The origins of the OHMI Trust’s work and the importance of adapted instruments for inclusive music-making

One of the aims of England’s national curriculum for music is for learners to:

However, a learner with a physical disability, such as having only one hand, will find many traditional instruments almost impossible to play (Kinsella & Fautley, Reference KINSELLA and FAUTLEY2019). A critical issue, made clear by Lord Lipsey to the House of Lords, is that there is a ‘lack of musical instruments which can be played with limited arm capacity’ (House of Lords, 2014, n.p.). What this has resulted in, in many learning settings, is learners being excluded from practical music-making both within mainstream school-based education (Kinsella & Fautley, Reference KINSELLA and FAUTLEY2019), as well as in higher education (Bremmer, Reference BREMMER2023), which also impacts on the social, developmental, intellectual and emotional enrichment that a quality music education brings (Kinsella & Fautley, Reference KINSELLA and FAUTLEY2019).

A core aim of The OHMI Trust is to remove the barriers to music-making faced by those who are physically disabled through the development and utilisation of adapted musical instruments.

Nikki:Tell me about The OHMI Trust and the work is does with young people.

Rachel:The OHMI Trust was founded 14 years ago after a young person went to school. This particular young person had cerebral palsy and a weakness on her left-hand side. She asked if she could play a musical instrument, as her father did, and got told very nicely and politely by the school: ‘No, sorry, there’s nothing suitable for you’. Her father, being a professional musician, decided that this wasn’t the best state of affairs for music, and his daughter, and so he founded The OHMI Trust. The key focus of The OHMI Trust has always been finding instruments that are suitably adapted for people with hand and arm impairments. If you think of any musical instrument, almost certainly you need 10 very dexterous fingers to play them, and if you don’t have them or you can’t use your fingers in a dexterous way, then music making’s just kind of out the window before you start.

We’ve run a competition for several years. Initially, it was largely for instruments that were developed for somebody who had been able to play a regular instrument, where they’ve progressed through the music education system and then life got in the way and they’d had, for instance, a stroke or a traumatic accident, and they couldn’t continue to play with their standard instrument. What the competition enabled to happen was that the adapted instrument design was able to be shared, or a connection to the maker was able to be made. This meant that the adapted instrument was able to be utilised by more people.

In about 2015, we started to think: What happens with the children who never get the opportunity to learn a musical instrument because they were either born with, or had from a very young age, a physical impairment? What happens when they enter the music education system? Is there nothing for them? What happens then? We started working with one music service and some individual children. To start with, we had 15 individual children in one music area, and we trialled what we could get our hands on. At that time that was only one-handed recorders and trumpets on stands. What the initial research evaluation [Fautley and Kinsella, Reference FAUTLEY and KINSELLA2017] highlighted was that the instruments the children were provided with gave them everything they needed to progress at the same rate as their peers, and people were pleasantly surprised when those children managed to do, for instance, a Music Medal or even, to some degree, play the notes with some fingers and not just the open note. But in their research, Martin [Fautley] and Victoria [Kinsella] said: Well, this is lovely for these 15 children in individual lessons, but what about a whole class music making? So, in 2019, we started in one music area, now we’re currently working with six, and moving towards 9!

In relation to whole class music making, what this has forced everybody to think about is that this is not a choice situation. Those children are in their primary [school] music class, whether they want to be there or not, they’re given an instrument which they may or may not want to play, and from an OHMI Trust perspective, it’s a really good thing because we have to find solutions for those children. Therefore, attention has to be given to finding what those solutions might be.

We’ve had to look at the broad range of instruments and every music hub we’ve taken on has introduced another collection of instruments that they teach. So, this year, for example, we’ve had to find a djembe stand for somebody who can’t hold a djembe. This is when it starts to get tricky because if you put the djembe on the floor, it deadens the sound. If you put it on the child’s shoulders, she will get tired in the session. We’re just constantly having to source different instruments and different solutions. Also, a lot of the children that come through do have use of one hand, so our standard adapted instruments, where you can play everything with one hand, works for them. But that’s not the case for everyone! For instance, sometimes we’re having to look at other alternatives or perhaps they’ve got issues with their embouchure, or they’ve got a tracheostomy, and that means that if they’re in a whole class session with, say, brass instruments, we have to look at things for that.

