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 Motes1 (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.
Table 1 Distraction Therapies
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
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.
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 disability2. 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 scale3 (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.
2
3
QFWFQ Duo’s work “Disconcertio” can be seen at http://www.qfwfqduo.com/qfwfqmovs.html
Based upon The Warwick-Edinburgh Mental Well-being Scale
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 NordoffRobbins 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.