Doctor’s Note
KU research unlocks the medicine in music.
Deanna Hanson-Abromeit is a professor of music therapy at the University of Kansas, home to the nation’s second oldest music therapy program. She is also a mother, musician, clinician, researcher, and visionary working to transpose the power of music into healing. Her work addresses widespread health issues that patients face from their first days of life through adulthood.
For nearly 30 years, Hanson-Abromeit has bridged her mastery of art and science to deepen our understanding of both. As a researcher at KU, Hanson-Abromeit created the Therapeutic Function of Music (TFM) Plan, a tool that is revolutionizing the field of music therapy and has the potential to improve the lives of millions.
Using the TFM Plan, Hanson-Abromeit and her colleagues are targeting brain and early language development, easing complications from prematurity and neonatal opioid withdrawal syndrome, and addressing symptoms of chronic obstructive pulmonary disease (COPD).
Healing harmonics
Early in her career, Hanson-Abromeit sought to develop a music therapy program for neonatal intensive care unit (NICU) patients. Her first day training in the NICU, Hanson-Abromeit thought she would simply observe — until a nurse placed a newborn in her arms.
The baby was premature and had several health complications. His condition was delicate and his treatment intricate. Tubes and wires connecting the infant to monitors and respiratory support were secured to Hanson-Abromeit’s shirt.
Soothing infants with song is ancient medicine born of ancient wisdom, so deeply woven into our humanity that it is now innate.
Caught off guard by the request to soothe the baby but guided by her experience as a mother, Hanson-Abromeit found that caring for an infant in crisis came instinctively once she started to sing. While doing so, Hanson-Abromeit’s instincts as a researcher also came into play, prompting her to note how the baby’s breathing or heart rate responded to her singing.
“Babies really attend to music in different ways than they attend to other stimuli. … Some of my big research is understanding why and how that happens.” —Deanna Hanson-Abromeit, professor of music therapy and music education
Sound can be supportive or detrimental for patients transitioning from the womb to the world. Much of the earliest information we gather about the world comes by way of sound. A parent’s heartbeat provides a constant backdrop against which foundational sensory experiences take shape. The tone and pitch of their voice construct the framework of our understanding of emotion. The rhythm of their rocking and swaying provides our first comfort.
In utero, fetuses are protected from overwhelming sensory experiences while their brains develop. But the sudden influx of sensory information from their new environment can overwhelm premature infants and stress their underdeveloped systems. For any newborn, receiving comfort through singing is natural. Hanson-Abromeit wanted to understand why.
Call and response
“Singing at the bedside,” Hanson-Abromeit said, “I was seeing that subtle changes in what I was doing in the music, like the tempo, the rhythmic complexity, the number of pitches and the range that I was using — I could see the direct effect on these infants. Because they were hooked up to machines, I could see changes in their respiratory rates, and changes in their heart rates, and changes in their oxygen levels. And I could see these really, really subtle behavior changes that would give indicators of self-regulation or stress.”
“I could sing at the bedside and capture their attention in a way that wasn’t happening with other stimuli.” —Deanna Hanson-Abromeit, professor of music therapy and music education
“Putting on the recorded music was not the same as having me … at that bedside,” Hanson-Abromeit explained. “I was cuing into what the baby’s behaviors were, and I was adjusting what I was doing in the music to a way that they could handle and adapt, and then moving them into a slower rate of breathing.”
Premature babies have underdeveloped lungs and may require ventilation, but using ventilation that is too strong or for too long a period can cause damage. Throughout her time working with infants in the NICU, Hanson-Abromeit found that by adapting various elements in her singing, she could help guide infants to more regulated states where they required less and less respiratory support. Reducing ventilation reduces the risk of lung damage, and, in a regulated state, an infant’s systems can focus their energy on development.
During her time in the NICU, Hanson-Abromeit played several parts simultaneously: a keen researcher, an effective clinician, and a versatile musician. Blending different perspectives, skills, and expertise, she was able to key into the subtle ways sound carries healing. What she learned would inspire her work for years to come.
