Rhythm and Melody in Speech Therapy for the Neurologically Impaired

Some 19 years ago, at the Veterans Administration Hospital in Cincinnati, Ohio, the music therapist, ward physi cian, and staff observed that stroke pa tients who were unable to speak could often sing or hum familiar songs. This sparked the development of a music therapy technique designed specifically to facilitate the return of speech in neurologically impaired patients. Music has been used previously in speech therapy. Palmer (1952) des cribed a child who suffered from severe encephalitis, but was able to sing a song learned prior to the illness. The child was intelligent when singing and ap peared to comprehend the words. He continued to improve and redevelop language ability. Palmer observed that “...music served as an intervening wedge, or as a carrier of communica tion.” He also observed. “. .an increase in propositional quantity” when melodic patterns were used with adult aphasic’ patients. More recently, Gerstman (1964) re ported similar findings in a 47-year-old woman with a cerebral vascular accident in whom again singing appeared to cata lyze the return of speech. Unlike other techniques involving mu sic and speech therapy (Albert, 1973), the technique presented here has been developed by a music therapist and is based upon both musical and thera peutic principles. The therapeutic pro gram from its progressive levels of ac complishment and interaction with others to possible neurophysiological foundations for its success is dis cussed below.