Neurologic Music Therapy

Question 1

What is Neurologic Music Therapy (NMT)?

Answer 1

The therapeutic application of music to cognitive, sensory & motor dysfunctions due to neurologic disease of the human nervous system

Question 2

What is NMT based on?;

According to Michael Thaut, the brain that engages in music is what?

Answer 2

A neuroscience model of music perception & production & the influence of music on non-musical brain & behaviour functions;
Changed by engaging in music

Question 3

In what areas does NMT utilise standardised clinical techniques?

Answer 3

Sensorimotor training; speech & language training; cognition training

Question 4

Otherwise known as the “working mechanisms of music”, what 4 areas of research informs overall treatment & treatment techniques?

Answer 4

Rhythmic stimulation & entrainment; patterned information processing; differential neurological processing; affective-aesthetic response: arousal, motivation, emotion

Question 5

Evidence shows that the auditory & motor systems have what?

Answer 5

A rich connectivity across a variety of cortical, subcortical & spinal levels (auditory rhythm has a profound effect on the motor system)

Question 6

Explain Audio-spinal Facilitation

Answer 6

Auditory stimulation excites neurons in the spinal cord which in turn primes the muscles for movement; occurs at a pre-cognitive level

Question 7

Explain Rhythmic Stimulation;
Within how long does change occur?;
What can impede impact?

Answer 7

Provides timing through predictability; impacts timing & fluency of movement output;
3-4 beats - no training period;
Cortical focus

Question 8

How does Entrainment occur?;
It happens without any conscious…;
Our brain detects the space between…

Answer 8

When the frequency of activity of one system determines the frequency of activity in another; internal oscillator entrains to a more powerful external oscillator;
Thought; occurs naturally & quickly;
Sounds (a change within 5-10% difference; body won’t notice)

Question 9

What does research on Patterned Information Processing demonstrate?;
What does rhythm provide?;
What is it based on?

Answer 9

That music facilitates cognitive processing, enhancing learning, memory & executive functioning (shows how we process sounds & how brain predicts); provides temporal templates (processing time & space)
Time information across duration of time period/movement (not just end points);
Gestalt principles (hearing things as a whole)

Question 10

Explain Differential Neurological Processing;

According to Levitin & Triovolas, music listening, performing & composing engage which regions of the brain?

Answer 10

Music activates parallel or shared neural pathways; it’s not cortically distinct but shares cortical networks activated in similar non-musical tasks;
Bilaterally, in the cortex, neocortex, paleo & neo-cerebellum

Question 11

Music has significant effects on arousal, motivation & emotion which effect what?;
The motor system is physiologically very sensitive to what?;
Arousal & cognitive processing are primary to what?

Answer 11

Learning & behaviour;
Arousal by the auditory system;
Effectively processing emotion

Question 12

List the 5 steps of the Transformational Design Model (TDM) according to Thaut

Answer 12

Diagnostic & functional assessment; development of therapeutic goals & objectives; design of functional nonmusical exercises; translation into functional therapeutic music experiences; transfer into functional nonmusical real-world applications

Question 13

List 3 sensorimotor techniques;
List 3 communication techniques;
List 3 cognition techniques

Answer 13

Rhythmic auditory stimulation (RAS); patterned sensory enhancement; therapeutic instrumental music performance;
Melodic intonation therapy (MIT); Rhythmic speech cueing; developmental speech & language training (DSLM);
Music attention control training (MACT); Associative mood & memory training (AMMT); Music psychotherapy & counseling (MPC)

Question 14

MIT utilizes a patient’s unimpaired ability to sing to facilitate what?;
According to Schlaug, what do MIT results show?

Answer 14

Speech production;

Significant changes in brain structure through neuroplasticity; axon connections increased in right hemisphere

Question 15

What is the ultimate goal of MIT?;
How should the content of the phrases be?;
What should melodies not resemble?

Answer 15

To remove the musical elements entirely so the patient presents normal speech;
Meaningful to or functional for the patient;
Familiar melodies

Question 16

List the steps in a typical MIT session

Answer 16

Therapist hums melody while tapping patient’s left hand (along with metronome); therapist sings words alone; both sing together; therapist fades while patient continues; both alternate; prompt questions - patients may answer in song then eventually just speech

Question 17

What does Music Speech Stimulation utilize?;

What is the therapist’s role?

Answer 17

Music related materials such as songs, rhymes, chants or musical phrases; over-learned familiar songs (e.g. twinkle twinkle) to elicit speech responses ;
To sing & accompany or just accompany & may fade singing at certain times to trigger automatic response

Question 18

What does Rhythmic Speech Cueing control?;

How is it implemented?

Answer 18

The initiation & rate of speech through cueing & pacing;

The therapist will use the client’s hand, drum or metronome to prime speech patterns or pace the rate of speech

Question 19

What is DSLM?;

Through what methods is this achieved?

Answer 19

The specific use of developmentally appropriate musical materials & experiences to enhance speech & language;
Singing, chanting, playing musical instruments, & combining music, speech & movement

Question 20

What does MACT involve?;

Musical elements cue musical responses in order to practice what?

Answer 20

Structured active or receptive musical exercises, using pre-composed performance or improvisation;
Sustained selective, divided & alternating attention functions

Question 21

What does music psychotherapy & counseling use musical performance to address?;
What does this facilitate?

Answer 21

Issues of mood, control, affective expression, cognitive coherence, reality orientation & appropriate social interaction
Psychosocial functions