The effectiveness of Speech–Music Therapy for Aphasia (SMTA) in five speakers with Apraxia of Speech and aphasia

Abstract

Background: Several studies using musical elements in the treatment of neurological language and speech disorders have reported improvement of speech production. One such programme, Speech–Music Therapy for Aphasia (SMTA), integrates speech therapy and music therapy (MT) to treat the individual with Apraxia of Speech (AoS) and aphasia. We have observed encouraging results in clinical practice, but there is still no empirical evidence of the effect of SMTA.

Aims: The current study investigated the effectiveness of SMTA on verbal communication in daily life.

Methods & Procedures: Five participants with AoS accompanied by aphasia were included in an efficacy study using a case series design with multiple measurements. All participants received 24 SMTA sessions including two 30-min sessions per week. Pretreatment and posttreatment (immediately and 3 months after treatment stopped), verbal communication (intelligibility and comprehensibility) were tested with the Amsterdam-Nijmegen Everyday Language Test. The Aachen Aphasia Test (AAT) and the Diagnostic Instrument for Apraxia of Speech (DIAS) were also administered. The participants were tested four times before the start of the treatment (baseline) with a related test for progress on articulation (Modified Diadochokinesis Test (MDT)) and once with an unrelated control test (Psycholinguistic Assessment in Language Processing of Aphasia 12; repetition of number series). During the treatment, both tests were administered weekly.

Outcomes & Results: Intelligibility of verbal communication for all participating individuals, as well as comprehensibility in four out of five participants, improved after 24 SMTA treatment sessions. All measures of MDT and repetition of AAT showed significant improvement for all participants. Four participants also improved on the test for articulation of phonemes and the diadochokinesis test of the DIAS. Furthermore, two participants improved on the articulation of words (DIAS). The improvement remained stable after treatment ended (follow-up). For three out of the five participants, no improvement was found on the control tests. Two participants also showed improvement on almost all outcome measures, but also improved on the control tests. SMTA not only affected articulation but also positively influenced the severity of the aphasia in four out of five participants.

Conclusions: SMTA seems an effective treatment programme for at least three of the five individuals that were treated in the current study. This treatment led not only to better articulation, but more importantly, also to improvement in communication in daily life.

Keywords:

• Apraxia of Speech
• treatment
• speech–music therapy

Acknowledgements

We are grateful to the individuals with AoS and aphasia who participated in this study. We also want to thank the speech therapists and music therapists of “Revalidatie Friesland” for treating and testing the patients, and the MA students of the University of Groningen for testing the patients and scoring the outcome measures. We would like to thank two anonymous reviewers for their valuable comments on earlier versions of this paper. Finally, we acknowledge Diane Black and Roelien Bastiaanse for proofreading and suggestions on earlier versions of this article.

Notes

1. We define verbal communication in terms of intelligibility and comprehensibility of verbal expression according to the conceptors of the Amsterdam-Nijmegen Everyday Language Test (Blomert, Kean, Koster, & Schokker, 1994).