Introduction
The intersection of music with parent-infant bonding represents one of the most intriguing objects of scientific investigation, lying at the crossroads of the greatest part of diverse disciplines, from psychology to musicology and neuroscience. My interest in the field is triggered by the fact that music is one of the basic human cultural phenomena with a very profound influence on the emotional and social development of humans. This is because music as a form of nonverbal communication is expected to strengthen the emotional bond between infants and parents, and thus enable an increase in the processes of early emotional and cognitive development. In researching this area, I anticipate that literature would indicate that music contributes to the enhancement of parent-infant bonding, exactly how musical activities, are the means through which this emotional bond would be created and fostered attachment security between the parent and infant. I also expect to learn how this can affect the developing brain of the child in areas such as emotional regulation, learning language, and social communication.
Sandra E. Trehub has been involved in the realization of music about bonding between parents and their infants. Trehub’s findings show that parents instinctively involve music in soothing infants, bonding, and communicating emotions. In particular, her seminal work is the one that describes the native musicality of infants and the role of early musical exposure in later development (Trehub, 2003). Colwyn Trevarthen makes his most profound contribution with the research on the infant’s innate musicality and how this underpins enabling the development of communication and emotional exchange between the infant and its caregiver. Hargreaves et al. (2012) defined the term “communicative musicality” to further explain how the musical characteristics of human interaction, rhythm, and melody in speech, work to foster emotional and social development in infants. Cirelli et al. (2018) were among the first to study how musical rhythm and melody could shape early development within the infant brain. Their study extends what is known about how infants can perceive and react to musical cues, allowing for early social understanding and emotional connections with their caregivers.
Jessica Grahn’s area of interest is in infant development, her research on “Music and movement” brought out the neural mechanisms that underlie music’s social bonding effects and are informative of how rhythm and music could influence parent-infant interactions, according to McGarry et al. (2019). Tom Fritz has expanded on the role of music in social cohesion and bonding, extending this to the parent-infant dyad. His work in “Universal Recognition of Three Basic Emotions in Music” touches on how music has developed to become an instrument for social binding and expression of emotions, hence presenting it in a light as to how it might have worked in the early development of a human being (Fritz, 2009).
Rationale
The study by Kehl et al. (2020) considered creative music therapy (CMT) to see if it could ameliorate the levels of anxiety, stress, and depressive symptoms in parents with preterm infants and facilitate the parent–infant relationship. The literature review, summarily put, says that having a preterm infant is a stressful experience and might disrupt the natural bonding process. With the help of these findings, the authors argued that CMT could be a therapeutic intervention to lessen these challenges. The rationale is based on current research pointing at the salutary effects of music therapy, both in individuals’ psychological well-being and in the enhancement of dyadic relationships.
Ghetti et al. (2023) proposed a controlled trial that will help to investigate how parent-led, infant-directed singing can help in promoting the bonds between preterm infants and parents. The literature review in this research opens the way towards giving an extensive preview of the difficulties that the parents of preterm infants encounter in forming a secure attachment and the important role of early interventions in helping this process. The justification is based on how the quality of interaction and emotional bonding might be improved with music as a therapeutic intervention, considering research that has revealed positive outcomes on the physiological states of infants and anxiety reduction in parents through music therapy. In contrast to the first article, the efficacy of a parent-led approach within music therapy is this time openly targeted in this study, giving a clear angle in the selection of the literature in putting a focus on the direct impact of a dyadic intervention rather than underlying therapy on a more general scale.
Newman et al. (2022) study systematically review the empirical literature on available music intervention and its effect on the relationship quality with young children and their parents. The rationale should be built around the critical importance of secure attachment in early childhood to long-term well-being, and the potential of music interventions to support this aspect of child development. A gap still exists in the literature regarding direct assessments made for the security of attachment following music interventions. This is a comprehensive approach aimed at underpinning the rationale of the study and drawing from a wide scope of research evidence for the justification of the need for a systematic review within this domain. The literature coverage of the paper is wider than that of the other two articles concerning different aspects such as those of parent-child relationships, intervention techniques, as well as those of outcomes.
The literature chosen across the three studies represents an understanding of the importance of early parent-infant bonding and challenges within different contexts, of which prematurity is one of them. Some differences may be noted in how the literature was used by each study to elaborate on its specific focus—be it the direction of CMT’s psychological benefits, the efficacy of parent-led singing interventions, or a much broader review of music interventions’ influence on attachment-related outcomes. An example of a bias potential in the literature selection would be the uniform accent made in all studies on the positive outcomes of music therapy with fewer details given on limitations or mixed results that might help round out the perspective on the efficacy of the intervention.
