Music therapy is an experiential form of therapy where the client's experience of the music is essential to the therapeutic effort (Bruscia, 1998). Participation in music making is one important factor in that experience (Sears, 1 968). The musical instruments used in a music therapy session and the ability of some clients to easily make music can be an important issue in effective music therapy, especially when instruments are used (Birkenshaw-Fleming, 2006; Lathom-Radocy, 2002; Peters, 2000). While music therapy is certainly possible without the use of musical instruments, playing musical instruments is an important component of many music therapy interventions. Further, AMTA Standards of Clinical Practice (2009) state that the highest quality musical instruments must be used in sessions.Music therapy literature acknowledges that some clients have difficulty using traditional musical instruments (Alvin, 1981; Lathom-Radocy, 2002). The literature explores the need for adapting instruments to facilitate use by music therapy clients with special limitations (Bitcon, 2000; Lathom-Radocy, 2002). Specific suggestions for how this can be accomplished are made. The seminal book on the subject is Clinically adapted instruments for the multiply handicapped by Clark and Chadwick (1979). It offers illustrated examples of altered picks, beater designs, shakers and bells, aids for wind instruments, strap designs, and frames and stands. Materials employed include bicycle handle bar-type grips attached to dowels with beater heads, plastic pipe fittings to make Ljoints, inflator bellows compressed to generate air, door knob grips, and gloves or elastic for attaching instruments or picks to body parts. Similar to Clark and Chadwick (1979), Birkenshaw-Fleming (2006) suggests simple modifications that facilitate reaching (such as extending the pedals for the piano), holding the instruments (such as taping, drilling, or clamping to tables or suspending from music stands), and adapting mallets (such as wrapping with carpet tape or attaching Velcro straps). For mallets, Bitcon (2000) suggests wrapping cotton around the handle with tape or using Airecast (a professional casting material). Other sources focus on ergonomie considerations that target the specific needs of a special user group. Edelstein (1989) addresses the needs of upper-limb amputees, making suggestions for appropriate instruments or payability modifications. Boyette (2005) advocates the use of a splint to reinforce physical limitations. Clark and Chadwick (1979) and Denenholtz (1959) suggest adapting existing instruments and equipment with materials borrowed from other objects or using children's instruments that are already simplified to make playing easier. In the early literature, these adaptations tend to look improvised or cobbled together, such as Bitcon's (2000) suggested use of tape wrapped around a mallet. Visual and tactile aesthetics are important considerations for client's self-esteem and motivation to participate, which are not met with some of the suggested adaptations (Jordan, 2000). Currently, music therapists have access to well-made instruments designed for use in music therapy. Companies such as A Days Work (http:// www.adaysworkeducation.com) and Boehme Music (http:// www.boehmemusic.com/en/start.html) produce high quality musical instruments for use in music therapy, though some may be too expensive for practitioners.In recent years, the music therapy community addressed the development of specific instruments for use in music therapy settings. The 1 998 World Congress of Music Therapy sponsored a competition for the development of musical instruments for use in music therapy (http://www.musictherapy201 0arw.com). The Early Childhood News (2009) featured an instrument, the hydraulophone, for use in music therapy sessions (Cildiner, 2009). There are numerous books on general instrument construction (Buchanan, 1989; Robinson, 1973; Taylor, 1991; Waring, 2003). …
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