MARCH's Child...

photo: circa 1949, in  Watonga Oklahoma.

The  gaze already says  "Subdivide and conquer!"

"Knock, knock."

"Who's there?"

"Knock, knock."

"Who's there?"

"Knock, knock."

"Who's there?"

"Knock, knock."

"Who's there?"

Think you know who MARCH's child is?

Violinist Susanna McCleary shimmers in a silver top as she strides over the Miles Nadal Jewish Community Centre stage, one hand balanced lightly on the back of her mother, Dorothy de Val. McCleary leads the pair in a rousing rendition of the klezmer piece Hora Marasinei, her brow furrowed in concentration as her bow darts and dances over her violin. De Val replicates her rhythms on the piano, and mother and daughter sway in synchrony.

After their opening act, pianist Michael Arnowitt grabs his white cane and heads into the spotlight. As his nimble fingers plunge into a series of Bach selections, Arnowitt is mesmerized by the music, punctuating the accents with sharp tosses of his head. The final, plaintive note quivers for an eternity in the hush of the room.

This performance on October 15 last year, “An Evening in the Key of B: A Benefit Concert,” was a fundraiser for the non-profit organization BALANCE for Blind Adults (balancefba.org), which helps visually impaired clients regain their independence.

Roy Thomson Hall is humming today as parents, children and an autism service dog troop in to the Toronto Symphony Orchestra’s matinee performance of “Let’s Dance,” featuring moves from ballet to hip-hop.

Most make a beeline for the Resources Table, stacked with goodies. There are sunglasses in funky pink, orange, green and yellow; headphones; ear plugs; and hair spirals to stretch when you’re anxious. All of these help to channel arousal.

A gangly, soft-spoken tween and his mother join the swarm. Michelle Saunders is excited about the upcoming show but isn’t sure her son will last through it all. Emerson loves music, but struggles to block out ambient noise and focus on the tunes, says Saunders. Sometimes he shuts down, and the pair have to leave. It’s tough emotionally and financially for both. “But as a parent of a kid with autism, you get used to abandoning plans,” she says.

Emerson may or may not make it to the end today. “But in this environment, that’s OK,” says Saunders. He grabs some ear plugs, while his mother scoops up a fidget toy shaped like a musical note to tone down her own tension. “Just in case,” she says. Fortified with the freebies, they head into the auditorium.

It is April 27, 2019 and this is the Toronto Symphony Orchestra’s first Relaxed Performance, geared towards people living on the spectrum, or anyone with sensory or communication sensitivities. These shows feature a laid-back atmosphere, where spectators’ issues are addressed so they can relax and enjoy themselves.

Hypersensitivity to sensations is one of these issues. Those who live with autism have unique ways of processing signals from the environment, says Relaxed Performance consultant Rachel Marks, who worked with the TSO to shape today’s recital. Many have trouble filtering out extraneous stimuli from those they’re trying to concentrate on. The barrage of sensory input from typical concerts can be so overwhelming and anxiety-provoking that many people on the spectrum will forego these occasions.

But nerves aren’t the only problem. Parents of typically developing children often make snap judgements when a child on the spectrum has a meltdown from sensory overload. “They make not-so-friendly comments about the ‘bratty kid,’” says Marks. Caregivers wanting to shield their loved ones from these negative comments avoid public places like theatres.

Relaxed Performances began in the United Kingdom in response to these concerns, and have spread to theatres across Canada, including Mirvish Productions, Soulpepper, Stratford and Young People’s Theatre. Some shopping malls and restaurants are also sensory-friendly, offering periods of reduced sound and lighting. “People are becoming more open and inclusive,” says Marks.

Relaxed Performances accomplish this goal by tuning in to the audience’s concerns. Detailed guides, for instance, available long before the show, allay fears about the future. These visual aids reassuringly lay out the nitty gritty details of the upcoming experience, from where to park to who will take your ticket. “A prepared person is more confident,” says Marks.

Reducing the sensory stimulation also helps patrons on the spectrum to unwind. Anyone wishing to retreat from the noise can relocate to the unbooked back rows or escape to a quiet room equipped with colouring books, modelling clay and other soothing activities.

