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Music & Aphasia: Relearning Language through Music Prepared for: EDUC 520 Instructional Linguistics Prepared by: Miranda M. Rowland Date: April 23, 2012

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Mu s i c   &   A p h a s i a :   R e l e a r n i n g    

L a n g u a g e   t h r o u g h  Mu s i c  Prepared  for:   EDUC  520  Instructional  Linguistics  Prepared  by:     Miranda  M.  Rowland  Date:  April  23,  2012        

 

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 I.  Introduction  

    An  old,  Chinese  proverb  states,  “Music  comes  from  the  heart  of  the  human  

being.  When  emotions  are  born,  they  are  expressed  by  sounds  and  when  sounds  are  

born  they  give  birth  to  music”  (Degmecic,  2005).  Music  and  language  play  important  

roles  in  the  lives  of  many  people;  however,  we  seldom  stop  to  realize  just  how  

critical  these  two  components  of  life  can  be.  Imagine  that  you  are  suddenly  faced  

with  an  inability  to  create  speech  due  to  a  problem  in  the  brain.  This  is  commonly  

referred  to  as  aphasia;  language  loss  or  disorder  following  brain  damage.  A  recent  

story  about  Congresswoman  Gabby  Giffords,  illustrates  how  effective  music  can  be  

when  relearning  a  language  that  was  lost  due  to  aphasia.  There  have  been  several  

studies  that  have  discussed  the  benefits  of  using  music  for  therapeutic  purposes,  as  

well  as  scientific  studies  of  the  brain  and  language  with  music  as  a  medium  for  

conversation,  however,  I  know  very  little  about  this  subject.  

  This  research  project  will  enable  me  to  understand  music  and  language  

through  an  entirely  different  lens.  I  will  be  focusing  this  study  on  the  abilities  that  

music  has  to  aid  those  patients  struggling  with  aphasia,  more  specifically,  Gabby  

Giffords.  I  will  begin  by  introducing  the  definitions  of  music,  language,  and  aphasia.  I  

will  also  discuss  the  brains’  ability  to  learn  new  material,  which  is  called,  

neuroplasticity.  I  hope  to  find  a  way  to  connect  each  of  these  to  find  if  music  is  in  

fact  a  useful  tool  to  help  these  difficulties  with  language.  There  will  be  images  of  the  

brain  when  it  is  fully  functional  within  music,  the  brain  when  it  suffers  from  aphasia  

as  well  as  provide  the  reader  with  images  of  typical  human  brain  as  well  as  the  brain  

that  is  affected  by  aphasia  and  music.      

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II.  What  is  Language?       Before  taking  this  class,  I  would  define  language  as  the  words  people  use  to  

communicate.    Fromkin,  et  al.  describe  language  as  “the  source  of  human  life  and  

power”  (Fromkin,  p.  3).  In  order  to  understand  a  language,  a  person  must  be  able  to  

understand  “sounds  (or  signs)  that  are  in  [the]  language  and  what  sounds  are  not”  

(Fromkin,  p.  4).  In  other  words,  a  person  becomes  familiar  with  the  codes  of  their  

respective  languages  and  is  able  to  determine  when  a  sound  is  outside  that  of  their  

language.  Human  beings  are  able  to  communicate  through  languages,  signs  or  

sounds.  Mithen  describes  languages  as  “an  intentional  means  to  communicate  ideas  

or  knowledge  to  one  or  more  other  individuals  .  .  .”  (Mithen,  p.  21),  while  Sacks  

states,  “we  are  a  linguistic  species  –  we  turn  to  language  to  express  whatever  we  are  

thinking  and  it  is  usually  there  for  us  instantly”  (Sacks,  p.  215).  Many  may  take  the  

availability  of  or  the  ability  to  speak,  for  granted.  What  would  happen  if  we  lost  

control  of  that  ability?    

III.  The  Brain  &  Neuroplasticity       The  human  brain  is  a  “massively  parallel  device,  with  operations  distributed  

widely  throughout”  (Levitin,  p.  85).  It  is  divided  into  four  lobes;  the  frontal,  

temporal,  parietal,  and  the  occipital  lobe;  see  Figure  1.The  frontal  lobe  of  the  brain  is  

responsible  for  motor  functions,  planning,  judgment,  impulse  control,  and  memory.  

Within  the  frontal  lobe  are  three  divisions,  the  prefrontal  cortex,  premotor  area  and  

the  motor  area.  As  stated  by  Sacks,  “neurologists  often  refer  to  a  ‘speech  area’  in  the  

premotor  zone  of  the  brain’s  dominant  (usually  left)  frontal  lobe”  (Sacks,  p.  215).  

