The Communication Corner: Parkinson’s Disease and Active Music Therapy

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Active Music Therapy: An Interactive Way to Stimulate Emotional and Motor Rehabilitation for Parkinson’s Disease Patients

         Over the past several years, Music Therapy has become a widely used method of treatment in a medical setting. Individuals who participate in music therapy, benefit on multiple levels including, emotional, cognitive, social, intellectual,  and physical. Music therapy has also been known to reduce levels of stress and anxiety, as well as improve cognitive functioning in Alzheimer’s Disease patients. Research is also suggesting that music therapy is a beneficial therapy method for individuals struggling with Parkinson’s Disease. As you may or may not know, Parkinson’s disease affects roughly 500,000 individuals in the United States, with 50,000 new cases developing annually. Parkinson’s disease is a degenerative neurological disorder that is caused by degenerative neurons in the brain, responsible for controlling movement. Active music therapy is believed to help improve the functional status of individuals, diagnosed with Parkinson’s disease.

    Active music therapy is a specific approach to music therapy that involves the improvisation of music, in which the patient and the music therapist use musical instruments and their voices. By having the patient’s play musical instruments, the sensory organs are actively engaged. Furthermore, the patient begins to create music and rhythm which stimulates emotional and motor responses. Thus, providing movement of different sensory pathways in the brain. In a study that compared the effects of active music therapy to general physical therapy, 32 adults, 65 years of age with Parkinson’s disease, were compared between the two therapy methods. Researchers found that active music therapy not only increased the motivational level and quality of life in patients with Parkinson’s, but it also improved motor functioning levels of bradykinesia and emotional status. Bradykinesia is a medical term that is defined by extreme slowness of movement of the limbs and reflexes. The researchers hypothesized that the improvements found in bradykinesia were the result of activation of the emotional neural-based network in the brain. In other words, the temporary emotional response, facilitated increased motor functioning by activating the cortical-basal ganglia motor loop, which is the circuit area in the brain that is primarily affected in Parkinson’s disease patients.

    The previous findings post a positive opinion of active music therapy as a vital resource in the lives of individuals battling Parkinson’s disease. Music therapy has been proven to provide tranquility during taxing situations, improve cardiac functioning, and recently, motor and emotional functioning in Parkinson’s patients. Emotional and motor functioning are not the only highly praise outcomes of active music therapy. Parkinson’s patients have reported improvements in social interaction, involvement, responsiveness, and awareness. Active music therapy continues to grow in popularity and continues to prove that it is a unique and beneficial approach to standard therapy methods for Parkinson’s disease patients.

 

Resources:

Psychosom Med. 2000 May-Jun;62(3):386-93 Active music therapy in Parkinson’s disease: an integrative method for motor and emotional rehabilitation.

CLAUDIO PACCHETTI, MD, FRANCESCA MANCINI, MD, ROBERTO AGLIERI, CIRA FUNDARO`, MD, EMILIA MARTIGNONI, MD, AND GIUSEPPE NAPPI, MD

 

http://www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease_backgrounder.htm

The Communication Corner: Creating a Wellness Group!

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Pamela Rowe, Speech and Music Therapy has created a Company-wide Wellness Group using the Fitbit Fitness and Health Technology.  Pamela Rowe, MA, CCC-SLP started this program to help support a healthy lifestyle for the employees, which will help to serve the community as a whole.  The fitbit is the device we picked to help tracks steps, distance, and calories burned.  Fitbit has a few different models to choose from which include the Zip, Flex, and One. We have been using the fitbit zip for healthy competition between co workers.  By joining the group online, you are able to see the members step count for the month.  It’s the motivation you need to get out and be more active.

The zip is the smaller wireless tracker. It’s able to sync stats to the computer and select smartphones.  It also encourages you to set goals and challenge friends. The zip is easy to wear while it tracks steps, distance and calories burned.  Another device is the Flex. It’s a wireless wristband that tracks activity and sleep.  It helps to keep you motivated with real stats right on your wrist.  The flex can also be worn at night to track your sleep and number of times you wake up, so you can sleep more soundly.  The Flex has a silent wake alarm that vibrates to wake you up.  The last device they offer is called the One, it’s a wireless activity and sleep tracker.  This device never sleeps.  During the day it tracks steps, distance, calories burned and stairs climbed. At night it tracks your sleep quality, helps you sleep more soundly, and wakes you up with a vibrating alarm.  Fitbit offers a lot of different devices to turn everyday life into a social, achievable, awesome path to fitness.

The online wellness program for the fitbit  works great and is very simple to navigate. You just sync your device to your computer or smartphone.  The whole process is done wirelessly. When I started the program, I just opened the app on my phone and it automatically syncs when you tap the fitbit.  When you log on to your fitbit dashboard, you can see your step count, calories, distance and active minutes for the day. If your apart of a group, you can see everyones stats and see how you compare.  The visual chart helps to motivate you to reach goals and challenge friends.

