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Singing Gives Speech Back to Mute Stroke Patients

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For hundreds of years, scientists, physicians and others have observed that many people who cannot speak well or even speak at all—folks who have had a stroke, for instance—can still sing perfectly well. So this concept is being applied to a specific type of stroke rehabilitation therapy that can help you or a loved one make a comeback if stroke robs you of the ability to speak. The technique may also help people who have other serious neurologic problems that take away their voices. Here’s how this marvelous speech-restoring technique, called melodic intonation therapy, works its magic…

AT A LOSS FOR WORDS

Mute is what we call the inability to speak. The technical terms are apraxia of speech (AOS), in which people know what they want to say (and what it means) but can’t say it because a brain glitch makes their speech muscles uncooperative…and aphasia, in which people have trouble (to greater or lesser degree) understanding language or even the concept of speech because of damage to the main language centers in the left half of their brains. Aphasia and AOS often happen at the same time because of a stroke.

It’s often difficult for doctors to know whether a mute stroke patient is suffering from aphasia or only AOS, but, either way, a technique called melodic intonation therapy, or MIT, can help the patient get his or her voice back by “remodeling” the brain. In fact, a team of researchers has found evidence that, although MIT has long been used to help patients with aphasia speak, its greater success might be its impact on AOS. This idea comes from the researchers’ review of the scientific literature, which showed that MIT works better in patients who have a sense of grammar—such as adult patients with known AOS due to stroke—than in patients whose stroke has strongly affected their ability to understand language.

The best news, however, is that this means MIT can help people other than stroke patients—including, for example, people with Parkinson’s, palsy or other serious neurologic diseases that affect their muscles rather than their cognitive ability to recognize language. If you have faced a speech challenge with little success from other therapies, MIT could be a game changer for you.

FROM SONG TO SPEECH

MIT is a technique that uses a patient’s ability to sing—which is often preserved even when the ability to speak is gone—to get him or her to be able to speak again. In this way, it is similar to music therapy used for people who stutter (and also for children who are mute because of AOS), but MIT aims to get the right part of the brain to take on new tasks and grow in new ways to compensate for the left part damaged by a stroke.

How it’s done: First, patients listen to and hum along with a therapist. This leads to singing common phrases in unison with the therapist, such as “Good morning,” “How are you?” or “Please pass the salt.” The phrases are sung in an exaggerated manner—as if performing on a Broadway stage. As the patient sings the phrases, he or she uses the left hand (which, unlike the right hand, is generally unaffected when a stroke strikes the left side of the brain) to tap out the rhythm. This helps stimulate new language pathways in the right brain to make up for the damaged parts in the left.

The stroke patient goes on to practice singing phrases unaccompanied by the therapist and practices longer, more complex phrases. Eventually, the singing is phased out, leaving the patient with a new way to speak. In other words, the patient can stop singing the notes…and keep saying the words.

WHO BENEFITS MOST

Depending on the type and extent of stroke injury a person has, he or she may be able to return to near normal speech or simply be helped to communicate basic needs. Generally, though, MIT works best in a stroke patient—or anyone—who can…

  • Understand words spoken by others but has great difficulty or an inability to repeat words spoken by others.
  • Clearly sing along to well-known songs but make only nonsense words or mere syllables when he or she tries to speak.
  • Pay attention and have the motivation to want to speak again.
  • So if someone close to you has a stroke that leaves him or her without speech or unable to sensibly say words or sentences—or if that person is you—don’t assume the silence can’t be broken. Ask the neurologist or other health practitioner who is arranging rehabilitation about including MIT in that care. And because MIT may be particularly effective in people who lose the ability to speak because of palsy and other neurodegenerative disorders, such patients or their loved ones ought to inquire about trying MIT instead of traditional music therapy. It could be a breakthrough that transforms the quality of life.

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    Source: Study titled “Melodic intonation therapy: back to basics for future research,” published in Frontiers in Neurology. Date: September 18, 2014 Publication: Bottom Line Health
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