Methods
Kehl et al. (2020) utilized a quantitative and qualitative method in a mixed-methods pilot study design to assess the influence that creative music therapy (CMT) has on parents of preterm infants. The quantitative part consists of psychological questionnaires measuring anxiety, stress, and depressive symptoms of the parents as well as an implicit measure of parent-infant attachment. The qualitative part consists of semi-structured problem-centered interviews with parents to explore further the subjective experiences of participation in CMT. The approach is mixed methods, gaining a comprehensive understanding of the impact of CMT through statistical analysis of psychological outcomes and with richness and narrative in the data about parent-infant bonding.
Ghetti et al. (2023) are carrying out a randomized clinical trial (RCT), which is the gold standard in research for proving causality. The effect of parent-led infant-directed singing on parent-infant bonding in preterm infants is expected to have as its comparative measure the response differences between intervention and control groups. Data for this study will be quantitative in nature, collected with the aid of the Postpartum Bonding Questionnaire and other measures relevant to infant development and maternal well-being. The RCT design, by its emphasis on randomization, control, and standardized measures, it offers a rigorous methodological approach to testing the specific intervention’s efficacy. Newman et al. (2022) wrote a systematic review, a different type of method from that used in the first two articles. This study was aimed at synthesizing the existing empirical literature concerning music interventions and the quality of the parent-child relationship for young children. The design will consist of inclusive and exclusive criteria for studies, rigorous searching of databases, and thematic synthesis of findings across the included studies. Whereas the first two articles used primary data collection and analysis methods, this is a systematic review aggregating and analyzing findings from previously conducted research, thus providing a broad overview of the field.
Although all three of these studies are related with an interest in the role of music therapy in the context of parent–infant bonding, there are some substantial differences in the research design and data collection/analysis approaches. The first article thus has a mixed-methods design that allows exploration of both measurable outcomes from CMT and personal experiences of participants to the extent that a clear understanding is achieved through this that neither purely quantitative nor qualitative designs could alone. The second article, on the other hand, used an RCT design with its main emphasis on the empirical testing of the efficacy of the intervention and on measurable, quantitative results that would prove its effect. The methodology in the third article on systematic review is far more different than the primary research on the first two, it has focused more on synthesizing and analyzing pre-existing research findings to draw general trends, fill gaps, and implications for further research. Differences between these two can be attached to their ways of getting to understand the dynamic complexity of music therapy and the bonding of parent and infant. Each method has its specific strengths: mixed methods bring depth and breadth, RCTs the empirical rigor of a specific intervention, and systematic reviews an overall comprehensive overview of the field.
Findings
Kehl et al. (2020) have stated in their study the positive impacts of creative music therapy (CMT) on the anxiety and depressive symptoms of parents with premature infants and increments of parent-infant attachment. Kehl et al. (2020) included 16 parent couples, making a total of 32 individual participants (mothers and fathers). The quantitative data showed a major reduction in parental anxiety and depressive symptoms, thereby supporting our hypothesis that CMT can be a supportive tool clinically. This was further enriched by the qualitative findings reflecting personal experiences and perceived bonding with the infant and increases in their interaction with quality by the parent. The authors explain these findings as evidence of how the CMT has dual effects on the psychological well-being and empowerment of the parent-infant dyad and further bring to light opportunities in developing the application of music therapy within the context of neonatal care.
As stated by Ghetti et al. (2023), in a randomized clinical trial, the specific influence on bond outcomes by parent-led, infant-directed singing was studied. Though the original study included 213 families, the further details specify that of the 206 infants Although the authors conducted the study with a pretty rigorous methodology and anticipation for a positive effect founded on previous literature, the results haven’t indicated a significant difference in bonding scores between the intervention and control groups. In the discussion sections, the authors interpreted the results of both studies carefully, to the effect that although singing with parents did not yield a significant effect on bonding as measured via the Postpartum Bonding Questionnaire, the same never worked to reduce the perceived utility and the acceptability of the intervention to the parents.
Newman et al. (2022) conducted a systematic review that combines results from various studies to address the research question of music interventions in terms of the overall effect of music interventions on parent–child attachment. The tendency of the studies about music interventions concerning improvements in attachment-related behaviors, such as emotional co-regulation, parental sensitivity, and overall relationship quality, is positive. However, the authors report the variation in methodological rigor and lack of direct attachment security measurements in the reviewed studies. As noted by the works reviewed by Newman et al. (2022) and Kehl et al. (2020), there are positive effects. But Ghetti et al. (2023) provide a critical counterpoint that not all music therapy interventions result in measurable improvement in bonding. This difference highlights the complexity of research on therapeutic interventions and the need to have tools of measurement well-defined and able to catch the subtle impacts of music therapy. A mixed-methods approach by Kehl et al. (2020) gave a better understanding of the impact of CMT beyond numerical scores and pointed to the therapeutic value of music for parent-infant relations. Ghetti et al. (2023) still accept that their study results in null findings but provide subjective value regarding music therapy for participants. They also suggest future research, which can probably unveil other outcomes or may define intervention techniques.
