Melodic Intonation Therapy for Aphasia Recovery

Aphasia is a language disorder that often results from brain injuries such as strokes, head trauma, brain tumors, or infections. It occurs when key brain areas responsible for speech processing and production—such as Wernicke’s and Broca’s areas—are damaged. This condition affects an individual's ability to produce and comprehend speech, as well as their reading and writing skills, leading to varying degrees of communication difficulty. The severity of aphasia can range from mild challenges to cases where verbal communication becomes nearly impossible.

Growing evidence suggests that music therapy can support individuals with neurological disorders in improving their communication skills. Singing, in particular, has been found to be beneficial for individuals with aphasia due to several factors: (1) it is an innate human ability, (2) it shares overlapping neural networks with speech, (3) it engages broader neural circuits that may remain functional after a stroke (Pillay & Dunay, 2017). These insights contributed to the development of Melodic Intonation Therapy, a structured, music-based rehabilitation approach used to treat language disorders.

Melodic Intonation Therapy (MIT) utilizes musical elements to aid speech recovery by helping individuals form and organize words into sentences. It facilitates speech production by reinforcing the connection between sounds, word structures, grammar, and vocabulary.

With the support of a music therapist, patients undergoing MIT first practice maintaining the rhythm of spoken phrases initially sung by the therapist. They then attempt to replicate these phrases while preserving prosody, intonation, and rhythm. As therapy progresses, the therapist gradually reduces their support, and the patient transitions away from using musical cues. The ultimate goal of MIT is to help individuals regain natural, independent speech.

In a study led by Popescu et al. (2022), Melodic Intonation Therapy (MIT) was found to be effective in improving language expression in individuals with post-stroke aphasia, particularly in tasks like repetition of words and phrases. The therapy was shown to have a small to moderate effect on non-communicative language expression, meaning it helped patients in tasks where they had to produce speech without necessarily engaging in everyday conversation. MIT was most effective when it focused on speech repetition, and the study noted that spontaneous recovery (the natural improvement that occurs with time after a stroke) could influence the results.

-Asila Folds, Music Therapy Intern

References:

Pillay, S. B., & Dunay, M. (2017). Aphasia and the neural basis of language impairment. International Journal of Neuroscience, 127(11), 993–1002

Haro-Martínez, A., et al. (2021). Melodic intonation therapy for post-stroke non-fluent aphasia: A systematic review and meta-analysis. Frontiers in Neurology, 12, 700115

Popescu, T., et al. (2022). Melodic intonation therapy for aphasia: A multi-level meta-analysis of randomized controlled trials and individual participant data. Annals of the New York Academy of Sciences, 1484(1), 130-148.

Intro to Me!

Hello! My name is Asila Folds, and I am thrilled to join Therabeat, Inc. as one of the new music therapy interns. I am originally from New York City, and I hold a Bachelor of Music in Vocal Performance from Ithaca College. Currently, I am pursuing a Master’s Equivalency in Music Therapy, with a certification in Disability Studies at the University of Georgia. My interest in music therapy began after researching its impact on dementia to support my grandmother. This experience opened my eyes to the profound ways music can improve the quality of life. I am eager to continue learning how music therapy supports individuals across various therapeutic disciplines.

My first week at Therabeat, Inc. has been nothing short of amazing. I’ve had the privilege of observing the talented music therapists here and meeting some truly incredible clients. It has been inspiring to watch the therapists use music to foster growth, connection, and healing. I’ve also enjoyed observing other disciplines, such as physical, occupational, and speech therapies, and witnessing how collaboration across therapies can amplify progress. The dedication of the staff and the resilience of the clients have been deeply motivating, and I feel so honored to be part of this community.

I am beyond excited to continue this journey, contribute to sessions, and grow as a music therapist alongside the exceptional team at Therabeat Inc. I am looking forward to the next six months of learning, making music, and helping clients reach their goals!

-Asila Folds, Music Therapy Intern

Hello!

Hello! My name is Rebecca Smith, and I am one of the new interns at Therabeat, Inc.! I’m originally from Woodstock, Ga, and am working towards a music therapy equivalency certification and masters degree from the University of Georgia. I received a bachelors degree in music from Kennesaw State University, where my primary instrument was voice. I have always loved music, but was unsure how to turn my passion into something more. When I discovered music therapy I instantly knew I wanted to learn everything I could about music therapy.

My first week of internship has flown by and has been better than I could have imagined. I have loved getting to observe so many new therapists and meet so many many new people in such a short amount of time. I have especially loved having the opportunity to observe other therapy disciplines such as physical, speech, and occupational therapy. Seeing how everyone supports each other at In Harmony Pediatric Therapy has been a highlight.

I’m so excited to be apart of team Therabeat, Inc. for the duration of my music therapy internship. I can not wait to see how I grow as I begin to take the next steps in becoming a music therapist.

-Rebecca Smith, Music Therapy Intern

Farewell!