Self-expression is another aspect of the new project. Many children on the spectrum have developed unique ways of coping with anxiety, including vocalizing or performing repetitive actions like rocking or flapping their arms, says Marks. In addition to these actions, called stimming, some children living with autism have coexisting attention deficit disorder, which provokes constant motion. While these behaviours are frowned on during traditional concerts, they’re expected at Relaxed Performances.

Parents benefit from these concessions as much as the children. It’s comforting to know that everyone is there for the same reason, says Marks. “They’re able to enjoy that moment so much more because they’re not worried about inconveniencing other families.”

Today’s Relaxed Performance is an extension of the Toronto Symphony Orchestra’s general commitment to accessibility, says Aaron McFarlane, director of education and community engagement. The orchestra has the largest outreach to elementary students in Canada. It’s also long offered accessible seating, assisted hearing devices, back supports, and accommodations for service animals.

Last year the TSO pooled their expertise on the Relaxed Performance and set the date for its premiere. McFarlane had experience working with children on the spectrum, while guest conductor Daniel Bartholomew-Poyser was a veteran of the relaxed initiative. McFarlane consulted a series of experts on autism (including Rachel Marks) and reached out to over 75 community groups serving neurologically diverse children, rapidly selling out the show’s over 800 seats.

Those who missed out on a ticket needn’t fret. “I see this as a transition to one day when all performances will be accessible to those with sensory issues,” says McFarlane.

Bartholomew-Poyser is equally dedicated to the enterprise. Face beaming, he strides to the front of the stage and invites the crowd to feel at home – they can vocalize, flap their arms, or dance in the aisles. “You’re welcome to take care of your needs,” he says. The audience cheers.

Bartholomew-Poyser is clearly in his element. He’s been conducting Relaxed Performances with the Thunder Bay Symphony Orchestra since 2012. They got positive feedback after the first one, and developed a large and loyal following for subsequent spinoffs. “Both children and parents were so grateful to have a place to come without fear of judgment,” says the conductor.

Bartholomew-Poyser is tinkering just a little with today’s numbers. He’s toning down the percussion section and also warning the audience of any sudden loud noises. “There will be no surprises,” he promises. But most importantly, he’s making the spectators feel safe under his wing.

Saunders and her son are both touched by the conductor’s attitude. Emerson is used to environments where he has to work so hard to stay still that he can’t appreciate the show. “For him to know that he could enjoy himself – that was a child balloon,” says his mother.

The conductor’s words are equally reassuring for Saunders. “Normally in performances I have to put a hand on his knee to remind him to calm his body and quiet his voice,” she says. But not today. “We’re both relaxed – that’s the beauty of it.”

It seems like the other spectators are equally at ease. They’re singing, rocking, and running up and down the aisles. One girl stands up and pretends to conduct.

As the concert progresses, kids skip down to the front row, where they twirl and bounce alongside the professional dancers. One teenager with a grey hoodie makes an impromptu debut, leaping onto the stage where he kicks his long legs in perfect tandem with the lithe Irish jiggers. He ignores his caregiver who’s frantically beckoning to him.

Emerson is intrigued by the boy’s bravado, watching the breakout star with wide eyes as the tween wriggles around in his seat. The younger boy worries that the show crasher is headed for trouble. But when the teen hops gracefully back to the floor at the end of the number, the auditorium erupts in applause. Emerson joins in, relieved. “Nobody freaked out – everyone enjoyed it,” says Saunders. “That’s what a Relaxed Performance is all about.”

The children’s joyous reaction to today’s music doesn’t surprise professionals in the field of autism. Many individuals on the spectrum are musically gifted, says Rachael Finnerty, psychotherapist, music therapist, and founder of the Ontario Music Therapy Academy. According to one study, kids on the spectrum had better pitch, rhythm and recollection for melodies than their typically developing counterparts.

This natural aptitude can be harnessed to address verbal and non-verbal communication difficulties, which are common in this population, says Finnerty. Many children living with autism are uninterested in conversing, and produce stilted learned phrases rather than off-the-cuff answers.

