Table 3.

Active Music Engagement Intervention Components and Theoretical Principles.^*.

Intervention component	Theoretical principles
Component 1: Music-based play activities	(1) Predictable environments provide structure that supports child competence.
	Therapist uses familiar music activities to provide structure and increase child’s ability to predict what will happen in their environment.
	(2) Leveled activities help ensure success and support child competence.
	Therapist tailors physical activity requirements to meet the individual needs of each child. Enables child success and engagement during periods of high or fluctuating symptom distress.
	(3) Opportunities to make independent decisions support child autonomy.
	Child chooses from a variety of music play activities, and each activity includes a wide range of materials. Activities include a wide range of materials and activity options so child can make choices for self and others.
	Therapist uses improvisational techniques to follow child-initiated changes in their music making (eg, child changes tempo or style of playing).
	(4) Activities structured to support caregiver-child interaction.
	Activities are designed to structure and support reciprocal caregiver-child interactions. Therapist individualizes experiences to support increased frequency and quality of interactions.
Component 2: Music play resource kit	Supports independent use of music play to manage distress between therapist-led sessions.
	Activities mirror content from therapist-led sessions. The kit includes:
	(1) Professional audio recording of music composed and/or arranged specifically for the AME intervention.
	(2) Age-appropriate musical instrument and play materials that correspond to each activity.
	(3) Activity cards designed to give children/caregivers information “at-a-glance” on ways they can use their kit.
Component 3: Session planning and caregiver tip sheets	(1) Promotes caregiver competence about how children use play to cope and ways to engage their child in music play during transplant.
	(2) Promotes caregiver autonomy by empowering caregivers with skills/resources to support their child during treatment
	(3) Supports caregiver-child relationships through normalizing, music-based play activities

^*Table reprinted with permission in accordance with creative commons open access license “Attribution-NonCommercial 4.0 International” (CC BY-NC 4.0) http://creativecommons.org/licenses/by-nc/4.0/ for the following publication: Russ KA, Holochwost SJ, Perkins SM, et al. Cortisol as an acute stress biomarker in young hematopoietic cell transplant patients/caregivers: active music engagement protocol. JACM. 2020;26(5):424- 434.