Journal of Research in Music

Education
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Access to Music Education: Nebraska Band Directors Experiences and

Attitudes Regarding Students With Physical Disabilities
David Nabb and Emily Balcetis
Journal of Research in Music Education 2010; 57; 308
DOI: 10.1177/0022429409353142
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Access to Music Education:

Nebraska Band Directors
Experiences and Attitudes
Regarding Students
With Physical Disabilities

Journal of Research in Music Education

57(4) 308319
2010 MENC: The National
Association for Music Education
Reprints and permission: http://www
.sagepub.com/journalsPermissions.nav
DOI: 10.1177/0022429409353142
http://jrme.sagepub.com

David Nabb1 and Emily Balcetis2

Abstract
Students with physical disabilities frequently are excluded from participation in instrumental
music programs, yet the obstacles band directors face that preclude integration of these
students have not been documented systematically. The primary purpose of this study was
to measure Nebraska High School band directors concerns regarding the integration of
students with physical disabilities into their band programs. Results of a survey of 221
Nebraska high school music programs suggested that awareness of options for ways to
include students with physical disabilities, availability of adapted instruments, and the cost of
acquiring such instruments are among band directors primary concerns. Conclusions drawn
from this survey serve as evidence that there is a need for adapted instruments and suggest
that integration of students with disabilities and without disabilities in band would provide
benefits for all.
Keywords
disability, assistive technology, adapted musical instrument, access to music education

As jazz singer Patty James reminded her audience, Everybody knows that you need
two arms to play the saxophone (James, 1982). Modern woodwind instruments,
including flutes, saxophones, and clarinets, designed for persons with disabilities are
not readily available. As a result, children born with an upper limb disability and those
who begin music study and later acquire a disability, particularly one that limits the
use of the hands, cannot begin or may be forced to resign from their music studies
(Mailhot, 1974). Meanwhile, MENC: The National Association for Music Education
1

University of Nebraska at Kearney, USA

Ohio University, Athens, USA

Corresponding Author:
David Nabb, FAB 226, University of Nebraska at Kearney, 905 W. 25th St., Kearney, NE 68849
E-mail: nabbd@unk.edu

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Nabb and Balcetis

seeks to conduct programs and activities to build a vital musical culture and an enlightened musical public for the benefit and the general welfare of all persons (MENC,
2008). Such goals are difficult to achieve, given music teachers lack of awareness of
how to integrate students with disabilities into instrumental music classes and the current difficulty in obtaining musical instruments designed for use by these students.
Instrumental music teachers who wish to include a student with a physical disability
in their program face an array of challenges for which the teachers may not feel adequately prepared. For example, it is possible that teachers may not know that complex
musical instruments can be made accessible to people with disabilities. Those who do
know that adapted instruments are available may never have needed to locate instruments and may not know where to find them. Additionally, teachers may have concerns
regarding time to learn and teach the adapted instruments and the availability and the
cost of the instrument. Beyond concrete concerns, it is possible that teachers may consider the psychological costs of integrating students into mainstream education to outweigh the benefits. Although these are possible concerns, a systematic investigation of
the actual impediments to integrating students with disabilities into mainstream music
education has not been conducted.
The primary goal of this article is to explore what difficulties instrumental music
directors face when attempting to integrate students with physical disabilities into mainstream music education. We focused our own investigation on issues such as awareness of
instruments meant to assist in the integration, problems experienced when attempting to
do so, and perceptions of the benefits of integrated music programs. We approached these
questions by surveying instrumental music instructors regarding their experiences with
students with physical disabilities and their perception of integrated music programs.
Students with and without disabilities maintain remarkably similar interests with
regard to music and musical instrument preferences (Jellison & Flowers, 1991). Music
educators should recognize that it would be natural and perhaps even beneficial for
a saxophone player, for example, undergoing a disabling event to return to his or her
former instrument. Of course, a student who has experienced a medical procedure, such
as an upper limb amputation, could participate in school instrumental music by playing
bass drum or learning the trumpet. The review of adaptations in the following section
makes clear that there are many possibilities other than requiring a student with a physical disability to become a percussionist or trumpeter. If instructors are knowledgeable
about the range of available options and various means to taking advantage of these
options, students with a disability can make the choice that most interests and suits them
and their music education goals. This investigation explored the degree to which
instructors are knowledgeable about such options. In addition, this investigation explored
what obstacles band directors face in trying to integrate students with disabilities into
band and their perceptions of the costs and benefits of doing so.

