Music Therapy is not necessarily the first port of call for clients whose families have suffered a stroke when it comes to regaining speech. However, I have found that the work I have done with this client group where we have targeted speech retrieval Neurologic Music Therapy has been incredibly effective. It has been so exciting to share the joy that clients and their loved ones feel when the words come back.
In my experience, there are several specific techniques that are extremely effective. However, I've found it so important to create a low-pressure feel-good atmosphere of enjoyment as a way of promoting maximum interactions whilst the client gets a much-needed boost and also has the pleasure of interacting meaningfully without words as a precursor to verbalisation.
Here is a description of the Melodic Intonation Therapy process which works so well with this client group:-
Assessment: The first step in MIT is to assess the individual's speech and language abilities. The therapist evaluates the person's current speech capabilities, identifying areas of difficulty and strengths.
Selection of Target Phrases: Based on the assessment, the therapist selects specific target phrases or sentences that the individual will work on during the therapy sessions. These phrases typically start with simple, highly repetitive sentences and capture what the client would most like to say, so that they are motivated to be able to say it!
MIT uses rhythm and melody to assist with speech production. The therapist and the client practice the chosen phrases which are set to a catchy melodic fragment. The melodic line incorporates leaps where there are stresses in the sentence. The client is invited to tap in time with the beat with their left hand so as to stimulate the right hemisphere sensorimotor network that helps control mouth movements. The therapist starts with humming the tune and gradually brings in the words.
Gradual Complexity: As the individual becomes more proficient at producing the target phrases in a melodic and rhythmic way, the complexity of the sentences increases. Longer and more complex sentences are introduced as therapy progresses.
Repetition and Generalization: Repetition is a key element of MIT. Clients practise the target phrases repeatedly in therapy sessions to build their ability to produce them accurately. The goal is to facilitate the generalization of these patterns to everyday speech. I also record the fragments for the client to play in between session times or embed them within a personalised SONG.
Gradual Fading: Over time, the melodic and rhythmic elements are gradually faded out as the individual gains more control over their speech. The ultimate aim is for the client to produce the target phrases in a natural, conversational way. Although, in my experience it is just such a joy to have the words return in any fashion that getting to speech sort of tone is not necessarily an immediate priority.
Come and talk to us at This Inner Voice, if you would like to find out more about this wonderful intervention:
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