Therapeutic singing protocols for addressing acquired and degenerative speech disorders in adults

Abstract

The ability to communicate and make oneself understood is integral to a person’s quality of life. It affects social interaction, educational and vocational opportunities, and ultimately independence and sense of self. Unfortunately, speech production is often impaired as a result of neurological damage (e.g., traumatic brain injury, stroke) or disorders (e.g., Parkinson’s disease). There are many similarities and shared neural mechanisms between speech and singing. For example, both singing and speech utilize rhythm, pitch variation, tempo, dynamics, articulation, and respiratory support. Music therapists manipulate these elements of music when addressing therapeutic goals for people with neurogenic speech disorders. Many clinical protocols to address speech disorders in adults have now been published to guide clinical practice in music therapy. This paper summarizes existing music therapy and singing-based protocols used to address commonly occurring acquired or degenerative speech disorders, namely dysarthria, dysphonia, dysprosody, and apraxia of speech. We examine individual and group therapy protocols used in medical and community settings for people with neurogenic speech disorders caused by traumatic brain injury, stroke, spinal cord injury, and Parkinson’s disease. We highlight the strengths and limitations of these protocols and make recommendations for clinical practice.