Self expression

Note-Able Music Therapy

Manal Toppozada leads a rehearsal at Note-Able Music Therapy Services.

Manal Toppozada leads a rehearsal at Note-Able Music Therapy Services.

Photo/Eric Marks

For more information, visit

What do Nat King Cole, Indiana Jones, and Pyramid Lake have in common? They’re featured in a song written by the participants of music therapist Sara Rosenow’s Exploring Music 1 class, a popular Note-Able Music Therapy Services session.

Many in Reno are familiar with the Note-Ables band. Note-Able Music Therapy Services was founded in 2003 by executive director Manal Toppozada. And though Toppozada calls the band her baby, 95 percent of the work the organization does is music therapy, a clinical and evidence-based use of music to achieve non-musical goals.

“We use music to affect changes in people’s lives,” Toppozada says, referencing the organization’s mission to provide inclusive music programs and music therapy services for children and adults of all ages and abilities.

In the McKinley Arts & Culture Center’s basement studio, the varied participants of Rosenow’s session break into groups to brainstorm new lyrics for “L–O–V–E,” made famous by Nat King Cole. As Rosenow sings the customized versions, where lollipops, elephants and ice cream reign, the participants dissolve into laughter.

“I focus a ton on self-expression in here,” says Rosenow once the session, designed to help adults with disabilities, ends. “Anybody can play for enjoyment and to express themselves, and that’s what we preach here.”

In a different room on the other side of the basement she sets out a puzzle, a memory game and a ukulele for a one-on-one session. When Kaz Baron, a 9-year-old with bright eyes and brown hair, enters the room he heads straight for the ukulele.

“The biggest thing we work on [with Kaz] is attending behaviors,” Rosenow said beforehand. Attending behaviors are physical demonstrations of attention and engagement during conversation. “Music is a perfect way to reinforce, to prompt or to cue.”

At one point during their meeting, Rosenow guides Kaz in a game that calls for him to play the drums at the same time she plays her guitar. When she stops strumming, he must freeze.

“Music therapy is all about celebrating the little things,” she says. As if to demonstrate, Kaz’s eyes gleam, a grin splits his face, and he laughs as they compose their own duet throughout the game.

Toppozada recounts a “powerful window” of a moment that came about while she was working with a gentleman with dementia.

“There’s a lot of research in dementia in music,” she says. “One gentleman was having difficulties engaging, and we did a lot of singing. It jogs memories. His wife would bring him in and say, ’You take him!’ and then take a walk. He’d come in agitated and grumpy, and she’d walk in the door, and he’d call her over and would sing ’You Are My Sunshine’ and ’Let Me Call You Sweetheart’ to her. They’d walk out holding hands.”

Toppozada says Note-Able Music Therapy Services helps more than 400 people a year. They see about 100 people on site each week ranging from toddlers to septuagenarians.

Mary Lee Fulkerson’s brother, Jim Metzker, began participating at 50 after living with their parents his entire life.

“He was timid about everything, from answering a simple question to ordering from a menu,” Fulkerson says. “He also had anger issues. I heard about this group, and [he] began singing every Monday.”

Fulkerson says her brother’s life changed. He learned to take the bus, find a job, and got his own place.

“I go to rehearsals just to watch the sunshine on the faces of the students,” says Fulkerson.

Toppozada notes that while there are other valid ways of using music to help such as music by the bedside or singing at nursing homes, they are not music therapy in a clinical sense.

“I think about it in terms of seeing a personal trainer versus a physical therapist,” she says. “Both are great, but they serve different functions.”