Music, however, is an alternate language. Like the spoken tongue, it has its own set of rules – passages often echo each other, and harmonic structures give phrases predictable endings, says Finnerty. The give and take of improvisational music simulates the patterns of spoken conversation.

These parallels between music and speech can help children grasp the fundamentals of social communication, says Finnerty. During music therapy sessions, Finnerty will echo a child’s mood on an instrument. For instance, if he’s running around the room, she might play a series of rapid notes as a gesture of empathy. “This demonstrates that I see you, I’m with you,” says Finnerty. Creating music together can teach other social skills such as listening, responding appropriately, and taking turns.

Music can also help children on the spectrum express themselves creatively. While they might toil to articulate their thoughts and feelings, they can compose song segments on the spot. “In music, answering a question isn’t a struggle – they hear the melody and just respond in that moment,” says Finnerty.

Music not only enhances social communication, it can also change the functioning of the autistic brain. A Canadian study published in 2018 was the first research demonstrating the ability of music to modulate neural pathways, boosting social interaction.

The skill of sensorimotor integration was the key to this effect. This coupling of perception to action is critical in order to make sense of our environment and to operate on it, says the paper’s lead author, Megha Sharda, postdoctoral fellow at the University of Montreal. For example, as children learn to walk, they fuse sensory input from their joints with data from their balance organs. These messages are synthesized to create a picture of the child’s relation to space. This in turn dictates her/his next movement.

This coordination between sensory and motor functions (sensorimotor integration) is a necessary building block for language and social skills which develop later in life, says Sharda. For instance, when you’re having a conversation, you have to simultaneously listen to the other person, ignore extraneous sounds, plan your response, then actually say the words.

This normally smooth process is undermined by faulty connections in the brain, says Sharda. The hearing processing area (auditory cortex) and the movement area (motor cortex) are inadequately amalgamated, and this disconnect limits the synchronization of information necessary for social interactions.

Music, which engages all our senses and links them to movement, can address this impairment, says Sharda. In her study, 45 minutes of singing and playing instruments over an 8-to-12-week period improved children’s social communication. Simultaneously, brain scans showed an increase in connections between the auditory and motor areas.

Though music might be beneficial in the long run, some children halfway through today’s recital need a break from all the fun. Emerson’s earplugs have helped him ignore background noise, and the games on his mother’s iPhone have let him zone out for a while. And though he hasn’t had to escape to the quiet room, just knowing it existed has been heartening, says Saunders.

The quiet room currently has only two occupants – a five-year-old boy sporting yellow headphones and his father are enjoying a moment of solitude. Even after covering his ears, the child is agitated by the loud melodies and the large crowd and has had to take a breather.

Luckily, he’s been thoroughly prepped for this eventuality. The 40-page visual guide, which became a favourite bedtime story, detailed the options to decompress, including watching the program on a screen in the tunnels or chilling out in this sanctuary. “It really helped him to prepare and made him excited about this show,” says his father. Now the boy dives under the “fort” created by a table draped by a floor-length black cloth. One foot is sticking out. “Guess where I am,” he challenges his dad.

Back in the auditorium, the hour-long interlude ends all too soon. Bartholomew-Poyser takes a bow, and the audience jump to their feet, clapping, whistling and yelling “Whoo! Whoo!” They don’t seem to want to leave.

A crowd gathers around a violinist crouching at the edge of the stage. She’s giving the children some lessons, letting them grasp her bow as she plays Twinkle, Twinkle, Little Star. In the lobby, three boys are tossing around the fidget toys, while a girl with feathers in her hair dances with her mother.

As Bartholomew-Poyser heads out of the auditorium, several parents thank him for giving their families a sense of security. “People felt good in their skin, just as they were – it was heartwarming to hear that,” he says.

Saunders also leaves on a high note. Her son made it through the performance, which meant that she got to enjoy her first uninterrupted idyll at the symphony. Today’s success shows that it’s not a big deal to accommodate people with differences, she says.

And the effort matters. “It was a phenomenal demonstration of leadership and compassion,” she says. “It really made the autism community feel part of Toronto.”