It has forced us to look at a broader range of instruments, and it’s also forced us to look at the cost of the instruments, and the manufacturing processes. The vast majority of our instruments still are made by a very small handful of people, and that very small handful of people that are getting older. The problem is that there’s currently no pipeline of makers behind them. So, in response to this, we’re trying to explore new technology like 3D printing. For example, we had a 3D printed, one-handed clarinet that came to our competition in 2018. That was probably the first thing that was ever made because we had a competition as opposed to somebody specifically commissioning it. And now we have a 3D printed version of that clarinet. Is it straightforward? No! There are so many issues with materials, they’re definitely not as strong, schools are constantly asking for the 3D printed files. It’s not just a question of pressing ‘print’. There’s a lot of finishing and that kind of thing. But we are trying to do what we can to make the price more affordable for schools and music service settings. For instance, an original, wooden one-handed clarinet costs £6000 to start with whereas the 3D printed version is £3000. So, we’ve managed to cut the cost in half, but, in terms of quality, it’s currently not as good as a regular ‘off the shelf’ clarinet.

The OHMI Trust’s work has significantly impacted music education by providing learners with physical disabilities the opportunity to learn musical instruments. Significantly, as identified by Fautley & Kinsella (Reference FAUTLEY and KINSELLA2017), this has allowed these learners to not only participate in whole class music-making, but also allow them the opportunity to progress at the same rate as their peers. The number of music hubs The OHMI Trust works with continues to grow, and this expansion has positively forced the organisation to find solutions for a broader range of adapted instruments, including using new technologies like 3D printing to make instruments more affordable.

Despite the successes, The OHMI Trust faces several challenges in aiming to elicit greater inclusivity in music-making. First is the sourcing and adapting a wide range of instruments to accommodate various physical disabilities, which can be complex and resource-intensive. Second, although 3D printing technology has helped reduce costs, the quality and material strength of these printed instruments are not yet on par with traditional ones, posing durability and performance concerns. Third is the reliance on a small number of ageing instrument makers, with no clear pipeline of new makers to continue this specialised work. This creates a risk of losing valuable expertise and skills in future years. These challenges arise in ensuring that adapted instruments are available and suitable for all learners in music-making settings, requiring continuous innovation and creative problem-solving to meet diverse needs effectively. What these issues raised by Rachel highlight is the need for ongoing support, research and development in this important area.

Navigating through a world of disability and adaptation

The journey into the world of disability and adaptation made Rachel acutely aware of the challenges faced by individuals with physical disabilities. In turn, this led her to a career at The OHMI Trust, where she currently serves as General Manager. The narrative that follows underlines the importance of not only support from the school and music services, but also creative adaptations made by teachers in order to overcome obstacles related to having a physical disability. What resonates most is how inclusive practices can enable individuals to achieve their full potential.

Nikki:How did you get into your role at The OHMI Trust?

Rachel:Well, I left classroom music teaching about 21 years ago. I didn’t do it for very long, but I stopped to have a career break and have my son. When he was 2, he had a stroke, and from then on, he couldn’t use his right side. There’s no obvious medical reason why he had a stroke. I then found myself in the world of disability and adaptation. He’s 21, and doing well in life, although he does have a permanent physical impairment. I think it makes you more aware than before of all those little things that are suddenly a struggle.

For example, I remember him coming home in about Year 3 [approximately 7–8 years old] with a letter from school saying that they were going to have keyboard lessons in school. I thought: Well, I’m not going to tell him he can’t do it, but I sort of fully expected somebody to. In fairness to the school and to the music service involved, they didn’t, and he carried on having keyboard lessons probably for 7 years. He did GCSE music. He’s still singing now. He’s not playing the keyboard so much anymore, but he’s still singing. He’s working towards Grade 8.