Paving the Way for Adapted Instruments

It is an unnecessary and unfortunate loss for the entire community that students with
physical disabilities are excluded from participation in instrumental music programs.

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However, anecdotal accounts provide preliminary evidence that individuals and some
companies have laid the foundation for assisting students with participation in instrumental music.
In some cases, it is possible to adapt an instruments repertoire to accommodate onehanded players, as is the case for the piano (Zeigler, 2007). Additionally, little modification or only minor changes to playing technique are necessary to allow a one-handed
player to perform on some conventional brass and percussion instruments (Chadwick
& Clark, 1980). Many musical instruments have been physically altered to serve players with disabilities. Some of the most dramatic of these adaptations have been for
woodwind instruments.
Available only intermittently or after individual request, some woodwind instruments originally designed for two-handed performers have been adapted for musicians
with only one hand. For instance, Zen-On, Aulos, Mollenhauer, Dolmetsch, and Maarten
Visser have intermittently offered one-handed recorders (Dickeson, 2004; Dolmetsch,
2005; Godby, 2002; Nabb, 2006; Peskin, 2004). Other woodwind instruments have been
adapted at least as far back as 1822, when Cornelius Ward built a right-handed flute for
Colonel Count Rebsomen (Lancaster, 2008). Rebsomen had lost his left arm and right
leg while fighting in Napoleon Bonapartes army. Reportedly, Rebsomen was able
to play his one-handed flute quite well. As a tribute to Rebsomens success, Antoine
Bebiguier dedicated his own Opus 46 to him (Bate, 1995; Lancaster, 2008). Similarly,
Edit van der Burg Mayer returned to professional playing on a one-handed flute adapted
by Maarten Visser after surviving a serious head injury. In 2003, she won first prize in
her age category at the 20th Dutch National Flute contest (Nabb, 2007; Niele, 2000).
Unfortunately, the Rebsomen and Visser flutes were custom efforts for specific individuals and were not developed for widespread distribution.
The saxophone has been adapted, and it is the Conn Company that likely developed
the first one shortly after World War I (Cohen, 1987; Horwood, 1989). In the 1970s,
the University of Alberta built a few adapted saxophones for amputees that relied on
electronic solenoids to depress the keys of the missing hand (Charles, James, & Stein,
1988). Hank de Marco, a saxophone player who lost an arm to cancer, returned to professional playing using one of these adapted saxophones. The instruments allowed persons with disabilities to participate in music study; however, because they required at
least a small stump to remain on the amputated limb, they cannot be considered a
completely one-handed system. Additionally, they must be custom fitted to the amputees stump, making production time-consuming and expensive.
With a privately designed and built one-handed saxophone by Martin Foag of
Germany, Stephan Tiefenbacher returned to professional playing after losing an arm and
suffering a serious head injury in a motorcycle accident (Tiefenbacher, 2008). In addition,
the first author of this study returned to professional performing and university teaching
following a major stroke he survived at the age of 37 (Nabb, 2005). Nabb performs on a
one-handed toggle-key system (TKS; for the right hand) saxophone built by Jeff Stelling.
The TKS is a completely one-handed system and has the potential to be used to make
left-handed saxophones and could be integrated on other woodwind instruments. However, at present, the TKS has been implemented only on two right-handed saxophones.

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Of course, brass and percussion instruments often require fine motor skills in only
one hand; therefore, many players with a physical disability in one hand can play these
instruments normally or can simply switch to use the nonconventional hand. Nonetheless, brass instruments have been adapted as well. In 1998, Andrew Forster built a
trumpet with valves operated by foot pedals (Snedecker, 2005). Other brass instruments
have been engineered with compressed air or solenoids moving the valves (Snedecker,
2005). Amy Carol Parks performs as a professional French horn player and is now a
dean at the Levine School of Music in Washington, D.C. (A. C. Parks, personal communication, November 17, 2008). Although she wears a prosthesis on her left arm, she
performs on adapted horns played with the right-hand operating valves.