Saunders and Emerson exit Roy Thomson Hall and brace themselves against the biting wind of this early spring day. They’re still smiling.

Vivien Fellegi is a former family physician now working as a freelance medical journalist.

Banff International String Quartet Competition, in partnership with Autism Calgary and Xenia Concerts, presented a relaxed concert, by 2016 Competition winners, the Rolston Quartet, on August 31, 2019, at Calgary’s Indefinite Arts Centre at the close of this year’s competition.

The National Ballet of Canada presented a relaxed performance of YOU dance, the company’s community engagement program, at the Betty Oliphant Theatre Saturday, September 21, 2019 at 5:30pm.

YPT (Young People’s Theatre) has two relaxed performances in every run. Looking just at their next two shows: for A Million Billion Pieces, these performances will be Wednesday, December 4 at 10:30am, and Sunday, December 8 at 2pm; and for The Adventures of Pinocchio they will be Friday, December 13 at 10:15am and Saturday, December 14 at 2:30pm.

Soulpepper theatre company has had one relaxed performance already this season (Betrayal, September 15), and another two have been scheduled for the upcoming run of Peter Pan (December 19 at 11am and December 22 at 1pm).

Shakespeare in the Ruff, in partnership with Autism Ontario, offered relaxed performances of their production of The Winter’s Tale, in Withrow Park, Toronto, on August 20 and 27, 2019.

The Stratford Festival is offering a relaxed performance of The Neverending Story at the Avon Theatre, October 2 at 2pm.

Toronto Symphony Orchestra has announced two further relaxed performances during the 2019/20 season now under way: February 22, 2020, and May 24, 2020. Details of both can be found in the concert listings on their website under the heading Relaxed Performances.

In closing, a request: if you are aware of other examples of relaxed performance practices or opportunities, either recent or upcoming, please let us know at editorial@thewholenote.com. That way we can keep track of efforts being made to raise awareness not just of the barriers, but to the ways they are coming down.

There is a buzz in the air at Toronto’s Kensington Gardens seniors home, as a pair of virtuoso violinists tune up their instruments in the chapel. The residents are gathering in neat rows next door in the Multipurpose Room lit by blinding white fluorescent beams. Some shuffle in, bony hands clutching hefty walkers. Others, slumped forward in their wheelchairs, are pushed by staff. Near the front, a nervous senior wrings her hands and chuckles. “Oh my goodness. It’s so exciting to have the kids – it’s such a warm atmosphere,” she says. In the back, a man with translucent skin and a rich baritone voice is getting into the mood, snapping his fingers and crooning a love song to anyone who’ll listen.

Rebekah Wolkstein and Drew Jurecka stride in, introduce themselves, and plunge deep into Dvořák’s Humoresque. Jurecka half-closes his eyes as he taps the beat with his feet. Wolkstein wrinkles her forehead as she meshes her part with his. The violin bows whizz in perfect synchrony, connected by an invisible skein of sound.

Sparked by the players’ youthful vitality, the residents are jolted to attention. Some sit a bit straighter, a new glow in their gaze. Others start to sway. The nervous woman’s eyes are riveted on the artists, and she starts bobbing her head to their beat. A young girl wraps her arms around the waist of a loved one, and the two rock back and forth in tandem.

Wolkstein and Jurecka have performed at illustrious concert halls across Ontario and beyond: Toronto’s St. Lawrence Centre for the Arts, Ottawa’s National Arts Centre, London’s Aeolian Hall. But this afternoon, away from the red carpet, the plush seats and glitzy curtains, the duo is equally at home in this downtown Toronto long-term care residence. “I like these intimate concerts the most,” says Wolkstein. “When you look out, you can tell you’re bringing so much joy to these people who are really isolated.”