His keyboard teacher was brilliant and was very creative in the way he taught him and used lots of improvisation and reworking of things. So, he adapted the way he was teaching. I remember, in one school concert, the teacher mouthed 1, 3, 5 et cetera for whichever finger the children were supposed to be using. When it got to my son’s group, be suddenly switched from numbers to letters, like C, E, G because my son and the other children were using different fingers from each other. Not long after that, a General Manager job came up at The OHMI Trust where I’ve been ever since.

Growth or knowledge transfer?

The challenges and considerations in providing inclusive music education for learners with physical disabilities are discussed. Focusing on the balance between organisation growth and knowledge transfer, Rachel emphasises that while building growth is indeed important for accessibility, there are identifiable gaps in some teachers’ knowledge with regard to adapted instruments, how they can be used effectively in music-making settings, and that there is a current lack of understanding of specific needs of learners with physical disabilities. This knowledge, she feels, is of high importance so as not to potentially discourage learners from pursuing music.

Nikki:You said you’re looking towards working with 9 music areas. Is the plan to have The OHMI trust as a nation-wide organisation?

Rachel:I think I’m in two minds about whether there’s this need to have growth or whether it’s a question of a knowledge transfer. For example, if you can walk into a music shop and buy a musical instrument that meets your needs, if you can go into a school and there’s a teacher who ‘gets it’ and can teach you, if there’s an ensemble that meets in a venue that’s suitable for you, if each music service has a cupboard full of adapted instruments then we don’t need to be here, and that’s absolutely fine. That would almost be the best thing ever. That would mean I wouldn’t get calls from parents saying: ‘My child’s doing recorder the next term in school, and he’s only got one hand’. The point is that there’s still a lot of gaps in knowledge. For instance, I had an e-mail from a music teacher in a secondary school a couple of weeks ago saying he’s got a child in his school who had quadriplegic cerebral palsy, was in a wheelchair and the local music service had advised that she should play trombone. The teacher asked me whether I had a trombone stand. The problem wasn’t whether we had a trombone stand; but someone with quadriplegia probably has very poor control of their hands, and trombones require very precise positioning to be in tune and in time, and I just couldn’t see how this could work for the pupil. So, I arranged to have a video call with the teacher, the student and her teaching assistant. Having had the video call, I was certain she wasn’t going to play the trombone. However, in this secondary school, trombone, flute and viola were offered as instruments in whole class ensemble teaching, so I sent a digital instrument that she could use instead of a traditional viola, because she could then position it where she needed it. Ultimately, it wasn’t the perfect solution, but it was more plausible than a playing a trombone. Did she continue past whole class? No, but she was able to join in that lesson very successfully. There’s a lot of knowledge transfer to happen. I have no problem with people coming to me and saying haven’t got a clue what to do because we can work through and find what’s available and what’s affordable. But for somebody to recommend something that’s so wide of the mark and it’s going to set up that student to fail and potentially put them off music forever.

The limitations of current data sets and the impact these have on inclusive practices

Data can be seen as important for identifying and supporting learners with physical disabilities (UNICEF, 2020), particularly in the context of music education, where adapted instruments are required to support inclusion (Fautley & Kinsella, Reference KINSELLA and FAUTLEY2019). In the conversation that follows, Rachel highlights that there is a lack of awareness among some educators and music hubs about the presence of learners with physical disabilities and the available data that can be obtained from England’s Department for Education. Not only this, but she also emphasises the need for accurate and sufficiently detailed data so that learners can receive the support they require; without these data, inclusivity in music-making settings is likely to be compromised. That said, despite these limitations, data can be viewed as an important starting point for identifying learners who need additional support.

Nikki:What problems, if any, have you encountered in the research you do to support The OHMI Trust’s work?

Rachel:I think data is a key one. For example, the number of times I get told: ‘We don’t really have any children like that here’. That’s not true. The children are there, it’s just we’re less aware of them. One of the things I found really useful is the DfE [Department for Education] statistics. They’re broken down by local authority. According to the DfE statistics, 90% of children with special with physical disabilities in England are in mainstream schools. So, if I’m ever doing a presentation in front of people from a known geographical area, I will pull out the figures and they look at me very surprised.

