music&aphasia:relearning & languagethroughmusic&...music&aphasia:relearning &...
TRANSCRIPT
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
Rowland 2
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.
Rowland 3
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
Rowland 4
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
Rowland 5
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.
Rowland 6
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
Rowland 7
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
Rowland 8
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?
Rowland 9
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
Rowland 10
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.