Post on 17-Mar-2023
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doi:10.1093/mtp/miz006Advance Access publication July 18, 2019Music Therapy Perspectives, 37(2), 2019, 151–168
© The Author(s) 2019. Published by Oxford University Press on behalf of American Music Therapy Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Asha Ward is a research engineer currently undertaking an engineering doctorate (EngD). Her work focuses on making accessible musical instruments and interfaces for those with complex needs.
Dr. Tom Davis is a lecturer in Creative Technology with an interest in instrument building and improvisation.
Dr. Ann Bevan has been a registered nurse for over 40 years and now teaches children’s nursing, she is an action researcher.
Address correspondence concerning this article to Asha Ward, Centre for Digital Entertainment, Media and Communication, Bournemouth University, Fern Barrow, Poole BH12 5BB, UK. E-mail: ablatherwick@bournemouth.ac.uk.
Music Technology and Alternate Controllers for Clients with Complex Needs
ASHA WARD, EngD Centre for Digital Entertainment, Bournemouth University, Poole, UK
TOM DAVIS, PhD Creative Technology Department, Bournemouth University, Poole, UK
ANN BEVAN, PhD Child Health Nursing, Bournemouth University, Bournemouth University, Poole, UK
ABSTRACT: Music technology can provide unique opportunities to allow access to music-making for clients with complex needs. While there is a growing trend of research in this area, technology has been shown to face a variety of issues leading to underuse in this context. This literature review is a collation of information from peer-reviewed publications, gray literature, and practice. Focusing on active music-making using new types of alternate controllers, this re-view aims to bring together information regarding the types of tech-nology available, categorizes music technology and its use within the music therapy setting for clients with complex needs, catalogues work occurring within the field, and explores the issues and poten-tials surrounding music technology and its use in practice.
Keywords: music, music therapy, review literature, sound, technology
Introduction
This article provides a review of music technology used in music therapy, examining the types of technology currently used for sound exploration and music-making by both music therapy practitioners and researchers. The review highlights key developments within the field of music technology, with a focus on applications in music therapy for those with complex needs. The data gathered are a collation of peer reviewed and grey literature (institutional reports), alongside firsthand re-search carried out by the first author as part of an engineering doctorate.
The primary focus of this review is technology for active music-making, with a focus on alternate controllers that pro-vide control and potential for expression through sound and
music. For this review, active music-making is defined as playing instruments or actively exploring sound through inter-action with technology. The term complex needs refers to a spectrum of cognitive, physical, and/or sensory impairments or disabilities that can lead to individuals experiencing min-imal movement, disordered movement, altered states on con-sciousness, and/or no verbal communication (Magee, 2012).
Literature Review Strategy
Keyword searches of Google Scholar, Google, and the Bournemouth University Library Catalogue were used for article se-lection. The following keywords were used: music technology for music therapy, new interfaces for musical expression, music tech-nology and special education needs, music technology SEN, and music technology complex needs. The Nordoff Robbins Evidence Bank (2014) (specifically account no. 16) was also consulted as well as Research and Resources for Music Therapy 2016 (Cripps, Tsiris, & Spiro, 2016). This selection of papers expanded as litera-ture was reviewed. Papers were scanned for their significance as they pertained to the use of technology, both novel or off-the-shelf, with users with complex needs for active music-making or sonic exploration, or that they featured details of such technologies in use, or that they explored issues around and/or reviewed usage of such technology in use. Some grey literature was also consulted (Department for Education, 2011; Farrimond, Gillard, Bott, & Lonie, 2011; Ofsted, 2012; O’Malley & Stanton Fraser, 2004) as this provided a different perspective on technology usage in practice.
Context
Music technology reviews have been undertaken to address the use of music technology by music therapists (Cevasco & Hong, 2011; Clements-Cortes, 2013 Crowe & Rio, 2004; Hahna, Hadley, Miller, & Bonaventura, 2012; Knight & Krout, 2017; Knight & Lagasse, 2012; Magee, 2006; Magee & Burland, 2008; Streeter, 2007; Whitehead-Pleaux, Clark, & Spall, 2011), and to outline the aims of national music education plans within government policy (Department for Education, 2011; Ofsted, 2012), and to guide government policy (Farrimond et al., 2011). Magee (2014) edited a volume of articles drawing together uses of music technology in thera-peutic and health settings. These authors highlighted the im-portance of music technology, the types of music technology used, where technology is useful, and how technology could be improved to break down barriers and allow access to
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music-making for those with complex needs. This literature review aims to take another step in this discussion, by further organizing this information and providing a timeline of devel-opment to the current state of the art.
The use of music technology for clients with complex needs in music therapy settings is broad, drawing from a variety of fields. Technology usage combines elements of human com-puter interaction (HCI), music therapy, music psychology, music education, and music technology. The scope of litera-ture featured in this review reflects this, with a focus on the ways technology can be used to increase access to active music-making opportunities for clients who are unable to use traditional musical instruments.
The review begins with an overview of the evolution of tech-nology, electronic music technology (EMT), and EMT for those with multifaceted needs. Following this are sections on the computer as the bridge, new developments, available tech-nology, and music technology used in music therapy practice, including issues related to these practices.
Evolution of Technology
Within the last two decades, technology usage in general has become increasingly accessible (Cevasco & Hong, 2011). This has proliferated into all areas of everyday life as devices such as smartphones, smart watches, tablets, and portable computers become more ubiquitous both inside and outside of the home (Nagler, 2011). In the broader view, this explo-sion of technology has led to changes in how we interact with music (Misje, 2013). Software has become more accessible, with programs for music-making such as Garageband coming preinstalled on every Apple Macintosh computer (Cevasco & Hong, 2011). Handheld devices like the iPad offer free apps for portable music access and making, both increasing the opportunity for the everyday user to create and share con-tent, and the opportunity to have a “band-in-a-box” with a variety of functions being achievable with one device. The uses and accessibility of technology has expanded the pos-sibilities for users with complex needs to participate in active music-making.
Electronic Music Technology
Electronic music technology is a wide-reaching branch of technology that has progressed over the last 30 years. Developments in hardware and software, and creation of new instruments that utilize technology, have pushed boundaries forward both in terms of the creation and production of music. While the history of the development of EMT, specifically elec-tronic instruments, is beyond the scope of this review, over-views can be found in literature (Bongers, 2000; Challis, 2009; Paradiso, 1997) along with proceedings from dedicated con-ferences like new interfaces for musical expression (NIME). Comprehensive introductions to the world of NIMEs can be found (Lyons & Fels, 2015) and books such as those by Miranda and Wanderley (2006), offering a reference point for the con-trol of sound using technology and issues surrounding the cre-ation of new instruments (Ward, Woodbury, & Davis, 2017).
EMT for Clients With Complex Needs
EMT that increases accessibility for clients with complex needs has been defined as a range of tools and devices which
are able to generate musical sounds through electronic, digital, or mechanical means (Magee, 2012). Definitions in-clude: “any equipment, device, or method that systematically fosters independent functioning, including the production of or response to music” (Crowe & Rio, 2004, p. 283); “the ac-tivation, playing, creation, amplification, and/or transcription of music through electronic and/or digital means” (Hahna et al., 2012, p. 456); and “a wide range of devices, equipment and software, spanning amplification devices, MIDI (musical instrument digital interface) devices and instruments, com-puter software, assistive devices, brain computer interfaces, as well as electronic musical instruments and specialist inter-faces such as switches and sensors” (Burland & Magee, 2013, p. 179). These types of technology, and their relationship to music therapy clinical practice, began being discussed in the late 1980s (Krout, 1987) and early 1990s (Krout, 1992), with the use of music technology for those with complex needs also being covered in popular music magazines (Thomas, 2012).
While the term EMT covers a wide range of technology to facilitate musical interaction within the field of music therapy (Magee & Burland, 2008), instruments created with tech-nology are often called digital musical instruments (DMIs) in the field of new interfaces for musical expression (NIME) (Poupyrev, Lyons, Fels, & Blain, 2001). Since the 1980s there has been a rapid expansion of EMT use with the field of music therapy (Whitehead-Pleaux et al., 2011) and many DMIs have been developed both commercially and for re-search purposes. DMIs can be aimed at a typical population or can be bespoke. Bespoke instruments use technology or combinations of technology to allow an individual access to active music-making. These technologies can include hard-ware and/or software.
DMI Development and Musical Genres
The expansion of DMIs can be in part attributed to the strong links between the type of music that has historically been created using music technology—that of hip-hop/rap and later, electronic dance music (EDM) (Crooke, 2018)—and client preference—particularly of children and adolescents—of those receiving music therapy (Viega, 2015). Music ther-apists striving to explore genres that heavily resonate with their clients have used hip-hop and rap and its strong links to the transformational power of music to “facilitate group experience and catalyse personal and social transformation” (Lightstone, 2012, p. 41). Themes explored within hip-hop culture and EDM, which took root from the oppressed ori-gins that forged the development of genres, can be likened to a “universal language” (Lightstone, 2012, p. 40), particu-larly when working with children and adolescents (Hadley & Yancy, 2012).
Types of Technology
Categories of Technology
Crowe and Rio (2004) completed a comprehensive his-torical literature review of technology and its implication in music therapy practice and research for music therapy edu-cation. From this, they organized the types of technology into taxonomical structures. They concluded that there are seven types of technologies: “(a) adapted musical instruments, (b)
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recording technology (c) electric/electronic musical instru-ments, (d) computer applications, (e) medical technology, (f) assistive technology for the disabled and (g) technology-based music/sound healing practices” (Crowe & Rio, 2004, p. 291). These categories are exhaustive in terms of covering all types of technology used in the music therapy environment but do not focus on those used primarily for active music-making. The categories also include technology that is used for 1) ana-lysis and logging of data about client progress, 2) creating and hearing listening material, and 3) medical technology that in-volves sound waves.
The rate of change within the technological environment of electronic music has meant that there have been several de-velopments since the creation of these categories that are diffi-cult to place within them, and there is technology that crosses between them. Magee’s classifications (2006, 2012) reflect more up-to-date inclusions of self-contained music creating devices (such as synthesizers), music listening devices (such as mp3 players like the iPod), digital handheld music devices or DHHMDs (Nagler, 2011) (such as the iTouch app and iPads), and music games (such as Guitar Hero).
Krout (2015) subsequently provided four categories of electronic music resources based upon those that have been reported as being useful in music therapy clinical practice, and are also affordable and available. These included general or stand-alone products, computer software, electronic key-boards, and tablet computers (e.g., iPads).