The maestro
As a child, Hanson-Abromeit discovered she had a gift for music. As a first-generation college student, she earned a bachelor’s degree in music therapy before beginning her career as a board-certified music therapist. Two children, a master’s in music therapy, and a doctorate in music education soon followed. Creator of KU’s Baby-Music Intervention Research (babyMIR) lab, Hanson-Abromeit now leads the development and advancement of the theory, design, research, and implementation of music-based interventions, with a focus on infants and families.
As a member of KU’s dynamic research community since 2003, Hanson-Abromeit is at the heart of a team of experts in the arts and sciences who work together to unlock music’s therapeutic potential. KU has a legacy of collaboration across disciplines and campuses in pursuit of advancements that improve lives. A crucial step toward such advancements is the clear identification of the challenge, the proposed approach to address the challenge, and the measurements researchers will use to test their approach. When the measurements don’t yet exist, researchers like Hanson-Abromeit call up Jayhawk might, determination, and creativity, and get to work.
To make the power of music measurable, Hanson-Abromeit created the Therapeutic Function of Music (TFM) Plan, revolutionizing the scientific research of music as a therapeutic treatment.
“I’ve always been a musician. My mom made sure that I had piano lessons. When it was time to join band … the band director said, ‘Hey, play the French horn.’ And so I did. … Really, it was easy for me.” —Deanna Hanson-Abromeit, professor of music therapy and music education
Articulating the science of music
Music is a universal component of humanity, but scientific examinations of its effects are lacking. We know music can affect our energy levels or state of mind. In some cases, we believe it even has the power to heal. Without thorough scientific analysis, can we know whether music truly helps, or how? That’s where the TFM Plan comes in.
“As music therapists, we’re trying to … harness very specific aspects of the music to intentionally target change.” —Deanna Hanson-Abromeit, professor of music therapy and music education
Hanson-Abromeit’s TFM Plan clarifies how and why specific characteristics of music are therapeutic. Addressing gaps in the scientific understanding of music, its applications, and its benefits, the TFM Plan is the first framework to synthesize music theory, basic sciences, and applied sciences to formally document the explicit ways elements of music can be used in targeted, music-based therapies and interventions. This framework allows researchers and clinicians to address specific health needs by designing therapies around music that directly contribute to healing.
Because it more clearly articulates the evidence-backed role of music in therapy, the TFM Plan can help researchers improve the development and implementation of music-based studies.
The TFM Plan also increases consistency in the application and measurement of musical elements in a therapeutic context. By using the TFM framework, researchers can increase the accuracy and reliability of their data.
Orchestrating research
With the support of KU’s Life Span Institute and funding through Frontiers Clinical & Translational Science Institute at the University of Kansas Medical Center and the Meredith Willson Pilot Research Program, Hanson-Abromeit, music therapist and graduate student Annie Roberson, and their colleagues recently used the TFM Plan to design and implement a music-based intervention for early language development. This pilot study is the first of its kind.
“We’re not just performing music at people and hoping that it solves their problems. We are intentionally changing the way that we are using music or delivering music to create change.” —Annie Roberson, music therapist and graduate teaching assistant
Language development is a complex process that relies on focused, face-to-face interaction and vocal play with caregivers during the first two years of life. Before the creation of this study, there were no known evidence-based music interventions designed to promote such interactions and encourage the prelinguistic language skills that infants and toddlers build upon to form words and meaning — skills such as gesturing, babbling or vocalizations, eye contact, and shared attention.
Over a four-week period, parents and their six- to 15-month-old babies gathered twice a week for 30-minute sessions led by Roberson and other music therapists at Positive Bright Start, one of KU’s community partners in Lawrence, Kansas. Through a series of songs selected with elements such as rhythm, melody, tempo, and volume in mind, these babies were prompted to exercise their burgeoning communication skills.
