Music Therapy and Aphasia
Dr Shelagh Brumfitt
Music Therapists have worked with people who have aphasia and others with brain damage to try and create change in their communication abilities.
Music Therapy is the use of music and musical activities in conjunction with interpersonal skills to achieve therapy goals (Magee and Wheeler, 2003).
Music Therapists have worked to show that communication may show some changes after music therapy. It may make some changes to the amount of speech and language, the clarity of the speech, the speed of speech, the loudness, the amount of breath the individual can use or the individual's mood.
Here is the web page for the British Society of Music Therapists BSMT
There are not many music therapists who work with people who have aphasia.
The techniques which are used include:
Using music to start a to and fro action between the therapist and the patient, using melody rather than language. This may be very helpful for people with no communication or very little. Speech sounds may be practised to melody and the number of sounds can be increased over time. Automatic speech in songs can also be brought out, such as using a well known song to help the person use language.
Pacing techniques help to make sure the speed of speech is steady. This helps with intelligibility.
Melodic Intonation Therapy
This was used a lot by speech and language therapists in the past, but now it seems that Music therapists use it more. This was designed for people with aphasia and makes use of the individual's ability to use melody when trying to produce speech.
Ordinary conversation would be practised, such as 'how are you' but sung with a melody. This can help some aphasic speakers. This would be practised and then the melody would be faded out when the individual had managed to speak the phrase.
Here in Sheffield we tried Music Therapy with an elderly man who had a lot of communication difficulties. The Music therapist was able to work well with him and he showed some changes in how he used his voice (it got stronger), his confidence improved, he did not feel so sad, and was less likely to cry.
All of this is very experimental and we are trying lots of ideas to see what works.
At São Paulo University some therapists have set up a choir formed and conducted by people with aphasia. I heard about this at a conference. It was a very interesting idea and would need some support from people with a music background and possibly a music therapist and a speech and language therapist who could work together on this.