Researchers from the Vanderbilt Brain Institute (TN) and Boston University (MA) have studied song completion in persons with aphasia (PWA). The purpose is to expand our understanding of mechanisms underlying the widely observed phenomenon that PWA are frequently better able to sing the lyrics of familiar songs than they are able to speak the same words conversationally.  Clinically, aphasia treatment regimens such as Melodic Intonation Therapy (MIT) have aimed at finding ways to leverage such strengths in song performance, where found, to improve speech therapy outcomes.

The current investigators recruited 20 PWA of varying diagnostic categories and severity levels, of whom 19 had aphasia from stroke, together with 20 age-matched individuals to serve as scientific controls.  All subjects were asked to participate in three tasks:  (1) completing a song phrase in both melody and lyrics, given an establishing melody-and-lyric introduction;  (2) speaking the completion of a phrase from song lyrics, given a establishing lyric introduction in speech alone; and (3) completing the melody of a song phrase to the nonsense syllable ‘bum’ in place of lyrics, following a melodic introduction with the same nonsense syllable in place of lyrics.

Results show that PWA generally perform best in Task 1 (lyrics supported by the melody), followed by Task 2 (the lyrics produced as speech without melody), followed by Task 3 (melodic phrase completion produced to a nonsense syllable).  The control subjects performed more or less equivalently in Tasks 1 and 2 (lyrics either with or without melody), but less well in Task 3 (melody to the nonsense syllable ‘bum’).  For PWA, these results underscore the importance of integrating melody with lyrics for most successful performance levels.  In such circumstances, benefits appear to derive from complexly and tightly interconnected interactions of the multiple dimensions involved, including meter, melody, rhythm, lyrics, rhyme, and sense.  These appear collaboratively to support broadly networked, synchronized, and often emotionally satisfying activities.  Previous studies have suggested that persons with non-fluent aphasia may be especially good candidates, though – given that every individual’s deficits and residual capabilities will be unique – clinicians must remain alert to individual candidates from other diagnostic categories.  Interestingly, among PWA in this study with the greatest aphasia severity, there was a subset who performed better in Task 3 (melody only) than in Task 2 (spoken delivery of lyrics only), though therapeutic implications of this remain to be explored.

With this work, the authors have broadened to our understanding of how performances of music and lyrics present, independently and together, in persons with and without aphasia.  In so doing, they suggest perspectives that may help better identify candidates for music-based interventions and align intervention strategies with particular clients.

For further reading:   A. Kasdan, S. Kiran,  2018. Please don’t stop the music: song completion in patients with aphasia. Journal of Communication Disorders, 75:72-86 https://doi.org/10.1016/j.jcomdis.2018.06.005

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