Music and communication

Also called Music therapy, Singing and language, Rhythm and speech

Singing, rhythm and music therapy as routes into language, for people who cannot yet speak and people who have lost speech.

What it is

Music and communication covers the ways that singing, rhythm and shared music-making open a door into language. A child who has no words may sing a whole chorus. A person with aphasia after a stroke who cannot say their own name may sing Happy Birthday perfectly. A person with late dementia who has stopped talking will join in a hymn from sixty years ago.

None of that is a trick. Music and speech share a lot of brain, and they do not share all of it, which is why one can survive when the other is damaged.

Who it can help

Babies and toddlers, for whom song is how language is first learned; see play and language. Non-speaking and minimally speaking children, including many autistic children. Adults with aphasia after stroke or brain injury. People with dementia. People with profound and multiple learning disabilities, for whom music may be the most responsive channel there is.

It is not a cure and it does not replace AAC. Music is a way in; the words still need somewhere to live afterwards.

How it works

Song gives words three things speech does not: a melody to hang on, a rhythm to time them, and repetition without boredom. A child learns "wheels on the bus" from a tune long before the words come alone. Leaving a gap at the end of a familiar line, "the wheels on the bus go round and..." and waiting, is the simplest communication temptation there is, and it works at every age.

Melodic intonation therapy is the formal version for aphasia: phrases are sung on a simple two-note melody with a tapped rhythm, then the melody is gradually taken away. Music therapists, who are registered health professionals, use improvised music to build turn-taking, joint attention and intention to communicate in people who have no other route. Intensive interaction and music therapy overlap heavily.

Music is also vocabulary. Songs, artists and "again" belong on any person's system, because asking for music is one of the first things people want to say.

Getting started

This week, sing the same three songs every day and leave the last word off the end of a line. Wait. Take any sound, movement or look as the answer and finish the line.

Put music words on the board: song, music, again, loud, quiet, and the names of five songs the person loves. For an adult who has lost speech, sing familiar songs together and notice which words come; those are the words to build from.

Ask the GP, the school or the care home about a referral to a music therapist. NHS provision is patchy, so also look for charitable services in your area.

Where to get help

The British Association for Music Therapy holds the register of qualified music therapists and lists services. Nordoff and Robbins runs music therapy centres across the UK. Stroke Association covers singing groups for aphasia. Alzheimer's Society covers music and dementia. PMLD Link covers music with people with profound and multiple learning disabilities. Say Aphasia runs peer groups where singing often features.