What is Music Therapy?

Article by Moody Neuro

By Amanda Gilbert MT-BC, CBIS Staff Music Therapist at the Moody Neurorehabilitation Institute

Many people know of someone in their lives who has received music therapy services, and many have encountered videos or some like representation documenting music therapy methods and techniques. Music therapists can be found working with infants, children, adolescents, adults and elderly persons and may be called upon to assist those facing neurological conditions, specific psychiatric needs, developmental or learning disabilities, aging-related conditions, acute or chronic pain, the consequences of struggles with substance abuse, or the effects of more typical physical disabilities. Despite its rapid growth and wide application in the healthcare field, one of the most common questions any music therapist still receives is “What is music therapy?” The American Music Therapy Association tells us:

 

“Music therapy is the clinical and evidence-based use of music interventions to accomplish goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. Music therapy interventions can be designed to promote wellness, manage stress, alleviate pain, express feelings, enhance memory, improve communication and promote physical rehabilitation (American Music Therapy Association, 2013).”

 

So, what then does THAT mean? Let’s break this definition down:

 

“Music therapy is the clinical and evidence-based use of music…”

 

During the last 30 years, brain imaging has improved to the extent that it is now capable of showing us exactly what is happening when we are involved in listening to, creating, playing, or even reading music. These studies have found that the reactions generated in areas of the brain activated when we are engaged in these activities are not unique to musical stimuli, and that these areas therefore are not devoted exclusively to processing music-related information. They are used for other functions, too. When we complete musical tasks, we are helping our brain practice skills that are inevitably carried over into more classically functional areas (like moving, talking, and thinking). Research has shown that music participation drives plasticity in the human brain, which makes its auditory, learning, and motor areas interact more efficiently. Music therapists are charged with keeping up to date with current evidence supporting the clinical use of music and of incorporating the sources of that evidence into their practices.

 

“…use of musical interventions…”

 

During a typical music therapy session, you may see patients singing, drumming, listening to music, learning new instruments, or writing songs. There is no need for a person to have had a history of being involved in music in order for that person to benefit from MT. The music therapist will take all of a patient’s relevant strengths, barriers, and goals into consideration when designing these interventions.

 

“…to accomplish goals…”

 

While music therapy definitely can be fun, there is always an underlying goal to any activity. Music therapists create music interventions so as to address goals that can translate into beneficial changes seen in everyday life. They communicate with  patients and their loved ones as well as with therapists from other disciplines currently treating those patients in order to determine which skills are most important to address, and to assign priority to the addressing of each one. Obtainable and measurable goals are then created with objectives acting as stepping stones to each subsequent accomplishment.

 

“…within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.”

 

Board certified music therapists, holding the credential MT-BC, are qualified to practice anywhere in the United States. They have completed an approved college curricula (including an internship) and have passed the national examination offered by the Certification Board for Music Therapists. Therapists can complete additional training in order to earn specializations in other areas including but not limited to Neurologic Music Therapy (NMT), Neonatal Intensive Care (NICU), Bonny Method of Guided Imagery (GIM), and Nordoff-Robbins Music Therapy (NRMT). At the Moody Neurorehabilitation Institute, music therapy treatment is provided from an NMT-based perspective, focusing on the relationship between music and the brain.

 

“Music therapy interventions can be designed to promote wellness, manage stress, alleviate pain, express feelings, enhance memory, improve communication and promote physical rehabilitation.”

 

Music therapists address goals designed to promote a healthy lifestyle, to decrease pain, to provide a much-needed emotional outlet, to assist in memory, to improve verbal and nonverbal communication, and to augment rehabilitation of physical ailments in specific muscle groups. Neurologic Music Therapists address motor, cognitive, and sensory goals engaged in efforts to combat neurological disease. These therapists are trained specifically in the science of music perception and production and in the effects of same on the non-musical brain. Because music engages multiple areas on both sides of our brains, NMTs can assist those who have difficulty with speech, walking, and in the moving of their hands or arms.  This fact also leaves NMTs in an exceptional position to aid individuals in need when working to improve their attention, speed of processing, memory, and other like thinking skills.

Music therapy is a unique, evidence-based medium through which hundreds of thousands of people accomplish incredible goals each year. While the field is in its relative infancy, the future of MT looks bright as more individuals and facilities begin to learn the benefits it can provide.