Conclusion
The qualitative-quantitative combination by Kehl et al. (2020) is complemented by Ghetti et al. (2023) through a randomized clinical trial, while Newman et al. (2022) report on a systematic review. Findings pointing to the benefits of creative music therapy (CMT) in reducing anxiety and depressive symptoms among parents in the study by Kehl et al. (2020) are very persuasive based on richness in quality, apart from the quantitative data collected. The mixed-methods design allowed for an in-depth exploration beyond the numbers, revealing the depth of the impact of CMT on the parent-infant relationship, which aligns with my observations of music’s emotional resonance in families. On the other hand, in one study by Ghetti et al. (2023), the results should, however, set off a note of caution: parent-led, infant-directed singing did not enhance bonding as measured by conventional tools, although the intervention was more accepted and valued by parents. The most defining factor of this study is the large sample size, which underscores the complication in measuring the effects of music therapy and thus perhaps signifies a refined or alternative method of measurement to capture the subtlety of the dynamics of parent-infant interactions.
Newman et al. (2022) attempted to build on this evidence further by conducting a systematic review, summarizing findings from studies that evidence a positive contribution by music to attachment-related behaviors, for example, emotional co-regulation and parental sensitivity. However, the review also demonstrated that the field shows diversity and methodological challenges, which would appear to highlight the need for direct measures of attachment security to robustly ensure the efficacy of music interventions. The differences among these studies, namely the methodological approaches, the sample sizes, and the findings, point to the diversity in the research done in the field of music therapy related to parent-infant bonding. While Kehl et al. (2020) and Newman et al. (2022) substantiate the potential of music therapy, the cautionary results of Ghetti et al. (2023) remind us how important research designs are that are rigorous and elaborate enough in assessing the real impact of interventions.
I suggest that future research might employ mixed-methods designs where appropriate to secure access to the measurable outcomes of music therapy, as well as to the rich subjective experience of participants. Moreover, a larger sample size and diversity, implemented through longitudinal designs, would shed more light on music therapy’s long-term influence on parent-infant bonding. There is much to be gained by developing and employing more direct measures of attachment security in this work. Finally, the research that explores the differential impacts of music therapy based on intervention and context will offer valuable guidance towards the tailoring of interventions to specific needs and circumstances.
References
Cirelli, L. K., Trehub, S. E., & Trainor, L. J. (2018). Rhythm and melody as social signals for infants. Annals of the New York Academy of Sciences, 1423(1), 66–72. https://doi.org/10.1111/nyas.13580
Fritz, T. (2009). Universal Recognition of Three Basic Emotions in Music. Current Biology, 19(7), 573–576. https://doi.org/10.1016/j.cub.2009.02.058
Ghetti, C., Gaden, T. S., Bieleninik, Ł., Kvestad, I., Fernanda, L., Arnon, S., Dulsrud, J., Elefant, C., Epstein, S., Ettenberger, M., Glosli, H., & Nowak, L. K. (2023). Effect of Music Therapy on Parent-Infant Bonding Among Infants Born Preterm. JAMA Network Open, 6(5), e2315750–e2315750. https://doi.org/10.1001/jamanetworkopen.2023.15750
Hargreaves, D., Miell, D., & MacDonald, R. (2012). Musical Imaginations: Multidisciplinary Perspectives on Creativity, Performance and Perception. In Google Books. OUP Oxford. https://books.google.com/books?hl=en&lr=&id=qiwKUqCk1x0C&oi=fnd&pg=PA259&dq=Trevarthen+The+Musicality+of+Motherhood&ots=-en_gJSWxH&sig=m2bEaL50pGJm6U2xrE4GYig0SXk
Kehl, S. M., Ghaemmaghami, P. L. M., Haller, M., Pichler-Stachl, E., Bucher, H. U., Bassler, D., & Haslbeck, F. B. (2020). Creative Music Therapy with Premature Infants and Their Parents: A Mixed-Method Pilot Study on Parents’ Anxiety, Stress and Depressive Symptoms and Parent–Infant Attachment. International Journal of Environmental Research and Public Health, 18(1), 265. https://doi.org/10.3390/ijerph18010265
McGarry, L., Sternin, A., & Grahn, J. (2019). Publications | Lucy McGarry, Ph.D. Www.lucymcgarry.com. http://www.lucymcgarry.com/publications/
Newman, L. J., Stewart, S. E., Freeman, N. C., & Thompson, G. (2022). A Systematic Review of Music Interventions to Support Parent–Child Attachment. Journal of Music Therapy, 59(4), 430–459. https://doi.org/10.1093/jmt/thac012
Trehub, S. E. (2003). The developmental origins of musicality. Nature Neuroscience, 6(7), 669–673. https://doi.org/10.1038/nn1084
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