The Long Journey to Language and Speech Recovery for a Man with Global Aphasia and Apraxia: A Music Therapy Case Study

Andrea Robinson
MMusTher, BMus, LTCL, NZ RMTh, NMT Private practice

Keywords: Rehabilitation, music therapy, stroke, global aphasia, language and gesture.

Abstract

This case study describes a music therapy programme with a 47-year-old man who experienced a serious left hemisphere stroke, leaving him nonverbal as a result of global aphasia and apraxia. Global aphasia is a serious language disorder where patients are unable to initiate or copy sounds or words, diagnosed by a speech-language therapist after a year of little or no change to a person’s verbal output. In this case study a variety of music therapy methods were used to address the client’s aphasia and apraxia. These included established music therapy methods, such as familiar song-singing and rhythm games; exercises suggested in the SIPARI® music therapy programme for people with aphasia, utilising singing, intonation, prosody, breathing, rhythm and improvisation; Modified Melodic Intonation Therapy (MMIT), targeting functional phrases; and additional methods developed by the music therapist. Several Neurological
Music Therapy (NMT) principles – repetition, feedback and cueing – also played an important role in the therapeutic process, although specific NMT methods were not used. After 22 months of music therapy, the client was able to communicate using single words and short phrases. This paper describes the methods and resources used, and illustrates the role music therapy can play in aphasia rehabilitation in the community.

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