The  temporal  lobe  is  involved  in  many  functions  of  the  body  including,  auditory  

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perception,  memory,  speech,  and  emotional  responses.  The  parietal  lobe  is  

responsible  for  cognition,  processing  information,  and  speech,  while  the  occipital  

lobe  is  in  control  of  visual  perception  and  color  recognition.  Each  of  these  areas  is  

important  and  is  in  a  constant  state  of  change.      

  Neuroplasticity  is  defined  as  “the  brain’s  ability  to  reorganize  itself  by  

forming  new  neural  connections  throughout  life.  Neuroplasticity  allows  the  neurons  

in  the  brain  to  compensate  for  injury  and  disease  and  to  adjust  their  activities  in  

response  to  new  situations  or  changes  in  their  environment”  (MedicineNet.com).  In  

other  words,  neuroplasticity  allows  our  brains  to  heal  and  filter  new  information.  

After  a  brain  injury,  the  brain  begins  to  repair  itself  by  forming  new  connections  in  

order  to  make  it  out  of  the  injury  in  a  positive  manner.    

  Experts  in  the  field  suggest  “that  regional  specificity  may  be  temporary,  as  

the  processing  centers  for  important  mental  functions  actually  move  to  other  

regions  after  trauma  or  brain  damage”  (Levitin,  p.  85).  This  is  to  say  that  

neuroplasticity  allows  our  brains  to  process  information  in  different  centers  of  the  

brain  in  order  to  survive  brain  damage.    

IV.  Aphasia       Aphasia  is  defined  as  “the  inability  to  speak  because  of  damage  to  the  

language  pathways  in  the  brain’s  left  hemisphere”  (Fromkin,  p.  46).  There  are  two  

types  of  aphasia,  Broca’s  aphasia  and  Wernicke’s  aphasia,  (see  figure  2).  Broca’s  

area  is  the  region  of  the  brain  in  the  left  hemisphere  that  is  designated  for  speech  

production,  while  Wernicke’s  area,  also  in  the  left  hemisphere  is  the  location  in  

which  word  recognition  occurs.  Broca’s  aphasia  is  “characterized  by  labored  speech  

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and  certain  kinds  of  word-­‐finding  difficulties”  (Fromkin,  p.  47).  In  other  words,  the  

ability  to  understand  spoken  language  is  still  in  tact  but  the  ability  to  reciprocate  

through  dialogue  is  broken.  Patients  with  Broca’s  aphasia  may  struggle  to  put  

together  simple  sentences  but  remain  coherent  in  their  delivery.  A  patient  with  

Wernicke’s  aphasia  will  not  face  problems  with  broken  speech  and  will  seem  to  be  

fluent  when  speaking,  but  have  an  inability  to  use  or  understand  the  most  basic  

nouns  and  verbs.          

  According  to  Sacks,  “for  those  with  aphasia,  the  inability  to  communicate  

verbally  may  be  almost  unbearably  frustrating  and  isolating.  .  .”  (Sacks,  p.  215).  

Aphasia  in  patients  varies  from  person  to  person.  For  example,  Marjorie  Nicholas,  

associate  chairwoman  of  the  department  of  communication  sciences  and  disorders  

at  the  MGH  Institute  of  Health,  states  that,  “some  [patients]  might  have  a  severe  

problem  in  expression  but  really  good  understanding  of  spoken  language,  and  

somebody  else  might  have  a  very  different  profile”  (Weintraub,  2012).  

  The  most  recent  case  of  aphasia  that  has  been  in  the  public  is  that  of  

Congresswoman  Gabrielle  Giffords.  Giffords  suffered  from  aphasia  because  of  tragic  

incident  in  an  Arizona  shooting.  On  January  8,  2011,  Giffords  was  critically  injured  

by  a  gunshot  wound  to  the  head,  which  was  reported  to  be  an  attempt  at  

assassination  on  the  Congresswoman.  Since  the  shooting  occurred  Giffords  has  had  

multiple  surgeries  to  remove  bullet  fragments  as  well  as  a  plethora  of  physical  and  

speech  therapy  sessions.  Her  speech  therapists  have  utilized  music  as  a  vehicle  to  

relearn  spoken  word.    

   

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V.  Music  as  a  Medium  for  Re-­learning  Language       Researcher  Steven  Mithen  states,  “music  and  language  are  universal  features  

of  human  society”  (Mithen,  p.  25).  In  other  words,  it  would  seem  understandable  

that  music  could  be  used  as  a  universal  language  to  relearn  a  spoken  language.      