Digital Handheld Music Devices
The category of DHHMDs have become ubiquitous aids for aiding in music-making. DHHMDs have become part of everyday life in an unanticipated convergence of technologies that has altered the practice of music therapy in a profound manner (Nagler, 2011). DHHMDs offer a new class of music listening experiences, predictive selections, and active music-making without need for therapeutic interventions. These de-vices have become multitasking musical companions allowing complex musical ideas to be created and shared without tech-nical training (Nagler, 2011). New technologies such as tab-lets featuring touch screens, particularly the iPad, have created a shift toward screen-based mobile music-making. The touch screen allows direct interaction to music apps using intuitive motion (Krout, 2015). Comprehensive reviews of iPad re-sources are available to help clinical practice (Knight, 2013). With each of the four methods of music therapy (recreating, improvising, listening, and composing) being able to be ac-centuated by apps (Knight, 2013).
iPads and Apps
iPads have become prolific in school settings, offering multifunctionality, the ability to tailor to individual styles of use, ease of use, portability, and high quality of graphics and sound (Krout, 2015). iPads have been used to create powerful and expressive controllers for digital music (Favilla & Pedell, 2014) with many music-based applications developed to meet different needs. Some apps tie into existing software to provide a new facet of access while others offer experiences unique to the device. Krout (2014b) provides an exploration of a number of apps for engaging young people with Autism Spectrum Disorders, the needs they address, and their efficacy
in music therapy. He suggests that the therapist must balance the advantages and disadvantages of using such technology against each client’s needs, abilities, and goals. Apps such as Beatsurfing (Lobby & De Ridder, 2018) allow the creation of custom graphical user interfaces (GUIs). These can be de-signed by the user through building with lines, polygons, cir-cles, and faders. Parameters such as size, color, orientation, 3D position, and value that can also be customized (Lobby & De Ridder, 2018). These GUIs can then be connected to MIDI-compatible software, hardware, or other MIDI-enabled apps to provide bespoke interaction and allow configurable sonic output. One such app is ThumbJam (Sonosaurus, 2018) which provides a vast array of features. Included in the app are over 40 sampled instruments, hundreds of scales, and an array of customization of how it can be played, and what is displayed on screen (including user uploaded backgrounds) (Matthews, 2018). ThumbJam also offers arpeggiating, looping, recording, effects selection and manipulation, instrument creation, and the ability to import and export data. The ever-growing app market means it is easier than ever to find screen-based appli-cations that fit the needs of the user and also offers access to the developers in terms of suggesting updates and tailoring for specific needs.
The Computer as the Bridge
Traditional acoustic instruments are “stand-alone” in the fact that they are composed of an excitation mechanism (string, reed, skin, etc.), a resonant capacity (the body of the instrument), and the specific timbre they produce. If, however, we add a computer as a bridge in this system, we arrive at DMIs. A DMI “implies a musical instrument with a sound gen-erator that is separable (but not necessarily separate) from its control interface” (Malloch, Birnbaum, Sinyor, & Wanderley, 2006, p. 49). DMIs break the coupling between the action used and the sound produced. This can be thought of as a three-layer system (Figure 1) consisting of the control inter-face, the processing (which can be achieved via a separate computer or an on-board system), and the effort mech-anism or output (audio/visual/haptic feedback) (Hunt, Kirk, & Neighbour, 2004).
Useful methods of classification can be adopted from the fields of HCI, music technology, and new interfaces for mu-sical expression (NIME), when categorizing new technology which uses the computer as the bridge. Wanderley (2001) suggested the term gestural controller to describe interfaces that consist of two elements. The first element is an interface that features one or more sensors to detect the physical inter-action of the performer (these can be in the form of body movement, empty-handed gestures, or object manipulation). The second element is the auditory, tactile-kinesthetic, and/
Figure 1. Three layers of digital musical instrument (DMI).
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or visual feedback given to indicate the instrument’s status the performer.
Wanderley (2001) proposed a three-tier classification of such controllers as:
• Instrument-like controllers—where the input device design tends to reproduce each feature of an existing (acoustic) in-strument in detail (e.g., an electric keyboard)
• Augmented Instruments (also called Hybrid Controllers)—instruments augmented by addition of sensors (e.g., the Yamaha Disklavier)
• Alternate controllers—whose design does not follow one of an established instrument—an example would be the Hands (Waiswisz, 1985; Wanderley, 2001, p. 6)
Alternate controllers offer unique opportunities to create interactive musical systems from the ground up to specifically suit client need. Using new or bespoke modes of interaction and processing these interactions into meaningful content pro-vide unique potential to increase accessibility to active music-making. Alternate controllers can be designed with client cap-abilities at the center of the design process, can be built to assist both in terms of physical access and learning needs, and can be tailored to provide feedback to suit the client or con-text they are being used in.
Alternate Controllers
Alternative controllers take two forms: 1) those that require physical touch to control, which are referred to as touch-based, and 2) those that do not, which are referred to as empty-handed.
Touch-Based Alternate Controllers
Touch-based controllers use direct physical interaction with a control interface to acquire control data for musical systems. Notable developments in this area are discussed below.
MidiGrid. One of the first examples of using a touch-based alternate controller was explored by Hunt and Kirk (2003). In their long-term project (beginning in 1987) titled MidiGrid, they utilized the mouse and keyboard to control sound in software used by children and young people in a music therapy setting. Hunt and Kirk (2003) used the advent of MIDI (musical instru-mental digital interface) within their project. MIDI is a commu-nication protocol that was developed in 1983 to allow various pieces of technology to use a connective language. The MidiGrid project was furthered by the development of MidiCreator (Kirk, Abbotson, Abbotson, Hunt, & Cleaton, 1994), which con-verted signals from electronic sensors into MIDI. MidiCreator could then be connected to the MidiGrid software. A computer could be equipped with MidiGrid allowing users to explore the creation and composition of musical work without the need to learn a traditional instrument. MidiGrid has been used by a wide range of people, such as composers, schoolchildren, special needs teachers, and their clients (Hunt & Kirk, 2003).
Skoog 2. A more recent development is the Skoog 2 (Skoogmusic, 2018), a wireless Bluetooth-enabled tactile foam cube with companion app and software. Manipulation of the Skoog surface can be mapped to proprietary sounds within the software or can connect to external MIDI-compatible soft-ware. The system provides a wealth of resources “out-of-the-box,” allowing for user customizable sounds and notes as well
as controllable sensitivity settings for note triggering. This pro-vides a hands-on musical experience for those with no pre-vious musical knowledge affording individual exploration in a solo setting (Nath & Young, 2015).
Music production controllers. Music production con-trollers (MPCs) are generic devices developed for electronic music-makers that feature triggering pads often used with MIDI-compatible software. They provide another modality of interaction that can be used as a tool to increase accessibility; however, these devices require a person familiar with music technology to set them up. The configurability of these devices allows adjustment to fit specific client requirements; addition-ally, functionality allows user profiles to be stored and recalled as needed. In a setting where resources have to be shared, this is an important feature as it provides the flexibility to allow users with different abilities to dictate the media content being triggered by the pads. This also allows for different levels of support (from simple note triggering to timing support) de-pending once again on client needs and preferences. This type of music technology is often very attractive to children and young people providing a motivator for engagement.
Switches. Another touch-based alternate controller used extensively, particularly for clients with severe disabilities, is the switch (Bache, Derwent, & Magee, 2014; Crowe & Rio, 2004). Switches are electronic or mechanical devices which, via a control unit or cordless receiver, provide a simple mech-anism for choosing and communicating (Magee, 2012). Switches use physical action or gesture to give direct access to a variety of electronic music devices. There are a large range of switches that offer many forms of control. Bache and col-leagues (2014) provide a comprehensive overview of switches and their use with those with complex needs. Switches are a commonplace assistive technology that can be used in com-bination with specialist or commercial software. Custom built switches based on motor, cognitive, or sensory needs facili-tate interaction based on clinical need. Sounds triggered by a switch can give a sense of control to clients, reinforcing a sense of self and allowing for expression (Swingler, 1998). Communication by using switches is often a starting point for nonspeaking clients (Hunt et al., 2004; Magee et al., 2011)
Mogees. An alternate controller providing an out-of-the-box package is the Mogees (Mogees, 2018). Mogees is a contact microphone which when placed on any surface detects when the surface is “played.” Mogees has the potential to be used in a variety of settings and with objects that users are familiar with or motivated to interact with. It is highly portable and affordable.
Musii. Finally, another interesting alternate controller is the multisensory interactive inflatable Musii (Musii, 2017). Musii is a soft inflatable object that emits sound and illumin-ates with color when touched. It enables any nonmusician to experience the act of creating music by translating physical interaction with the device into stimulating audio, visual, and tactile sensation (Musii, 2017).
Empty-Handed Controllers
Empty-handed controllers do not require physical touch and use mechanisms such as infrared light, ultrasonic sensors, electromagnetic fields, radar, cameras, or microphones to de-tect sound or physical movement. Sonic parameters can be mapped and controlled from this information. This can be
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particularly useful in facilitating clients with complex needs by providing high levels of control, especially for those with physical disabilities or impairments.
The earliest empty-handed controller is considered to be the Theremin, patented in 1928 by Leon Theremin, in which the player uses the proximity of their hands to two metal aerials to control frequency and amplitude of a sound. The earliest documented use of alternate controllers for music-making in music therapy can be traced back to 1987. Nagler and Lee (1987) used microcomputers in music therapy sessions to “investigate the possibility of enabling a se-verely physically handicapped person to create music with minimal assistance” (p. 72). Using an Apple II microcom-puter, Mountain Computer Music System, Express 3 infrared tracking device, and the Viewpoint optical indicator (an infrared light beam) clients could control the music based on their head movements, allowing them to achieve inde-pendent music-making.
Soundbeam. One of the first empty-handed commercially available alternate controllers for music therapy was the Soundbeam system (Soundbeam, 2018). Soundbeam is a tool that converts movement within an ultrasonic beam into MIDI information. Although it can be found in the equipment stores of many special educational needs schools in the United Kingdom, it has been described as poorly used (Magee, 2012). Factors that contribute to this may be that due to its complexity, specialist training is required to use the device and there is an inherent difficulty in placing the beams optimally to suit the movement of some users. The beams travel out linearly which can be unsuitable for users who cannot follow that axis of movement (Ellis & Van Leeuwen, 2000). The lack of tactile feedback can also mean a disconnect between cause and ef-fect for some users. Despite these drawbacks, Soundbeam has been extensively used in practice, possibly due to the unique mode of interaction it affords and the fact that there is a wealth of material and resources to enable people to use the system (Soundbeam, 2018).
Music Maker. Other motion capture systems use cameras to capture movement data. A notable development is Music Maker, which turns body movements into sound using a nonobtrusive camera. Music Maker uses displays of cartoon drawings or pictures of musical instruments to give an element of fun and can be adjusted according to patients’ levels of support needed, therapeutic goals, and type of equipment available in hospitals or patients’ homes (Gorman, Lahav, Saltzman, & Betke, 2007).
Eye gaze systems. Additionally, some control mechanisms include eye gaze systems. These detect the user’s direction of gaze as control information, often utilizing a “dwell” type eye event to elicit a mouse click. Eye gaze systems are often the only access method available to those with diagnosis of “locked-in syndrome” (Vamvakousis & Ramirez, 2016), they are used due to the efficient and less effortful way they can be used to provide access to the computer (Bache et al., 2014). Hardware and software developments by commercial com-panies such as Tobii, Sensory Guru, and Smartbox (Bache et al., 2014) have pushed forward the development of the mu-sical applications of eye gaze. One such example is EyeMusic, which provides a “system that transforms eye movement data into musical compositions and data sonifications” (Hornof &
Sato, 2004, p. 185). However, use of such systems do require skills developed over time by the client.
Clarion. A notable recent development in this area is the Clarion. The Clarion is a highly configurable software instru-ment developed as part of the Open Orchestras project (Open Orchestras, 2018). The Clarion allows the client to specify “the sound the instrument makes; the number of notes that are available to play; the shape, position and colour of the notes; and crucially the way in which [you] play them” (Farrimond, 2016). It integrates with eye gaze systems, SmartNav and the iPad, allowing use with existing hardware resources. Clarion comes as part of a package offered by Open Orchestras which includes the Clarion software, repertoire, training resources and support, and an evaluation framework.
New Developments
A number of recent related developments have impacted the world of DMIs. Microcontroller boards like Arduino (Arduino, 2015), affordable computers such as the Raspberry Pi (Raspberry Pi, 2015), and software such as Max/MSP (Cycling’74, 2018) allow for bespoke systems to be created. Sensors can directly capture a person’s input and then be in-tegrated as a control device for software, or stand-alone be-spoke devices can be created at a low cost. The development of the Internet of Things (Internet of Things Council, 2018), and Web portals and Webpages with tutorials such as Instructables (Autodesk, 2018) have provided a community of DIY develop-ments and assistance (in the form of forums) for those wishing to create bespoke instruments. Hacker communities are also providing space and tools, along with “hackathon” style com-petitions (often 24-hr themed competitions which are supplied and sponsored by companies), allowing for rapid prototyping of accessible instruments and new tools while also bringing together people with a range of skill sets to create and share information online. There are now also many intermediary ap-plications that allow for the quick creation of enticing inter-faces to trigger music and sound.
