Strumming a guitar with tiny fingers and a wide smile, 4-year-old Gabbie Guzon didn't realize the power of her rendition of "This Old Man." For most children this song resonates with playtime, but for Gabbie the rhyme could be propelling her recovery from cancer.
In early August, doctors told Gabbie's family that the little girl faced a fight against leukemia. She was already battling Down syndrome.
Since then Gabbie and her family have spent long stints away from their home in Hoffman Estates at Advocate Lutheran General Hospital in Park Ridge where doctors prevented the cancer from spreading.
"She has been very tough through this," Gabbie's mother Jennifer Guzon said. "She's very strong but the hard part is when the chemo knocks her out."
Former Arizona congresswoman Gabrielle Gifford sang "Girls Just Want to Have Fun" during her music therapy, highlighting the power of song as part of healing. She said music therapy helped her regain her speech after she was struck by a bullet at a rally.
"The brain is able to access information differently and express information differently," said Susan Cotter-Schaufele, music therapy supervisor at Advocate Health in Park Ridge. "Dementia patients, and all patients in between, may not be able to say anything to you, but they can sing a favorite song."
While music is often used for speech restoration, the approach is now utilized for a variety of different treatments and has gained validity with recent studies. But how affective is the approach and will it gain more mainstream use?
Music can have beneficial effects on mood, anxiety and pain in cancer patients, according to a study conducted by Drexel University researchers last year. To a lesser extent, music was found to positively influence blood pressure and heart rate.
Doctors and therapists have started to prescribe music therapy to combat a range of medical issues such as dyslexia, Alzheimer's and muscle injury, said Jeffrey Wolfe, director of music therapy for the Music Institute of Chicago's Institute for Therapy Through the Arts in Evanston.
Cognition, memory and other mental processes are influenced through music therapy because sound can elicit memories or patterns of thinking. These interventions can also impact patients physically because music ignites areas of the brain connected to heartbeat and breathing, according to music therapist Rebecca West, who practices at the Institute for Therapy Through the Arts.
"The reason music is so effective is because it targets so many different regions of the brain simultaneously and cross-laterally," Wolfe said. "When someone engages in music, there is a process that is occurring physiologically, through the body, and chemically, in the brain."
Music therapists can modulate different parts of a song, such as pitch or rhythm, to target distinct areas of the brain, West said. When working through physical rehab, a therapist creates music that helps a patient move more fluidly.
For a disorder with a psychological and physical component, such as anxiety, music therapists simultaneously calm and interact.
"The active process of making music releases happy endorphins and decreases cortisol, which is typically known as the stress chemical," West said. "If they have a really fast heart rate, we use the idea of the isoprinciple - meeting them where they are, starting with a faster tempo and then gradually bringing that tempo down."
For a patient with cancer, releasing endorphins assuages the often debilitating effects of chemotherapy. And for a 4-year-old, it is a chance to escape the routine of being in a hospital.
Banging on a drum to rhythm of her music therapist's guitar, Gabbie seems completely unaware of the plastic tube snaking up from her arm to a plastic bag filled with chemotherapy drugs.
"This is the highlight of her day," Gabbie's mom Jennifer said.
During Gabbie's rounds of chemo (some of which can last up to 35 consecutive days), she has music therapy sessions. The therapists expose her to an array of music intended to help her psychological and emotional state, said Katie Bender, Gabbie's music therapist.
Since Bender also needs to address Gabbie's Down syndrome, many of the sessions become interactive, she said. Singing songs with consonant sounds helps Gabbie to verbalize while also helping her mood.
Although institutions such as Advocate Health offer music therapy, some medical professionals and insurance companies aren't willing to acknowledge the field, Wolfe said.
"I think a lot of it is because of insurance companies," he said. "But also doctors are looking for a healing process and with music therapy we are looking for a whole life process."
Insurance companies often limit the amount of time a patient receives treatment, which is a problem for music therapy because it often takes more time, Wolfe explained.
Another obstacle for the field is a lack of research - something that could deter insurance companies from covering therapy. Many studies rely on self-reporting from participants and don't document vital signs, a team from Drexel University reported.
Music does have an effect on blood pressure, heart rate and breathing but to what degree is still somewhat unknown, the study indicated. But more research continues to emerge in support of music's physical effects.
Organizations such as the American Music Therapy Association advocate for more research and have funded articles that appear in the Journal of Music Therapy. Music therapists indicate that the information contained in these articles help to validate their work in helping people.
"We really have to fight to say yes there is research to support what we do," West said.
At Columbia University's Mailman School of Public Health in New York, music permeates the early childhood education research.
As part of proactive intervention for children at risk for learning and emotional disabilities - i.e. CARING - the Early Childhood Parents and Children's Lab is exploring the benefits of music and art therapy.
Pre-school children often improve learning through interactive playtime, researchers in the lab said. Music and art can be incorporated into a child's play to help them develop and learn.
Psychologists in the lab are trying to understand if early therapy can prevent problems from emerging and facilitating better learning in children.
Similar studies are investigating the positive effects of music on development. Two studies published in the December issue of The Journal of Music therapy focused on music therapy's effects on children with developmental issues such as autism.
The measured effects of music on a person's well being may still be ambiguous, however, many music therapists and patients attest to its power from their own experiences.
"Often times I see Gabbie totally engrossed in an instrument that I'm offering," Bender said. "It often takes a prompt from me, but sometimes she'll just look up at me and smile. I don't know if that's a great improvement but it's enjoyable for me."
Doctor's have told Jennifer that Gabbie's cancer is now in remission and that a sixth chemo session, administered last week, would be her last.
"This process has been hard," Jennifer said. "We've been away from the comfort of our own home and we've been away from her father because he's been out home with our other baby."
How much music therapy contributed to Gabbie's physical recovery is unclear, but Jennifer and Gabbie's therapist attest to the immense impact music had on Gabbie's emotional strength during the fight for her life.