Melodic intonation therapy paired with video feedback: A potential method for bolstering production?

Abstract

Melodic intonation therapy (MIT) is a behavioural speech-language intervention that uses pitch and rhythm (i.e. melody) to increase speech fluency and facilitate improved word retrieval. It is a well-known therapeutic option for individuals with non-fluent aphasia. Though MIT can enhance speech and language production, its clinical utility is limited when those engaged in MIT are unable to routinely use its facilitatory techniques independently. Video feedback is a tool that can enhance learning and has shown potential as a mechanism to bolster behavioural interventions. The present study aimed to examine whether MIT paired with direct video feedback could promote independent utilisation of the trained elements that compose MIT, thereby facilitating sustained improvements in speech and language production. One individual with chronic non-fluent aphasia and apraxia of speech participated in 20 90-minute MIT treatment sessions provided over the course of four weeks. The sessions included a video review of the previous session with the participant judging their own productions and the treating clinician providing feedback regarding the participant's use of MIT's facilitatory techniques. The participant was stimulable to the treatment, evidenced by increased intelligibility during the session, but did not use the trained techniques independently and failed to maintain observed gains during assessment periods. Therefore, in the present study, the pairing of MIT and video feedback was not sufficient to promote increased independent use of trained treatment components. Demographic factors such as age and lesions in the prefrontal cortex and insular cortex are likely to have influenced treatment outcomes.