Objective:

To review the development and implementation of melodic intonation therapy (MIT) for patients with expressive aphasia.

Background:

Upwards of 2 million Americans live with aphasia, and with approximately 1 in 3 stroke patients developing aphasia, this number is estimated to increase by 180,000 each year. Aphasia can be devastating to a patient’s quality of life, as it limits occupational and social opportunities. Melodic intonation therapy (MIT) is a form of speech and language therapy that utilizes musical intonation and left hand tapping to restore propositional speech by engaging language-capable regions in the right hemisphere.

Design/Methods:

A literature review was performed using the PubMed and GoogleScholar databases.

Results:

MIT for aphasia was first described in 1973 by Albert, Sparks, and Helm in Boston. The inspiration for MIT came from the observation that many patients with non-fluent aphasia were capable of fluently singing song lyrics with appropriate articulation. It was theorized that singing could be used to restore functional speech. Though several variations of MIT have emerged, the original program involved 3 steps: intoning in unison with the clinician, independently responding to questions with intoned speech, and gradually removing the musical aspect of speech to restore normal prosody. Traditionally, intoned speech exercises were accompanied by left hand tapping on each syllable to augment recruitment of the right hemisphere, a concept that has been corroborated by fMRI, DTI, and PET studies. While MIT was originally thought to be an effective treatment for Broca’s aphasia, recent evidence suggests that MIT more directly treats apraxia of speech and does not provide significant benefit for agrammatism. Auditory-motor feedback training has since been incorporated to facilitate self-correction and improve fluency.

Conclusions:

Since its inception in 1973, melodic intonation therapy (MIT) has demonstrated clinical benefit for patients with expressive aphasia, particularly those challenged by apraxia of speech.