Introduction Patients with tetraplegia due to spinal cord injury often present unique challenges in music therapy as physical limitations can affect their ability to participate in active music-making. People with tetraplegia also face unique challenges related to identity, independence, and activities of daily living. Adaptive technologies can offer increased accessibility of creative expression such as music-making and composition, but they are often underutilized due to a lack of research and of clinician competency in this area.