Neurologic Music Therapy is a research-based system of standardized clinical techniques for sensorimotor training, speech and language training, and cognitive training. NMT is used in neurologic rehabilitation, neuropediatric therapy, neurogeriatric therapy, neuropsychiatric, and neurodevelopmental therapy. It is based on the rational–scientific mediating model (R–SMM), a neuroscience model of music perception and production and the influence of music on functional changes in nonmusical brain and behavior function (Thaut,2005). NMT uses a wide variety of techniques to address motor control, cognition, speech and language, and psychosocial behavior with neurological disorders such as stroke, Parkinson’s disease, Huntington’s disease, traumatic brain injury, multiple sclerosis, autism, Alzheimer’s disease, cerebral palsy, developmental disorders, intellectual disabilities, and spinal cord injuries. NMT to Address Sensorimotor Goals
Basic science and clinical research supporting the use of music to facilitate functional movement goals in both the upper and lower extremities with many different types of neurologic disorders have continued to grow over the last 20 years. Recent studies looking at the effects of RAS on gait in people with Parkinson’s disease (de Dreu, van der Wilk, Poppe, Kwakkel & van Wegen, 2012; Kadivar, Corcos, Foto & Hondzinski, 2011), traumatic brain injury (Hurt, Rice, McIntosh & Thaut, 1998), multiple sclerosis (Baram & Miller, 2007; Conklyn et al., 2010), spinal cord injuries (de l’Etoile, 2008), and spastic diplegic cerebral palsy (Baram & Lenger, 2012; Kim et al., 2011) continue to show the significant impact of rhythm on gait kinematics through better posture, more appropriate step rates (step cadence) and stride length, and more efficient and symmetric muscle activation patterns in the lower extremities during walking. A Cochrane review of music therapy for acquired brain injury (Bradt, Magee, Dileo, Wheeler & McGilloway, 2010) suggested that RAS, a NMT technique, is beneficial for improving gait parameters in stroke patients, including gait velocity, cadence, stride length, and gait symmetry, with these conclusions based on studies of RAS. Music therapy offers a variety of musical interventions and experiences to address motor skills in neurological populations. Common goals that are addressed include gait and mobility, strength and endurance, coordination, balance and posture, and range of motion. These goals are addressed through techniques such as Rhythmic Auditory Stimulation (RAS), Patterned Sensory Enhancement (PSE), and Therapeutic Instrumental Music Performance (TIMP). NMT to Address Speech/Language Goals
NMT can play a large role in the development, adaptations, and rehabilitation of both verbal and nonverbal communication skills. Techniques in NMT can be used to address disorders such as apraxia; fluency disorders such as stuttering and cluttering; aphasia; and voice disorders which may result in abnormal pitch, loudness, timbre, breathe control, or prosody of speech. Goals in the area of speech and communication address issues such as functional and spontaneous speech, speech comprehension, motor control and coordination essential for articulation, fluency of speech, vocal production and sequencing of speech sounds, and rate and intelligibility. The following eight techniques address speech disorders, based on the current research in this area: Melodic Intonation Therapy (MIT), Musical Speech Stimulation (MUSTIM), Rhythmic Speech Cuing (RSC), Vocal Intonation Therapy (VIT), Therapeutic Singing (TS), Oral Motor and Respiratory Exercises (OMREX), Developmental Speech and Language Training through Music (DSLM), and Symbolic Communication Training through Music (SYCOM). NMT to Address Cognitive Goals
Several neurologic music therapy interventions have been developed to address cognitive learning, based on research evidence providing clinical support in the role of music to aid in memory, attention, and executive function training. Four areas are addressed in cognitive training techniques: attention, auditory perception and sensory integration, memory, and executive functions. Standardized techniques include Musical Sensory Orientation Training (MSOT), Musical Attention Control Training (MACT), Musical Neglect Training (MNT), Auditory Perception Training (APT), Musical Mnemonics Training (MMT), Musical and Echoic Memory (MEM), Associative Mood and Memory Training (AMMT), and Musical Executive Function Training (MEFT).