The past six months as a Therabeat intern have shaped me and pushed me to become the greatest therapist I can be. It has been quite an adventure learning how to navigate session planning and assignments, living on my own, and working with clients in a full-time position. Although the days felt slow, the months flew by, and I am in shock that it is already December! I started this internship with hot weather and sunshine, but now it gets dark before dinner and I have to turn my heat on in the house. There have been many highs and a few lows navigating imposter syndrome, balancing the full-time workload, and learning and observing new music therapy methods. The consistent result of these highs and lows was personal growth, which is exactly what to look for in an internship. The transition from student to professional came with many twists and turns, but thankfully I feel prepared to enter the professional sphere!

I have learned how to work with other disciplines while here at Therabeat, Inc. I have gotten the incredibly special opportunity to work with speech and physical therapists and it is amazing to see how much can coincide with the other therapeutic forms. I have learned so many new interventions and ways to approach music therapy by receiving help and inspiration from observing different therapists. I now have prior experience working side by side with PT, and Speech and it has increased my knowledge of those fields as well as music therapy. I also finally got to try using a laminator for the first time. They sure are handy, I now have a library of visuals I can use in future sessions! I am excited to apply that knowledge in my future endeavors. I have also learned how to communicate with the parents of my clients. I now feel comfortable communicating with a parent/guardian about the skills addressed in sessions and how they were addressed through music. I believe good communication with the parents is important for them to see and understand their child’s growth.

I am so thankful to everybody at Therabeat Inc. for taking me in and helping me grow. I could not have gotten here without their support!

-Janelle Lockney, Music Therapy Intern

Music Therapy in the Neonatal Intensive Care Unit

Music therapy is a profession that uses clinical and evidence-based music interventions to address specific therapeutic goals to improve the health and well-being of a patient within a therapeutic relationship. Neonatal Intensive Care-Music therapy is defined by Standley and Gutierrez (2020) as “an evidence-based, specialized training in music therapy, neurodevelopmental, and family care intervention for premature infants.” NICU-MTs are equipped with counseling skills, experience working in a NICU interdisciplinary team, and providing assistance to parents who may become overwhelmed by the stress of the NICU. For premature infants, the NICU is a stressful environment that includes loud noises, bright lights, separation from their parents, and invasive treatments that are necessary to save the infant’s life. Music therapy is employed to assist in improving the health of infants, resulting in shorter hospital stays, increased resting energy preservation, and increased growth (Allen, 2013).

The purpose of studying music therapy on infants in the NICU is to find interventions that improve infant health, decrease infant and family anxiety, and get the infants home faster. The NICU is a stressful environment for preterm infants with bright lights, loud noises, and increased physical touch from nonmaternal figures on a regular basis. Preterm infants are “touched, positioned, examined, and manipulated more than 8 to 12 times over a 4-hour period to assess and evaluate their clinical status. Each of these stimuli can be viewed as a stressor by the immature system of a premature infant, which can lead to impaired oxygenation, blood flow, heart rate, and behavioral responses” (Allen, 2013). When introduced at an appropriate decibel level, music can counteract the negative effects of physical discomfort.

In this photo, the music therapist is using a music therapy technique called multimodal sensory stimulation.

Caine (1991) did a study that showed “that listening to continuous music for up to four hours a day… has a number of physiological benefits such as: reduced infant stress, increased weight gain, stabilized heart and respiratory rates, increased oxygen saturation, and reductions in apnea and bradycardia.” Kraft (2021) also found that music interventions improve premature infants’ vital signs, movement patterns, and positive neurodevelopment. Maternal singing is especially beneficial because it reduces the mother’s stress, increases her attachment to her infant, and trains her to combat overstimulation with her child. Maternal singing “is particularly responsible for sustaining infant’s attention, modulating arousal and enabling mother-infant protocol versatile self in at term infants” (Trehub, 2017). Live singing is important to continue in the home because it promotes “social development as evidenced by the infant giving positive responses to eye contact, watching or focusing attention on the caregiver, orienting the head and eyes to visual and auditory stimuli, mimicking care-giver facial expressions, and beginning to self-regulate” (as cited in Standley, 2019).

-Janelle Lockney, Music Therapy Intern

References:

Kraft, K. (2021). Maternal anxiety, infant stress, and the role of live performed music therapy during nicu stay in the netherlands. International Journal of Environmental Research and Public Health, Vol. 18(No. 13), p.7077.

Caine, J. (1991). The effects of music on the selected stress behaviors, weight, caloric and formula intake, and length of hospital stay of premature and low birth weight neonates in a newborn intensive care unit. The Journal of Music Therapy

Trehub, S. (2017). The Maternal Voice as a Special Signal for Infants. 10.1007/978-3-319-65077-7_3. 

Standley, J. (2020). Benefits of a comprehensive evidenced-based NICU-MT program: Family-centered, neurodevelopmental music therapy for premature infants. Pediatric Nursing, Vol. 46(No. 1), p.40-46.

Allen, K. (2013). Music therapy in the nicu: Is there evidence to support integration for procedural support? Advances in Neonatal Care, Vol. 13(No. 5), p.349-352.