Rhythmic Speech Cueing and Developmental Speech and Language Training through Music: What are they?
Rhythmic Speech Cueing (RSC) and Developmental Speech and Language Training through Music (DSLM) are two Neurologic Music Therapy (NMT) techniques that work on gaining and rehabilitating accurate and fluent speech. While their overall goals overlap, they take distinctly different paths.
DLSM is more often used when speech has not yet been developed to its appropriate level due to a developmental delay, rather than a loss of speech. In short, DLSM is used to habilitate, while RSC is more often used to rehabilitate. Due to the nature of each technique, DLSM is often used with younger populations and RSC with older ones. However, they are not exclusive to those population and can have effective uses, when used appropriately, with their counter “age group”. As always, choosing interventions that are age and developmentally appropriate is imperative.
RSC is much more formulated by a specific protocol. Its purpose is to decrease stuttering and cluttering that may occur in a fluency disorder, control rate of speech to increase intelligibility, and facilitate rhythmic sequencing. Overall, RSC should increase oral motor planning. RSC is effective because of how rhythm entrains to stimulate interaction between auditory and motor systems within the body.
There are three primary steps to RSC. Step 1: Find the initial rate of speech by having the client repeat a pattern of sound such as “pa”, “ta”, etc. Step 2: Slow down talking approximately 60% from the initial rate of speech. Step 3: Repeat functional phrases to a metronome at the new rate. There are two ways in which a phrase can be set to the rhythm. Metered, which is when every syllable of a phrase is beat/tapped out, or patterned, which is when the rhythm is still controlled for clarity in pace of speech, but not every beat is denoted. Patterned phrases should rhythmically imitate the prosody of how a phrase would actually sound, emphasizing what would be in natural speech.
DLSM does not have a specific protocol. It can be carried out in many ways and for multiple purposes. Because of this, it can also be more “fun”, contributing to its lean towards children. In its broadest form, this technique’s purpose is to use music and related materials to enhance and facilitate speech (e.g. singing, playing musical instruments, and combining music, speech, and movement). Broken down, this takes many forms, such as articulation, phrase lengths, and receptive and expressive language comprehension and production. The goals surrounding DLSM can also go beyond simply speech production. Then can often be in conjunction with expanding social and academic skills. For example, learning to ask and answer “WH” questions (i.e. who, what, where, when)
As stated previously, these techniques are not exclusive. They can, in fact, be paired together to increase an intervention potency. For example, I worked with a young client who loved the song “You’re Welcome” from Disney’s Moana. If you are familiar with the tune, you will recall a bridge section of the song that is a rap. We would sit at the piano together, with the lyrics of the song in front of us. I would play the piano as my client sung along. Going at a moderate pace, we would sing through the chorus using the catchy melody and funny lyrics as motivations to practice her articulation in a DLSM fashion. However, when the rap portion would arrive, I would play the chord with each beat of the rhythm (patterned RSC), going even slower for longer phrases and syllabic words, in a modified RSC fashion. We would go through particularly challenging phrases at varying speeds until there was clarity in the articulation.
Like all techniques, there is a time and place for them. The key is having a solid understanding in order to carry them out in a way that maximized their effects. However, just as understanding is important, so is patients. Techniques are not magic wands and their interventions spells you cast. It may take time and modifications, but diligence on both the client and therapists part will produce results that have life changing consequences.
-Noriah Uribe