This is, in fact, their mission. Jurecka and Wolkstein have been sent here by the Concerts in Care (CIC) program run by the Health Arts Society of Ontario (HASO), who bring the thrill of high-quality concerts to seniors sequestered in longterm care (www.concertsincareontario.com). HASO selects classical and jazz musicians from the province’s elite arts organizations, including the Canadian Opera Company, the Toronto Symphony and Tafelmusik Baroque Orchestra. Supported by corporations such as Azrieli Foundation, BMO Financial Group, government agencies, private sponsors, and modest fees from the homes, the group has presented almost 1200 concerts for 61,500 seniors in Ottawa, Pembroke, Sudbury and the GTA.

Concerts in Care started more than a decade ago. It’s the brainchild of Canadian retired insurance executive David Lemon, who founded the Health Arts Society of British Columbia in 2006. Watching a close elderly friend wither away in a nursing home left a deep impression on the philanthropist. “She had a huge amount of time on her hands, with nothing to do,” says Lemon. As dementia robbed her ability to communicate, loved ones stopped visiting, and she languished in loneliness.

By the end of her life she was cooped up in a room without mementos, separated only by plastic curtains from three confused roommates whose cries woke her up at night. Lemon was devastated by these insults to her dignity. “We as a society are not doing a good job giving full respect to these people,” he says.

After her death, it gradually dawned on the lifelong music lover that he could make a dent in their despair. Drawing on his network of musicians as well as his own success running an insurance business, he hit on the notion of bringing top-notch concerts to seniors facilities. While these places had long hosted amateur entertainers, Lemon felt that residents deserved more. “It’s so wrong to think that’s good enough for our frail elders,” he says. “They’re entitled to the same quality as we are.”

Since the first Concerts in Care recital comforted clients at a rehab hospital in Vancouver, six more sister societies, each one autonomous but bound by the same values, have emerged across Canada. The Health Arts Society of Ontario (HASO), was established in 2011. Together these groups have regaled the elderly across most of Canada.

The shows provide more than just first-class entertainment for shut-ins. They also help to ease the pain of estrangement which pervades many seniors homes.  

“It can be very lonely even in a large institution,” says Health Arts Society of Ontario executive director Debra Chandler. While some gregarious seniors welcome the opportunity to befriend others in their building, many yearn for their old social life and have trouble adjusting to their new reality. Some will barricade themselves in their rooms, seeking comfort from a few familiar belongings. “Whatever facility they are in can feel like a prison,” says Chandler.

And there’s little to fill the vacuum left by these losses. “They might get a movie or a bingo game once a week if they’re lucky,” says Jeanne Lamon, artistic director of HASO. “There isn’t much to stimulate their minds.”

York University researcher Ami Rokach studies the problem of loneliness. The clinical psychologist says there are 1.4 million elderly Canadians who suffer significantly from the condition. “That’s a public health crisis.” The cumulative loss of loved ones with increasing age, as well as a decline in mobility can both lead to social isolation. Elders deposited in seniors facilities, rarely visited by relatives steeped in the “me first” Western culture, often feel abandoned.

Persistent loneliness can become toxic. “People begin to think they’re alone because they’re inferior and unlovable,” says Rokach. Patients who feel worthless often neglect their health, worsening any pre-existing medical problems. As well, the chronic stress of alienation wears down the mind and body, triggering depression, elevated blood pressure, lowered immunity, and even a shortened lifespan.

The live concerts at least partially redress the sting of rejection. “People at the top of their game are coming to play just for them – that means they care,” says Rokach.

Musicians are chosen for their kindness as well as their capability, says Lamon. Once a potential performer has aced the audition, Lamon usually attends their first concert and evaluates their capacity to relate to residents. “I look at how the musicians talk to the audience – I can sense whether they’re in their own world, or reaching out to them,” she says. Performers are expected to supplement the pieces with stories. A Tafelmusik ensemble, for instance, might provide historical context by describing the instruments used during the Renaissance. Players sometimes share personal anecdotes. On one occasion, a young man introduced Liszt’s Spanish Rhapsody by describing the Spanish woman who had taught him the dance steps in the piece. “This makes people feel like they know him a little bit – and turns the concert into a social experience,” says Chandler.