Benefits of Integrated Instrumental Music Programs

Although the pioneering musicians who perform on adapted instruments came upon
their disabilities differently, their experiences after receiving their adapted instruments
are similar. These musicians report that receiving an adapted instrument played a pivotal role in their physical and psychological recovery. For instance, when describing his
first session playing Amazing Grace on his new instrument, Hank de Marco (1982)
said, Suddenly I was lifted out of a complete depression, and I was just flying, like
I was on cloud nine.... It was just a great feeling. I mean it was the greatest feeling Ive
ever had in my whole life.
Kyung Sun Orr lost his left arm in an airplane accident when he was 16 years old.
According to his parents, when Kyungsun regained consciousness, he immediately
became aware that he had lost his arm, yet his first statement was, I want to play the
saxophone (quoted in Loss of Arm Doesnt Deter Saxophonist, 2005). Kyungsun Orr
participated in the university band and took saxophone lessons at Clemson University on
a TKS saxophone designed by Stelling Brass and Winds. Common among these testimonials is that participation in instrumental music played an important role in recovery.
Benefits to students with disabilities. The exclusion of persons with physical disabilities
from music making continues, despite substantial evidence that they would benefit
from musical activity. During and immediately following World War II, the medical
community began exploring the use of music in the rehabilitation of injured military
personnel (Barksdale, 2003). The results were consistent and clear: Music was remarkably effective in rehabilitation. Results indicated that music allowed for expression of
creativity within populations limited in communication skills. Music also provided
opportunities for positive social experiences, self-growth, self-awareness, and improved
well-being (Barksdale, 2003). Involvement in music confers physical and cognitive
benefits as well. Students with physical disabilities involved in musical instrument study
experienced improved handeye coordination; endurance when pursuing challenging,
long-term learning goals; concentration during complex cognitive and motor tasks; tolerance to overcome frustration; and self-confidence (Probst, 1991).
Benefits to musical community. Students with disabilities included in music education
experience substantial benefits, but these benefits are not specific only to them. In a
survey of Texas music educators, 85% of the respondents indicated that music

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instruction was equally beneficial for students with and without a disability (Jellison,
1992). Positive collaborative experiences improve the attitudes of students without a
disability toward students with disabilities. A recent review of 32 studies published
from 1975 to 2005 that examined attitudes toward persons with disabilities in music
programs indicated that extended, direct interactions between students with and without disabilities positively influenced attitudes and decreased prejudice (Jellison & Taylor, 2007). Including students with disabilities in instrumental music programs thus can
provide substantial benefits to these musicians and to peers as well.
Costs of integrated music education. There are reasons to suspect that some instructors
may not perceive integrated music education as beneficial. Because of a lack of specialized training to deal with students with disabilities, perceptions of the time, training,
and specialized knowledge needed to integrate students may seem too costly, prohibitive, or unavailable. And teachers may believe that to gain the necessary knowledge
would come at the cost of the educational experiences of the students without physical
disabilities. Additionally, band directors, like other teachers, parents, and administrators, may be concerned about the possible disruptions, financial cost, emotional consequences, and psychological distress that come from such a transition (Hayasaki &
Moore, 2002). One goal of the current investigation was to explore whether band
instructors believed integrated education would provide benefits.

Research Objectives
The primary purpose of this study was to identify the obstacles band directors encountered when actually attempting to integrate students with physical disabilities into
instrumental music education. We also explored directors reactions to one particular
adapted instrument that could assist in integrating students into instrumental music
education. We focused on the adapted flute because (a) according to Yamaha Corporation, more flutes are sold in the United States annually than any other woodwind instrument (K. Witt, personal communication, March 28, 2005), and (b) the flute can be
adapted easily, given the use of plateau-style (closed-hole) keys. This research had
three additional objectives. First, we measured perceptions of the size of the population
of students with a disability. Second, we assessed whether band directors were aware of
ways to involve these students. Third, we asked directors who integrated students into
music education about the limitations they experienced in addition to the benefits that
they perceived all students experienced as a result of integrated music education.

