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Music therapy for non-fluent aphasia


Music therapy for non-fluent aphasia is a method for treating patients who have lost the ability to speak after a stroke or accident. Non-fluent aphasia, also called expressive aphasia, is a neurological disorder that deprives patients of the ability to express language. It is usually caused by stroke or lesions in Broca’s area, which is a language-dominant area responsible for speech production in the left hemisphere. However, lesions in Broca’s area only affects patients’ speech ability, while their ability to sing remains unaffected. Since several studies have shown that right hemispheric regions are more active during singing,music therapy involving melodic elements is deemed to be a potential treatment for non-fluent aphasia, as singing might activate patients’ right hemisphere to compensate with their lesioned left hemisphere. Aside from singing, many other music therapy techniques have also been attempted and the effectiveness of some techniques is shown. Although there are many possible explanations for the mechanism of music therapy, the underlying mechanism remains unclear, as some studies indicate contradictory results.

A common method of therapeutic singing is guiding patients to sing familiar songs. Patients are led to sing along the song with therapists, who might adjust the tempo, volume, and pitch according to each individual patient to optimise the therapy process. The lyrics that patients can most easily produce are repeated several times. The employment of singing in the treatment of aphasia is not a novel therapy technique, as in the past therapists already noticed that patients who had difficulty speaking were still able to sing.

Vocal Intonation is introduced to make aphasic patients intentionally exaggerate the intonation of daily phrases. The most well-known application of vocal intonation in music therapy is Melodic Intonation Therapy (MIT). When receiving MIT, patients intone phrases with 2-3 syllables on only two pitches, which are determined by the natural prosody of phrases. Stressed syllables are intoned on a higher pitch, while unstressed syllables are intoned on a lower pitch. However, various intonation in daily conversational phrases may be used, so patients can practice communicating different meanings through different intonation. In addition, body cues, such as head or hand movement, may be used to help patients perceive different pitch in vocal intonation.


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