family Based Approach (VFBA), there is increased emphasis on incorporating wellness and health promotion strategies into the overall treatment plan. The goal of this model for children and families is to help them take steps not only to overcome whatever symptoms they have but to propel them towards true mental health and wellness. To get there requires attention to domains such as nutrition, parental mental health, sleep, mindfulness, and physical activity, often given short shrift in traditional approaches. Music and the arts are also highly encouraged within the VFBA. According to the Department of Education, approximately 75% of American high school students rarely or never participate in music or art training outside of the school.
While participation in music and the arts is widely viewed as positive for child development, there remains much to learn about how music affects the brain. To investigate this question further and to bolster the level of scientific evidence that supports the role of music, Dr. Hudziak and his postdoctural associate Matt Albaugh, along with a team comprised of scientists from the University of Vermont, Montreal Neurological Institute, Harvard, and Washington University, examined brain scan data from the National Institutes of Health MRI Study of Normal Brain Behavior.
The subjects for the study were 232 typically developing children without psychiatric illness between the ages of 6 and 18, all of whom received structural MRI scans at up to three different time points. With these serial MRI scans the examiners were able to see how the thickness of the brain cortex changed with age. Prior studies have indicated that the cortex generally thins across adolescence as the brain undergoes a normal "pruning" process that may be related to more efficient brain functioning. A delay in this cortical thinning process, particularly in more “executive functioning” regions such as the prefrontal and orbitofrontal cortex, has recently been shown among those with clinical attention problems and ADHD.
The amount of musical training a child had was also measured to see if this variable, along with age, was related to cortical thickness. The average time playing an instrument was about two years, hardly an amount associated with more virtuoso musicians.
The main result of the study was that years of musical training were indeed related to age-related cortical thinning. Specifically, more musical training was associated with accelerated thinning, not only in the expected areas of the brain such as those that control motor functions but also in some of the very same regions implicated in those with more pronounced attention problems. "What was surprising was to see regions that play key roles in emotional regulation also modified by the amount of musical training one did," Dr. Hudziak mentions in a podcast related to the article.
Certainly, much more research is needed to support the idea of musical training as an effective treatment for diagnoses such as ADHD, but this study raises some thought-provoking possibilities. It is also a nice statement, particularly for those inclined to view psychiatrists as medication dispensers, that the study appeared as the lead article in the Journal of the American Academy of Child & Adolescent Psychiatry.
In discussing the implications of their results, the authors highlight Venezuela’s El Sistema program that has brought musical training and performance to millions of disadvantaged children both abroad and here in the U.S.. This program touts improvements in drop-out rates, employment, and community involvement among its participants. Such efforts are critical as many families are unable to access music lessons due to their cost. Dr. Hudziak, who has done a lot of work in the past on the genetic influence of various traits and abilities, notes that our culture seems to have it backwards in promoting certain activities only for children who seem born to excel at them. He questions why "only the great athletes compete, only the great musicians play, and only the great singers sing," especially as children age. This important question is now underscored by the accumulating data linking wellness activities to positive changes in brain development.
@copyright by David Rettew, MD
photo courtesy of nuchylee and freedigitalphotos.net
David Rettew is author of Child Temperament: New Thinking About the Boundary Between Traits and Illness and a child psychiatrist in the psychiatry and pediatrics departments at the University of Vermont College of Medicine.