Populations

Populations of interest

The populations of interest for this study include populations living with or without communication disorders.

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

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 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

 

 

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).
 
Associations
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.
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