Levitin  states,  “musical  activity  involves  nearly  every  region  of  the  brain  that  we  

know  about”  (p.  83-­‐84).  If  this  is  fact,  then  music  therapy  sounds  like  the  perfect  

medicine  to  relearn  one’s  spoken  language.  He  also  describes  the  similarities  

between  processing  spoken  word  and  music  in  the  brain.  “Some  of  the  music  

processing  has  points  in  common  with  the  operations  required  to  analyze  other  

sounds;  understanding  speech,  for  example,  requires  that  we  be  able  to  understand  

aspects  beyond  the  words  .  .  .”  while  music  uses  sounds  in  correlation  with  words  to  

relay  meaning  beyond  the  words  (Levitin,  p.  84).  Mithen  2005,  agrees  with  Levitin  

as  he  describes,  “speech  syntax  is  processed  not  only  in  Brocas  area  .  .    but  also  in  

the  equivalent  area  of  the  right  cerebral  hemisphere  .  .  .    musical  syntax  .  .  .  appears  

to  be  processed  in  these  same  areas,  although  that  in  the  right  rather  than  the  left  

cerebral  hemisphere.  .  .”  (Mithen,  p.  66).    

  Meghan  Morrow  is  a  music  therapist  and  brain  injury  specialist  at  TIRR  

Memorial  Hermann  Rehabilitation  Hospital  in  Tucson,  Arizona.  She  has  been  

working  closely  with  Congresswoman  Gaby  Giffords  during  her  ordeal  with  aphasia.  

She  states,  “music  is  that  other  road  to  get  back  to  language”  (Moisse,  p.  1).  She  

compares  the  brain  to  that  of  an  interstate,  meaning  that  thoughts  and  language  can  

no  longer  move  forward  on  the  path  but  you  can  still  maneuver  around  and  

eventually  end  up  where  you  need  to  go.  Similarly,  the  pathways  in  the  brain  that  

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are  used  more  frequently  will  be  stronger  but  there  are  still  back  roads  that  connect  

the  essential  areas  of  the  brain,  however  weak  they  may  be,  they  are  still  present  

and  will  still  function  properly  with  patience  and  practice.  Giffords’  use  of  music  and  

“layering  words  on  top  of  melody  and  rhythm”  have  enabled  her  to  train  the  “less  

traveled  pathway[s]”  in  her  brain,  to  reach  her  destination;  spoken  word  (Moisse,  p.  

1).  For  further  information,  see  links  to  videos  in  the  reference  section.  

  Levitin  states,  “listening  to  or  recalling  lyrics  invokes  language  centers,  

including  Broca’s  and  Wernicke’s  area,  as  well  as  other  language  centers  in  the  

temporal  and  frontal  lobes”  (Levitin,  p.  84).  Sacks  describes  that  many  patients  with  

aphasia  find  reassurance  when  using  music  to  find  language.  “Being  able  to  sing  

words  can  be  a  great  reassurance  to  such  patients,  showing  them  that  their  language  

capacities  are  not  irretrievable  lost,  that  the  words  are  still  ‘in’  them,  somewhere,  

even  though  it  may  take  music  to  bring  them  out”  (Sacks,  p.  216).  Sacks  also  

discusses  the  idea  that  aphasic  patients  can  do  more  than  recall  words  to  a  song  but  

can  also  relearn  sequences.  He  says,  “many  aphasic  patients  can  get  not  only  the  

words  of  songs,  but  can  learn  to  repeat  sequences  .  .  .  days  of  the  week,  months  of  

the  year,  etc.  They  may  be  able  to  do  this  as  a  series,  but  not  to  disembed  a  

particular  item  from  the  series”  (Sacks,  p.  217).    Otherwise  stating,  music  can  be  

helpful  in  recalling  sequences  but  it  does  not  mean  a  patient  with  aphasia  can  

remember  these  words  as  separate  from  the  series  in  which  it  belongs.    

