Melodic Intonation Therapy for Stroke Survivors

Singing Syllables for Stroke Survivors

Image courtesy of Brain World

Melodic intonation therapy is an alternative method of processing language in order to overcome a speech impediment, disability or injury. A patient is encouraged to use the right side of their brain to articulate thoughts into language. Normally, the right side of the brain handles the neural process of creating and listening to music. By using melodic intonation therapy, doctors and clinicians are able to create a new neural pathway for those who have/had had a substantial brain injury or disability.

What Happens During A Stroke?

Blood Barriers in the Brain That Are Bursting or Barricaded By a Blockage

A stroke happens when a blood vessel in a person’s brain ruptures and bleeds. The blood rushes out into areas that it is not supposed to be in, which causes damage. Alternatively, a stroke can happen in an inverse way, and can be caused by a blockage in the blood supply. Therefore, a stroke causes damage by blocking oxygen and nutrition from reaching the areas they should be delivered to. According to the Centers for Disease Control and Prevention (CDC), about 795,000 Americans suffer a stroke each year.

When a stroke happens, areas of the brain are deprived of oxygen and nutrients. This typically results in damage to those portions of the brain. Depending on the portion of the brain that is affected, there are a variety of consequences for suffering a stroke. Some of the different consequences of a stroke can include paralysis, a feeling of numbness or weakness in different parts of the body, vision problems, loss of balance, trouble walking, difficulty understanding speech, slurred speech, and difficulty speaking. Melodic intonation therapy is often a treatment plan that can benefit stroke survivors.

Chart with examples
Melodic Intonation Therapy allows stroke survivors to start with simply melodies and sentences and advance to more advanced and difficult sentences and melodies. Image courtesy of Melodic Intonation Therapy

How Can Melodic Intonation Therapy Help Stroke Survivors?

A Repetition of Rhythms and Cadences

Individuals who suffer a stroke, most frequently develop speaking problems. This is typically caused by an abnormality in the function in the left hemisphere of the brain. The left side of the brain is responsible for both processing and articulating speech, as well as understanding written language. In particular ,the Broca’s Area of the left hemisphere controls the process of turning your thoughts and ideas into actual words and sentences. When the Broca’s area is damaged, the sufferer may have difficulty resuming normal speech functions while they recover. This means that the stroke caused damage to the specific areas of the brain that typically control the speech process.

left brain chart
Melodic intonation therapy has been shown to be effective for left hemisphere stroke survivors. Image courtesy of

Those who have suffered from a left side stroke are prime candidates to receive melodic intonation therapy. By teaching a patient to hum or sing words and phrases, the doctors are able to provide the patient with an alternate neural pathway to handle speech functions. By first converting speech into song, and then removing the melody, doctors are able to create a whole new way for the brain to process words. The word intonation in the phrase “melodic intonation therapy” means the rise and fall of a voice in speaking. Doctors are able to use the instrumental nature of the voice to adapt the right hemispher, so that it can create spoken language. 

The melodic patterns inherent in the spoken word allow for a pretty impressive neural work around. The patients learn to sing words first, but then actually learn to drop the melody portion of the “song.” By singing the words without melody, they are instead, speaking them. Because of this, the patient does not need to have any natural singing or musical ability.

Usually, the patient is taught to speak in a simple way. By using simple words with few syllables, the patient and their doctor are able to create melodies that contain all the words they wish to express. By allowing the musical portion of the brain (the right hemisphere) to complete the neural process, doctors are able to circumvent the left hemisphere, which has been damaged. 

There are many different ways that doctors use melodic intonation therapy for stroke survivors. A lot of this is up to the doctors and patients discretion. Oftentimes, a doctor might accompany the patient who is singing or humming by playing along on a musical instrument. Sometimes a doctor will use familiar melodies such as the happy birthday song melody or the ABCs, so that the patient can focus more on the words and less on learning a new melody. Other times, the doctor might have the patient sing or hum the song and then ask them a question such as “What did you just say?” in order to force them to practice recalling the words in the melody. 

With a qualified professional, melodic intonation therapy has provided real benefits for those who have suffered from left hemisphere strokes. By increasing a stroke survivor's ability to use and recall language through melodic intonation therapy, a doctor is able to help them maintain and strengthen all of their professional, communal, and familial bonds during the healing process. Melodic intonation therapy allows stroke survivors to maintain the bonds of friendship and community they have cultivated throughout their lives.

hands playing piano
The music used in melodic intonation therapy gives some patients back their grasps on the spoken word.

Thanks to melodic intonation therapy, music is playing an even bigger role in allowing us to express all of our feelings with those we care about. As somebody who watched his grandmother lose her ability to recall spoken word after a stroke, I could not be more grateful for those who are using something as beautiful as music to return something so important to the world. The ability to express love, and loss, is something that all of us deserve a chance to experience before we go.

Edited by Cara Jernigan on January 21, 2021.

Anthony Stockton
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