For more information about music therapy or to find a music therapist, please look to the following websites:

 

American Music Therapy Association

www.musictherapy.org

 

The Certification Board for Music Therapists

www.cbmt.org

 

The Center for Biomedical Research in Music

cbrm.colostate.edu

Learn about how Moody Neuro can help with neuropsychology and counseling, speech and language disorders, physical therapy, outpatient rehabilitation assistance, community integration programs, and occupational therapy.

 

Strokes are medical conditions that affect millions globally. In the United States, more than 795,000 people have a stroke each year, with about 610,000 cases being first or new strokes. 

These can lead to a wide range of physical and cognitive impairments. Speech and language disorders are among the most common and most challenging consequences of strokes, occurring in about a third of stroke survivors. 

Understanding Stroke-Induced Speech & Language Disorders

Stroke-induced speech and language disorders significantly impact communication abilities. Among these, aphasia, dysarthria, and apraxia of speech are prevalent. Understanding how they are diagnosed and their specific symptoms can aid in prompt and effective management.

Aphasia

Aphasia is a common outcome of stroke, manifesting as difficulty in speaking, understanding, reading, and writing. There are many different types of aphasia, depending on the affected brain area, and are categorized based on the symptoms present:

  • Expressive Aphasia (Broca’s Aphasia): Characterized by broken speech, limited vocabulary, and difficulty forming complete sentences. Patients often understand what is being said to them but struggle to verbalize responses.
  • Receptive Aphasia (Wernicke’s Aphasia): Patients can produce fluent speech but may lack meaning or include nonsensical words. They often have significant difficulty understanding spoken language.
  • Global Aphasia: A severe form of aphasia where individuals have extensive difficulties with both speech production and comprehension.
  • Anomic Aphasia: Individuals have difficulty finding words, particularly nouns and verbs, making their speech sound vague.

Dysarthria

Dysarthria is a speech disorder that affects 20-30% of stroke survivors. It occurs when stroke impacts the muscles responsible for speech, leading to slurred or slow speech that can be hard to understand. It is typically diagnosed through a physical examination and a series of speech evaluations conducted by a speech-language pathologist (SLP). 

It is characterized by the following symptoms:

  • Slurred or slow speech that can be difficult to understand
  • Monotone or robotic-sounding speech
  • Difficulty controlling the volume of speech, which may be too loud or too soft
  • Challenges with the rhythm and flow of speech, including rapid speech that’s hard to interrupt or slow, drawn-out speech
  • Respiratory issues affecting the ability to speak loudly or for extended periods

Apraxia of Speech (AOS)

Apraxia of speech is a neurological disorder characterized by difficulty sequencing the movements needed for speech. This is caused by the impact of the stroke on the brain’s pathways involved in producing speech. 

Patients with AOS know what they want to say but struggle to coordinate the muscle movements to articulate words correctly. This results in distorted speech, difficulty initiating speech, or the inability to accurately produce speech sounds or sequences of sounds. 

How Long Is the Stroke Speech & Language Recovery Time?

According to one study on post-stroke speech and language therapy, approximately one-third of stroke patients experience speech problems after a stroke. Many of these individuals begin to recover within a few months, with significant progress typically observed within three to six months.

In another study, 62% of subjects had speech challenges after suffering from a stroke. By six months post-stroke, 74% were able to completely recover their communication abilities. 

However, the figures above provide a general timeline for post-stroke speech and language recovery. Stroke speech recovery time is highly individualized and can vary depending on several factors. These can include the following:

  • Severity of the Stroke: More severe strokes often lead to extensive brain damage, resulting in longer and more challenging recovery periods for speech.
  • Location of the Brain Injury: The brain’s specific regions control different speech and language functions; damage to these areas directly impacts recovery complexity and duration.
  • Age and Overall Health of the Patient: Generally, younger patients with better overall health before the stroke tend to experience faster and more complete recoveries.
  • Pre-existing Conditions and Comorbidities: Conditions such as diabetes or hypertension can slow down recovery by complicating the overall health scenario and rehabilitation process.
  • Individual Variability and Resilience: Personal resilience, the support system’s strength, and the individual’s motivation significantly influence the pace and success of speech recovery efforts.

The first three months after a stroke is a crucial period for recovery, as a majority of stroke patients see the most significant improvement during this period. However, it’s also important to note that, although at a slower pace, recovery can continue well past the 6-month mark with continued therapy and practice. 

This underpins the importance of early intervention and ongoing rehabilitation efforts, including speech therapy, to maximize each patient’s recovery potential. 

What Does the Stroke Speech & Language Recovery Process Look Like?

The journey to regain speech and language after a stroke is multifaceted and varies significantly from one individual to another. Understanding the structured phases of recovery can provide insight into what patients and their families can expect during this challenging time. 