Makey Makey
Packages such as the Makey Makey (Makey Makey, 2018) allow conductive objects (e.g., fruit, putty, metal) to be con-nected to a microcomputer to emulate keyboard presses, which can then be used to trigger sound. For example, users could create a piano from bananas by using Makey Makey and connecting it to software such as Garageband or SoundPlant (Blum, 2018). Both these softwares allow sounds to be as-signed to keyboard presses.
Bare Conductive
Bare Conductive Touch Board (Bare Conductive, 2018) is another microcomputer featuring 12 touchpads that allow conductive materials to be connected via crocodile clips. The out-of-the-box setup allowed 12 sound samples to be triggered monophonically from a memory card placed in a slot embedded on the board which then play via an on-board headphone jack, or connected to a speaker. The board is well documented and designed to be used with minimal tech-nical knowledge. The board also offers expansion for those with more technical knowledge as it contains a built-in general MIDI chip for those wishing to reprogram the board
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to allow polyphonic notes, or to allow creation of bespoke MIDI-enabled instruments. The Bare Conductive website (https://www.bareconductive.com/) features very comprehen-sive step-by-step guides for setting the board up and provides ideas for utilizing the board practically. These new develop-ments expand possible modes of interaction by providing off-the-shelf software and hardware that may be commonplace in music therapy settings, or simply using everyday items that the client may find enticing and motivating to engage with.
Leap Motion
Other new technologies such as the hand gesture tracker Leap Motion (Leap Motion, 2017) offer toolkits to build custom systems. The Leap Motion system converts hand movements to data, thus providing a flexible tool for mapping client-specific movements to sound (Uwyn.com, 2018).
Microsoft Kinect
The Kinect (KinectSEN, 2018) is a camera-based movement tracker made by Microsoft that allows body movement by skeletal tracking to be used to control data, thereby producing sound through movement.
GestureSEN
An excellent resource for gesture-based systems used in special education is the gestureSEN website (https://web.archive.org/web/20180723042755/https://kinectsen.wikispaces.com/home). The site, run by teachers in special schools, aims to explore how established and emerging gesture-based technology could help people with severe learning difficulties with their engagement, creativity, and in-dependence skills (Gesturesen.wikispaces.com, 2018). The site featured information on using eye gaze, Kinect, Leap Motion, iPad, and Virtual Reality in special education settings. Unfortunately, due to the closure of Wikispaces website, the content from the gestureSEN website is only viewable through internet archive websites such as https://web.archive.org/.
Games Controllers
Finally, game controllers such as the WiiMote and the Xbox controller alongside music-themed games can also provide unique mechanisms through which to access musical inter-action, with schools typically having these resources available for general use.
All of the above offer new methods of access to music-making with the computer that move away from the keyboard and mouse paradigm. These tools provide the flexibility to create systems that tailor to client capability, motivation, and curiosity.
Available Technology
As evidenced by the literature presented, there are many technologies available for aiding accessibility to music-making. As a growing field that crosses many disciplinary areas, challenges are created for music therapists. The pri-mary challenges are: knowing where to find this technology, examples of its use in similar contexts, and guidelines for integrating it into clinical practice.
Table 1 provides a summary of developments, including off-the-shelf DMIs, that have been used with clients who have complex needs. The DMIs included in the table were selected
because there is evidence that they been used with people with complex needs, through either peer-reviewed published literature, anecdotally, or observed firsthand by the first author. The DMIs reviewed are further organized into two categories: 1) commercially/freely available, and 2) research only. This decision was based on the fact that while some of the research and technology developed may show great promise for cli-ents with complex needs, they have not subsequently been made available for wider use. The two categories are then fur-ther divided into three subcategories: touch-based, software-based, and empty-handed. A final section provides some con-text to how the technology may be relevant to music-making in a music therapy setting.
Controlling Sound With Technology
Paine and Drummond (2009) suggest there are two distinct approaches to computer-assisted music: “control of predeter-mined sequences of sounds (such as the triggering of sound samples) or creation of sounds in real-time by the manipula-tion of software synthesis variables” (p. 2). Technology offers the ability to control and trigger sound in different ways that extend past that of acoustic instruments. Technology can also provide responses to interaction in ways that acoustic instru-ments cannot. It can offer physical and/or cognitive support, and scaffold capability to give users access in ways traditional instruments do not allow. Swingler (1998) suggests that few children have the physical coordination or control necessary for traditional performance. As such, technology can help to shift beyond traditional musical qualities toward a new and developing musical aesthetic, one enabled by the introduction of electricity to musical activity. He suggested that this allows the opening up of many musical doors so all can enjoy being expressive with sound: “Many techniques can be made easily available to virtually all kids through technology” (Swingler, 1998, p. 5). Through technology, small motions can lead to sound production and engagement. For example, with even something as simple as a microphone there are great oppor-tunities for utilizing feedback and amplification to allow the “tiniest voice and smallest nuances to be enhanced and ex-tended” (Ellis & Van Leeuwen, 2000, p. 8).
Music technology can therefore help to:
• Transduce movement and gestures into musical expression (Hunt et al., 2004)
• Make it possible for a client to realize a creative idea re-gardless of implementation or user and to give the oppor-tunity for an aesthetic experience (Misje, 2013)
• Allow people to lose themselves in artistic expression (with a quality of interaction so high that they are not aware they are using technology) (Hunt, Kirk, Abbotson, & Abbotson, 2000)
• Give initialization opportunities to usually passive users enabling the concept of selfhood, which can be inhibited for individuals with profound and multiple learning disabil-ities (PMLD)
• Provide, sometimes for the first time (Swingler, 1998), that “make something happen!” moment as described by Ellis (1997), which is a foundational experience of learning
These simple but crucial experiences may help users to en-counter and develop communication skills through sound. This
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Music Technology and Alternate Controllers for Clients with Complex Needs 157
Tabl
e 1
Alte
rnat
e C
ontr
olle
rs
Inte
ract
ion
mod
alit
yC
omm
erci
ally
/ fr
eely
ava
ilabl
eD
escr
ipti
onD
etai
ls
Touc
h
Gen
eral
tec
hnol
ogy
Switc
hes
Bro
ad r
ange
of
elec
tron
ic o
r m
echa
nica
l to
ols
to a
llow
on/
off
sele
ctio
ns
Tailo
rabl
e to
use
r, ea
se o
f int
egra
tion
to c
urre
nt r
esou
rces
, can
be
wir
ed o
r w
irel
ess,
tr
igge
r or
sta
rt/s
top
soun
d ef
fect
s, m
usic
al n
otes
/phr
ases
, rec
orde
d sa
mpl
es, o
r se
quen
ces
of s
ampl
es. “
For
exam
ple,
the
clie
nt m
ay a
ctiv
ate
a C
D p
laye
r or
pre
-re
cord
ed m
usic
trac
k” (K
nigh
t & L
agas
se, 2
012,
p. 1
92).
Bac
he e
t al.
(201
4) p
rovi
de
an in
-dep
th r
evie
w o
f pra
ctic
al s
witc
h us
e.
iP
adTo
uch
scre
en h
andh
eld
devi
ce s
peak
er,
mic
roph
one,
and
mot
ion
dete
ctio
n
Mul
tiuse
dev
ice,
tailo
rabl
e to
use
r, fa
mili
ar te
chno
logy
, ent
icin
g, d
irec
t int
erac
tion
with
app
s, s
elf-
cont
aine
d w
ith s
peak
er o
n-bo
ard,
com
mon
ly a
vaila
ble.
Use
ful f
or
quic
kly
reco
rdin
g m
ultit
rack
mus
ic a
rran
gem
ents
from
live
or
plug
ged-
in s
ourc
es.
Abi
lity
to c
aptu
re s
ound
usi
ng b
uilt-
in m
icro
phon
e. A
pps
can
emul
ate
inst
rum
ents
en
ablin
g th
e cl
ient
to p
lay
a st
ring
ed in
stru
men
t by
touc
hing
the
scre
en, o
r a
win
d in
stru
men
t by
blow
ing
into
the
mic
roph
one
(Kni
ght &
Lag
asse
, 201
2). “
App
s ca
n be
us
ed to
rec
ord,
syn
thes
ize,
man
ipul
ate,
or
prov
ide
feed
back
to c
lient
act
ions
and
so
unds
” (p
. 194
). K
nigh
t (20
13) p
rovi
des
an in
-dep
th r
evie
w o
f iPa
d ap
plic
atio
ns in
m
usic
ther
apy.
iPod
Tou
chA
s iP
adSi
mila
r to
iPad
but
sm
alle
r in
form
fact
or a
nd w
ith e
nhan
ced
secu
rity
(not
con
nect
ed
to a
net
wor
k)
A
pps
Piec
es o
f sof
twar
e fo
r us
e on
tabl
et o
r sm
artp
hone
dev
ices
Wid
e va
riet
y, s
ome
free
. App
s fo
r C
hild
ren
with
Spe
cial
Nee
ds (2
018)
is a
web
site
fo
r fin
ding
spe
cific
app
s ai
med
at c
hild
ren
with
spe
cial
nee
ds fe
atur
ing
mus
ic a
s w
ell a
s ot
her
apps
with
rev
iew
s an
d vi
deos
. Offe
ring
the
abili
ty to
tailo
r co
nten
t and
in
tera
ctio
n to
clie
nt r
equi
rem
ents
.
G
ener
ic m
usic
pr
oduc
tion
cont
rolle
rs (M
PCs)
Trig
ger
pads
with
ve
loci
ty s
ensi
ngM
IDI-
com
patib
le. S
ome
com
e w
ith o
wn
softw
are
inst
rum
ents
, req
uire
s te
chni
cal
know
ledg
e to
set
up.
Pro
vide
s ab
ility
to p
rese
lect
sou
nds
repr
esen
tativ
e of
a w
ide
vari
ety
of g
enre
s en
able
s cl
ient
s an
acc
essi
ble
way
to p
erfo
rm th
eir
cultu
ral o
r m
usic
al id
entit
ies.
Allo
ws
ther
apis
ts to
offe
r di
vers
e so
und
pala
tes
valu
able
for
play
ing
diffe
ring
feel
ings
or
emot
ions
dur
ing
impr
ovis
atio
n (C
rook
e &
McF
erra
n, 2
019)
. Can
al
so b
e us
ed in
com
posi
tion
to p
erfo
rm a
nd r
ecor
d dr
um b
eats
and
mel
odic
pat
tern
s (C
rook
e, 2
018)
, or
to tr
igge
r or
laun
ch a
ran
ge o
f loo
ps o
r sa
mpl
es, a
llow
ing
for
the
play
ing
of p
reco
mpo
sed
piec
es a
nd li
ve r
emix
ing.
Mus
ic R
adar
(201
8) p
rovi
de a
n ov
ervi
ew o
f ava
ilabl
e M
PCs.
