Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2011, Article ID 250708, 14 pages doi:10.1093/ecam/neq072 Original Article The Impact of Group Drumming on Social-Emotional Behavior in Low-Income Children Ping Ho,1 Jennie C. I. Tsao,1 Lian Bloch,2 and Lonnie K. Zeltzer1 1 Pediatric Pain Program, Department of Pediatrics, David Geﬀen School of Medicine, University of California, Los Angeles, USA 2 Clinical Science Program, Department of Psychology, University of California, Berkeley, CA, USA Correspondence should be addressed to Ping Ho, pingho@ucla.edu Received 10 August 2009; Accepted 19 May 2010 Copyright © 2011 Ping Ho et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Low-income youth experience social-emotional problems linked to chronic stress that are exacerbated by lack of access to care. Drumming is a non-verbal, universal activity that builds upon a collectivistic aspect of diverse cultures and does not bear the stigma of therapy. A pretest-post-test non-equivalent control group design was used to assess the eﬀects of 12 weeks of school counselor-led drumming on social-emotional behavior in two ﬁfth-grade intervention classrooms versus two standard education control classrooms. The weekly intervention integrated rhythmic and group counseling activities to build skills, such as emotion management, focus and listening. The Teacher’s Report Form was used to assess each of 101 participants (n = 54 experimental, n = 47 control, 90% Latino, 53.5% female, mean age 10.5 years, range 10–12 years). There was 100% retention. ANOVA testing showed that intervention classrooms improved signiﬁcantly compared to the control group in broad-band scales (total problems (P < .01), internalizing problems (P < .02)), narrow-band syndrome scales (withdrawn/depression (P < .02), attention problems (P < .01), inattention subscale (P < .001)), Diagnostic and Statistical Manual of Mental Disorders-oriented scales (anxiety problems (P < .01), attention deﬁcit/hyperactivity problems (P < .01), inattention subscale (P < .001), oppositional deﬁant problems (P < .03)), and other scales (post-traumatic stress problems (P < .01), sluggish cognitive tempo (P < .001)). Participation in group drumming led to signiﬁcant improvements in multiple domains of social-emotional behavior. This sustainable intervention can foster positive youth development and increase student-counselor interaction. These ﬁndings underscore the potential value of the arts as a therapeutic tool. 1. Introduction Children under age 18 years represent a quarter of the total population of the USA (74 million) [1]; 39% are low- income, that is, living in families earning less than double the federal poverty level [2]. Although European Americans represent the largest number of low-income children (26%, 10.9 million), other groups are more disproportionately represented: Latino (61%, 9.4 million), African American (60%, 6.5 million), American Indian (57%, 0.3 million), Asian American (30%, 0.9 million), children of immigrant parents (58%, 7.4 million), children of native-born parents (35%, 20.2 million) [2]. 1.1. Mental Health Needs of Low-Income Youth. Low-income youth are commonly exposed to stressors [3–12] that are well-established risk factors for behavior problems and school failure in the general youth population [13]. Corre- spondingly, socioeconomic disadvantage is associated with internalizing (e.g., depressive, anxious, somatizing, post- traumatic stress) and externalizing (e.g., antisocial, aggres- sive, delinquent, substance abusing) behavior in children and adolescents [3, 9, 14–22]. The burden of chronic stress held by low-income youth is compounded by poor access to health and mental health care [1, 22–26]. Moreover, low- income families may be reluctant to obtain services, for reasons ranging from stigma and attitude towards treatment [27, 28] to psychosocial and legal ramiﬁcations of reporting problems [12, 29, 30]. Minority youth, in particular, are at greater risk of encountering the “triple threat” of suboptimal health, lack of access to care and inferior services [26]. Notwithstanding, relatively few mental health interven- tions have targeted low-income youth, and most aim to reduce a single problem behavior or deﬁcit [31–37] in contrast to a positive development approach of increasing core assets that may inﬂuence a range of problem behaviors