“I think music was … my first language. … I think of memories from growing up, and music is kind of the constant throughline. … My grandmother was a church pianist, and I think the second that I could sit on a piano bench and look up at the keys, she had me sitting up and picking out notes with her and teaching me songs.” —Annie Roberson, music therapist and graduate teaching assistant
As they interacted with the therapists, their parents, and other children, the young study participants were encouraged to sing along to songs designed to promote the specific prelinguistic language skills of gesturing, vocalizing, and joint attention. They were also encouraged to practice gestures such as waving, clapping, and pointing. Vocalizations included simple sounds and words — for example, moving from “ma” to “mama.” Vocal play and back-and-forth conversational exchanges are crucial to early language development, and the study provided parents with creative ways to increase and improve such exchanges.
“We’re starting to be able to unpack each of these aspects of what is in a music-based intervention … in a way that gives us a better and deeper understanding, I hope, of that intersection between the art and the science.” —Deanna Hanson-Abromeit, professor of music therapy and music education
Tuned-in parents
While the complete data from this research study are still being compiled and analyzed by the team at KU, the Kansas families who were involved noticed benefits right away. Mothers Dazia Gallagher and Amanda Frederick, who were among the participating parents, incorporated elements from the classes at home to support their children’s growing language skills.
“Most of life’s most beautiful emotions are formed into poems and songs, and people are able to relate to those things. I think music is a big part of just being human.” —Dazia Gallagher, study participant
“The universal language. … Music can … help with memory and acquiring new skills. When my grandmother was in her last days, she had aphasia, so she couldn’t really talk anymore, but she could still sing.” —Amanda Frederick, study participant
Thinking about the positive influence the study had on her son, Hudson, Gallagher said, “I feel like [the study] was for both of us, just being able to learn how to utilize different techniques and different fun ways to teach him how to use his own voice and learn words.”
Since Hudson participated in the study, Gallagher said, “It’s definitely been easier to understand what he needs. … He’s better at learning, ‘Oh, I need to be able to use my voice to tell her what I need.’ ... So he’s not as frustrated as he used to be. … He’s definitely been talking and babbling a lot more.”
Feedback loop
One outcome that surprised Gallagher was how the music sessions increased Hudson’s interest in books. One of his favorite songs from the study was “The Itsy Bitsy Spider.” Through repetition, increased focus, interaction, and vocal play between parents and children, the young study participants grew familiar with the songs. Familiar lyrics helped the children build connections between certain sounds and words.
In addition to singing the song together during music sessions, Hanson-Abromeit and her team provided each study participant with a book version of “The Itsy Bitsy Spider” so the children could interact with words they were beginning to understand and practice behaviors that support early reading steps. As Hudson became familiar with the song’s lyrics, “The Itsy Bitsy Spider” became one of his favorite books to sit with and explore while practicing beginning reading behaviors.
“The Itsy Bitsy Spider” made a big impression on Amanda Frederick’s daughter, Cordelia, too. According to Frederick, “[Cordelia] didn’t start doing the thing where she would ask for ‘The Itsy Bitsy Spider’ song until after we’d started doing the class. Her grandma sang that song with her all the time before, but now she recognizes it.”
High fidelity
Study participant Amanda Frederick is enthusiastic about KU’s mission as a leading research institution and sees a lot of value in studies that take a deeper look into what’s at play between music and language development.
“I think it’s really important, even though a lot of research is getting its funding cut right now. Extra important,” Frederick said. “Music connects to different parts of the brain that are so important. I think it’s critical to research that and take advantage of that.”
Other participants noted the dual appeal of the study’s emotional and practical benefits, too. As parents saw improvements in their children’s language abilities, they were also lifted by the social aspects of the sessions and the opportunities to bond more deeply with their children. Overall, the study accomplished something that all research at KU aims to achieve: improving people’s quality of life in Kansas and beyond.
Composing interventions for respiratory health
Hanson-Abromeit’s TFM Plan research method has also guided studies for treating chronic obstructive pulmonary disease (COPD), the most common aging-related lung disease and the fourth leading cause of mortality worldwide. Working in concert with colleagues at KU Medical Center who specialize in neuroscience, pulmonology, and engineering, Hanson-Abromeit leveraged the TFM Plan to create a novel singing-based intervention designed to improve lung function in COPD patients.
An ensemble of researchers
Jiwoong Choi is a research assistant professor of pulmonary, critical care, and sleep medicine in the internal medicine department of the KU School of Medicine. But medical research wasn’t always his focus.
