Music therapy assessment of communication abilities

Recently the American Speech Hearing Association (ASHA) has expressed concerns about music therapists assessing communication.  As a speech-language pathologist myself, I know well  the skills required to perform comprehensive evaluations for both pediatric and adult clients. We use norm referenced, standardized batteries of tests that provide highly detailed, statistical information about communication, to include assessment of syntax, semantics, articulation, pragmatics and phonology. Often testing requires more than one session to complete, depending on the age and presenting issues.  

Music therapists (MTs) are trained to assess communication through music. The tasks are less comprehensive than SLP assessments but still provide important information as to how a client functions and identifies possible abilities that can be leveraged toward disabilities.  The following are examples of a music therapists assessment of expressive skills: 

  1. evaluate if a client can complete the last word or words of a phrase in a known or familiar song demonstrating recall, anticipation, timing and production abilities
  2. evaluate if a client can vary vocalizations or verbalizations demonstrating auditory perceptual skills, imitation, repetitions and production abilities
  3. evaluate if a client can generate original words and/or ideas for songwriting activities demonstrating word finding (divergent and convergent), concentration, ability to initiate and develop an idea to completion
  4. evaluate if a client is able to take turns vocally or with musical instruments demonstrating pre-conversational and pragmatic abilities 

Music therapists assess receptive skills as follows:

  1. evaluate whether clients respond better to sung than spoken cues. Positive responses to sung cues demonstrate cognitive priming, leveraging the right hemisphere's capacity for melody perception. In addition to cognitive priming, sung cues can improve  success of comprehension because of decreased rate of syllable production in sung phrases versus spoken ones
  2. evaluate the client’s ability to follow directions in musical tasks (e.g. play this, then play that this way, etc.) demonstrating comprehension, sequencing abilities. Music may provide compelling activities that motivate a client to perform at their best

The music therapist benefits greatly from SLP assessments that identify needs and establish goals, some of which can be addressed by music-based interventions. SLPs can benefit from the identification of abilities in music that can be used to motivate a client and to provide another entry point into communication development or recovery.

Speech therapists use word lists, games, books and conversations to address communication goals. Music therapists use songwriting, improvised music, and familiar songs to address some of these same goals. By working together, we have the opportunity to serve clients to reach their optimal functioning. 

Here are references to studies that are relevant to this discussion. It is my hope that speech-language pathologists and music therapists will continue to share their skill sets for the betterment of the clients we mutually serve. 

Thompson WF, Schlaug G. The Healing Power of Music. New therapies are using rhythm, beat, and melody to help patients with brain disorders recover language, hearing, motion, and emotion Scientific American Mind; March/April 2015, pp 33-40. [PDF]

Wan CY, Bazen L, Baars R, Libenson A, Zipse L, Zuk J, Norton A, Schlaug G. Auditory-Motor Mapping Training as an Intervention to Facilitate Speech Output in Non-Verbal Children with Autism: A Proof of Concept Study PLoS ONE 2011;6(9):e25505; doi:10.1371/journal.pone.0025505. [PDF]

Wan CY, Schlaug G. Neural pathways for language in autism: the potential for music-based treatments.Future Neurol 2010;5(6):797-805. [PDF]

Schlaug G, Norton A, Marchina S, Zipse L, Wan CY. From singing to speaking: facilitating recovery from nonfluent aphasia. Future Neurol. 2010;5(5):657-665. [PDF]