Melodic Intonation Therapy
Many stroke survivors and people with aphasia are left with little or no speech. However, they are often able to sing, sometimes with the same fluency and clarity they had before the onset of illness. In 1973, researchers developed a therapy based on the fact that speech and singing are stored in different parts of the brain. We use the left side of the brain for speech and movement. Music uses large areas of the brain and ‘as patients learn to put their words to melodies, the crucial connections form on the right side of their brains.’1
Melodic Intonation Therapy (MIT) aims to convert singing into speech; the term ‘intonation’ simply means ‘singing’. It emphasises the melodic patterns that already exist in normal speech. There are usually three levels of treatment built around useful common words and phrases. As the therapy progresses, the phrases become longer. For example, you might begin with “I love you” and progress to “I love my daughter and son.” Traditionally, these phrases would be sung in two pitches, so that your voice would rise and fall on specific words.2However, at the moment, there is a great deal of diversity in the way each therapist runs his or her sessions.
Some use as many as nine different pitches; some accompany the patient on a musical instrument.Many use familiar songs, while others write a new song for each person.3 Most therapists ask you to tap out the rhythm of the syllables with your left hand while you are singing and repeating the phrases. This is believed to bring in the motor and auditory systems.4 Other techniques a therapist might use include the following: you sing with the therapist and then alone, or you hum and use the song to answer a question, such as “What did you just say?”5
The intensity and frequency of MIT can vary. In certain circumstances, it might be offered five days a week for approximately 90 minutes per session. Most therapists decide on the duration and number of sessions that best suits their client. The leading researcher in a recent study, neuroscientist Dr Gottfried Schlaug, believes that MIT is both useful and easy to offer. He hopes to make it possible for family members and carers to provide MIT at home. He writes:
‘The great advantage of this technique is that it is very simple. You don’t have to be trained opera singer, a trained musician to apply it.’6
- Possible benefits of Melodic Intonation Therapy for stroke
- Arguments against using Melodic Intonation Therapy for stroke
- Notes and references
Aviva Cohen is the author and CEO of Neuro Hero