Nikki:Why do you think that is? Why do you think they’re surprised?

Rachel:Because I don’t think they know that this data exists. For example, when I’m presenting to music hubs and I talk about the DfE statistics, that’s when the pens come out and they suddenly start writing the numbers down. I’ve also had music hubs say to me: ‘Oh, I wish Iʼd known about this last week when I was doing the Arts Council data return’. They just don’t know that it’s actually been around for a long time.

Nikki:So, what does this mean for inclusivity in whole class music lessons?

Rachel:I think this starts to raise the expectations that there are children there, inevitably children in every cohort and in every music service up and down the country, that require some level of additional support. It’s then a question of how we go about identifying who they are, what they need, and how we get those adapted instruments out to them. But without the data we just can’t be as inclusive as we can be. Unfortunately, I know of numerous children that have been excluded from having whole class music lessons because there is a belief that, because of their physical disability, they can’t play an instrument. That’s just not the case. For me, the most important thing is that everybody should have the chance to play, every child should be able to take part in a music session, no child should be excluded, and they should not have music as something that they can’t do.

Nikki:Does the DfE data tell you everything you need to know about raising awareness for greater inclusivity in music lessons?

Rachel:No; it’s a starting point, but it doesn’t actually tell us very much about what the disability is. For example, whether it affects hands or feet or legs, or something else. It doesn’t tell us about the children who’ve got a visual impairment. Also, for music specifically, there’ll be children who are missed within the data and there’ll be children who are included that perhaps don’t have an issue with learning a musical instrument. But it is useful to have some figures as a starting point.

For The OHMI Trust, unpacking that data is so important because, for children in whole class music lessons, there are some those who have an issue with their hands and/or their arms that we can help, but also it could be children with ADHD [Attention Deficit Hyperactivity Disorder] who really struggle with sitting still and need that freedom of movement, and we can help so they can use, say, a trumpet stand which allows them to be free in their movement. But, by getting this type of data with an increasing number of music services and getting feedback from research evaluation of our work, we’re starting to build a clearer picture of the landscape in music education, and people are starting to listen to us when we’re talking about that type of data. This makes organisations realise that, perhaps, they’re missing some children in that area that they should be working with and for whatever reason aren’t.

Nikki:Of course, the quantitative data from the DfE statistics only tells part of the story, what about qualitative data?

Rachel:That’s definitely not as strong. For example, we deal with the schools, the music services also deal with the schools, the individual music teacher meets the children and probably nobody meets the parents or guardians. Understanding that whole chain is really difficult when you’re the outside organisation like The OHMI Trust because we’re not the people contracted by the schools to deliver the sessions. There’s definitely a distance between our organisation and the child and the parents.

Is terminology really that important when talking about physical disabilities?

The next part of the conversation highlights the subjective nature of politically correct words and the potential for misunderstanding and misusing medical terms to describe physical disabilities. In light of these challenges, The OHMI Trust take a different approach; instead of using language, they focus on practical assessments to evaluate a learner’s physical abilities. This creative method helps to identify any barriers to using a music instrument so that a suitable alternative can be found and focuses on what the learner can do rather than what they cannot do.

Nikki:What about terminology? How important would you say terminology is in discussions about children with physical disabilities? What impact that might have on a child’s music education?

Rachel:Very important, but there are different types of terminology, such as political correctness terminology there’s also medical terminology. Personally, I struggle with the politically correct terminology because it’s very subjective and everybody will have a different view about it. For example, are they ‘disabled people’, or are they ‘people with disabilities’? I also know of some examples where medical terminology has been used incorrectly. For example, I went to visit a child in a specialist school setting who I was told in advance was hemiplegic, which is a weakness on one side of the body. So, I took a whole load of woodwind and brass instruments, and when I got there, it turned out that this child actually had arthrogryposis, which is a connective tissue condition, and she couldn’t physically bring her hands anywhere near her face. She couldn’t feed herself. She couldn’t do anything. So, my whole bag of one-handed woodwind and brass was completely useless to her because she couldn’t actually bring her hands close enough to her face to use them. There are people using words that they don’t what they mean and using them incorrectly, which is more problematic than saying ‘I don’t know’ and then give a factual statement of what they can’t physically do.