Methods
Survey Instrument
We designed a survey instrument (see appendix online at http://jrme.sagepub.com/
supplemental) in light of reviewed research, discussions with professional physical
therapists and public school music teachers, and input from music education and psychological testing experts. We pilot-tested an online draft survey and revised it with

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assistance from researchers in psychological testing and music education. The final
survey explored several areas. As follows, we describe the specific questions we asked.
Perceptions of the size of population of students with disabilities. We gathered information
regarding perceptions of the size of the population of students with physical disabilities.
We asked respondents whether physical disabilities limited instrument choice, or the ability to participate in music entirely, for any student(s) in any school in which they worked
and whether one or more students discontinued instrumental music study after becoming
disabled or developing physical problems in one hand. Respondents checked either yes or
no to answer these questions. In addition, respondents reported the number of students
with physical disabilities (or family members on their behalf) who expressed interest in
playing an instrument during the past five years. Awareness of options for students. We
measured awareness of adapted instrument programs. Respondents reported by checking
yes or no whether they were aware that conventional musical instruments, of any kind,
can be adapted to compensate for a student with a physical disability.
Attitudes toward one-handed flute programs. We assessed impressions of the potential
of a one-handed flute to increase accessibility to instrumental music programs. Respondents indicated the degree to which they believed that the availability of a one-handed
flute would enable more students, particularly those with physical limitations, to participate in school instrumental music. Respondents responded using a Likert-type scale
from 1 (strongly disagree) to 7 (strongly agree).
Obstacles to integrating students. We assessed the actual problems experienced by
respondents regarding the integration of students with physical disabilities into music
training. We asked these questions of a subset of the full samplenamely, those respondents who reported including students with physical disabilities in instrumental music
programs. Using a Likert-type scale from 1 (not at all) to 7 (a great deal), respondents
indicated the degree to which seven factors limited their ability to accommodate students. Respondents indicated whether time constraints, awareness of options for how to
include students with physical disabilities, availability of adapted instruments, personal
qualifications to instruct on and maintain adapted instruments, and cost of acquiring
and maintaining such instruments limited their ability to accommodate students.
Benefits to integrated music education. We measured teachers views regarding whether
students with physical disabilities and/or their peers without disabilities benefited from
the inclusion of the students with physical impairments in instrumental music. Using a
Likert-type scale from 1 (strongly disagree) to 7 (strongly agree), respondents indicated the degree to which they believed that the student(s) with physical disabilities
included in their programs benefited from their experience in instrumental music. They
also indicated the degree to which they believed students without physical disabilities
benefited from working with those students.

Sample
The population included head band directors from all of Nebraskas 301 high schools
with music programs. We sent a survey to every high school on the music program list
maintained by the Nebraska School Activities Association (2007). We sent all schools

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Table 1. Actual Proportion of Schools and Sample Return Rate as a Function of School Size

Variable
Actual
population
Sample return
rate

School Size
AA

12.0% (n= 36)

6.0% (n = 18)

16.3% (n = 49)

32.9% (n = 99)

32.9% (n = 99)

10.9% (n= 24)

6.3% (n = 14)

15.8% (n = 35)

30.3% (n = 67)

36.7% (n = 81)

an initial notice informing them of an upcoming opportunity to assist in a survey of

music programs in the state. Three weeks later, we sent an initial survey to all schools.
We later sent two reminder letters, including additional copies of the survey, to schools
that had not responded at the time of the mailing. We instructed schools to have their
head band director, or the band director with the most experience, complete the survey.
We monitored responses via coded return envelopes to avoid multiple responses from
a single school. This process yielded a return of 221 surveys, a 74% response rate.
Because a schools music program class rating can be different from its athletic class
rating, we used the Nebraska High School Athletic Association Music Class rankings to
assess school size. To ensure that the response rate was equal across all sizes of music
programs, we performed a chi-square analysis of the return rate against the expected
return rate given the actual distribution of schools across each class size. As seen in
Table 1, the proportion of returns closely reflected the actual proportion of schools
across all music program class sizes. Comparison of the return rate in each class against
the actual percentage of schools in each class suggests that there were no differences
between the collected and actual (i.e., observed and expected) percentages, c2(4, n=
222)= 1.92, p= .75. Survey responses from schools of classes AA, A, or B (n= 73)
were considered a part of the large school group, whereas those from schools of classes
C or D (n=148) were considered a part of the small school group (see Table 1).