M
usic
-bas
ed v
ideo
ga
mes
V
ideo
gam
e sy
stem
us
ing
gene
ric
or b
espo
ke
to th
e ga
me
cont
rolle
rs
Fam
iliar
to u
sers
, ent
icin
g te
chno
logy
, eas
y se
tup,
can
pot
entia
lly u
se e
xist
ing
reso
urce
s. B
lain
e (2
005)
pro
vide
d a
revi
ew o
f alte
rnat
e m
usic
-bas
ed v
ideo
gam
e co
ntro
llers
. Wik
iped
ia (2
017)
pro
vide
s a
list o
f mus
ic-b
ased
vid
eo g
ames
. Use
of
the
WiiM
ote
in m
usic
ther
apy
has
been
exp
lore
d (B
enve
nist
e, Jo
uvel
ot, &
Mic
hel,
2008
), an
d de
velo
pmen
ts s
uch
as th
e W
iinst
rum
ent c
an b
e do
wnl
oade
d to
util
ize
the
myr
iad
of d
ata
that
the
WiiM
ote
prod
uces
(The
Wiin
stru
men
t, 20
18).
Gam
es a
vaila
ble
incl
ude
Wii
Mus
ic b
y N
inte
ndo.
(Con
tinue
d)
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Music Therapy Perspectives (2019), Vol. 37158
Spec
ific
devi
ces
Des
crip
tion
Det
ails
Skoo
g 2
Wir
eles
s fo
am c
ube
with
fiv
e ta
ctile
pre
ssur
e-se
nsiti
ve p
ads.
Wir
eles
s, p
orta
ble,
eas
y to
set
up.
Sim
ple
and
intu
itive
. Ow
n ap
p an
d so
ftwar
e to
cu
stom
ize
sens
itivi
ty a
nd s
ound
cre
ated
, MID
I-co
mpa
tible
. Man
y re
sour
ces
for
use
in
spec
ial e
duca
tion
on w
ebsi
te. P
rovi
des
dire
ct c
orre
latio
n be
twee
n ph
ysic
al c
onta
ct
and
soun
d pr
oduc
ed, u
sing
vir
tual
mus
ical
inst
rum
ents
, sam
ples
, or
MID
I. O
fferi
ng
dyna
mic
con
trol
ove
r m
usic
al g
estu
res
(Sko
ogm
usic
, 201
8). “
The
inst
rum
ent d
oes
not
sim
ply
trig
ger
sam
ples
whe
n pr
esse
d bu
t use
s so
phis
ticat
ed s
ynth
esis
to d
ynam
ical
ly
man
ipul
ate
the
vari
ous
inst
rum
ent s
ound
s th
ough
pre
ssin
g, s
quee
zing
, rub
bing
, st
roki
ng, t
iltin
g or
man
ipul
atin
g th
e Sk
oog”
(Far
rim
ond
et a
l., 2
011,
p. 2
8).
Mak
ey M
akey
Mic
roco
ntro
ller
boar
d w
ith s
ix c
onne
ctor
s th
at e
mul
ate
QW
ERTY
ke
yboa
rd p
ress
es a
nd
mou
se c
ontr
ol
Turn
eve
ryda
y ob
ject
s in
to to
uchp
ads,
no
softw
are
to in
stal
l, fa
st s
etup
. Can
be
conn
ecte
d to
con
duct
ive
obje
cts
such
as
frui
t, co
nduc
tive
tape
, pen
cil g
raph
ite, a
nd
clie
nts
touc
hing
eac
h ot
her
in c
hain
s as
a m
eans
to tr
igge
r so
unds
(Mak
ey M
akey
, 20
18).
The
proc
ess
allo
ws
appr
opri
atio
n en
ablin
g cl
ient
s to
gai
n au
thor
ship
of t
heir
in
stru
men
ts, a
nd b
ecom
e an
intr
insi
c pa
rt o
f the
ir d
eplo
ymen
t (H
ayes
, 201
6).
Alp
haSp
here
G
lobe
-sha
ped
MID
I co
ntro
ller w
ith 4
8 pl
ayab
le v
eloc
ity-s
ensi
tive
pads
and
ow
n so
ftwar
e.
Alp
haSp
here
is a
tang
ible
con
trol
ler,
whe
n co
nnec
ted
to A
lpha
Live
sof
twar
e/us
ed w
ith o
ther
MID
I sof
twar
e ca
n be
set
up
to tr
igge
r an
d m
anip
ulat
e so
und
and
prov
ide
a un
ique
mod
ality
of a
cces
s th
at c
an b
e en
ticin
g to
clie
nts
(Pla
ce, L
acey
, &
Mitc
hell,
201
4).
MID
ICre
ator
Dev
ice
to c
onve
rt s
igna
ls
from
ele
ctro
nic
sens
ors
into
MID
I dat
a.
Clie
nts
can
cont
rol s
ound
s w
ith p
hysi
cal a
ctio
ns a
nd g
estu
res,
can
be
used
to d
etec
t si
mpl
e bo
dy m
ovem
ents
(Kro
ut, 2
014a
). C
an b
e co
nnec
ted
to M
IDI t
o be
use
d w
ith
othe
r sy
nthe
size
rs. S
enso
rs a
vaila
ble
incl
ude
pres
sure
, dis
tanc
e, p
roxi
mity
, dir
ectio
n,
etc.
(Mec
kin
& B
ryan
-Kin
ns, 2
013)
.
I-
Cub
eX
Softw
are
and
digi
tizer
fo
r cr
eatin
g sy
stem
s w
ith a
var
iety
of s
enso
rs
avai
labl
e
Tool
s to
cap
ture
the
hum
an a
ctio
ns a
nd/o
r env
ironm
enta
l var
iabl
es a
nd m
ake
thes
e si
gnal
s av
aila
ble
to o
ther
equ
ipm
ent s
uch
as a
com
pute
r or a
mus
ical
inst
rum
ent t
o tri
gger
sou
nd, m
usic
, vid
eo, g
raph
ics,
ani
mat
ion,
robo
tic m
ovem
ent,
etc.
MID
I dat
a ar
e us
ed, t
rans
mitt
ed v
ia M
IDI c
able
, USB
cab
le, o
r Blu
etoo
th w
irele
ss (I
-Cub
eX, 2
018)
.
Ky
ubEl
even
feat
her
touc
h ke
ypad
s on
five
sur
face
s of
a 3
-inc
h w
oode
n cu
be
with
acc
eler
omet
er
Mak
er fr
iend
ly, o
pen-
sour
ce D
IY M
IDI k
eybo
ard
feat
urin
g ca
paci
tive
sens
ing
and
acce
lero
met
er. F
ully
pro
gram
mab
le, s
et s
cale
, tw
eak
note
vel
ocity
cur
ves,
map
di
ffere
nt in
stru
men
ts to
diff
eren
t pad
s to
con
figur
e to
mus
ical
tast
e (K
yub
MID
I ke
yboa
rd, 2
018)
. Use
r ca
n al
so c
onfig
ure
the
way
the
inst
rum
ent l
ooks
and
sou
nds
by
desi
gnin
g th
eir
own
inte
rfac
e.
Su
zuki
QC
hord
El
ectr
onic
inst
rum
ent
with
on-
boar
d sp
eake
r an
d LC
D d
ispl
ay.
A d
evic
e fo
r co
mpo
sitio
n, te
achi
ng, a
nd th
erap
y. In
corp
orat
ing
tech
nolo
gy fr
om a
ba
sic
keyb
oard
and
ele
ctri
c gu
itar
and
com
bini
ng b
oth
in a
por
tabl
e, e
asy-
to-u
se
way
. Eig
hty-
four
diff
eren
t cho
rd c
ombi
natio
ns, 1
00 in
stru
men
t voi
ces,
orc
hest
rate
d rh
ythm
s. F
eatu
res
thre
e se
ctio
ns; a
touc
h-se
nsiti
ve 4
oct
ave
“str
um p
late
,” a
rhy
thm
se
ctio
n, a
nd c
hord
but
ton
sect
ion.
Eac
h of
thes
e ar
eas
can
be u
sed
inde
pend
ently
or
com
bine
d w
ith a
var
iety
of s
ound
s ob
tain
able
. Sou
nds
are
alw
ays
in tu
ne. C
an
be a
dapt
ed to
all
abili
ty le
vels
. Can
stim
ulat
e in
tera
ctio
n, in
crea
se c
oord
inat
ion,
st
imul
ate
gros
s an
d fin
e m
otor
ski
lls, a
nd in
crea
se s
elf-
expr
essi
on. P
itch
bend
whe
el
for
expr
essi
on. C
hang
eabl
e so
ng c
artr
idge
s. C
an c
onne
ct to
spe
aker
or
MID
I dev
ice
(Suz
uki Q
chor
d, 2
018)
.
Tabl
e 1.
Con
tinue
d
Inte
ract
ion
mod
alit
yC
omm
erci
ally
/ fr
eely
ava
ilabl
eD
escr
ipti
onD
etai
ls
(Con
tinue
d)
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Music Technology and Alternate Controllers for Clients with Complex Needs 159
Yam
aha
DJX
-iiB
Gro
ove
mac
hine
in a
bo
x-sh
aped
des
ktop
m
odul
e fo
rm w
ith
scra
tch
pad
and
fade
r.
Can
sel
ect f
rom
70
patte
rns,
mut
e pa
rts,
add
pre
set h
its o
r fil
ls, a
nd s
hift
key
of th
e pa
ttern
s pl
ayin
g an
d us
e ef
fect
s. P
rovi
des
oppo
rtun
ities
for
the
clie
nts
to c
ompo
se
mus
ic b
y as
sem
blin
g lo
ops,
impo
rtin
g ot
her
song
s or
sec
tions
of s
ongs
, and
/or
reco
rdin
g he
r or
his
ow
n m
usic
, offe
ring
acc
essi
ble
and
dyna
mic
mea
ns o
f exp
ress
ing
emot
ions
(Whi
tehe
ad-P
leau
x et
al.,
201
1)
M
usii
Soft
infla
tabl
e se
lf-co
ntai
ned
port
able
un
it th
at e
mits
sou
nd
and
illum
inat
es w
hen
thre
e in
flate
d co
nes
are
touc
hed,
with
wir
eles
s co
ntro
l
Sim
ple
to u
se, n
eeds
no
extr
a eq
uipm
ent o
r tr
aini
ng to
ope
rate
. Abi
litie
s to
m
ake
mus
ic a
nd c
olou
r th
roug
h to
uch
and
mov
emen
t with
exp
ansi
ve li
brar
y of
so
unds
cape
s (o
ver
50) a
nd in
nova
tive
mus
ical
sys
tem
. Can
not p
lay
out o
f tim
e or
ou
t of t
une.
A n
umbe
r of
peo
ple
can
play
har
mon
ious
ly a
s a
grou
p or
an
indi
vidu
al
can
beco
me
an o
rche
stra
. Tac
tile
phys
ical
form
that
ena
bles
the
user
to s
ee a
nd fe
el
the
beam
that
they
are
inte
ract
ing
with
. “M
usii
has
been
des
igne
d fo
r de
velo
pmen
tal
play
in th
e SE
N s
ecto
r...T
he m
ulti-
sens
ory
expe
rien
ce o
f pla
ying
Mus
ii ha
s m
any
ther
apeu
tic p
ossi
bilit
ies
incl
udin
g en
cour
agin
g m
ovem
ent,
deve
lopm
ent a
nd
awar
enes
s of
pro
prio
cept
ion,
turn
taki
ng, c
ause
and
effe
ct, c
reat
ivity
, exp
ress
ion
and
com
mun
icat
ion.
It c
an b
e us
ed fo
r st
imul
atio
n or
for
calm
ing.