Pamela Rowe, MA, CCC-SLP, Clinical Director of Pamela Rowe, Speech Therapy says, “As a Business Owner, I find that Fitbit.com Wellness Program is unique. It combines social media with wellness which is a great fit for today’s active professional.  It raises Team morale and instills a healthy lifestyle, not to mention a healthy competitive spirit.”  The fitbit is a great device to show activity during your day and motivate you to a healthier lifestyle.

www.fitbit.com

The Communication Corner: New Research Regarding Specific Language Impairment

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Information Processing and Proactive Interference in Children With and Without Specific Language Impairment

A recent study was conducted to see if children with a Specific Language Impairment (SLI) will differ from their peers in resistance to proactive interference under different conditions.  Proactive interference is the difficulty of learning new information because of already existing information.  Evidence has shown that children with SLI have a deficit in inhibition control, to focus on relevant information in presence of irrelevant information. People who are more efficient in resisting interference from irrelevant information (external or internal) have more free working memory capacity.  This information is what began the research to examined whether problems in proactive interference contribute to the working memory deficit in children with SLI.

Only a few studies have looked at executive functions such as inhibition control, or sustained attention with children with a SLI. Those findings show that children with SLI show slower development than Typical Language Development (TLD) peers but disappears once they get to school age. When looked at all the different studies, it suggest that problems of children with SLI are not limited ot specific modalities.  After these findings the study here was to focus on resistance to proactive interference.  Two questions were to be answered from the study: Experiment 1: Do children across groups show same degrees of interference in a condition where previous target items become distractors? Experiment 2: Do children’s responses to items follow a highly practiced item show an increase in reaction item reflecting greater proactive interference?

Three groups were formed based on age and language status, 22 child with SLI, 22 children with typical language development and 22 language-matched controls. All the children spoke English as primary language and had normal hearing based on the hearing screen. Also no other developmental disorder besides SLI.   All children scored within the average range on the Test of Nonverbal Intelligence-Third Edition.   From previous findings children with SLI were expected to perform poorly from peers. The children were required to listen to a long lists of items (2-6 items) belonging to a particular category(ex.animals), then reorder and repeat the items based on a given criterion (ex increasing size). Several standardized language measures where administered to the children to determine which group was appropriate.

The first experiment included manipulations to increase proactive interference by using previous target words as distractors. If the items from previous trail aren’t deleted from working memory efficiently, then recalling relevant information becomes more difficult.    Out of the 168 items, a distractor was presented on 48 items, half of these distractor items (24) were words from previous category.  The other 24 distractors did not belong to any category previously, they served as a baseline condition. Performance on items that used previous target words as distractors in trials was used to measure resistance to proactive interference.  The 3 groups did not differ in baseline performance, but vocabulary size did show a positive effect on performance accuracy.  The findings were that the interference condition has a negative effect on all children’s performance.  The negative effect is larger in children with Specific Language Impairment (SLI) than in Typical Language Development (TLD) children.   In each condition the younger children were slower than the older participants.

Experiment 2 will view the interactions between working memory and interference.  The repetition of the item in a category should increase that item’s representation in working memory and make it hard inhibit same response on the next trial because of interference.  Children with SLI are expected to take longer to build strong working memory due to previous evidence.  The same groups of children were used in this experiment.  The children were presented with 6 target items (six different, 14 item blocks) four times, they were not informed that items were repeated and how to perform task in usual manner.  The results were that SLI showed similar improvement in performance but more gradually, they required 2-3 repetitions to achieve the same increase in accuracy that TLD achieved in a single repetition.   Overall the second study showed us that children with SLI need to work harder than their peers to achieve the same goals, which may overload their system.

The results show us that children with SLI have a weaker resistance than their peers to proactive interference.  SLI children show difficulty with suppressing irrelevant information, make more interference errors than typically developing children and show a slower rate of implicit learning.  If you notice your child having trouble in any of these areas of language please contact a certified or licensed Speech Language Pathologist for an Evaluation.

Journal of Speech, Language, and Hearing Research February 2014, Vol.57, 106-119. doi:10.1044/1092-4388(2013/12-0306)

History: Accepted 02 May 2013 , Received 21 Sep 2012 , Revised 20 Feb 2013

ttp://jslhr.pubs.asha.org/Article.aspx?articleid=1802631

http://www.alleydog.com/glossary/definition.php?term=Proactive+Interference

http://www.kon.org/urc/v7/richardson3.html

The Communication Corner: Clinical Director awarded the ACE Award

Pamela Rowe, MA, CCC-SLP, Clinical Director of Pamela Rowe Speech and Music Therapy,  recently received the Award for Continuing Education (ACE).  The ACE is awarded by the American Speech-Language-Hearing Association (ASHA) to Speech Language Pathologist who have demonstrated commitment to lifelong learning by earning 7.0 ASHA CEUs (70 contact hours) within a 36-month period.

Beside showing her commitment to learning, Pamela Rowe, MA, CCC-SLP is an active member in the field of Speech Language Pathology.  She is a member of the American Speech-Language-Hearing Association (ASHA), Florida Association of Speech-Language Pathologist and Audiologists (FLASHA), The Corporate Speech Pathology Network (CORSPAN), and Community Leader on ASHA Community.  She’s also an affiliate with Special Interest group 2 Neurophysiology and Neurogenic Speech and Language Disorders, Special Interest Group 13 Swallowing and Swallowing Disorders, and Special Interest Group 15 Gerontology.  In addition to being an active member in the community, Pamela is also a published author with ASHAsphere, The ASHA Leader and the Independent Clinician.

