While treatment protocols based on the neurobiology of trauma exist for adults (van der Kolk, 2015), limited strategies are available when working with children abused at infancy (Black, Woodworth, Tremblay, & Carpenter, 2012). Recent research suggests that how music is processed in the brain can be used to create safe, predictable, motivating interactions that have the potential to help children develop neural plasticity, higher-order processing, and self-regulatory behaviors (Stegemöller, 2014). This case study investigated (a) the ways in which the trauma history of a nine-year-old child informed current treatment, and (b) the ways in which musicking experiences supported a safe environment for the child to engage in self-regulation, verbalizations, and interactions with others despite his ever-changing trauma responses (e.g., seizures, dissociative responses). The researchers compiled and analyzed data from past and current music therapy sessions to track the child’s verbalizations, types of music engagement, and self-regulation strategies. Data were analyzed for trends to identify when various musicking experiences appeared effective in supporting the child’s ability to verbalize, engage with others, and self-regulate. Results suggested that the use of predictable rhythmic music cues, especially in 6/8 meter; repetitive, bilateral arm movements when playing instruments; bell-like instruments within sensory-based experiences; trading instruments; and unique vocal-guitar accompaniments and repetitive melodic motifs provided emotional connections for the client to increase responses within the three identified goal areas. These strategies support a neurobiological approach to treatment and provide an initial guide for music therapists working with children traumatized as infants.