The
syn
chro
nise
d so
und
and
light
ing
as w
ell a
s th
e vi
sual
and
tact
ile fe
edba
ck o
f the
infla
tabl
e en
able
a
deep
er u
nder
stan
ding
of t
he m
usic
you
are
mak
ing”
(Mus
ii Lt
d, 2
017)
Rea
ctab
le
Tabl
e w
ith to
uch
scre
en
and
mov
eabl
e ob
ject
s (R
eact
able
Tec
hnol
ogy,
20
17)
Obj
ects
inte
ract
with
the
tabl
e su
rfac
e an
d ea
ch o
ther
to m
ake
mus
ic. A
llow
s in
tuiti
ve a
nd c
olle
ctiv
e cr
eatio
n of
com
plex
mus
ical
pie
ces,
col
labo
rativ
e sh
arin
g sp
ace
betw
een
user
s, p
rom
otes
imita
tion
gam
es, i
ncre
ases
vis
ibili
ty o
f act
ions
, en
able
s m
onito
ring
oth
er p
artic
ipan
t’s w
ork,
aid
s in
red
ucin
g so
litar
y pl
ay s
eque
nces
, fa
cilit
ates
ass
ocia
tive
play
(Vill
afue
rte,
Mar
kova
, & Jo
rda,
201
2)
Te
nori
-On
Han
dhel
d sc
reen
w
ith 1
6 ×
16
grid
of
LED
sw
itche
s. B
uilt-
in
spea
kers
, dia
l and
bu
ttons
con
trol
sou
nd
and
beat
s pe
r m
inut
e pr
oduc
ed
Cre
ate,
con
trol,
or p
erfo
rm m
usic
al m
ater
ial o
n vi
sual
ly ri
ch to
uch-
sens
itive
inte
rface
(F
arrim
ond
et a
l., 2
011)
. Sw
itche
s ac
tivat
ed in
diff
eren
t way
s cr
eate
mus
ic fr
om 2
56
soun
ds. E
ngag
ing,
mot
ivat
ing,
sen
sory
, wel
l sui
ted
for i
mpr
ovis
atio
n, e
asy
to u
se/h
ard
to m
aste
r. C
ombi
nes
visu
al a
nd m
elod
ic s
enso
ry in
form
atio
n, c
an s
timul
ate
cogn
ition
, m
emor
y, a
nd p
erce
ptio
n. C
an fu
nctio
n as
a rh
ythm
mac
hine
with
bas
ic o
r com
plex
rh
ythm
ic b
eats
that
can
be
loop
ed o
r cha
nged
. Not
es a
nd m
elod
ic p
hras
es c
an b
e ad
ded
as w
ell,
crea
ting
up to
16
laye
rs o
f sou
nd (C
lem
ents
-Cor
tes,
201
4). C
lem
ents
-Cor
tes
(201
4) p
rovi
ded
an in
-dep
th s
tudy
of t
he T
enor
i-On
in a
clin
ical
mus
ic th
erap
y se
tting
.
R
olan
d H
ands
onic
Dev
ice
with
13
ultr
a-se
nsiti
ve to
uch
pads
Ei
ght h
undr
ed a
nd fi
fty r
eady
-to-
play
sou
nds,
or
impo
rt c
usto
m s
ound
s. R
espo
nsiv
e an
d th
eref
ore
not o
verl
y de
man
ding
to p
lay,
with
eas
y ad
just
men
t of v
olum
e (C
halli
s &
Sm
ith, 2
012)
. Can
be
calib
rate
d to
clie
nt n
eed
in te
rms
of s
ensi
tivity
. Can
con
nect
to
oth
er M
IDI d
evic
es a
nd M
IDI c
an b
e re
cord
ed fr
om th
e de
vice
for
anal
ysis
.
Ko
rg K
aoss
ilato
r/K
aoss
ilato
r Pr
o/Ko
rg
Min
i Kao
ss P
ad
Aud
io e
ffect
s un
it w
ith
an X
/Y to
uch
scre
en.
Min
i Kao
ss p
ad fe
atur
es
on-b
oard
spe
aker
and
m
icro
phon
e
Posi
tioni
ng a
fing
er-t
ip o
n th
e to
uch
scre
en tr
igge
rs s
peci
fic s
ound
pro
gram
s. A
bilit
y to
trig
ger
indi
vidu
al n
otes
or
patte
rns
of n
otes
dep
endi
ng o
n th
e na
ture
of t
he c
hose
n so
und
and
setti
ngs
sele
cted
. Mov
ing
arou
nd th
e sc
reen
mov
es b
etw
een
note
s w
ithin
a
pred
efine
d sc
ale
or c
hang
es th
e na
ture
of t
he s
ound
. Allo
ws
the
resu
lts o
f act
ions
to
be
sam
pled
as
repe
atin
g lo
ops.
Par
ticul
arly
effe
ctiv
e fo
r th
ose
with
res
tric
ted
hand
an
d fin
ger
mov
emen
t, be
ing
easy
to in
tera
ct w
ith, t
o pr
oduc
e co
mpl
ex m
usic
al id
eas
and
patte
rns
(Cha
llis
& S
mith
, 201
2).
Tabl
e 1.
Con
tinue
d
Inte
ract
ion
mod
alit
yC
omm
erci
ally
/ fr
eely
ava
ilabl
eD
escr
ipti
onD
etai
ls
(Con
tinue
d)
Dow
nloaded from https://academ
ic.oup.com/m
tp/article/37/2/151/5533486 by guest on 06 July 2022
Music Therapy Perspectives (2019), Vol. 37160
Soun
dHou
se
Spec
ial A
cces
s K
it (B
anan
a Ke
yboa
rd)—
disc
ontin
ued
Sixt
een
keys
con
figur
ed
like
an o
vers
ized
pi
ano
with
sof
twar
e co
mpo
nent
Cur
ved
to s
uit t
he ra
dial
mov
emen
t of a
n ar
m. L
ight
touc
h ac
tivat
es m
usic
, sou
nds,
or
spe
ech
prog
ram
med
into
eac
h ke
y. A
llow
s co
nnec
tion
of u
p to
eig
ht s
witc
hes
for
activ
atio
n of
key
s on
the
keyb
oard
(Sou
nd H
ouse
, 201
7). I
nnov
ativ
e, a
dapt
able
con
trol
su
rfac
e th
at r
equi
re m
usic
ians
to p
ress
, squ
eeze
, or
stri
ke th
em to
cre
ate
and
cont
rol
mus
ic th
roug
h co
rres
pond
ing
mus
ical
sof
twar
e (F
arri
mon
d et
al.,
201
1). U
ser
frie
ndly
, ea
sy to
lear
n. A
rran
ge c
ombi
natio
ns o
f sou
nds
(MID
I sou
nds
or w
ave
files
). R
ecor
ding
fe
atur
e en
able
s re
al-l
ife p
erfo
rman
ces
to b
e sa
ved
and
voic
e an
d C
D s
egm
ents
to b
e re
cord
ed. A
rran
gem
ents
can
be
prin
ted
off a
nd fo
rmat
ted.
Var
iety
of g
loba
l set
tings
cu
tting
dow
n on
indi
vidu
ally
pro
gram
min
g ea
ch k
ey o
r sw
itch.
Aim
ed a
t fos
teri
ng
deve
lopm
ent o
f sw
itch
use,
cau
se-a
nd-e
ffect
, tim
ing,
cho
osin
g (S
ound
Hou
se, 2
017)
.
N
umar
k O
rbit
Wir
eles
s M
IDI c
ontr
olle
r Si
xtee
n ba
cklit
cus
tom
izab
le p
ads,
four
sel
ecta
ble
bank
s to
ass
ign
up to
64
cues
, lig
htin
g tr
ansi
tions
, vid
eo c
lips,
sam
ples
, etc
. Con
trol
whe
el a
nd o
n-bo
ard
acce
lero
met
er. C
an b
e co
nfigu
red
and
map
ped
to c
ontr
ol o
ther
MID
I sof
twar
e,
acce
lero
met
er fo
r m
otio
n co
ntro
l. C
omes
with
dem
o so
ftwar
e th
at s
how
how
to u
se
with
trac
ks a
nd e
ffect
s (N
umar
k.co
m, 2
018)
.
M
ogee
s R
eson
ance
con
tact
m
icro
phon
eEn
able
s in
stru
men
ts to
be
crea
ted
from
any
sur
face
/obj
ect a
long
side
con
figur
ing
of
the
soun
ds c
reat
ed w
ith d
edic
ated
iPho
ne/iP
ad a
pp. I
nteg
rate
s w
ith s
tand
ard
digi
tal
audi
o w
orks
tatio
ns v
ia A
udio
Uni
ts o
r VST
plu
g-in
. Can
be
used
to p
rovi
de e
xpre
ssiv
e in
stru
men
t by
usin
g di
ffere
nt a
reas
of s
urfa
ce tr
igge
r di
ffere
nt s
ound
(Mog
ees,
201
8),
allo
win
g fo
r ob
ject
s to
be
used
that
are
mot
ivat
ing,
fam
iliar
, or
enga
ging
to c
lient
s.So
ftw
are-
bas
ed
Gen
eral
tec
hnol
ogy
Des
crip
tion
Det
ails
Gen
eric
dig
ital
audi
o w
orks
tatio
ns
(Abl
eton
Liv
e/A
udac
ity/R
eape
r/C
ubas
e/Lo
gic/
Sona
re b
y C
akew
alk/
Gar
ageb
and)
Mus
ic r
ecor
ding
/co
mpo
sitio
n so
ftwar
e U
ses
pres
et o
r us
er d
eter
min
ed s
ettin
gs v
ia o
n-sc
reen
, or
pull-
dow
n m
enus
. Allo
w fo
r re
cord
ing,
com
posi
ng, p
layb
ack,
and
cre
atio
n of
mus
ic. S
ome
com
e w
ith c
onte
nt s
uch
as in
stru
men
ts a
nd s
ampl
es a
vaila
ble
for
inst
ant u
se. A
bilit
y to
use
sof
twar
e in
stru
men
ts
(VST
s), i
nput
mic
roph
ones
, or
elec
tron
ic in
stru
men
ts. G
arag
eban
d is
pre
inst
alle
d on
M
ac c
ompu
ters
with
out
-of-
the-
box
sam
ples
and
inst
rum
ents
ava
ilabl
e. R
eape
r is
af
ford
ably
pri
ced,
Abl
eton
is p
rize
d fo
r liv
e pe
rfor
man
ce. A
udac
ity is
free
war
e. C
an
expo
rt n
otat
ion
in s
ome
case
s. K
rout
(201
4a) p
rovi
des
a re
view
on
usin
g so
ftwar
e fo
r m
usic
com
posi
tion,
arr
angi
ng, n
otat
ing,
impr
ovis
ing,
and
seq
uenc
ing.
Sp
ecifi
c de
vice
sD
escr
ipti
onD
etai
ls
C
lari
on
Softw
are
inst
rum
ent
Allo
ws
user
to c
hang
e ev
ery
elem
ent i
nstr
umen
t inc
ludi
ng s
ound
, not
es, s
hape
, po
sitio
n an
d co
lour
of n
otes
, and
how
thos
e no
tes
are
play
ed. I
nteg
rate
s w
ith e
ye
gaze
sys
tem
s, S
mar
tNav
and
iPad
. Pac
kage
offe
red
by O
pen
Orc
hest
ras
incl
udin
g re
pert
oire
, tra
inin
g re
sour
ces,
sup
port
, and
an
eval
uatio
n fr
amew
ork
(Ope
n O
rche
stra
s, 2
018)
.
M
agix
Mus
ic M
aker
Dig
ital a
udio
w
orks
tatio
nPr
ovid
es 4
25 s
ound
s &
loop
s, s
even
free
Sou
ndpo
ols
(1,9
27 s
ound
s &
loop
s) th
ree
softw
are
inst
rum
ents
, eig
ht tr
acks
, and
eig
ht e
ffect
s. C
an b
e us
ed w
ith s
mar
t boa
rds.
Hyp
erSc
ore
A g
raph
ical
com
posi
tion
envi
ronm
ent
Use
rs d
raw
str
okes
and
line
s to
exp
lore
mus
ical
idea
s. G
raph
ical
ele
men
ts a
re
map
ped
to m
usic
al s
truc
ture
s, a
llow
ing
user
s to
sha
pe m
usic
al p
rogr
essi
ons
visu
ally
(G
rier
son
& K
iefe
r, 20
13; M
acho
ver,
2004
).
