(English below)
文/ Lisa Eng/ Zoe
Here is Part 2. Part 1 please click the link above.
🌟關於音樂治療在語言、言語功能上的應用，小整理的第二部分來啦🤘歡迎有興趣的讀者參考交流🎵
嗓音語調治療法 (Vocal Intonation Therapy, VIT)
💡是什麼？
藉由發聲練習，改善各類嗓音問題，如發聲（phonation）、音調、音調變化、音域、音量、音色、共鳴、呼吸支持等。
👫誰適用？
因結構、神經、生理、心理因素造成的嗓音問題。
🎶治療性音樂應用：
與合唱團、聲樂課的發聲練習有相似之處，可能的訓練內容包括：
🌼頭、頸、肩放鬆練習
短跳音練習：練習橫膈膜及腹部肌肉的使用
🌼樂句、音階發聲練習：練習換氣、氣息分配、音域
🌼長音練習：練習氣息分配、音量變化、音質（如共鳴位置）
🌼在樂句中加入節奏、重音、漸強等音樂元素：練習語韻、氣息支持
🌼搭配湯匙、手指等道具練習：改善舌頭位置、口型
＊發聲練習搭配鋼琴伴奏時，伴奏提供速度、強弱、音高、節奏等聽覺提示，能有效提升治療成效，同時增加個案練習動機。
治療性歌唱 (Therapeutic Singing, TS)
💡是什麼？
泛指治療中的歌唱應用，來綜合訓練各類言語及語言功能、呼吸功能，同時提升個案的治療意願。
👫誰適用？
有語言、言語、呼吸訓練需求的各類個案。
🎶治療性音樂應用：
有特定目的性地在治療中加入歌唱應用。
例如，在做完OMREX、VIT訓練，達成特定目標後，透過TS做綜合練習。
透過音樂的發展性語言及言語訓練 (Developmental Speech and Language Training through Music, DSLM)
💡是什麼？
用適合發展年齡的音樂媒材、音樂體驗（如：歌唱、吟誦、樂器玩奏），來促進言語、語言發展。例如：數字、顏色、形狀等認知上的單字、概念訓練，及發音、言語清晰度等動作練習。
👫誰適用？
語言發展遲緩，正在發展新的語言、言語技能的兒童，可能的診斷包含：言語失用症、自閉症、腦性麻痺、智能障礙等。
🎶治療性音樂應用：
DSLM並非特定介入方式，而是涵蓋了各類音樂應用。治療師需根據個案診斷特性與現階段語言發展的需求，藉由文獻了解非音樂的介入手法，若合適時與個案的語言治療師溝通，並轉譯為治療性音樂應用。
例如：將個案現階段練習的子音－母音單字融入歌曲中，提供重複練習發音的機會，同時提高學習特定發音時的正向情緒連結。
透過音樂的象徵性溝通訓練 (Symbolic Communication Training through Music, SYCOM)
💡是什麼？
透過音樂即興進行非口語及口語溝同互動，模擬並訓練語言規則、輪流、手勢的使用、一來一回的對話、問答、開始與中止一段溝通、情緒的表達等等。
👫誰適用？
完全缺乏功能性溝通、表達能力的個案。可能是腦損傷、泛自閉症、腦麻、及各種其他疾患造成。
🎶治療性音樂應用：
各式的訓練溝通行為的音樂即興。
例如：治療師與個案面對面輪流在同一個鼓上即興，個案在即興玩奏中發展眼神、手勢的溝通，及輪流的概念。
♥️有任何心得想法，歡迎與我們分享！
♥️若有勘誤，也請不吝指教～
Reference:
Thaut, M., & Hoemberg, V. (2014). Handbook of neurologic music therapy (First). Oxford University Press
Thaut, M. (2005). Rhythm, Music, and the Brain: Scientific Foundations and Clinical Applications. Routledge.
Speaking Through Singing! Part 2
Vocal Intonation Therapy VIT
💡HOW?
To improve voicing problems, e.g. phonation, tone, tone changing, vocal range, volume, intonation, breathing support, resonance, etc. through voice practice
👫WHO?
Structural, neurological, physical, or psychological voice issues.
🎶THERAPEUTIC MUSIC APPLICATION
The exercise is similar to the choir warmup practice, possible trainings including:
🌼 Head, neck, shoulder relaxation practice
🌼 Short and instant sound(i.e. staccato) singing: to train the diaphragm and abdominal muscle
🌼 Music phrases and scale vocal exercising: practice breathing, breath distribution, vocal range
🌼 Long-notes singing practice: breath distribution, volume change, voice quality( e.g. resonance position)
🌼 Embedding rhythm, accent (i.e.emphasizing on particular notes), crescendo (i.e. gradually increase the volume), and other musical elements in a musical phrase: to practice speech prosody, breathing support
🌼 Practice with an object or prop, e.g. a spoon or a finger: to reinforce tongue position, mouth shape
*VIT practice will be accompanied with piano by a music therapist. The piano accompaniment provides auditory cues, which includes tempo, dynamics, pitch, rhythm, etc., can highly improve the therapeutic efficacy and increase client’s motivation to practice.
Therapeutic Singing, TS
💡HOW?
TS generally refers to the singing application during music therapy. It is designated to train various speech and language functions, respiratory functions, and boost clients' motivation to receive rehabilitation.
👫WHO?
Clients have needs for improve their speech, language, and respiratory functions.
🎶THERAPEUTIC MUSIC APPLICATION
Applying singing with specific aims in music therapy sessions.
Ex: After finishing OMREX, VIT practice and achieving the goal, the client will do a comprehensive practice through TS.
Developmental Speech and Language Training through Music, DSLM
💡HOW?
Applying musical media/resources, musical experiences( e.g. singing, chanting, instrument-playing), which are developmental-age-appropriate, to reinforce speech and language development. For example, vocabulary of cognitive concepts( e.g. numbers, colors, shapes, etc), and articulation, and punctuations of the concepts themselves.
👫WHO?
Children with speech delay, developing new speech and language skills. Possible diagnoses: childhood apraxia of speech (CAS), autism spectrum disorders, cerebral palsy, intellectual disability.
🎶THERAPEUTIC MUSIC APPLICATION
DSLM is not an approach with step by step guidelines, but an application that widely covers different music applications. Music therapists will learn non-music intervention through research literature based on client's diagnosis, prognosis, and current speech development needs. Discuss with speech and language pathologists if possible, and transfer to therapeutic music application.
Example: Embedded client’s ongoing vowel practice into a song to provide the opportunity to practice the specific vowel, in the meantime, increase the positive emotional connection.
Symbolic Communication Training through Music, SYCOM
💡HOW?
Through music improvisation to conduct verbal and non-verbal communication, mock and instruct language rules, taking turns, and the usage of gestures, back and forth conversation/Q & A, start and stop a conversation, and emotional expression, etc.
👫WHO?
Clients who have a complete lack of functional conversation or expressive ability, possibly caused brain injury, autism spectrum disorder, cerebral palsy, and others.
🎶THERAPEUTIC MUSIC APPLICATION
Music improvisation to train communication and behavior with various applications
For example, a music therapist and the clients sitting face to face improved playing the same drum. Clients will develop non-verbal communication including eye-contact and hand gestures and the concept of taking turns.
♥️Let us know what you think, and don’t be shy to share with us.
If you find anything needing correction, please do not hesitate to advise.
Reference:
Thaut, M., & Hoemberg, V. (2014). Handbook of neurologic music therapy (First). Oxford University Press
Thaut, M. (2005). Rhythm, Music, and the Brain: Scientific Foundations and Clinical Applications. Routledge.
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