Results
Perceptions of the Number of Students with Physical
Disabilities in Student Body
Respondents reported their perceptions of the size of the population of students with
physical disabilities in their school. In general, 55% of respondents indicated that the student body included at least one such student. As expected, the likelihood that respondents
indicated that students with physical disabilities were in attendance at their school depended
on size of the school, c2(1, n= 219)= 26.88, p< .001. Of respondents from large schools,
80% knew of at least one student, as did 43% of respondents from smaller schools.
Beyond perceptions of the prevalence of students with disabilities within the
school body, 61% (n= 122) of all respondents indicated that within their career, they

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experienced firsthand a time when a students physical disability limited that students
participation in instrumental music. In addition, 30.7% (n= 68) of all respondents
indicated that at least one if not more students with a physical disability had expressed
an interest to the respondent in playing an instrument. Moreover, 7% (n = 16) of
respondents indicated that at least one of their own students had to discontinue music
study after developing physical problems in one hand. These statistics did not depend
on size of school, c2(1, n= 122)= 0.07, p= .80.

Awareness of Options for Students with

Physical Impairments
In general, 67% of survey respondents indicated being aware that conventional musical
instruments could be adapted to accommodate students physical needs. However, this
awareness depended on the school class size, c2(1, n= 221)= 10.02, p= .002. Of
respondents from large schools, 81% indicated awareness that instruments could be
adapted, whereas only 60% of respondents from smaller schools indicated awareness.

Attitudes Toward a One-Handed Flute

for Use in Instrumental Music Programs
Respondents agreed that the availability of a one-handed flute would enable more
students to participate in instrumental music education. Specifically, on a scale from 1
(strongly disagree) to 7 (strongly agree), participants, on average, circled 5.7. In fact,
84% of all respondents indicated some form of agreement with this statement, be it
mild, moderate, or strong, as indicated by their response of 5, 6, or 7 on this scale.
Belief that one-handed flutes would enable students with limitations to participate did
not depend on respondents size of school, F(1, 218)= 0.05, p= .82.

Obstacles to Integrating Students with Physical Disabilities

To explore the primary concerns instructors have regarding the feasibility of integrating students with physical disabilities into music education, we focused the next analysis on respondents who indicated that one or more students with a disability or their
family members expressed an interest to the respondent in playing an instrument
(31%, n= 68). These respondents indicated the degree to which seven factors influenced their ability to include the student in their music program. Respondents used a
1-to-7 Likert-type scale where higher numbers indicated greater concern for the factor.
As seen in Table 2, from the list of seven, the two most highly endorsed factors were
the availability of instruments, of any kind, to accommodate students needs (M =
4.4) and awareness of options for how to include students (M= 4.3). Respondents
indicated that their third biggest concern was the cost of acquiring instruments.
Interestingly, the factor respondents indicated as least influential was their knowledge
of how to maintain such instruments (M= 3.1). These results did not depend on the
school class, Fs< 1.

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Table 2. Endorsement of Factors That Influenced Inclusion of Students With Physical

Impairments in Music Programs

School size

Factor
Availability of instruments that accommodate
physical limitations
Awareness of options to include students with
physical impairments
Cost of acquiring such instruments
Having enough time to come up with solutions
Personal qualifications to instruct students with
physical impairments on the instruments
Cost of maintaining of such instruments
Knowledge of how to maintain such instruments

Large

Small

Overall

4.4 (0.3)

4.3 (0.4)

4.4 (0.3)

4.5 (0.3)

4.2 (0.3)

4.3 (0.2)

3.9 (0.4)
3.6 (0.3)
3.5 (0.4)

4.0 (0.4)
3.7 (0.3)
3.7 (0.4)

3.9 (0.3)
3.6 (0.2)
3.6 (0.3)

3.2 (0.4)
3.1 (0.3)

3.6 (0.4)
3.1 (0.4)

3.4 (0.3)
3.1 (0.3)

Note: Items were rated on a Likert-type scale from 1 (strongly disagree) to 7 (strongly agree). Standard
errors appear in parentheses.