M
IDIG
rid
Mus
ic s
oftw
are
Use
s m
ouse
and
key
boar
d m
ovem
ents
with
in a
grid
to tr
igge
r not
es, c
hord
s, s
eque
nces
, or
pat
tern
s of
sou
nd th
at c
an b
e pl
ayed
bac
k an
d lo
oped
(Hun
t & K
irk, 2
003)
.
Tabl
e 1.
Con
tinue
d
Inte
ract
ion
mod
alit
yC
omm
erci
ally
/ fr
eely
ava
ilabl
eD
escr
ipti
onD
etai
ls
(Con
tinue
d)
Dow
nloaded from https://academ
ic.oup.com/m
tp/article/37/2/151/5533486 by guest on 06 July 2022
Music Technology and Alternate Controllers for Clients with Complex Needs 161
Mic
roso
ft So
ngsm
ithM
usic
sof
twar
eG
ener
ates
mus
ical
acc
ompa
nim
ent t
o m
atch
a s
inge
r’s v
oice
usi
ng c
ompu
ter
mic
roph
one
inpu
t. M
usic
al s
tyle
and
feel
of s
ong
can
be s
elec
ted.
Son
gs c
an b
e po
sted
son
gs o
nlin
e, o
r us
ed to
cre
ate
mus
ic v
ideo
s
2S
impl
e m
usic
tool
kit
Softw
are
appl
icat
ions
Six
prog
ram
s th
at in
trodu
ce k
ey m
usic
al c
once
pts
in a
n in
tera
ctiv
e w
ay (2
Sim
ple,
201
7).
Empt
y-ha
nded
Cam
era-
base
dM
icro
soft
Kin
ect
RG
B c
amer
a, d
epth
se
nsor
, and
mul
ti-ar
ray
mic
roph
one
Prov
ides
full
body
3D
mot
ion
capt
ure,
voi
ce a
nd fa
ce r
ecog
nitio
n (K
inec
tSEN
, 201
8).
Eyes
Web
O
pen
deve
lopm
ent
softw
are
plat
form
R
eal-
time
mul
timod
al s
yste
m a
nd in
terf
ace
that
has
bee
n us
ed e
xten
sive
ly in
res
earc
h.
Syst
em s
uppo
rts
inpu
t dev
ices
incl
udin
g m
otio
n ca
ptur
e sy
stem
s, v
ideo
cam
eras
, ga
me
inte
rfac
es (e
.g.,
Kin
ect,
Wii)
, aud
io in
put,
anal
og in
puts
(e.g
., fo
r ph
ysio
logi
cal
sign
als)
. Out
puts
incl
ude
mul
ticha
nnel
aud
io, v
ideo
, ana
log
devi
ces,
rob
otic
pl
atfo
rms
(Cam
urri
et a
l., 2
000)
. Web
site
feat
ures
info
rmat
ion
on d
evel
opm
ent (
http
://w
ww
.info
mus
.org
/eye
sweb
_ita
.php
)
M
otio
nCom
pose
r (a
vaila
ble
2019
)Sy
stem
usi
ng tw
o ty
pes
of c
amer
a to
det
ect
mov
emen
t
Allo
ws
gest
ures
to b
e us
ed to
exp
lore
sou
nd e
nvir
onm
ents
(Ber
gsla
nd &
Wec
hsle
r, 20
16).
AU
MI
Free
sof
twar
e ap
plic
atio
n In
terf
ace
that
ena
bles
the
user
to p
lay
soun
ds a
nd m
usic
al p
hras
es th
roug
h m
ovem
ent
and
gest
ures
cap
ture
d vi
a w
ebca
m (L
arse
n, O
verh
olt,
& M
oesl
und,
201
6; O
liver
os,
Mill
er, H
eyen
, Sid
dall,
& H
azar
d, 2
011)
.
V
MI (
Vir
tual
Mus
ical
In
stru
men
t)Fr
ee s
oftw
are
Use
s w
eb c
amer
a to
det
ect m
otio
n. U
ser
virt
ually
“to
uch”
sha
pes
on s
cree
n to
trig
ger
soun
ds. R
equi
res
no s
peci
al e
quip
men
t, W
indo
ws
only
bas
ed c
ompu
ter.
Des
igne
d fo
r us
e by
ther
apis
ts a
nd e
duca
tors
, it i
s cu
stom
izab
le a
ccor
ding
to th
e pr
efer
ence
s an
d ne
eds
of th
e us
er, a
nd c
an b
e us
ed fo
r sp
ecifi
c th
erap
y or
edu
catio
nal g
oals
(Vir
tual
M
usic
al In
stru
men
t, 20
18).
Big
Eye—
disc
ontin
ued
still
ava
ilabl
e fo
r do
wnl
oad
Mac
into
sh o
nly
softw
are
prog
ram
U
ses
vide
o in
form
atio
n to
con
vert
into
MID
I mes
sage
s. A
llow
s tr
acki
ng o
f obj
ects
th
roug
h sp
ace
conv
ertin
g th
eir
para
met
ers
into
MID
I in
real
-tim
e (L
egac
y Pr
oduc
ts,
2018
).
C
amer
a Th
erem
in
Free
test
app
licat
ion
Cre
ate
soun
d fr
om m
ovem
ent u
sing
web
cam
(Cam
era
Ther
emin
, 201
8).
Mus
ical
Ges
ture
s To
olbo
xTo
olki
t for
exp
erie
nced
M
ax p
rogr
amm
ers.
C
olle
ctio
n of
mod
ules
and
abs
trac
tions
for
the
grap
hica
l pro
gram
min
g en
viro
nmen
t M
ax 5
to e
nabl
e ex
trac
tion
of m
ovem
ent d
ata
from
vid
eo (J
ense
nius
, God
oy, &
W
ande
rley
, 200
5).
Aer
odru
mPa
ckag
e fe
atur
ing
drum
stic
ks, s
oftw
are,
fe
et m
arke
rs, a
nd c
amer
a
An
air-
drum
min
g in
stru
men
t. R
uns
on c
ompu
ter
usin
g a
high
-spe
ed c
amer
a to
trac
k m
ovem
ents
to tr
igge
r dr
ums
(Kni
ght &
Kro
ut 2
017)
.
B
reak
-bea
mB
eam
zD
evic
e fe
atur
ing
four
br
eaka
ble
lase
r be
ams
Can
be
purc
hase
d as
a p
rofe
ssio
nal p
acka
ge fe
atur
ing
softw
are,
son
gs, s
truc
ture
d ac
tiviti
es, t
hera
py g
uide
s, a
nd le
sson
pla
ns
So
undb
eam
Dev
ice
feat
urin
g ul
tras
onic
bea
ms
and
switc
hes
(bot
h w
ired
or
wir
eles
s) a
nd a
sy
nthe
size
r un
it
Dev
ice
whi
ch u
ses
sens
or te
chno
logy
(up
to fo
ur u
ltras
onic
or
eigh
t sw
itche
s) to
tr
ansl
ate
body
mov
emen
t int
o m
usic
and
sou
nd u
sing
MID
I. N
ew u
nit f
eatu
res
touc
h sc
reen
inte
rfac
e, e
xten
sive
libr
ary
of s
ound
s, r
ecor
ding
and
com
posi
ng fu
nctio
ns,
trai
ning
pro
gram
s al
so a
vaila
ble.
Ext
ensi
ve s
uppo
rt fo
r us
e av
aila
ble
thro
ugh
onlin
e re
sour
ces
(http
s://w
ww
.sou
ndbe
am.c
o.uk
/).
Tabl
e 1.
Con
tinue
d
Inte
ract
ion
mod
alit
yC
omm
erci
ally
/ fr
eely
ava
ilabl
eD
escr
ipti
onD
etai
ls
(Con
tinue
d)
Dow
nloaded from https://academ
ic.oup.com/m
tp/article/37/2/151/5533486 by guest on 06 July 2022
Music Therapy Perspectives (2019), Vol. 37162
Ther
emin
(Mag
ee,
2006
)M
oog
Ther
emin
i—de
vice
feat
urin
g 32
w
avet
able
pre
set s
ound
s,
and
on-b
oard
spe
aker
an
d so
und
engi
ne
Can
be
used
at a
ny s
kill
leve
l, pr
ovid
ing
new
way
s to
exp
erim
ent w
ith m
usic
an
d ge
stur
al c
ontro
l. A
ssis
tive
pitc
h qu
antiz
atio
n al
low
s ea
ch p
laye
r to
adju
st th
e in
stru
men
t’s le
vel o
f pla
ying
diffi
culty
. “A
t the
max
imum
pos
ition
, the
The
rem
ini w
ill
play
eve
ry n
ote
in a
sel
ecte
d sc
ale
perfe
ctly
, mak
ing
it im
poss
ible
to p
lay
a w
rong
no
te. A
s co
ntro
l is
decr
ease
d, m
ore
expr
essi
ve c
ontro
l of p
itch
and
vibr
ato
beco
mes
po
ssib
le. W
hen
set t
o m
inim
um, t
he T
here
min
i will
per
form
as
a tra
ditio
nal T
here
min
” (T
here
min
i, 20
18).
Bui
lt-in
tune
r with
real
-tim
e vi
sual
feed
back
of p
laye
d no
tes
and
prox
imity
(use
ful f
or c
orre
ctin
g pl
ayin
g po
sitio
n). S
tore
sel
ecte
d sc
ale
& ro
ot n
ote,
se
t and
reca
ll a
spec
ified
pla
ying
rang
e, a
nd s
peci
fy p
atch
set
tings
. Sile
nt re
hear
sal
avai
labl
e vi
a he
adph
one
jack
. Tw
o lin
e le
vel a
udio
out
puts
, a p
itch
CV
out
put w
ith
sele
ctab
le ra
nge,
and
a m
ini U
SB ja
ck fo
r MID
I I/O
and
con
nect
ivity
(The
rem
ini,
2018
).
O
ptim
usic
/O
ptiB
eam
s (K
nigh
t an
d K
rout
201
7)
Inte
ract
ive
light
bea
ms
Pack
age
with
inte
ract
ive
light
uni
ts (t
he b
eam
s), l
apto
p w
ith O
ptiM
usic
sof
twar
e, U
SB
cont
rolle
r bo
x, u
ser
butto
n bo
x, r
eflec
tive
pads
/bat
s. In
tera
ct w
ith c
olor
ful b
eam
s of
lig
ht (2
, 4, 6
, 8, o
r 12
bea
ms)
, pas
s ha
nd o
r bo
dy th
roug
h th
e be
ams
or u
se r
eflec
tive
wan
d to
trig
ger
audi
ovis
ual e
vent
s in
rea
l-tim
e. C
omes
with
ove
r 80
inte
ract
ive
setti
ngs.
Pac
kage
als
o co
mes
with
trai
ning
(on-
site
or
e-tr
aini
ng) (
Opt
iBea
m, 2
018)
.
M
idiG
estu
reU
ltras
onic
bea
m s
enso
rSe
nsor
that
plu
gs in
to th
e M
IDIC
reat
or s
yste
m (s
ee M
IDIC
reat
or).
Leap
Mot
ion
(Lea
p M
otio
n, 2
017)
Smal
l dev
ice
to tr
ack
hand
mov
emen
t U
ses
two
mon
ochr
omat
ic IR
cam
eras
and
thre
e in
frar
ed L
EDs
to tr
ack
hand
and
fin
ger
mov
emen
t abo
ve d
evic
e. D
icke
ns, G
reen
halg
h, a
nd K
olev
a (2
017)
pro
vide
an
in-d
epth
des
crip
tion
of r
esea
rch
cond
ucte
d us
ing
the
Leap
Mot
ion
for
mus
ic
perf
orm
ance
with
use
rs w
ith c
ompl
ex d
isab
ilitie
s.
