Inside My Toolbox: A Music Therapy Intervention for Alternating and Sustained Attention

Alternating Attention vs. Sustained Attention

Families frequently request help with alternating and sustained attention. Here’s a quick breakdown:

• Alternating attention is the ability to quickly shift focus from one task to another. (Think answering a phone call while writing an email.)

• Sustained attention is the ability to stay focused on one task for a set period of time.

These skills are essential for daily life, and music provides a motivating way to strengthen them.

Step 1: Selecting Client-Preferred Songs

To prepare, I ask clients to choose 4–5 favorite songs and assign an instrument to each from my collection. This ensures the activity is motivating and personalized.

Step 2: Editing the Music for Alternating Attention

I download the songs and use GarageBand (or another editing software) to cut each track strategically:

• For alternating attention, I might cut songs right before the chorus or an exciting section to challenge the client to shift focus or anticipate the change.

• Where I cut depends on what the client can handle. Tracks can always be re-edited as their skills improve.

This helps target the neural mechanisms required for quick attention shifts.

Step 3: Adjusting Track Length for Sustained Attention

For sustained attention, I set track lengths based on what I know about the client:

• If a client struggles retaining their attention beyond 2–3 minutes, I may set the track at 3 minutes 30 seconds max.

• The goal is to stretch attention gently without overwhelming them, ensuring success and steady progress, as is the goal with any intervention I design as a music therapist!

Step 4: Running the Session

Once I’ve built the track list, I save it to my phone and bring it to each session. I lay out the chosen instruments, start the tracks, and guide the client through the activity.

After about 6 sessions, I review their progress. At this point, I might incorporate a new set of songs to ensure that the client finds the track stimulating and appropriately challenging.

Why This Works

This intervention leverages preferred music and instrument choice to maximize motivation while addressing both alternating and sustained attention goals. The result: clients build critical cognitive and motor skills in a fun, engaging way that feels natural.

Takeaway for Families

Behind every “simple” intervention lies a lot of clinical reasoning. Music therapists are trained to adapt music in real time to meet functional goals — in this case, strengthening attention and self-regulation.

As a board-certified music therapist, I’m often asked how I support people with intellectual and developmental disabilities in building attention skills. Today I’m sharing one of my go-to music therapy interventions—including why it works and how I tailor it to each client.