“My background is mechanical engineering. I did [a] bachelor’s, master’s, and Ph.D. all in mechanical engineering,” Choi said.
“I loved music from — well, the beginning of my memory. I learned the piano, violin, and my uncle played the guitar all the time to me. And I do the same thing for my kids now. … I spent more time in the college choir than my mechanical engineering studies, actually.” —Jiwoong Choi, research assistant professor of pulmonary, critical care, and sleep medicine
“For my master’s, I was doing serious fluid dynamics, computational simulations of fluid dynamics, and … I applied those to the lung function and structure function relationship,” Choi explained. Combining his expertise in engineering and fluid dynamics to enhance advanced CT imaging, Choi develops computational models that aid physicians and fellow researchers in the study and treatment of lung disease.
Rebecca Lepping is an assistant professor in the KU School of Medicine’s neurology department and the creator and director of the Power of Music (PROMUS) Laboratory.
“I chose that name because music is one of the only things that we have that activates nearly every part of our brain and nearly every part of our body,” Lepping said.
“I started playing piano when I was five. … I was a double performance major in flute and piano. … I have a master’s in piano performance. … I am a scientist and a musician. I don’t hold one of those as higher than the other. One is not more important than the other.” —Rebecca Lepping, research assistant professor of neurology
“I like to geek out on … how the auditory gets translated by your brain and your body signals into emotion, into cognitions, and understanding all of those links,” Lepping continued. Using the TFM Plan, Lepping took this interest a step further by working to improve COPD patients’ overall health and well-being through music therapy.
“There’s something about the music specifically, and Deanna [Hanson-Abromeit]’s work is really highlighting how we can improve the outcomes, improve the … effectiveness, and improve our understanding of why music therapy works if we understand what the music’s role is,” Lepping said.
Hanson-Abromeit, Choi, and Lepping integrated their expertise as scientists, researchers, and musicians to create a treatment that could improve the lives of millions of people around the world. “Because we know music, we can hone it and craft it in such a way that it becomes therapeutic,” Lepping said.
Vocal chords
To support a National Institutes of Health proposal, Hanson-Abromeit, Choi, Lepping, and their colleagues studied whether a targeted singing therapy could improve respiratory function in COPD patients. This pilot study was funded by the University of Kansas Medical Center’s Division of Pulmonary, Critical Care, and Sleep Medicine.
Lung tissue in COPD patients becomes more rigid as the disease progresses, making it difficult to fully exhale. This is called “air trapping.” The research team set out to address this specific symptom, guided by the TFM framework.
“If you imagine a balloon that has air in it, it’s harder to blow it up than a balloon that’s empty, right?” Lepping said. “The more air that’s already there, the harder it is to blow it up.”
“For COPD, that translates to: If you can’t expel all the air that’s in your lungs, it’s harder for you to take in more air, and you get shortness of breath, which is very distressing to people,” Lepping continued. “We wanted to craft the singing intervention to help fully, or more fully, expel the air that’s trapped in the lungs.”
To target the symptom of air trapping, study participants performed exercises that involved increasing the length of exhalations or changing the pitch of their singing. This kind of variation and complexity was key in measuring the effectiveness of the musical elements studied. Phrase length and pitch were among the primary musical elements used by the therapists during the singing sessions. Through singing, perhaps to one of their favorite songs, participants pushed their respiratory effort, often without realizing it.
Breath marks
“We actually have some very exciting preliminary evidence,” Lepping said. After only seven therapist-guided singing sessions, every study participant showed improvement in air trapping, as measured by lung volumes and quantitative CT scans.
- Lung volume improved by 11% in one patient.
- A second patient saw 17% improvement in lung volume, 1.8% increase in lung motion overall, and 33% motion improvement in the right upper lobe (RUL).
- A third patient saw 24.2% overall improvement in lung motion and 45% RUL movement improvement.
Study participants are already breathing more easily, and the researchers hypothesize that the reduction in air trapping will delay COPD progression.
