Activities in Music and Sound for Children with Complex Needs and Visual Impairment to Foster Learning, Communication and Wellbeing


Tuning In is a deck of 48 cards that set out around 300 activities involving music and sound, designed to be used by those working with or caring for blind or partially sighted children and young people who have complex needs – that is, with severe learning difficulties (SLD) or profound and multiple learning difficulties (PMLD).1 They are suitable for the spread of musical abilities that is most commonly found among this group, ranging from Sounds of Intent Level 2 to Level 4 (see These correspond to the earlier stages of musical development (Level 1 is the stage before auditory processing starts to emerge).

However, a significant minority of those who are blind and have SLD function at Level 5, meaning that they can perform pieces of music to a level at least in line with, or even more advanced than, their ‘neurotypical’ peers. Beyond this, a very small number will have the sophisticated performance skills that characterise Level 6, or will have the potential to acquire them. These children almost invariably have ‘absolute pitch’ or ‘AP’ (the ability to recognise or reproduce notes in isolation from others), which is extremely rare among the Western population as a whole (around 1 in 10,000) but relatively common among young people who have been blind from birth: research shows that around 40 per cent of blind babies – including those with SLD – will go on to develop AP.2 It is this ability that is likely to drive a high level of interest in music and deliver the capacity for exceptional performance.

If the child you are caring for or working with shows exceptional musical potential (for example, singing beautifully in tune; learning and remembering new pieces easily; perhaps teaching themselves to pick out tunes and harmonies on the keyboard), it is vital that they have access to appropriate tuition. In the UK, The Amber Trust can help, both in funding instrumental or vocal lessons and in supporting parents to find a suitable teacher in the local area. Please email

For visually impaired children with PMLD, and for many of those with SLD, the Tuning In Cards offer not only the resources to create a suitable music curriculum, but also show how music can be used to promote wider learning, social interaction and wellbeing.3 The cards should be used in tandem with the Tuning In Music Book, which contains 64 songs and musical activities that are designed to foster wider development, language and social skills.

Sounds of Intent Framework - detailed view


The Sounds of Intent framework on which the cards are based identifies six potential stages in the development of musical understanding, and three domains of engagement: reactive (listening and responding), proactive (creating or re-creating sounds and music) and interactive (playing or singing with others). The six levels and three domains give 18 ‘headlines’ of musical engagement. Levels 2 to 4 can be represented as three concentric circles.

Children and young people functioning at Sounds of Intent Level 2 will experience music in a purely sensory way, and may vocalise or make other sounds in response to what they hear. Those engaging with music at Level 3 will be able to catch on to the simple, moment-to-moment rhythmic and melodic patterns that characterise many pieces, and they may well try to emulate these themselves. It is at this stage of musical development that a child may first grasp that sounds can be used symbolically – to stand for something else: an idea, a person, a place or an activity. At Level 4, children and young people will start to learn, recognise and perhaps reproduce the main motifs that are used in music: the short phrases by which pieces are identified. Think of the first four notes of Beethoven’s fifth symphony, for example, or the McDonald’s advertising jingle. At this stage, children may combine motifs in new ways to form their own songs, made up of fragments of music that they have heard. Motifs can also be used symbolically in their own right – with or without their accompanying words – to facilitate understanding and open up a channel of expressive communication, when language alone does not work. So, in summary, each level can be labelled as follows:

Level 2 – ‘sensory’
Level 3 – ‘pattern’
Level 4 – ‘motifs’

Sounds of Intent Framework - level 2-4

These broad-brush descriptions are helpful for gauging the level at which a child or young person is functioning in music-developmental terms. However, in order to be of practical value to teachers, therapists and carers, more detail is needed, and the Sounds of Intent framework breaks down each of the main segments into four more detailed ‘elements’.

There are four elements (labelled ‘A’, ‘B’, ‘C’ and ‘D’) for each main segment of the framework. Take ‘Reactive, Level 2’, for example: ‘shows an emerging awareness of sound’. This is broken down into ‘responds to an increasing variety of sounds’ (labelled ‘A’); ‘responds differently to different sounds’ (‘B’), ‘responds to sounds in different contexts’ (‘C’); and ‘responds to sounds in multisensory activity’ (‘D’). So each element can be identified uniquely in terms of its domain, level and element.


Each of the 36 elements is allocated a card from the Tuning In Cards set, which sets out six potential strategies that teachers, teaching assistants, therapists and parents can use to promote musical activity at a particular level and in a given domain. For example, Card 18, ‘Tap into my love of pattern!’, pertains to Reactive, Level 3, Element B – ‘responds to regular beats at different speeds’ – and the six strategies are to be found on the reverse, as follows.

In addition to these ‘music-specific’ cards, there are 12 others (four at each level) that show how music can be used to support wider learning and development, and wellbeing. The areas are:

• body awareness and movement – ‘me: my body’
• wellbeing and emotional regulation – ‘me: my thoughts and feelings’
• social, language and communication skills – ‘me, you and other people’
• knowledge and understanding of the world – ‘me and my world’

For example, Card 45 looks like this:

Example view of Tuning In card 45

To get the most out of these resources it is important to know a child or young person’s level of musical engagement, and the Sounds of Intent framework can be used to make that judgement. The Sounds of Intent website ( has an online assessment tool that teachers and therapists in particular may find useful. Having established pupils’ or students’ level of musical functioning, it will then be possible to build a music programme, tailored to their needs, using the Tuning In Cards and Tuning In Music Book resources.

It is likely that children and young people with profound disabilities, in particular, will make small steps of progress. Research shows that this is likely to be around one Sounds of Intent level during their time at school.4 Hence, the ideas set out here should be treated only as a starting point, to get things going. Although musical styles and genres differ from one culture to another, the underlying structures in sound and the way the brain processes these seem to be universal, and it is important to offer musical experiences that are culturally relevant and age-appropriate. Be imaginative. Above all, have fun! Remember, music is not just about one session a week with a teacher or therapist: it can inform and enrich living and learning throughout the day.

The Tuning In Cards and Music Book are written by Adam Ockelford and published by Jessica Kingsley Publishers.


1 The Tuning In cards may also be of benefit to those without visual difficulties, including children on the autism spectrum.

2 Summarised in Focus on Music 2: Exploring the Musicality of Children and Young People with Retinopathy of Prematurity, by Adam Ockelford and Christina Matawa, published by the Institute of Education in London, 2009.

3 For those working with or caring for blind and partially sighted children in the early years (irrespective of any additional disabilities they may have), other resources have been created, which are available at

4 For more information see, for example, Music for Children and Young People with Complex Needs by Adam Ockelford, published by Oxford University Press, 2008.