Benefits of Integrating Students in Instrumental Music Classes

To assess perceptions of the benefits of integrating students, we focused the next analysis on the subset of respondents with experience integrating students with physical
disabilities into instrumental programs. In our sample, 26% (n= 56) of respondents
indicated having included such students in instrumental music programs. These
respondents strongly agreed with the statement that students with physical disabilities
benefited from their experience in instrumental music class. On a Likert-type scale
from 1 (strongly disagree) to 7 (strongly agree), participants circled, on average, 6.7.
In addition, respondents strongly agreed that the students without physical disabilities
in their music program benefited from working with the students with disabilities
(M= 6.3).

General Discussion
Data from this study support and supplement the scant research previously reviewed
regarding the obstacles band directors face when attempting to integrate students with
physical disabilities into mainstream instrumental music study. Results of this extensive survey indicated that instrumental music instructors, and particularly those teaching in smaller schools, were not fully aware of the options available to students. In fact,
respondents who were approached by families of the students indicated that one of the
primary factors affecting their ability to accommodate such students was the awareness
of options for how to include the students. Additionally, band directors were concerned about the availability of instruments, the cost of acquiring them, how or where
to get them, or how to finance their purchase.

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It is unfortunate that directors, particularly those at smaller schools, lacked awareness of options, because there are students who could benefit from, and would provide
benefits to, the instrumental music program. In fact, the majority of instrumental music
instructors indicated an awareness of students in their school who had physical disabilities and had experienced firsthand how this disability affected one or more students
participation in instrumental music. Instructors impressions of the size of the population
of students with disabilities were supported by statistics reported by the Nebraska
Department of Education (2008). In Nebraska alone, there were 472 students with orthopedic disabilities that affected educational performance. Such disabilities involved skeletal system, bones, joints, limbs, muscles, or central nervous system and affected the
ability to move, use, feel, or control certain parts of the body. In other words, hundreds
of students in just the state of Nebraska experienced physical limitations that could
preclude them from traditional instrumental music education.
Although awareness of options for integrating students was limited, respondents
believed that integration would be beneficial. Nebraska band directors felt strongly that
students with physical disabilities benefited from studying instrumental music, a result
that supports other research suggesting that instrumental music study benefited students
with and without disabilities (Jellison, 1992; Johnson & Darrow, 1997; Probst, 1991).
Although there is still a population of band directors, particularly those at small
schools, who lack awareness of options, including adapted instruments of any kind, to
assist in the integration of students with disabilities into mainstream music education,
some attention has been paid in the literature to students with special needs. For example, a recent report offered suggestions to assist band directors in integrating students
with disabilities into mainstream music education, including color coding music notation to assist students with visual processing deficits and reconsideration of evaluation
practices to fairly assess the progress of students with needs (Zdzinski, 2001). However, a fundamental step required to involve students with disabilities in instrumental
music education is to provide them with instruments that function with the students
physical limitation. Understanding the hindrances instructors face, including lack of
adapted instrument availability or knowledge of options, can allow educators to better
serve this population.

Conclusion
The results from this study indicate that band directors continue to face obstacles to
integrating students with physical disabilities into instrumental music programs. We
suggest the following steps that can be taken by individuals wishing to improve this
situation: (a) Inform music educators of existing programs and devices to assist these
students, and (b) lobby instrument builders and manufacturers to consider supporting
development of instruments designed for persons with disabilities. In combination,
these steps may help to improve the educational experiences offered to a population of
students that currently appears to be underserved.

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Declaration of Conflicting Interests

The authors declared no conflicts of interest with respect to the authorship and/or publication of
this article.

Funding
This research was carried out with support from the University of Nebraska at Kearney
Research Services Council, the University of Nebraska at Kearney One-Handed Woodwinds
Program, and Yanda's Music of Kearney, Nebraska.

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Nabb and Balcetis

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Bios
David Nabb is a professor of music at the University of Nebraska at Kearney. Since surviving a
stroke in 2000, he has worked to develop woodwind instruments that can be played with one hand
and continues to work to make adapted musical instruments available to people with disabilities.
Emily Balcetis is an assistant professor of psychology at New York University. Her research
interests include motivations and perceptions.
Submitted May 28, 2008; accepted May 5, 2009.

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