Bra
in c
ompu
ter
inte
rfac
e (B
CI)
Bra
infin
gers
(B
rain
finge
rs, 2
018)
Hea
dban
d fit
ted
with
se
nsor
s “D
etec
ts e
lect
rica
l sig
nals
from
faci
al m
uscl
es, e
ye m
ovem
ent a
nd b
rain
wav
es.
Bra
infin
gers
doe
s no
t dir
ectly
targ
et m
usic
cre
atio
n, a
s it
can
solv
e m
any
task
s su
ch
as s
impl
e cl
icki
ng, t
o co
mpl
ex c
ombi
natio
ns o
f con
trol
s. It
is s
oftw
are
that
con
vert
s al
l the
sen
sor
inpu
t dat
a in
to c
ontr
ols
term
ed B
rain
finge
rs. T
his
softw
are
is u
sefu
l for
a
broa
d ra
nge
of u
sers
, esp
ecia
lly p
eopl
e w
ith s
ever
e di
sabi
litie
s” (L
arse
n et
al.,
201
6,
p. 3
29).
Con
trol
s m
ost A
AC
sof
twar
e, e
duca
tiona
l sof
twar
e, a
nd v
ideo
gam
es.
Ey
e ga
zeEy
eMus
ic (L
arse
n et
al
., 20
16)—
lega
cy
files
ava
ilabl
e on
line,
re
quir
es te
chni
cal
skill
to in
stal
l (E
yeM
usic
, 201
8)
Softw
are
utili
zing
ge
neri
c ey
e ga
ze
equi
pmen
t
Syst
em th
at u
ses
eye
mov
emen
ts a
s in
put t
o el
ectr
onic
mus
ic c
ompo
sitio
ns. C
an b
e us
ed w
ith e
stab
lishe
d co
mpo
sitio
n so
ftwar
e al
low
ing
prer
ecor
ded
eye
mov
emen
t dat
a to
con
trol
mus
ical
com
posi
tions
(Hor
nof &
Sat
o, 2
004)
.
E-Sc
ape
(And
erso
n,
2018
)So
ftwar
e ut
ilizi
ng
gene
ric
eye
gaze
eq
uipm
ent (
or s
witc
hes)
Mus
ic s
oftw
are
spec
ifica
lly d
esig
ned
to b
e us
ed b
y pe
ople
with
dis
abili
ties
to c
reat
e or
per
form
mus
ic. S
yste
m o
pera
tes
via
larg
e gu
ided
pop
-up
men
us c
ontr
olla
ble
by
one
or m
ore
switc
hes,
mou
se, k
eybo
ard,
eye
gaz
e, o
r M
IDI c
ontr
olle
rs o
r se
nsor
s.
“At e
very
sta
ge, E
-Sca
pe a
sks
the
user
wha
t the
y w
ant t
o do
and
offe
rs a
ran
ge o
f op
tions
dep
endi
ng u
pon
whi
ch le
vel o
f com
plex
ity th
e us
er h
as c
hose
n to
wor
k at
” (F
arri
mon
d et
al.,
201
1, p
. 23)
. Tw
o m
odes
of o
pera
tion—
com
posi
tion
and
perf
orm
ance
. Can
out
put M
IDI d
ata
(Far
rim
ond
et a
l., 2
011)
.
Tabl
e 1.
Con
tinue
d
Inte
ract
ion
mod
alit
yC
omm
erci
ally
/ fr
eely
ava
ilabl
eD
escr
ipti
onD
etai
ls
(Con
tinue
d)
Dow
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Music Technology and Alternate Controllers for Clients with Complex Needs 163
EyeH
arp
Free
sof
twar
e ut
ilizi
ng
gene
ric
eye
gaze
eq
uipm
ent
Gaz
e-co
ntro
lled
or h
ead-
cont
rolle
d m
usic
inte
rfac
e to
hel
p us
ers
lear
n an
d pl
ay
mus
ic. V
amva
kous
is a
nd R
amir
ez (2
016)
pro
vide
a c
ompr
ehen
sive
art
icle
on
the
deve
lopm
ent o
f the
Eye
Har
p. T
he w
ebsi
te th
eeye
harp
.org
als
o pr
ovid
es a
wea
lth o
f in
form
atio
n ab
out t
he p
roje
ct (T
he E
yeH
arp,
201
8).
Eye
Play
Mus
icFr
ee s
oftw
are
utili
zing
ge
neri
c ey
e ga
ze
equi
pmen
t
Trig
ger
note
s fr
om a
ran
ge o
f ins
trum
ents
ava
ilabl
e w
ith a
djus
tabl
e no
te le
ngth
and
tr
ansp
ositi
on. C
reat
e ow
n sc
ales
. Loa
d an
d sa
ve s
ettin
gs. W
ebsi
te fe
atur
es r
esou
rce
for
use
(MB
MM
, 201
7).
B
reat
hJa
mbo
xxM
IDI c
ontr
olle
r de
vice
Han
ds-f
ree
elec
tron
ic, b
reat
h-po
wer
ed in
stru
men
t. U
ses
sip
and
puff
to d
eter
min
e am
plitu
de o
f not
e. S
oftw
are
incl
uded
to c
onfig
ure
devi
ce a
nd o
n-bo
ard
mod
ulat
ion
whe
el, b
utto
n, a
nd ja
ck s
ocke
t to
allo
w s
witc
h co
nnec
tivity
(Jam
boxx
, 201
8).
Yam
aha
WX
5, W
X11
MID
I con
trol
ler
devi
ces
Bre
ath
pow
ered
MID
I con
trolle
r tha
t allo
ws
for o
ne-h
ande
d pl
ayin
g. W
X5
feat
ures
MID
I ou
tput
; how
ever
, WX
11 re
quire
s an
add
ition
al M
IDI c
onne
ctio
n bo
x (M
BM
M, 2
017)
.
M
agic
Flu
teSt
and-
alon
e in
stru
men
tSe
lf-co
ntai
ned
inst
rum
ent w
ith b
uilt-
in to
ne g
ener
atin
g ha
rdw
are.
Plu
gs in
to e
xter
nal
spea
kers
. Tw
o se
para
te p
arts
, the
flut
e an
d co
ntro
l mod
ule
with
dis
play
. The
flut
e be
ing
the
rem
ote
cont
rol f
or th
e co
ntro
l mod
ule.
Mus
icia
ns c
an s
elec
t diff
eren
t so
unds
or
acce
ss th
e us
er s
ettin
gs w
ithou
t the
hel
p of
ano
ther
per
son
(MB
MM
, 20
17).
The
volu
me
is c
ontr
olle
d by
blo
win
g in
a m
outh
piec
e an
d th
e pi
tch
by
mov
ing
the
mou
thpi
ece
up/d
own
with
the
mou
th (V
amva
kous
is &
Ram
irez
, 201
6).
“The
inst
rum
ent r
educ
es th
e ph
ysic
al a
nd c
ogni
tive
chal
leng
es in
here
nt w
ithin
co
nven
tiona
l win
d in
stru
men
ts. O
ne m
usic
ian,
with
ver
y lim
ited
lung
vol
ume,
is
none
thel
ess
able
to r
ealiz
e th
e fu
ll dy
nam
ic r
ange
of t
he in
stru
men
t” (F
arri
mon
d et
al
., 20
11, p
. 29)
.In
tera
ctio
n m
odal
ity
R
esea
rch
only
Des
crip
tion
Det
ails
Touc
h
Gen
eral
res
earc
h
C
olla
bora
tive
inte
rfac
es r
evie
w o
f lit
erat
ure
(Bla
ine
and
Fels
, 200
3)
Rev
iew
pap
er o
f in
terf
aces
use
d fo
r co
llabo
rativ
e m
usic
-mak
ing
Com
preh
ensi
ve r
evie
w o
f con
text
and
des
ign
of a
num
ber
mus
ical
exp
erie
nces
for
novi
ces
Spec
ific
rese
arch
Mus
icki
ng
Tang
ible
s—R
HY
ME
Proj
ect
Tang
ible
inte
rfac
es
cons
istin
g of
inte
ract
ive
digi
tal “
furn
iture
”
Exam
inin
g th
e de
velo
pmen
t and
ben
efits
of u
sing
inte
ract
ive
digi
tal m
usic
furn
iture
fo
r di
sabl
ed c
hild
ren
by u
sing
two
co-c
reat
ive
tang
ible
inst
rum
ents
. OR
FI-2
6 so
ft py
ram
id-s
hape
d, p
illow
-lik
e m
odul
es, i
n th
ree
diffe
rent
siz
es (3
0–90
cm
) fea
turi
ng
bend
sen
sors
and
ligh
ts, t
he u
nits
can
com
mun
icat
e w
irel
essl
y w
ith e
ach
othe
r. W
ave
Car
pet-7
-bra
nche
d, w
ired,
inte
ract
ive,
sof
t, da
rk c
arpe
t with
ora
nge
velv
et ti
ps th
at
glow
. Cen
tral a
rm c
onta
ins
mic
roph
one,
two
arm
s co
ntai
n ac
cele
rom
eter
s th
at c
hang
e th
e re
cord
ed s
ound
. Tw
o ar
ms
cont
ain
bend
sen
sors
that
cre
ate
rhyt
hmic
al b
ackg
roun
d m
usic
. One
arm
con
tain
s a
web
cam
era.
Con
tain
five
sof
twar
e pr
ogra
ms,
offe
ring
diffe
rent
mus
ic a
nd d
ynam
ic g
raph
ics
to s
how
via
pro
ject
or e
mbe
dded
in o
ne a
rm, o
r vi
a fu
ll w
all p
roje
ctio
n. C
ente
r con
tain
s tw
o sp
eake
rs a
nd s
trong
vib
rato
r in.
Con
tain
s IR
-sen
sors
allo
win
g in
tera
ctio
n w
ith R
GB
LED
ligh
ts (A
nder
sson
& C
appe
len,
201
3).
Tabl
e 1.
Con
tinue
d
Inte
ract
ion
mod
alit
yC
omm
erci
ally
/ fr
eely
ava
ilabl
eD
escr
ipti
onD
etai
ls
(Con
tinue
d)
Dow
nloaded from https://academ
ic.oup.com/m
tp/article/37/2/151/5533486 by guest on 06 July 2022
Music Therapy Perspectives (2019), Vol. 37164
Noi
seB
ear
(Gri
erso
n an
d K
iefe
r, 20
13)
Mal
leab
le c
ontr
olle
rD
evel
opm
ent o
f rob
ust,
wir
eles
s, m
alle
able
con
trol
ler
for
child
ren
with
cog
nitiv
e or
ph
ysic
al d
isab
ilitie
s
B
ean
Ges
tura
lly c
ontr
olle
d di
gita
l ins
trum
ent
Dev
ice
desi
gned
aro
und
a W
ii nu
nchu
ck c
ontr
olle
r fo
r us
e in
a m
usic
ther
apy
setti
ng
(Kir
wan
, Ove
rhol
t, &
Erk
ut, 2
015)
MA
Wii
Dig
ital m
usic
al
inst
rum
ent u
sing
gen
eric
W
iiMot
e co
ntro
ller
Res
earc
h ex
plor
ing
WiiM
otes
as
virt
ual i
nstr
umen
ts fo
r ch
ildre
n w
ith b
ehav
iora
l di
sord
ers
(Ben
veni
ste
et a
l., 2
008)
.