Wolkstein has a special kinship with seniors. After her grandfather moved to a nursing home following a series of strokes, she visited him regularly. Since he had trouble talking, they couldn’t communicate through language, so the violinist reached out to him through their shared medium of music. When she played familiar songs, he would start conducting with his good hand, often moved to tears, says Wolkstein. “It was the best way we had to connect to him.”

Wolkstein draws on this well of compassion to make her listeners feel welcome. “There’s this warm space we create for people to come out of their rooms and enjoy something together,” she says. While she sticks to the program during her formal recitals, Wolkstein sometimes invites personalized requests during her gigs with Concerts in Care. “That means so much to people when you can play the exact piece they want to hear,” she says.

Jurecka also makes an effort to bring the most vulnerable residents into the fold. Once after a concert at a hospice, he was asked to play at the bedside of a dying patient. The man’s family requested one of his favourite pieces, Amazing Grace. By the time the final notes soared to the ceiling, everyone was in tears. “Music reaches deep and evokes strong emotions,” says Jurecka.

It seems to be firing up today’s listeners. At times too much. One resident provides a running commentary throughout the show, steadfastly ignoring the embarrassed caregiver trying to shush her. The man with the beautiful baritone seems to think it’s an open mike day and spontaneously belts out A Nightingale Sang in Berkeley Square in perfect harmony with the instrumentalists.

The performers don’t mind when audience members crash the show. “We’re trained to deal with distractions,” says Wolkstein. Besides, their enthusiasm shows that they’re having fun. The singer knew all the words to the song and seemed to be stoked by his solo, says Wolkstein. “It’s wonderful that we can bring this gift to people who enjoy the music that we love,” she says.

While musicians have always recognized the therapeutic potential of pieces, research is finally validating these beliefs. Listening to our favourite tunes releases pleasurable chemicals, including dopamine and opioids, which elevate the mood and reduce stress, says neuroscientist Daniel Levitin, professor emeritus at McGill University, who details these effects in his book, This is Your Brain on Music.  Songs also keep us company. “If you’re depressed or feeling disconnected, it can be uplifting to listen to sad music and realize that you’re not alone – the composers have felt the same way,” says Levitin.

Live concerts are especially invigorating. In one recent study, Levitin showed that the brainwaves of people listening to the same music simultaneously began to coordinate with each other. He speculates that we secrete small amounts of oxytocin, the “cuddle hormone,” in these situations, stimulating a sense of trust and bonding.

Music’s ability to rekindle memories can also boost our spirits, says Levitin. Familiar tunes can evoke strong sentiments which transport us back to good times associated with these experiences. These soothing recollections can dispel some of the loneliness, he says.

Care staff have also witnessed the transformations wrought by tunes. “People leave the concerts in better spirits, smiling and dancing back to their rooms,” says Abiola Awosanya, programs manager at longterm care home Cedarvale Terrace. The music can take residents back to happier times when they attended shows with loved ones. The shared enjoyment also yokes audience members together, says Awosanya. “They look at each other, nod in agreement, and sometimes even reach out to hold hands.” Afterwards, some residents continue socializing, trading reminiscences sparked by the songs.

Chandler has heard similar testimonials from caregivers. At one Ottawa long-term care residence, a nurse began to cry after a musician performed for a client with dementia. “He’s been catatonic for years,” she told Chandler. “I’ve never heard him humming, but he’s humming today.”

At Kensington Gardens, the musicians wrap up the concert with a rousing, toe-tapping tango. The audience erupts into applause, one man shouting “Bravo, bravo” over and over. The duo bow and bid the crowd a wonderful afternoon.

It seems they’ve already made the residents’ day. The nervous lady seems calmer now, her hands still. “I think it’s amazing how good this is for people,” she says. Back in his room on the fifth floor, the man with the beautiful baritone is revelling in the afterglow of the limelight. “I’m old but I still have a good strong voice,” he says. “I held the show together.”

The musicians leave feeling satisfied that, for a short while at least, they’ve catalyzed a closeness amongst their listeners. “There are so many people who are lonely in Toronto – that’s why I love to put on concerts and see people come together and bridge those unseen divides,” says Wolkstein.

Vivien Fellegi is a former family physician now working as a freelance medical journalist.