Still Making Music: How Students with Traumatic Brain Injury Can Continue with Musical Activities

Still Making Music: How Students with Traumatic Brain Injury Can Continue with Musical Activities

By NAfME Member Patrick Bennington


Traumatic Brain Injury (TBI), of which concussions are a part, is a common problem in the United States. An estimated 1.4 million Americans experience a TBI each year, with approximately 50,000 people dying from their injuries.1 Traumatic brain injury may be described as an injury that occurs when a sudden trauma damages the brain.

Common causes of traumatic brain injury include automobile accidents, sports injuries, and physical violence. Depending on the severity of the injury, effects can last for a couple of hours or throughout a person’s lifetime. No matter the severity of a student’s injury, he or she can benefit from musical activities, whether through listening to music, performing on an instrument, or singing.


human brain structure, image illustration


Engaging in musical activities while recovering from a mild injury may be limited depending on a physician’s advice or the comfort level of the injured student. If singing or playing a musical instrument is uncomfortable for a student recovering from a TBI, musical activities may be limited to music listening. Damage to the head’s peripheral audio structures is a common result of head injuries, and may result in hearing loss.2 Students with severe hearing impairments may be able to hear only loud sounds, and as a result, they may be more aware of vibrations than sound. They will rely more on vision than hearing as their primary method of communication. The severity of the hearing loss will dictate the interventions used in a music classroom. If a student has only a slight or mild hearing loss, simply seating the student at the front of the room so he or she can hear the teacher better may be the only intervention needed.

Students with more severe hearing loss may need equipment (hearing aids, microphones, etc.) to enhance their hearing. Students with a severe or profound disability may need an assistant who can use sign language to assist in their normal classroom activities.

Some students with TBI may be sensitive to the loud volume levels inherent in most school bands and orchestras. For some, general music classrooms may be too loud as well, especially when using instruments. For these students, music teachers can provide music listening activities that include selected pieces of music, or music that is currently rehearsed by an ensemble. General music teachers could provide listening assignments based on musical instrument identification or pitch change identification. They could also provide recordings of songs that the class will sing in the future.

Another example of a listening assignment may be a handout that includes rehearsal strategies paired with an mp3-player and headphones placed in a separate room may allow the student to remain engaged with the ensemble’s current music selections.




One common music-making activity in schools is playing an instrument in the school orchestra or band. Physical coordination is largely responsible for the success of school musicians. Fine motor skills are needed when playing woodwind and string instruments. Students who develop fine motor function deficiencies may have more success on brass instruments rather than woodwinds, since brass instruments do not require students to use as many fingers.3 Since many instruments are designed with sound quality in mind, rather than for ease of holding the instrument, adaptations may be necessary.

Modified instruments are available for students who have types of physical maladies that make playing instruments difficult. There are many ways in which the instrument can be modified. Instruments can be made more ergonomic and less likely to cause strain.4 Velcro straps may be used to secure some lightweight instruments (especially small percussion instruments and mallets) to a person’s wrist. Specially designed stands may be used for heavier instruments.5 Students interested in playing guitar can use modified instruments and equipment such as larger picks and instrument stands designed to hold the guitar. A student with a strength deficiency may find the electric guitar easier to play than the acoustic guitar because the electric guitar usually uses a lighter string gauge.6

There are many examples of students with TBI who still participate in their preferred musical activities, from a teenager listening to his preferred music, to an orchestra student performing the music she loves. Each of these examples can hopefully provide encouragement to those with traumatic brain injuries so that they do not have to give up an activity they love.




  1. Lee L. Saunders, Anbesaw W. Selassie, Elizabeth G. Hill, Joyce S. Nicholas, Michael D. Homer, John D. Corrigan, and Daniel T. Lackland, “A Population-based Study of Repetitive Traumatic Brain Injury Among Persons with Traumatic Brain Injury,” Brain Injury 23, no. 11 (2009): 866-872.
  1. Sanjay K. Munjal, Naresh K. Panda, and Ashis Pathak, “Relationship Between Severity of Traumatic Brain Injury (TBI) and Extent of Auditory Dysfunction,” Brain Injury 24, no. 3 (2010): 525-532.
  1. Kimberly McCord and Margaret Fitzgerald, “Children with Disabilities Playing Musical Instruments,” Music Educators Journal, 92, no. 4 (2006): 46-52.
  1. Richard N. Norris, “Applied Ergonomics: Adaptive Equipment and Instrument Modification for Musicians,” Maryland Medical Journal, 42, no. 3 (1993): 271-275.
  1. Alice-Ann Darrow, “Adaptive Instruments for Students with Physical Disabilities,” General Music Today, 25, no. 2 (2012): 44-46.
  1. Adam P. Bell, “Guitars have Disabilities: Exploring Guitar Adaptations for an Adolescent with Down Syndrome,” British Journal of Music Education, 31, no. 3 (2014): 343-357.


About the Author:

June 27 - Bennington Photo


Patrick Bennington will be presenting on his topic “Still Making Music: How Students with Traumatic Brain Injury Can Continue with Musical Activities” at the 2016 NAfME National In-Service Conference this November in Grapevine, TX! Register today! 

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Join us for more than 100 innovative professional development sessions, nightly entertainment, extraordinary performances from across the country, and tons of networking opportunities with over 3,000+ other music educators! Learn more and register today: And follow the hashtag #NAfME2016!

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Brendan McAloon, Marketing and Events Coordinator, June 27, 2016. © National Association for Music Education (