VI.  Conclusions       Sacks  poses  the  following  question  about  the  recovery  of  speech  in  patients  

with  aphasia,  “  can  language  embedded  in  unconscious  automatism  be  ‘released’  for  

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conscious,  propositional  use”  (Sacks,  p.  218)?    In  my  opinion,  music  is  that  road  to  

releasing  one’s  spoken  language.  It  offers  patients  with  aphasia  another  attempt  at  

recovering  the  language  that  seems  to  be  lost.  Cynthia  Thompson,  a  professor  of  

communication  sciences  at  Northwestern  University  describes  reasons  that  music  

may  be  beneficial  to  a  person  with  aphasia.  She  considers  music  and  language  to  

take  place  in  similar  areas  of  the  brain  but  that  music  involves  more  activity  from  

the  right  hemisphere  of  the  brain  than  language.  Thompson  observes  that  singing  

“involves  neural  networks  that  differ  from  language.  In  particular,  the  right  

hemisphere  is  recruited  more  so  for  music  than  language”  (Rubin,  p.  1).  Since  

aphasia  occurs  in  the  left  hemisphere  of  the  brain,  where  the  language  center  is  

located,  one  may  lose  the  ability  to  speak  but  they  “often  retain  the  ability  to  sing”  

(Rubin,  p.  1).  This  is  often  why  speech  therapists  will  couple  music  with  the  

reacquisition  of  language  lost  by  aphasia  or  other  brain  injuries.  

  The  use  of  music  therapy  on  patients  with  aphasia  provides  them  with  the  

tools  that  they  need  to  strengthen  unused  neurological  pathways.  These  pathways  

are  not  necessarily  new  to  the  brain,  but  may  seem  new  to  the  patient  who  has  used  

them  infrequently.  Since  music  employs  the  right  hemisphere  of  the  brain,  patients  

with  aphasia  will  have  fewer  problems  singing  words  than  they  will  when  speaking  

them.  When  music  therapists  encourage  aphasic  patients  to  speak  words  

rhythmically,  this  advances  the  augmentation  of  neuroplasticity.  If  music  is  a  helpful  

tool  for  re-­‐learning  language,  lost  by  aphasia,  what  then,  are  the  implications  for  

using  music  as  a  means  to  acquire  a  new  language?  

   

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References:    

Print/Electronic:    Degmecic,  Dunja,  Ivan  Pozgain,  and  Pavo  Filakovic.  "Music  as  Therapy."     International  Review  of  the  Aesthetics  and  Sociology  of  Music  36.2  (2005):     287-­‐300.  Dec.  2005.  Web.  15  Mar.  2012.     <http://www.jstor.org/stable/3002173>.    Fromkin,  Victoria,  and  Robert  Rodman.  An  Introduction  to  Language.  9th  ed.  New     York:  Holt,  Rinehart  and  Winston,  1974.  Print.    Levitin,  Daniel  J.  This  Is  Your  Brain  on  Music:  The  Science  of  a  Human  Obsession.  New     York,  NY:  Dutton,  2006.  Print.    "MedicineNet.com."  Medterms.  6  Nov.  2004.  Web.  16  Apr.  2012.     <http://www.medterms.com/script/main/art.asp?articlekey=40362>.    Mithen,  Steven  J.  The  Singing  Neanderthals:  The  Origins  of  Music,  Language,  Mind,     and  Body.  London:  Orion  Group,  2005.  Print.    Moisse,  Katie,  Bob  Woodruff,  James  Hill,  and  Lana  Zak.  "Gabby  Giffords:  Finding     Voice  Through  Song."  ABC  News.  ABC  Nightline,  14  Nov.  2011.  Web.  15  Mar.   2012.  <http://abcnews.go.com/Health/w_MindBodyNews/gabby-­‐giffords-­‐   finding-­‐voice-­‐music-­‐therapy/story?id=14903987#.T2IFFM2qUt0>.    Rubin,  Bonnie  M.  "After  Injury,  Brain  Can  Keep  on  Healing."  Chicago  Tribune  4  Jan.     2012.  Web.    Sacks,  Oliver  W.  "Speech  and  Song:  Aphasia  and  Music  Therapy."  Musicophilia:  Tales     of  Music  and  the  Brain.  New  York:  Alfred  A.  Knopf,  2007.  214-­‐23.  Print.    Weintraub,  Karen.  “Treating  Gabrielle  Gifford’s  Aphasia.”  The  Boston  Globe.  February     17,  2012.    Videos:  Gabby  Giffords  ABC  News  1/3     http://www.youtube.com/watch?v=TQi7btgt_fw    Gabby  Giffords  ABC  News  2/3     http://www.youtube.com/watch?v=tiJ9X_wLSWM    Gabby  Giffords  on  D.  Sawyer     http://www.youtube.com/watch?v=1rcw_lQRXKM  

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Images:      

Figure  1.  A  “normal”  or  healthy  brain.            

Figure  2.  Broca’s  Aphasia  &  Wernicke’s                 Aphasia    

              Figure  3.  Human  brain  under  the                   influence  of  music.