“We did the sessions with the music therapist via telehealth … which means that potentially this is something that could benefit the people that we serve in rural Kansas and beyond,” Lepping said.
Music therapists around the world use singing exercises to address respiratory conditions. While group exercises have been found to improve mood and quality of life for respiratory patients experiencing isolation due to their symptoms, evidence showing physical benefits from these exercises was lacking.
That’s where the TFM Plan makes a meaningful difference. With Hanson-Abromeit’s matrix, researchers can more clearly identify which musical elements make therapies beneficial and adjust them to explore their full therapeutic potential.
“With this program that we’ve developed using Deanna [Hanson-Abromeit]’s Therapeutic Function of Music framework, we seem to be hitting the target, and that’s what’s really exciting.” —Rebecca Lepping, research assistant professor of neurology
Collaboration is key
As one of the nation’s leading research institutions, KU is dedicated to taking on global challenges and creating solutions that improve lives. In pursuit of groundbreaking advancements, our research community harnesses the brilliance of cross-disciplinary teams across five campuses.
“It’s really valuable to have these undergraduate, master’s, and Ph.D. programs at an R1 research institution that has influenced the whole state of Kansas,” Hanson-Abromeit said. “We’re able to accomplish things, we’re able to solve problems, we’re able to make a better way of life and appreciation for this experience of art and advancing science in a way that’s really meaningful.”
Choi also believes this marriage between art and science offers rich opportunities for research.
“The most exciting part of our collaboration now is the combination … [of] multiple multidisciplinary parts,” Choi said. Research at the intersection of music and medicine “is not a general track of pulmonary medicine,” Choi continued, “but personally, it is like a dream come true because I’m really in love with music and singing.”
“I didn’t expect to find this team, these team members, in any other place in the world.” —Jiwoong Choi, research assistant professor of pulmonary, critical care, and sleep medicine
“We needed to bring together this multidisciplinary team in order to do the rigorous science that’s necessary to really move the needle,” Lepping said. “The science that we do is not possible in just one lab. It takes so many people with so many different areas of expertise to really do the science that we need now. It takes a long time to do this collaborative science, but I think it’s worth it. I think it improves the quality of the science and the questions that we’re able to answer.”
KU’s research community is powered by hundreds of experts in a diverse array of fields, brought together by a spirit of creativity and service. This vast, versatile network sparks infinite opportunities for unexpected disciplines and research foci to unite and generate ingenious and life-changing results.
“Lift the chorus ever onward”
KU’s footprint in the music therapy landscape is practically as old as the field itself. Our music therapy program, the second oldest in the nation, celebrates its 80th anniversary in 2026. In fact, the “father of music therapy,” E. Thayer Gaston, was a distinguished KU professor.
Seventy years ago, the foundations for KU’s internationally renowned Life Span Institute were also forming. The institute is a sterling example of the cross-disciplinary, far-reaching research that KU is recognized for. Powered by nearly 400 KU researchers, staff, and graduate students, the research center works to improve lives throughout all stages, beginning in early development. Their contributions fuel KU’s #1 global ranking in intellectual and developmental disability research.
Expanding KU’s knowledge and influence, KU Medical Center leads the Frontiers Clinical & Translational Science Institute. The research hub at Frontiers accelerates the transformation of research advancements into real benefits for patients around the world, with a special focus on rural andunderserved communities across Kansas and Missouri.
The collaborative mission and support of these institutions are crucial to KU’s research culture. Jayhawks know that not all research occurs in labs. Some research happens at a baby’s bedside, in a mother’s arms, in a toddler’s classroom, or in a patient’s singing.
Stellar researchers like Deanna Hanson-Abromeit gather information and inspiration in unexpected places. With her mastery of arts and sciences, Hanson-Abromeit created a tool that composes medicine from music. Core to our humanity, music is many things to many people. Through Hanson-Abromeit’s work, it is also the heart of a KU discovery with the power to improve millions of lives.
Rising from heartland prairie, the University of Kansas harnesses insight from every perspective. Inspired by boundless horizons calling us to endeavor onward, Jayhawks persevere, powered by a mighty network of thinkers, questioners, and creators — in service of all.
Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002366. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.