What Is Melodic Intonation Therapy?

Melodic intonation therapy, or MIT, is a type of speech therapy for communication disorders like aphasia, using a certain kind of singing to help with verbal expression through normal speech. This therapeutic activity encourages the brain's right hemisphere to compensate for impaired speech abilities normally based in the left hemisphere. As a therapy, this practice was developed in 1973 by neurology researchers at the Veterans Administration hospital in Boston, based on clinical insight that some aphasia patients who could not communicate by speech were able to sing phrases. Melodic intonation therapy is facilitated by a specially trained clinician, such as a speech pathologist. It is believed to be effective with certain but not all types of aphasia.

The use of melodic intonation therapy with adults is based on a specific protocol, although there are variations depending on the training and preferences of the facilitating speech pathologist. In general, the process begins as the facilitator chooses a brief conversational phrase that the patient is likely to need to communicate, such as "thank you." The facilitator sings this phrase using a musical interval with only two pitches. A speech pathologist encourages the patient to use inner rehearsal, or mentally imagining oneself to be singing the musical phrase that is provided. Facilitators might also use rhythmic tapping on the patient's hand to support the experience of inner rehearsal.

When using melodic intonation therapy with children, a speech pathologist will employ a modified approach to the standard process. The facilitator will teach the child to repeat the musical phrase initially in Signed English, a type of sign language. Gradually, the facilitator leads the child to both sign and sing the phrase, and eventually to speak the phrase normally.

In the process of melodic intonation therapy, patients are taught to self-evaluate their level of success in reproducing the sounds made by the speech pathologist. The singing of words slows down the process of producing phonemes or individual speech sounds, allowing the patient to hear differences more distinctly. Transitioning the patient from melodic intonation to normal non-musical speech is called sprechgesang. This term is taken from the field of music, in which it refers to a recitation-like way of singing similar to speech.

Aphasia is a disorder in which the individual has difficulty understanding or producing language for communication. Melodic intonation therapy is not appropriate for certain types of aphasia patients, such as those with damage to both brain hemispheres.