Hannah Bush’s sweet voice fills a small room as it softly registers just above the acoustic guitar she plays; the rhythm underneath not a drum or a tambourine, but the steady beeping of a ventilator and other medical machines. Her audience of one will never applaud, but Bush will have the research-based knowledge that the little girl’s blood pressure has been reduced and so has her rapid heart rate — effects that will last after the music stops.

“Music therapists are specially trained to respond to the changes,” Bush, an assistant professor in the WVU School of Medicine, said. “Caregivers are very appreciative and a lot of times medical staff have expressed appreciation as they saw the changes, as well.”

Although recorded music can have a nominally positive effect, Bush’s visits to provide live music are particularly helpful to patients because she can adapt to each patient as she sees them move or she can tell if the music is having undesirable side effects.

“If a patient starts to move a little bit, I might start playing a little bit louder,” she said.

“If a caregiver starts singing, I can back off because I know they are preferred voices. You can’t do those things with recorded music; you’re really limited to just changing the volume.

“There’s so much that you can adapt in the moment by being able to read the patient, read the room and respond.”

Close up of stuffed animals with people in the background

Hannah Bush performs for baby Gavin Elliott, mother Jessica Warnick and grandmother Kathy Elliott at WVU Medicine Children’s.

Music therapy has long been a therapeutic treatment for adults who are on life support but had not been tried with children. Bush pursued research to support her efforts with pediatric patients, but found none.

“I just assumed it existed and it didn’t,” Bush said.

Knowing she wasn’t the only music therapist who sings to children on ventilators, Bush did her own research with 33 patients under 2-years-old, 17 of whom had live music intervention, while the remaining 16 hear 15-minute recordings of the same lullabies performed by the same music therapist.

Her findings, which appear in the "American Journal of Critical Care", revealed that on average, babies who heard live music had an immediate and significant reduction in heart rate, effects that lasted for the next hour. Patients who listened to recorded music did not have the same results.

Live music is also helpful for pediatric patients who are frightened of needles. And in the case of recent pediatric COVID-19 vaccination clinics, live music was a big help in modulating stress levels for children and their caregivers. Bush and a few of her students went to WVU vaccine clinics to play for dozens of children moving through at any given point during the day.

Woman smiling while playing guitar

Music therapist Hannah Bush laughs while playing guitar outside WVU Hospitals.

“That’s a fast environment — a lot of children in a small area feeding off of each other’s crying,” Bush said. “It’s okay to be afraid, but we were trying to ease some of that anxiety.”

The songs they played were familiar — “a lot of Country Roads” — and also songs from children’s movies. Bush and her students engaged some children in playing instruments with one hand, while the shot was going into the other arm; some of them sang along with the music, and some of them were just helped to breathe deeply as Bush played along to help cue the inhales and exhales that would make the children more calm. Caregivers who were with their children during these sessions also had reduced anxiety, Bush said, and the nursing students and pharmacy staff at the clinic experienced the “bystander effect,” as they were also affected by hearing children cry as they delivered hundreds of vaccinations.

Little boy smiling at his new harmonica

Pediatric patient Christian Martin smiles at his new harmonica after playing with Hannah Bush at WVU Medicine Children’s.

“Having that additional presence was distracting for everyone,” Bush said. “My students did a wonderful job; they came prepared, but they had not done procedural support before.”

Music therapy programs are housed in the WVU College of Creative Arts’ School of Music

and students must meet entry requirements, which include competency on guitar, piano, percussion and voice; however, she said lack of competency in one area should not sway anyone interested in a music therapy career path from living out that goal.

“If I grew up playing a trombone, can I do those things? Absolutely,” she said. “If I grew up playing nothing, could I be taught to do those things if I want to be a music therapist? Absolutely.”