{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:00:14Z","timestamp":1790359214599,"version":"4.1.0"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Posterior fossa syndrome (PFS) is a common complication following surgical resection of paediatric posterior fossa tumours, characterised by mutism, ataxia, emotional disturbance, and cognitive impairment. Despite significant rehabilitation needs, there is limited evidence regarding effective therapeutic approaches, including the role of music therapy. Music therapy is uniquely positioned to address the multidimensional needs of children with PFS, yet the low incidence and clinical heterogeneity of the syndrome preclude traditional empirical research designs. International consensus guidelines are therefore needed to consolidate clinical knowledge and support consistent, high-quality practice. This protocol describes a two-phase study to develop international consensus guidelines for music therapy practice with children with PFS. Phase 1 involves a pre-Delphi consultation with three regional Advisory Panels (North America, Europe, Australia), each comprising family representatives, music therapists, allied health professionals, and medical practitioners. These panels will identify clinical priorities, family concerns, and interdisciplinary outcomes to inform the development of the survey instrument. Phase 2 uses an international Delphi process with a minimum of 30 experienced paediatric music therapists, proceeding through three to five iterative rounds of item generation, rating, and refinement. Consensus is defined a priori as \u226580% agreement. Quantitative analysis will be conducted in R; qualitative data will be analysed thematically. The study will be conducted and reported in line with DELPHISTAR recommendations. The resulting consensus guidelines will support developmentally responsive, family-centred music therapy assessment and intervention for children with PFS, while identifying priority areas for future research in paediatric neuro-oncology and neurorehabilitation.<\/jats:p>","DOI":"10.1371\/journal.pone.0358571","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:24:31Z","timestamp":1790357071000},"page":"e0358571","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["A study protocol for international consensus guidelines on music therapy for paediatric posterior fossa syndrome"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7140-5481","authenticated-orcid":true,"given":"James","family":"Burns","sequence":"first","affiliation":[{"name":"University of Limerick","place":["Limerick, Ireland"],"department":["Health Research Institute"]},{"name":"Children\u2019s Health Ireland","place":["Dublin, Ireland"]},{"name":"National Rehabilitation Hospital","place":["Dublin, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Pool","sequence":"additional","affiliation":[{"name":"Anglia Ruskin University","place":["Cambridge, United Kingdom"],"department":["Cambridge Institute for Music Therapy Research"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Twyford","sequence":"additional","affiliation":[{"name":"Perth Children\u2019s Hospital","place":["Perth, Western Australia, Australia"],"department":["Child and Adolescent Health Service"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Baron","sequence":"additional","affiliation":[{"name":"Robert Connor Dawes Foundation","place":["Brighton, Victoria, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Thomas","sequence":"additional","affiliation":[{"name":"Alder Hey Children\u2019s NHS Trust","place":["Liverpool, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Men\u00e9n","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Institut Guttmann, Institut Universitari de Neurorehabilitaci\u00f3 adscrit a la UAB","place":["Badalona, Barcelona, Spain"]},{"name":"Universitat Aut\u00f2noma de Barcelona","place":["Bellaterra (Cerdanyola del Vall\u00e8s), Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Fallon","sequence":"additional","affiliation":[{"name":"University of Limerick","place":["Limerick, Ireland"],"department":["Health Research Institute"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janeen","family":"Bower","sequence":"additional","affiliation":[{"name":"The University of Melbourne","place":["Melbourne, Australia"],"department":["Faculty of Fine Arts and Music"]},{"name":"The Royal Children\u2019s Hospital Melbourne","place":["Melbourne, Australia"],"department":["Music Therapy Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"issue":"4","key":"pone.0358571.ref001","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1177\/104345429501200402","article-title":"Description of posterior fossa syndrome in children after posterior fossa brain tumor surgery","volume":"12","author":"EA Kirk","year":"1995","journal-title":"J Pediatr Oncol Nurs"},{"issue":"7","key":"pone.0358571.ref002","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1007\/s00381-016-3093-3","article-title":"Consensus paper on post-operative pediatric cerebellar mutism syndrome: the Iceland Delphi results","volume":"32","author":"T Gudrunardottir","year":"2016","journal-title":"Childs Nerv Syst"},{"key":"pone.0358571.ref003","first-page":"1995","article-title":"Cerebellar mutism syndrome in children and adults","volume-title":"Handbook of the Cerebellum and Cerebellar Disorders","author":"P Mari\u00ebn","year":"2021"},{"key":"pone.0358571.ref004","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.pediatrneurol.2022.04.014","article-title":"Cerebellar mutism syndrome in pediatric neuro-oncology: A multidisciplinary perspective and call for research priorities","volume":"132","author":"F Malbari","year":"2022","journal-title":"Pediatr Neurol"},{"issue":"6","key":"pone.0358571.ref005","doi-asserted-by":"crossref","first-page":"789","DOI":"10.3171\/2025.5.PEDS2593","article-title":"Toward reducing the risk of cerebellar mutism syndrome: Consensus statement from the posterior fossa society","volume":"36","author":"SM Toescu","year":"2025","journal-title":"J Neurosurg Pediatr"},{"key":"pone.0358571.ref006","doi-asserted-by":"crossref","unstructured":"Gr\u00f8nb\u00e6k JK, Boeg Thomsen D, Persson K, Mathiasen R, Juhler M. 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