With our OHMI Reveal and OHMI Connect system, when we’re trying to assess the needs of students, we deliberately don’t ask about medical terminology because it can be misconstrued, understood, and sometimes it tells us nothing. For instance, if we’re told a child’s got cerebral palsy, well, what does that mean? Physically, it could mean a very broad range of things from not a lot to can’t use any digit. Instead, what we do is we get the schools to gather some everyday craft and/or stationary items together that we’ve weighed up so they’re similar in weight to an instrument, and those items allow us to assess the gross motor or fine motor or the embouchure of the child. So, we’re not using language, and it gets us around the whole terminology problem area, and it’s important to say that the focus isn’t on what the student can’t do but, by picking up a ball for example, what they can do. By avoiding language, it allows us to understand the most important thing which is: what are the barriers of the instrument that is currently going to be provided, and what are the alternatives that are going to be most helpful for that child to do their music-making?

Nikki:What about working internationally? Do you find similar problems with language and terminology in other countries?

Rachel:Yes. For example, in America the word ‘handicapped’ is frequently used. Well, that term is on the DfE’s list of ‘no-go’ words for our country [see DfE, 2021], which I didn’t discover until very recently.

Implications for music education policy

The National Plan for Music Education states ‘we … expect music education to be fully inclusive, so that all music educators: commit to achieving greater access and more opportunity in music education’ (DfE, 2022, p. 8). As has been demonstrated throughout this conversation, there is still work to be done in this regard, particularly at the national level. Importantly, Rachel highlights that while some music hubs are doing commendable work, it is currently unclear what specific actions hubs are taking when working with physically disabled learners. Without this clarity, it is unclear how inclusivity is being addressed at scale.

Nikki:What about implications for policy? Are there any changes you’d like to see there?

Rachel:Yes, I actually discussed this in a recent meeting with [England’s] Arts Council. I was informed that there are some music services who are doing really good things with children with physical disabilities. At face value, that’s great; however, it’s really not clear what work they do. From a policy perspective, I think it would be really helpful if it could be defined what music hubs were doing within their geographical locations, and for which disabled children. We need to identify the locations that aren’t being as inclusive for children with physical disabilities. In short, if we’re not addressing the needs of those children, then we’re not meeting the requirements of education, and all the time we’ve got more children going through the system and we’re not meeting their needs, it’s reinforcing that the music is not for that group of people. Policy needs to be focused on the breadth of needs within disability and actually underlining that music services and schools must ensure that they really are offering something for everybody.

Future work

The final part of the conversation moves to potential future work for The OHMI Trust. Rachel suggests future work should focus on understanding learner journeys by speaking directly with children and young people, rather than relying solely on questionnaires. This would offer deeper insight, especially for those progressing from whole-class music to individual lessons on adapted instruments. She also highlights the need to support teachers, many of whom feel anxious about teaching unfamiliar instruments or making mistakes. Their concerns are valid, given the newness of the experience. Strengthening teacher confidence through collaboration and guidance, alongside richer learner feedback, could create a more inclusive and effective music education environment for both students and educators alike.

Nikki:So, what’s next?

Rachel:I think it would be really good to understand learner journeys with the work we do. For example, maybe get some feedback from the end users, the children themselves. At the moment, they’re quite young when they’re doing whole class music, but some of them may carry on and go onto have individual lessons on their adapted instrument. Currently, we do questionnaires when we go around and visit lessons, but actually having a conversation about their journey is much better.

The other part is to work more closely with teachers. From what I’ve seen, some teachers are really worries about saying the wrong thing, or worried about not being able to teach an instrument they’ve never seen. This is understandable as it’s a new experience for many of them and, of course, they don’t want to get it wrong.