Best practice recommendations for using music with children and young people with disorders of consciousness

Children and youth with Disorders of Consciousness (DoC) present with highly complex medical, physical, and behavioral needs. Additionally, involving such children and young people in meaningful activities with caregivers can be challenging due to the combined motor, sensory, cognitive and communication impairments. Authoritative guidelines for engaging children and youth in meaningful sensory experiences that can enhance social and emotional experiences are lacking due to the minimal research with this population. Music is a medium that optimizes sensory stimulation using salient stimuli in the auditory modality. Furthermore, music experiences require minimal physical demands and offer opportunities for social interactions in line with developmental milestones. The primary objective of this paper is to offer best-practice recommendations for musical stimulation with children and youth with DoC, including its use in leisure and relaxation activities. These recommendations are synthesized from the existing evidence and combined with expert opinion. They are intended for caregivers of children and young people with DoC, which include paid healthcare professionals and providers, as well as non-paid caregivers such as family, friends, and volunteers. These practical suggestions may be applicable in a variety of settings, including hospitals, educational and residential care settings, family homes, and rehabilitation units.