About

The SingWell project considers group singing as a meaningful social activity for people living with communication challenges that appears to have potential to support communication function.

While other effective interventions already exist for supporting communication deficits in communication challenges (CC), they tend to be costly to deploy, not widely available in remote communities, and generally not effective with regard to combating social well-being issues related to CC. Thus, group singing for CC appears to be an important complementary intervention worthy of further consideration from scientific, practical, economic, and ethical standpoints.

Singwell Research

Objectives

Knowledge Generation

The assembled network will increase scientific understanding of the effects of group singing on social well-being and its effects on communication function in people living with the following communication disorders:

Aphasia
Breathing disorders
Hearing loss
Stuttering
Parkinson’s disease

A secondary aim will be to document the ongoing interactions between communication gains and social well-being in adults living with communication challenges who engage in group singing. Moreover, we aim to clarify the sociobiological (e.g., neuroendocrinological) underpinnings of these social effects.

Knowlege Mobilization

The assembled network will be able to facilitate transfer and uptake of knowledge to receptor communities including support organizations, practitioners, and the general public. Through our website (singwell.ca) and our partnership with Choral Canada and communication disorder-related societies, we will be able to distribute best practice documents. Through our partnership with the Alliance for Healthier Communities we will build an economic case for the social prescribing of singing.

Training

The assembled network will provide interdisciplinary training to highly qualified personnel (inclusive of graduate students and postdocs). This will include training by experts in communication disorders as well as training by experts in different research methods of high relevance to this area of research (e.g., mixed linear modelling, gerontology, choral direction, social psychology, and neuroendocrinology). A culminating objective for training is to establish an accreditation program for practitioners, who wish to lead singing in groups composed of people living with CCs.

More generally, the current project will fill gaps in the literature, develop a comprehensive understanding of best practices, and work towards knowledge mobilization, thereby broadening the scope of individuals living with CCs who may benefit from group singing.

Populations of interest

People Living with a Communication Disorder

Aphasia

Aphasia is an impairment of language functions that affects over 100,000 Canadians. Because singing is often preserved in aphasia and experienced as highly pleasurable (Racette et al., 2006), many participate in singing choirs on a voluntary basis. One singing-based speech therapy, the Melodic Intonation Therapy (MIT), has been designed for non-fluent people with aphasia and has been used in subacute aphasia, that is soon after the stroke, with significant improvements in the patient’s daily life communication compared to a control group, which received other types of language rehabilitation (Van der Meulen et al., 2014).

Yet, MIT, is a one-on-one intervention that is costly in human resources and not as enjoyable as group singing. Group singing provides an attractive alternative intervention. In a blind randomized control pilot study (Zumbansen et al, 2017), choir participation was found to be effective in improving communication function. However, the study was highly limited in size (7 each in experimental and control conditions) and possibly administered too late in the process of recovery.

Associations

March of Dimes

Breathing Disorders

Breathing Disorders, inclusive of Chronic obstructive pulmonary disease (COPD), asthma and other chronic difficulties affects over three million Canadian adults. A number of studies including randomized-controlled trials (RCT) suggest that singing leads to improvements in the maintenance of lung functions (Bonilha et al., 2009; Gick & Nicol, 2015; Lewis et al., 2016).

Choirs

Hearing Loss

Hearing Loss due to peripheral (cochlear) and/or central losses (brain stem and beyond) affects over three million Canadian adults . Because singing requires sensitivity to fine- and gross-temporal structure, it has potential to be an effective way to rehabilitate central hearing loss. For example, our group found that 10 weeks of group singing in adults living with age-related hearing loss led to improvements in speech-in-noise perception (Dubinsky et al., 2019). These improvements were mediated by improvements in the neural representation of pitch, suggesting that the extra-musical benefits on speech perception were not merely a product of increased motivation to perform well in auditory tasks.

Associations

Canadian Hearing Society

Stuttering

Stuttering is a neurodevelopmental speech disorder concerning the flow of communication affecting approximately 290,000 Canadians. Individuals who stutter suffer from involuntary blockades as well as from sound and syllable repetitions and prolongations during speaking. Singing has been found to generate a dramatic reduction of stuttering symptoms compared to speaking (Falk, Schreier & Russo, 2020). There are, to our knowledge, no studies to date addressing the effects of group singing on communication and wellbeing in stuttering.

In sum, group singing appears to be a viable alternative to improving communication function in people living with CDs that may also promote social wellbeing. While other effective interventions exist for supporting communication function in people living with CDs (e.g., LSVT/LOUD for speech production challenges in Parkinson’s disease; Fox et al., 2006), singing offers important advantages: a) high intrinsic motivation which may sustain adherence leading to cumulative benefits (Livesey et al., 2012); b) the widespread availability of people who would be able to lead such groups following some brief training, which may help to address the critical need for CD support in small and isolated Northern communities (Winn, Chisholm, Hummelbrunner, 2014); and c) the potential for caregivers to receive benefits from observing (or participating with) loved ones in a meaningful activity that is ability focused (Tamplin et al., 2013). Thus, group singing for CD appears to be worthy of further consideration from scientific, practical, economic, and ethical standpoints.

Associations

Canadian Stuttering Association

Parkinson's Disease

Parkinson’s disease is a movement disorder affecting the dopamine producing nerve cells in the brain. Over 100,000 Canadians are living with PD. A secondary symptom of PD is speech and vocal-facial communication impairments. Even in early stages of the disease, PD patients experience disruptions to speech volume, intelligibility, and dynamic expression. There are also disruptions that our group has documented in facial mimicry and perception of speech emotion (Livingstone et al., 2016). Singing works to strengthen the muscles that have been compromised as a result of the disease. In particular, singing engages the lungs, larynx, head, and facial muscles (Müller & Lindenberger, 2011; Thompson & Russo, 2007). Prior research suggests that 13 weeks of group singing can lead to a wide range of improvement in speech production, including improvements to maximum inspiratory/expiratory pressure, maximum duration of sustained vowel phonation, and vocal prosody (Di Benedetto, et al., 2009; Russo, 2016).