Summary: A new music-therapy assessment called MuSICCA (Music therapy Sensory Instrument for Cognition, Consciousness and Awareness) offers a promising way to evaluate consciousness in children and young people who have sustained severe brain injuries. Designed for patients aged 2 to 18, the tool uses tailored, live musical stimulation delivered by a qualified music therapist. The therapist observes and records behavioral responses against a structured scale to provide a clearer indication of awareness and cognitive function.
Initial evaluations involving clinicians, music therapists and family members show strong support for MuSICCA’s validity and clinical utility. The tool is intended to help care teams identify subtle signs of awareness, improve communication between professionals and families, and guide care and rehabilitation planning.
Key Facts:
- Musical assessment: MuSICCA uses live, individualized music to elicit and measure behavioral responses related to consciousness in children with brain injury.
- Strong professional endorsement: In an early face-validity study, 85% of participants strongly agreed that MuSICCA appears to be a valid assessment and suitable for use with children and young people.
- Supports multidisciplinary care: The instrument provides structured observations that can be shared with families and the wider clinical team to inform decisions about care and rehabilitation.
Source: Anglia Ruskin University
Music-based assessment may improve detection of consciousness in children after severe brain injury, according to new research published in Frontiers in Psychology.
Children and adolescents with disorders of consciousness often depend entirely on caregivers for daily needs such as feeding, hygiene and mobility. Determining whether a young person can perceive, respond to, or interact with their environment is critical for planning treatment and supporting families, but reliable assessment tools for the 2–18 age range are limited. Neurodevelopmental changes across childhood and adolescence complicate interpretation of behavior and response.
To address this gap, researchers from Anglia Ruskin University, The Children’s Trust and Temple University developed MuSICCA, a structured, music-based behavioral assessment. During a MuSICCA session, a trained music therapist selects and performs live, personalized musical stimuli and adapts musical elements—such as tempo, dynamics or melody—based on the patient’s responses. The therapist records observed behaviors using defined rating scales, which are used to indicate levels of consciousness and areas of preserved function.
The live and individualized nature of the stimulus aims to maximize salience for each child and allow clinicians to detect subtle, meaningful changes in attention, intentional movement, eye contact, facial expression and other indicators of awareness. By combining standardized observation with the flexibility of real-time musical interaction, MuSICCA seeks to balance rigor with clinical sensitivity.
In a face-validity study, 20 participants—comprised of music therapists, non-music therapy healthcare professionals and family members with lived experience caring for a child with a disorder of consciousness—reviewed the MuSICCA protocol. After a demonstration, participants rated their agreement with two central statements: that MuSICCA appears to be an assessment of consciousness and awareness, and that it appears suitable for use with children and young people. Participants also provided qualitative feedback on strengths and limitations.
All participants agreed with both statements; 85% strongly agreed that MuSICCA is both a valid assessment and appropriate for pediatric use. Reported strengths included the tool’s comprehensive structure, clear guidance for assessors, opportunity for caregiver involvement, and the effective use of salient musical stimulation. Participants noted MuSICCA’s potential to support clinical teams by producing interpretable observations that can be communicated to family members and other professionals.
Lead author Dr. Jonathan Pool, Senior Research Fellow at Anglia Ruskin University’s Cambridge Institute for Music Therapy Research, emphasized the importance of reliable assessment methods for young people who cannot easily express their needs: “Children with disorders of consciousness are often almost completely dependent on others to meet their needs. Their therapists, nurses and caregivers must interpret very subtle behaviours to help them understand those needs. There is often great uncertainty when determining this, which makes it so important to find a reliable way of assessing levels of consciousness in these young people.”
Dr. Pool added that MuSICCA enables a rigorous, music-driven assessment that highlights both the level of consciousness and the strengths and weaknesses of a child’s responses, helping professionals and families understand how best to support recovery.
About this music and concussion research news
Author: Jamie Forsyth
Source: Anglia Ruskin University
Contact: Jamie Forsyth – Anglia Ruskin University
Image: The image is credited to Neuroscience News
Original Research: Open access.
“The development and face validity of the music therapy sensory instrument for cognition, consciousness, and awareness (MuSICCA)” by Jonathan Pool et al., published in Frontiers in Psychology.
Abstract
The development and face validity of the music therapy sensory instrument for cognition, consciousness, and awareness (MuSICCA)
Severe brain injuries in children and young people may lead to disorders of consciousness, posing complex challenges for survivors, families and care teams. Accurate assessment is essential for effective treatment planning and family support, but few fully validated behavioral tools exist for the 2–18 age group. Developmental changes across childhood add complexity to assessing awareness.
This study evaluated the face validity of a music-based behavioral assessment designed for children and young people with disorders of consciousness. Twenty participants, including music therapists, other healthcare professionals and family members with lived experience, reviewed MuSICCA and evaluated its appropriateness. They rated agreement with statements about MuSICCA’s validity and suitability and described perceived strengths and limitations.
Results indicated substantial agreement that MuSICCA appears to be a valid assessment of consciousness and awareness and suitable for pediatric use. The instrument was praised for being rigorous and comprehensive, providing clear guidance, involving caregivers, using salient stimulation, and supporting clinical and care teams. These findings suggest MuSICCA may be a valuable tool to inform treatment and support families of children and young people with disorders of consciousness.