Wam
Bam
Self-
cont
aine
d el
ectr
onic
ha
nd d
rum
Cre
ated
usi
ng p
iezo
sen
sors
. Pap
er d
escr
ibes
dev
elop
men
t and
test
ing
of d
evic
e us
ed
in fo
r m
usic
ther
apy
sess
ions
with
sev
erel
y in
telle
ctua
lly d
isab
led
clie
nts
(Jens
e &
Le
euw
, 201
5).
Touc
hTon
eD
igita
l mus
ical
in
stru
men
tD
evic
e fe
atur
ing
touc
h-se
nsiti
ve p
ads
desi
gned
to d
evel
op m
usic
al a
bilit
y, b
iman
ual
coor
dina
tion
and
incr
ease
soc
ial p
artic
ipat
ion
of c
hild
ren
with
hem
iple
gia
(Bha
t, 20
10).
Com
pute
r-A
ssis
ted
Mus
ic T
hera
pyA
ugm
ente
d re
ality
so
ftwar
eD
etai
ls s
yste
m d
evel
oped
with
Aug
men
ted
Rea
lity
tech
niqu
es a
llow
ing
mus
ic
com
posi
tion
and
crea
tion
activ
ities
usi
ng s
ound
and
col
our,
via
card
s (C
orre
a,
Fich
eman
, do
Nas
cim
ento
, & d
e D
eus
Lope
s, 2
009)
.
Se
nseE
ggW
irel
ess
cont
rolle
r de
vice
Dev
elop
men
t of a
han
dhel
d eg
g-sh
aped
dev
ice
feat
urin
g se
ven
on-b
oard
sen
sors
(b
utto
n, s
lider
, acc
eler
omet
er, w
ind
sens
or, u
ltras
onic
dis
tanc
e se
nsor
) and
a s
uite
of
sof
twar
e pa
tche
s ai
med
at f
or m
usic
al e
xplo
ratio
n an
d te
achi
ng. F
eatu
red
a co
mpo
nent
that
allo
wed
con
trol
of s
ettin
gs v
ia a
n iP
ad (B
lath
erw
ick
& C
obb,
201
5).
Soft
war
e-ba
sed
D
IYSE
sof
twar
eSo
ftwar
e th
at u
tiliz
es
Gui
tar
Her
o co
ntro
llers
Det
ails
dev
elop
men
t of s
oftw
are
allo
win
g co
nnec
tion
of e
xist
ing
cont
rolle
rs (G
uita
r H
ero
& W
iiMot
e, e
tc.)
to c
ompo
se a
nd r
esto
re m
usic
trac
ks, a
nd d
esig
n m
appi
ng
stra
tegi
es b
etw
een
inte
rfac
e an
d pl
ayed
sou
nds,
for
peop
le w
ho w
ith in
telle
ctua
l le
arni
ng d
isab
ilitie
s (L
uhta
la, K
ymäl
äine
n, &
Plo
mp,
201
1).
Empt
y-ha
nded
Cam
era-
base
dM
ovem
ent t
o M
usic
-MTM
Web
cam
era
and
softw
are
syst
emD
evel
oped
to a
ddre
ss th
e ne
ed fo
r af
ford
able
hom
e-ba
sed
mus
ical
pla
y sy
stem
, in
corp
orat
ing
auto
mat
ic m
ovem
ent r
ecog
nitio
n te
chno
logy
that
is n
onco
ntac
t and
no
ninv
asiv
e (T
am, S
chw
elln
us, C
eilid
h, H
amda
ni, L
amon
t, &
Cha
u, 2
007)
.
Bre
ak-b
eam
Ben
emic
/Oct
onic
Stan
d-al
one
inst
rum
ent
Dev
ice
with
arr
ay o
f eig
ht lo
w-c
ost i
nfra
red
dist
ance
sen
sors
. Ena
blin
g tr
igge
ring
and
m
anip
ulat
ion
of s
ound
s us
ing
MID
I mes
sage
s (C
halli
s, 2
011)
.
Eye
gaze
Eye
cond
ucto
rSo
ftwar
e us
es w
ebca
mSo
ftwar
e-ba
sed
mus
ical
inte
rfac
e to
pla
y m
usic
thro
ugh
eye
mov
emen
ts a
nd fa
cial
ge
stur
e us
ing
eye
trac
ker
equi
pmen
t and
web
cam
. Det
ects
gaz
e an
d se
lect
ed fa
cial
m
ovem
ents
ena
blin
g pl
ayin
g of
inst
rum
ents
, bea
t bui
ldin
g, s
eque
ncin
g m
elod
ies,
or
trig
geri
ng m
usic
al e
ffect
s (R
efsg
aard
, 201
8).
Not
e. M
IDI,
mus
ical
inst
rum
ent d
igita
l int
erfa
ce.
Tabl
e 1.
Con
tinue
d
Inte
ract
ion
mod
alit
yC
omm
erci
ally
/ fr
eely
ava
ilabl
eD
escr
ipti
onD
etai
ls
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Music Technology and Alternate Controllers for Clients with Complex Needs 165
control can lead to changes in behavior patterns beyond the environment of a therapy session with individuals becoming more self-aware and interactive outside of the sessions, more tolerant, and with a growing awareness of others (Swingler, 1998). Hunt and colleagues (2004) suggested that technology offers access to real-time sound control to those with limited movement, along with new sound worlds and timbres (Ellis & Van Leeuwen, 2000; Hunt et al., 2000; Kirk, Hunt, Hildred, Neighbour, & North, 2002; Misje, 2013). Computer music can be intriguing, particularly to young people, who may find trad-itional instruments, which are often associated with strict dis-ciplined methods, “off-putting” (Hunt et al., 2004).
Technology can also offer the sense of control and au-tonomy (Crowe & Rio, 2004) removing the need for pre-requisite skills for learning to occur (Nagler, 2011). This can help clients reach peak experiences that would be difficult using traditional instruments (Misje, 2013). Technology can offer the ability to readily create music, learn to play an elec-tric instrument, use computer programs, and/or to write and record. These activities can be condensed into a small amount of equipment, by offering the potential for many instruments to be accessed from one set up. This provides a “blank sheet” (Kirk et al., 2002) onto which individual instruments can be built for different uses/users. “This aural richness and variety provides the internal motivation.…. In addition, the technology also provides physical access for [people with disabilities]” (Ellis, 1997, p. 176). In cases where affordability is an issue, technology could be beneficial, given how expensive acoustic instruments can be. “It is possible to create sounds with as much musical interest as familiar orchestra instruments but which could not be produced by a known instrument. A new dimension for interaction can then be opened up, offering rad-ical possibilities for performance” (Kirk et al., 2002, p. 1023) that allow for and support unconventional playing (Ellis & Van Leeuwen, 2000). DMIs do not need to sound or play like con-ventional instruments, and they can be created to be operated by any part of the anatomy with no right or wrong technique, only that which is appropriate to the individual (Ellis & Van Leeuwen, 2000).
Music Technology Used in Music Therapy Practice
Music technology offers up new possibilities for exploration within music as part of the larger framework of music therapy (Misje, 2013). It has been used for many music-making activ-ities both as an active music technique (singing, music com-position, instrument playing) and as receptive intervention such as listening. Technology has also enabled the exploration of activities such as songwriting, recording, improvisation, listening, recreative, and multimedia project development as well as studying, learning, and composing and serving the needs of individuals with disabilities both in medical prac-tice and research (Crowe & Rio, 2004; Viega, 2016). Music technology in music therapy has been used to address iden-tity development (Magee, 2006); express thoughts and feel-ings (Whitehead-Pleaux et al., 2011); promote empowerment (Burland & Magee, 2013; Cappelen & Andersson, 2013); construct meaning (McDowall, 2008); and develop agency (Kruger, 2007). The development of on-task behavior, con-centration, cooperation, communication, self-expression, problem solving, and decision-making have all been shown
to be supported through the use of technology (Crowe & Rio, 2004). Technology can be particularly useful for those with short attention spans as it can be set up to instantaneously provide a relevant and enticing response, leading to enhanced focus and the potential to transcend disability (Swingler, 1998). Technology can also be used to provide individual control by community participation (Misje, 2013). This can be seen in the work of Andersson and Cappelen (2013), and through the RHYME project, using tangible interfaces for musicking (Small, 2011).
Incorporating Music Technology Into Practice
Nagler (2011) suggests the next steps for the inclusion of technology (specifically digital handheld music-making de-vices) in music therapy clinical practice are:
1. The creation and development of applications that allow for music therapists to use musical methods analogous with practices achieved using traditional instruments, thus allowing for “demonstration of patient progress to-ward specific goal attainment” (p. 198)
2. The development of accepted, common guidelines from experts in the field with best practices needed to dictate methods. Nagler (2011) suggests that the development and sharing of technology could be spurred on by the use of Creative Commons licensing and open-source networks. This includes the need to create a taxonomy of understanding (to codify the pitfalls, methods, and potentials) incorporating the vocabulary, structure, and architecture of technology (specifically of handheld music devices) into clinical practice
Farrimond and colleagues (2011) suggest simplifying the complexity of available technology by distinguishing between access needs and learning needs to aid in finding technology that is suitable for providing musical possibilities for clients. This can then lead to an emphasis on the creative prefer-ences and needs of the individual. Magee and Burland (2008) echoed this by advising “recommendations from allied fields advise that access to music-making for an individual with disabilities needs to start with examining the variance of the individual’s abilities, the type of input required to achieve a task, and the possible mappings between the two” (p. 126).
Further, developments in music education such as the Sounds of Intent framework (Vogiatzoglou, Ockelford, Welch, & Himonides, 2011) seek to provide “evidence-based guidance on appropriate music pedagogy for all children in special edu-cation (thus informing policy and practice)” (Welch, Ockelford, Zimmermann, Himonides, & Wilde, 2015, p. 3). The resources they provide are aimed at mapping the musical development of children and young people in special education settings.
Finally, a key issue for designers of new technology to con-sider is the “musicality, usability, accessibility and afford-ability” of technology (Challis, 2011, p. 6). As such, there are several design considerations that should be reviewed when designing technology specifically for the special education set-ting (Ward et al., 2017). These considerations aim to maximize the potential for new developments to be incorporated into practice, make technological tools less daunting to everyday users, and foster creativity and communication among users.
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Conclusion
While it is clear that incorporating music technology into clinical practice to enable active music-making has a myriad of potential benefits, it is also clear that the ever-changing landscape of technology can be overwhelming This can create gaps between the developer, clinician, and client. This ever-changing landscape may be particularly overwhelming for music therapists not already steeped in technology, as these systems often consist of several layers of technologies that re-quire technical skill to combine. Practitioners may find it dif-ficult to keep up with changes in technology, and figure out how to combine and integrate them into their practice. Still, despite these technical and financial challenges, the utiliza-tion of technology provides unique access to music-making for those that could not access traditional instruments or rep-ertoire. Alternate controllers, in particular, provide a means to explore new ways of utilizing an individual’s physical and learning abilities to provide meaningful and motivating mu-sical experiences. Using music technology in this manner, on its own or alongside traditional instruments, requires a dif-ferent approach to integration, repertoire, and skill set of the users. This approach must take into account the type of tech-nology, how it will be used, and also the intended outcome.
The potential in using technology is evident from the devel-opments presented in this article; this potential, however, must be discussed, shared, and best practices developed. There is still a growing need for a reexamination of the content of edu-cation and training that places technology at the forefront of music-making scenarios. The combination of this and new partnerships with those already steeped in technology would lead to a more established use of technology and would thereby build a new generation of clinicians.
Funding
Funding for the Centre for Digital Entertainment granted by the EPSRC (code: EP/L016540/1).
Acknowledgments
With thanks to the Three Ways School, Bath, UK, Luke Woodbury of DotLib. Dr. Tom Davis, and Dr. Ann Bevan of Bournemouth University for supervisory support.
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