Pamela stays busy in the field of Speech Pathology and explains,“I enjoy learning and collaborating within the field of Speech Pathology.  We are only limited by our creativity and compassion.  For the field of Speech Pathology, the best days are ahead of us.  The best is yet to come!”

http://www.asha.org/ce/CEUs/ace/

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The Communication Corner: Specific Language Impairment and Motor Skills

social-play

How Specific Language Impairment Affects Motor Skills and Language Processing

 

Specific Language Impairment, or SLI, as it is often called, is a language deficit found in children that impairs their  expressive and in some cases, receptive language capabilities. Expressive language is the area of communication that encompasses the ability to share thoughts, emotions, and ideas with others. Receptive language pertains to the ability to understand what other’s are saying to you and process receiving input. The cause of SLI is unclear and can occur when there is no sign of a neurological, hearing, or gross and fine motor impairment. However, some researchers have noted that children diagnosed with SLI tend to be clumsy and have soft gross and fine motor abnormalities.Researchers have also found that some children exhibited limb and finger movement abnormalities and have demonstrated trouble buttoning clothing, threading beads and hand gestures. A total of 29 conducted studies of motor skills and children with SLI reported similar findings which provides substantial evidence that language impairment in not the only aspect affected by SLI.

 

In a study conducted by Andrea C., DiDonato Brumbach, and Lisa Goffman, eleven children with SLI were compared to 12 age matched peers between the ages of 4-6 years old. The study focused on Syntactic Construction which examined error patterns in the production and use of syntax that varied in difficulty. Syntax is a linguistic term that pertains to grammar and the rules that guide the structure of sentences. The findings concluded that the children with SLI demonstrated difficulty using proper grammatical inflection (extra letter(s) added to nouns, adjectives, and verbs to reflect plurals and various tenses). Using comparisons from previous studies conducted by other researchers, Andrea C., DiDonato Brumbach, and Lisa Goffman concluded that it is common for children with SLI to leave out particles and inflections during speech. The researchers also found that articulatory movement is affected in children with SLI. After a series of tests and comparisons, it was concluded that SLI has an impact on movement and control of the articulators.

 

The main focus of this study was to create a paradigm for speech motor control that required   the participating children  to generate sentences without relying on imitation and copying sentences. The researchers used a priming task that asked if children with SLI and their normally developing peers, demonstrated predicted deficits in the production of syntactic structures. The researchers concluded that children with SLI expressed difficulty sequencing complex sentences as compared to their normally developing peers as well as,  expressing weakness in fine motor skills and precise movement of the articulators. The researchers concluded their study by reporting that although these findings provide evidence, they are only preliminary findings that merit further investigation and research. If your child has been diagnosed with SLI or you feel that your child is struggling with their syntactic construction and fine motor skills, please see a certified, licensed Speech Language Pathologist for an evaluation.

 

Resources:

Journal of Speech, Language, and Hearing Research February 2014, Vol.57, 158-171. doi:10.1044/1092-4388(2013/12-0215)

History: Accepted 14 May 2013 , Received 04 Jul 2012 , Revised 19 Dec 2012

 

The Communication Corner: Music Therapy and ADHD

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    Recent research studies show music therapy  to be highly effective when working with clients diagnosed with ADHD ( Attention Deficit Hyperactivity Disorder) and ADD (Attention Deficit Disorder). Music therapy is a positive way to gain management of behavior and motor impulsivity in clients of all ages who struggle with attention and hyperactivity. In addition, when used in conjunction with other complimentary neurotraining services,  music therapy has been proven to be effective in improving focus behaviors in clients with ADD and ADHD.

    One recent study, sought out to compare the impact of two different forms of music therapy: Improvisational and Instructive. The participants were adolescent boys between the ages of 11-16 years old, diagnosed with ADHD. The study concluded that there were no statistical differences between the two methods of music therapy in terms of motor impulsivity. However, all of the participants showed significant improvement in the Synchronized Tapping Task (STT) through both methods of treatment, but improvement was slightly greater with the instructional method of music therapy. During the study, the participants teachers reported findings of reduced restless and impulsive behavior. The study concluded that both instructional and improvisational methods of music therapy have been shown to reduce ADHD behaviors in the classroom environment.

     A truly wonderful benefit that comes from music therapy is the increase in dopamine levels in the brain and the firing of  synapses. Dopamine is responsible for our working memory, regulating attention, and motivation. Music therapy is also a useful tool for teaching planning, anticipation, and how to react to adults with ADHD. There is also a social aspect involved in music therapy that involves the instruction of eye contact, turn taking, sharing, and verbal/non verbal communication.  For more information on music therapy, please visit our website at www.speechorlando.com/music-therapy

 

References:

 

Rickson DJ. (2006). Instructional and improvisational models of music therapy with

adolescents who have attention deficit hyperactivity disorder (ADHD): a comparison of the

effects on motor impulsivity. J Music Ther. Spring;43(1):39-62.