On the surface, the program isn't what one might expect in an outpatient medical center. The teacher isn't a martial arts instructor - she’s a respiratory therapist. Actually the demonstration has nothing to do with the latest asthma inhaler or breathing device either.

What's obvious however is a light-hearted sense of playfulness and an eager desire to get started. After a short demo and a quick explanation of the ground rules, the instructor proceeds to pass out the tools. The children can’t wait to get started - surprising you might think, especially since the children are in a medical setting.

Reaching into small burlap bags, each child pulls out his/her own recorder (plastic flute-like instruments we called flutaphones when I was in elementary school). Scurrying to assume the proper finger positions, the younger children receive guidance from the therapist and the older children. Soon everyone’s making steady progress.

As anticipation gives way to smiles, each child has a chance to play a few notes. Laughter sets the tone as those first high-pitched screeching sounds (you know the ones) resound with each initial attempt. The instructor capitalizes on the moment by suddenly blowing as hard as she can into her instrument.

The children cringe, startle for a moment and look at each other in surprise. The room is silenced. Actually so is the waiting room. The therapist in the karate uniform has everyone's attention.

Without missing a beat (pardon the pun) she carefully explains and demonstrates that blowing lightly and evenly into the recorder is all that's needed to produce melodious sounds.

One child immediately blurts out, "I get it . . . it's like when I get an asthma attack. I try to breathe as hard as I can, and then I start choking. I feel so bad when my inhaler doesn't work . . . it's so scary!"

"Exactly!" the instructor responds. "That's why we’re doing this in the first place. When you get frightened or worried, your breathing gets worse. When you learn to relax, you do better. Breathe hard and you get noise, breathe gently and you have music!"

Within minutes musical notes and even semblances of scales are recognizable. Soon sustained notes and multiple notes are played with slow, deep and relaxed breaths. As the parents enter the room, it's obvious everyone is immersed in a fun-filled experience.

Yet something equally important is also happening. The children, thoroughly enjoying the music-making exercise, are actually performing breathing exercises which have great potential for helping them improve the quality of their lives. They're also succeeding at something few asthmatic children ever dream of - using their breath to make music. And they’re delighting in the experience!

The scenario I just presented is from our EMPOWER Asthma Management Program for children and their parents. A comprehensive series of educational sessions based on the 1997 National Institutes of Health (NIH) guidelines, EMPOWER uses a self-defense theme - a monkey dressed in a karate uniform as the program's icon. The EMPOWER staff guides each child and his/her parents through a series of 6 creative learning sessions. Upon completion, each child receives a black belt in asthma from a respiratory therapist wearing a karate uniform.

Designed to help children and their families, the program offers a host of insights and perspectives focused on effective prevention and treatment. These include understanding the fundamentals of asthma, recognizing and avoiding asthma triggers, learning to use asthma tools and medications correctly, enhancing communications with healthcare providers and dealing with often overwhelming issues such as stress and self-esteem.

And that's precisely where music-making comes in. In addition to playing the recorder, children also discover a unique means for developing a relaxed breathing rhythm that can help them stay calm and focused in the event of an asthma attack. Each child learns to play the drum through a delightful series of exercises that build self-esteem, camaraderie and a needed, yet often overlooked, sense of control.

While combining music-making with asthma may seem like a new and innovative approach, I remain inspired by a story from years past. A child facing the extraordinary challenges of asthma in an era when treatment approaches were yet to be discovered was given a simple prescription. His doctor suggested playing a wind instrument. Taking that order seriously, his mother, a violin teacher, lovingly taught him to control his breathing through rhythm. I wonder if that physician ever realized that a prescribed series of clarinet lessons would later EMPOWER his patient to overcome asthma and achieve success as an accomplished musician. After years of renowned leadership in the music instruments industry, he is recognized today as the Father of the Music-Making and Wellness Movement. It was through Karl T. Bruhn's caring, understanding and vision of music-making as a therapeutic intervention that Remo Inc. and Yamaha Corporation of America supported our program by providing drums and recorders.

As a physician and a chronic asthma sufferer, I find it exciting and rewarding to blend conventional medical approaches with creative music-making strategies that can improve the quality of life for each child facing the challenges of asthma. If you saw their smiles and heard their music, I'm certain you’d agree - Mind Over Matter!