Here’s a closer examination of each phase in the stroke speech recovery process.

Initial Assessment and Diagnosis

Before recovery can begin, a thorough evaluation is conducted by a team of healthcare professionals led by an SLP. This assessment aims to identify the type and severity of the speech and language disorder, be it aphasia, dysarthria, or AOS. The evaluation may include cognitive-linguistic assessments, comprehension tests, speech production analysis, and functional communication measures. 

Based on this assessment, a personalized therapy plan is crafted to address the patient’s specific needs.

Acute Phase

The acute phase typically occurs within the first days to weeks following a stroke. During this period, medical stabilization is the primary focus, with healthcare teams working to manage the immediate effects of the stroke. 

Speech therapy may begin with simple exercises or assessments to gauge the patient’s abilities. However, intensive therapy usually does not start until the patient is medically stable. During the acute phase, the goal is to support overall recovery and prevent complications immediately after the stroke.

Subacute Phase

The subacute phase generally spans from two weeks to three months post-stroke and is characterized by more intensive speech therapy interventions. As the patient’s medical condition stabilizes, the focus shifts to active rehabilitation. Therapy during this phase is tailored to the individual’s specific speech and language deficits and may include:

  • Exercises to improve articulation, fluency, and voice control for those with dysarthria.
  • Language therapy to enhance understanding, speaking, reading, and writing skills in patients with aphasia.
  • Motor speech exercises and strategies to improve speech planning and production in apraxia of speech.

The subacute phase is crucial for taking advantage of the brain’s natural recovery processes and neuroplasticity, where the brain begins reorganizing and adapting to the loss of function.

Chronic Phase

The chronic phase of recovery extends from several months to years after the stroke. It focuses on long-term rehabilitation and adjustment to any residual speech deficits. During this time, patients may continue to see gradual improvements in their speech and language abilities, although the rate of recovery may slow. Therapy in the chronic phase often includes:

  • Advanced communication strategies to cope with ongoing challenges in daily life.
  • Maintenance exercises to preserve and enhance speech gains achieved in earlier phases.
  • Supportive technologies and aids, such as communication devices, to assist in effective communication.
  • Community reintegration activities to help patients return to as normal a life as possible, engaging in social, vocational, or recreational activities.

What Is the Role of Neuroplasticity in Speech & Language Recovery?

Neuroplasticity refers to the brain’s fundamental property to change and adapt its responses to new experiences, learning, and environmental changes. This adaptive capacity enables the brain to reorganize itself by forming new neural connections.

When the brain, or a part of the brain, is damaged after a stroke, neuroplasticity is what allows the other parts of the brain to take over the functions of the damaged area. Through targeted rehabilitation and therapy, such as speech therapy for stroke survivors, patients can retrain other brain areas to perform the lost functions and facilitate recovery.

Enhancing Stroke Speech & Language Recovery Time

Adopting a comprehensive approach involving several key strategies is vital to enhance the stroke speech and language recovery time. This multifaceted approach can maximize the chances of regaining speech and communication abilities.

This comprehensive approach must incorporate the following strategies:

  • Early intervention to leverage the brain’s highest potential for neuroplasticity in the initial period following a stroke, significantly improving the chances for recovery.
  • Alternative communication strategies, such as gestures, writing, and visual aids, to help maintain communication during the recovery process. 
  • Adopting technology, including speech-generating devices and software applications designed for speech rehabilitation, for personalized exercises and continuous practice, which is vital for progress.
  • Providing continuous support from psychologists, support groups, and therapy to help manage feelings of frustration, depression, and anxiety, fostering a positive mindset essential for rehabilitation.
  • A healthy diet and lifestyle to supply essential nutrients that support brain function, along with regular physical activity, adequate sleep, and management of medical conditions.

Begin Your Post-Stroke Recovery Journey With Moody Neurorehabilitation

Moody Neurorehabilitation understands the complexities and challenges that come with post-stroke rehabilitation. We are dedicated to supporting patients and their families through this critical time with specialized care and personalized treatment plans.

Since our inception in 1982, Moody Neurorehabilitation has been a leader in brain injury rehabilitation. Our approach centers on providing comprehensive care tailored to each patient’s needs and goals. We believe in treating the whole person, not just the symptoms, to improve overall quality of life.

We invite you to start your recovery journey with us. Contact Moody Neurorehabilitation today to schedule a consultation with our experts. Let us help you navigate the path to recovery with care, compassion, and expertise.

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