Communication can be difficult for some people. It may be due to a moderate to severe stutter they've had all their life, or a catastrophic event like a stroke that renders them inarticulate. In today’s Friday Forum, WNIJ’s Guy Stephens tells us how researchers, including some at Northern Illinois University, are using music to help overcome or alleviate speech problems in ways they are still trying to fully understand.
Jaime Mayer oversees several projects at Northern Illinois University that explore the interfaces of music, language and thought.
“And what we have found over the years – and what we’ve already known, but now what I’ve been able to see, experience, clinically, over the years -- is that music has this way of drawing out language and cognition in ways other stimuli can’t or other situations cannot,” she said.
Mayer, an associate professor of speech-language pathology in the School of Allied Health and Communicative Disorders, says the results have been remarkable.
For instance, she’s used music with stroke victims and found they could sing even if they couldn’t speak at all – a condition called aphasia that’s not uncommon after a stroke.
“I’ve used it with people with really severe dementia who look like they’re completely in their own world,” Mayer said, “but then you stick a pair of headphones on them and start playing music from when they were in, say, their twenties, and all of a sudden they’re dancing along and singing a little bit and they’ve come to life.”
She also oversees the Bridges Choir at a local nursing home. It’s made up of people with stroke, brain injury or memory problems who nonetheless are able to sing, even if language or memory is otherwise hard for them.
How does this happen? Mayer says researchers have found it has something to do with how music is stored in the brain -- and it turns out nearly every part of the brain is involved.
“What this means is that, if someone has brain damage affecting a specific part of the brain, even if language and memory are almost completely gone,” she said, “music is much more likely to be spared.”
Mayer says they then can use music to draw out the individual. Another reason music works so well, she says, is something called “cognitive self-efficacy.”
“ … which is basically this belief that you are good at something, that you’re useful, that you’re able to do something,” she said, “and one of the biggest ways to boost that is to put someone in a situation where they are good at something.”
Something like singing. Mayer has seen that positive reinforcement give people a boost in efforts to improve function in other areas of their lives.
It’s not just extreme situations, like patients with strokes, where music can help improve communication. A generation of country music fans remember the late Mel Tillis as the performer who stuttered badly when he spoke but never when he sang. And there are other examples in the arts.
Jane Fraser, president of the Stuttering Foundation of America, says stuttering isn’t just one thing, but rather a spectrum, ranging from almost unnoticeable or occasional to so severe as to interfere with one’s ability to function at school or work.
There may be several causes, too. Genetics play a big part, but so can environmental or psychological factors, or some combination.
Fraser says experience has shown that something as simple as nursery rhymes help very young children with language skills. For them, as well as adults, singing can help with stuttering. She says a key part of that is the difference between conversational speech and an activity like singing.
“Some folks who stutter have a problem with word retrieval,” Fraser said. “They’re searching for the word. So, in other words, there’s a language component. And they’re searching for the word, and that may be part of what may be slowing them down and slowing down their speech. So the lyrics in the song are already given to them.”
Mayer refers to this as automatic versus volitional speech – something improvised as opposed to something that gets ingrained in your brain’s neural pathways as a memory, even if you aren’t conscious of it. An example of the latter could be when you hear a song on the radio that perhaps you haven’t heard in years, but are still able to sing along with it.
Fraser says a song’s rhythm also seems to help stuttering, and certainly the melody helps. She says specific centers and associations in the brain help explain why.
“Singing is probably over in the right hemisphere where there’s emotion and there’s happiness,” Fraser said, “and talking is usually in the left where you’re trying to think of what you’re going to say and under some kind of pressure to put a sentence together.”
As Fraser suggests, being familiar with a song isn’t the whole story. One of Mayer’s colleagues, NIU associate professor In-Sop Kim, actually tried to see what happens in the brain of someone who stutters when they use music to speak. Kim conducted a small study with a man who had a severe stutter, using a technique another researcher had developed.
“Simply, the guy thinks about the melody that he could do,” Kim said, “and then whenever he’d talk about some events, he’d think about the melody, and he’d put his words in the melody.”
Kim measured the man’s brain activity and found different parts of the brain were active when the man used the melody with the words.
“He actually used both the left and the right hemisphere more than earlier,” Kim said. “That means he used the right hemisphere more.”
Kim says the verbal results were obvious: only two disfluencies – pauses, repetitions and the like – recorded when the man used the technique, versus nine when he did not. Both sets of data seem to confirm what Fraser and Mayer say about music and speech centers in the brain.
Kim says the results are interesting, but he needs to conduct a larger study that includes a control group before he can say whether the brain activity or the usefulness of the technique he observed apply to a more general population.
Still, Kim, Fraser and Mayer agree that music has been shown to play an important part in helping stutterers, whether they pursue a music career or not, as well as those with more extreme challenges.
But, Mayer cautions, while music is a powerful therapeutic tool, it is not a cure-all. Some people with big deficits are helped and will improve in other areas, but many will not. Even so, she says music can still be important for them.
“You know, the big thing we’re looking at a lot of times in stroke and brain injury and dementia is just quality,” she said. “Quality of life. How much time out of the day do you spend, you know, being happy, or doing something that you feel is useful? In a social situation, say, or something that you’re proud of? And that’s sometimes, even, where this can come into play.”
And whether it’s a mild stutter or a massive impairment, improving someone’s quality of life seems reason enough to try.