Unlocking Language with Melodic Intonation Therapy: A Pathway to Speech Recovery in Stroke Survivors

 Will your incompetent? hospital fail to get this protocol installed, like usual?

Let's see how long incompetence reigned!

Melodic intonation therapy (2 posts to August 2014)

Unlocking Language with Melodic Intonation Therapy: A Pathway to Speech Recovery in Stroke Survivors

The following guide explains how Melodic Intonation Therapy works, who it helps most after stroke or Traumatic Brain Injury (TBI), and how speech therapists use it alongside other treatments to support speech recovery.

What is Melodic Intonation Therapy?

Melodic Intonation Therapy (MIT) is a treatment created in the 1970s(See how long everyone in stroke has been incompetent!) by speech therapists to help people who have trouble speaking after a stroke or TBI. The therapy is based on the idea that the brain handles speech and singing in different areas. Speech is usually controlled by the left side of the brain, while singing is managed by the right side.¹ If a person experienced damage on the left side of their brain, therapists can encourage stroke survivors to sing words rather than speak them.

How Does Melodic Intonation Therapy Work?

After a stroke, changes in the brain can make it harder for a person to express their thoughts and ideas. MIT helps by using the musical parts of speech, such as pitch, rhythm, and stress (emphasis on words or syllables).² Speech therapists encourage the person to “sing” or intone their words in a steady, melodic way. This approach activates the right side of the brain, which can help make up for damaged speech areas on the left side. Over time, this can help people speak more clearly and more naturally.

MIT uses many techniques, such as rhythmic tapping and speaking in a sing-song voice, to help retrain the brain and improve communication. The therapy is based on the idea that speech is more than just words; it also includes melody.

Techniques Used in Melodic Intonation Therapy

Speech-language pathologists (SLPs) trained in MIT use this approach to help people with speech difficulties caused by conditions such as stroke, TBI, or autism. Below is an overview of the most common techniques used in Melodic Intonation Therapy:³

• Humming: The therapist first introduces a phrase, such as “eating a pancake with syrup,” often using a picture as a visual aid. The therapist then sings the phrase to model how it should sound. The patient is encouraged to hum along, matching each syllable. Once the patient can hum the phrase correctly, they begin saying the words out loud, slowly transitioning from humming to clear speech.
• Immediate repetition: The therapist says a phrase or sentence, and the patient repeats it right away. This helps the patient practice copying speech patterns and sounds, which is an important step in rebuilding speech skills.
• Unison Intoning: The therapist and patient say a phrase or sentence together. Sharing the same rhythm and melody helps the patient follow along and learn the speech pattern more easily.
• Unison Intoning with Fading: The therapist and patient start by saying a phrase or sentence together. Over time, the therapist reduces their involvement until the patient is saying the entire phrase on their own.
• Responding to Questions: After the patient repeats a phrase, the therapist turns it into a question. The patient then responds by answering the question.

Melodic Intonation Therapy follows a hierarchical approach, meaning it begins with simple tasks and gradually becomes more challenging as the patient improves. For example, therapy may start with one-syllable words and then move to two-syllable words, followed by longer and more complex sentences.⁴

The Benefits of Melodic Intonation Therapy for Stroke Survivors

A stroke damages areas of the brain that are responsible for planning, controlling, and coordinating movement. Although the nerves and muscles themselves are usually intact, injury to the brain disrupts how movement signals are generated and sent. This can make it difficult to move parts of the body, including the arm, leg, or the muscles used for speech and swallowing.

For example, some stroke survivors experience weakness or paralysis on one side of the face or tongue, which can make swallowing or speaking clearly difficult.

Additionally, many survivors experience speech problems such as aphasia, a condition that affects a person’s ability to understand or produce speech. While aphasia can impact both understanding and speaking, difficulty with speaking is more common in stroke survivors. About one-third of stroke survivors are affected by aphasia.⁵

In aphasia, the brain has trouble sending the correct “messages” to the mouth and throat. As a result, words may come out incorrectly, or the person may struggle to speak clearly, even when they know exactly what they want to say.

In addition to improving speech, MIT can also help improve understanding of spoken language. It stimulates neuroplasticity, which is the brain’s ability to form new nerve pathways to replace those damaged by a stroke. MIT supports neuroplasticity by using music and rhythm to retrain the brain and can be effective in helping stroke survivors to improve their ability to speak.