Rehab

Not the Same Old Song

By Jennifer A. Rathbun, MM, MT-BC

Music, Speech, and Language

Melodic intonation therapy (MIT) has been widely used by speech-language pathologists with aphasic patients. According to Sparks and Holland,5 MIT is a step-by-step procedure that uses melody based on the natural prosody of functional phrases to stimulate verbal expression. Later, the melody is faded into chant and finally, the chant is faded into normal speech. At TIRR, both musical speech stimulation (MSS) and a modified form of MIT are used during sessions with a music therapist and speech-language pathologist.

MSS is the musical form of phrase completion. It uses the unimpaired ability to sing in order to facilitate spontaneous verbalizations. Patients are asked to complete phrases within familiar songs, such as "You Are My Sunshine." This automatic singing is practiced and then transferred into functional expression as automatic speech emerges.

Apraxic patients benefit from MSS because familiar songs have a predictable rhythm, which facilitates oral-motor timing. In addition, songs are directional-the chord progressions, or musical building blocks, lead the song to resolution.

Music therapists also provide simple instruments to facilitate the coordination of the breathing mechanism. The music made by these instruments, such as harmonicas, recorders, and melody horns (instruments with a small keyboard connected to a mouthpiece), motivates the patients to exercise breath control.