Integrating Music Therapy Services and Speech-Language Therapy Services for Children with SevereCommunication Impairments: A Co-Treatment Model

Abstract

Documenting how music therapy can be integrated with speech-language therapy services for children with communication delay is not evident in the literature. In this article, a collaborative model with procedures, experiences, and communication outcomes of integrating music therapy with the existing speech-language services is given. Using established principles of team planning, the co-treatment model is described in a case study, a 4-year-old child diagnosed with global developmental delay. Results indicated increased engagement in the classroom after integrating music therapy and speech-language therapy treatment strategies. ********** As the number of cases of children being identified with communication disorders increases, the need for cost effective treatment has become more apparent. Music therapists assess and develop treatment for people with developmental disabilities and emotional issues in facilities such as hospitals, schools, and inpatient and outpatient treatment centers. Speech-language pathologists not only work with people on speech and sound issues, but also work with individuals who have learning disabilities, memory problems and individuals who have problems with swallowing food or drink. In the past 25 years, the field also added augmentative and alternative communication (AAC) to its scope of practice. AAC can include using signs or gestures, pointing to pictures in a communication book, or using a computer-based device with synthesized speech output. Currently, speech-language pathologists (SLPs) and music therapists (MTs) are diligently working to improve techniques to address the varied and sometimes complex communication and educational needs of children with disabilities (Geist & McCarthy, 2008). Music provides a structured medium to accentuate the prosody or meaning of language in the context of an enjoyable, motivating stimulus (Pelliteri, 2000). Music therapists are trained to adapt elements of music e.g. tempo, rhythm, melody, harmony, and texture to promote effective communication strategies. Although communication and music therapy treatment have the potential to complement each other in a therapeutic context, studies documenting this interdisciplinary approach are not common in the literature. This article illustrates an example of how SLPs and MTs can effectively co-treat for a child with complex communication needs. Short-term effects of this treatment are presented. Music Promoting Speech Research had found that music techniques promoted increased breath and muscle control (Peters 2000, Cohen, 1994), stimulated vocalization (Staum, 1989), developed receptive and expressive language skills (Miller, 1982), and improved articulation skills (Zoller, 1991). Humpal (1991) and Cassity (1992) demonstrated how preschool children with speech-language disorders demonstrated social communication skills in basic group music activities with their non-disabled peers. AAC strategies paired with musical strategies are also noted in the literature. Herman (1985) demonstrated how children point to music symbol pictures to contribute to group "story songs" and what feelings they wanted to express. Signing and manual communication systems can be used to express song lyrics, and signs and singing can be used together for total communications experiences (Darrow, 1987a; Knapp, 1980). Buday (1995) found that children with autism learned more signs when they were paired with music and speech than when they were taught with music alone or speech alone. Technology makes it possible for students who are non-speaking to have a voice and participate musically (Humpal & Dimmick, 1995). Music Therapy and Speech-Language Therapy Collaboration When describing how music can be added to a speech-language therapy setting as treatment, Zoller (1991) stated, "Musical activities stress nonverbal forms of communication and often surpass physical, cultural, intellectual, and emotional limitations (p. …