Neurologic Music Therapy (NMT) is a specialized, standardized, and evidence-based system that uses music to address functional goals in people with neurological conditions. NMT applies the science of how the brain processes music to rehabilitate non-musical skills, focusing on interventions for cognitive, motor, and speech and language dysfunctions resulting from a neurologic event or disease. Therapists utilize structured musical exercises to stimulate and retrain brain functions. This approach views music through a neuroscience model, distinguishing it from traditional music therapy.
Core Principles of Neurologic Music Therapy
The foundation of NMT rests on neuroplasticity—the brain’s inherent ability to change and reorganize itself. Engaging with music stimulates multiple brain areas, creating new neural pathways or rerouting existing ones around damaged regions. NMT leverages the intrinsic structure of music, such as rhythm, pitch, and timing, to drive this neuroplastic change for functional recovery.
A primary mechanism is the auditory-motor feedback loop, which describes the close link between the auditory and motor systems. When an individual hears a rhythmic cue, the brain’s motor areas are automatically activated and synchronized with the external rhythm. This phenomenon, known as rhythmic entrainment, allows the therapist to use a steady beat to regulate and improve the timing and coordination of intrinsically rhythmic movements, such as walking.
Defining the Clinical Techniques
NMT employs a taxonomy of 20 standardized techniques designed to target specific functional behaviors across three primary domains: sensorimotor, speech and language, and cognitive function.
Sensorimotor Techniques
For motor rehabilitation, Rhythmic Auditory Stimulation (RAS) applies a rhythmic cue, often a metronome beat, to entrain the patient’s walking pattern. The therapist matches the rhythm to the patient’s current gait cadence and then gradually increases the tempo to establish a faster, more functional walking speed. Therapeutic Instrumental Music Performance (TIMP) uses playing instruments to simulate functional movement patterns. Instruments are strategically placed to encourage specific upper-extremity movements, such as reaching, grasping, and increasing range of motion or dexterity.
Speech and Language Techniques
In the speech domain, Melodic Intonation Therapy (MIT) helps patients with non-fluent aphasia learn to speak again by singing phrases. This technique capitalizes on the unimpaired right hemisphere of the brain, which helps stimulate the speech centers in the left hemisphere. Musical Speech Stimulation (MUSTIM) uses familiar songs or musical phrases to stimulate non-propositional or automatic speech, such as completing a song lyric or a familiar phrase.
Cognitive Techniques
For cognitive goals, techniques like Musical Attention Control Training (MACT) employ musical exercises to practice focused, sustained, selective, divided, and alternating attention functions.
Scope of Treatment
NMT is utilized across a wide range of patient populations and neurological conditions, targeting functional improvements that transfer directly to daily life. A large portion of the work focuses on individuals recovering from stroke or traumatic brain injury (TBI). For these individuals, NMT addresses motor deficits like impaired gait and speech disorders such as aphasia, supporting the recovery of articulation, voice control, and the ability to organize thoughts.
Patients with neurodegenerative diseases like Parkinson’s disease, multiple sclerosis, and Alzheimer’s disease also benefit. Rhythmic cues help patients with Parkinson’s overcome freezing episodes and improve the speed and length of their steps during gait rehabilitation. NMT techniques also help improve coordination, strength, and motor control for conditions like cerebral palsy.
Finding a Certified NMT
A practitioner of Neurologic Music Therapy must first be a board-certified music therapist (MT-BC), which requires an accredited degree and successful completion of a national certification examination. This initial certification ensures a comprehensive background in music therapy principles, clinical skills, and professional ethics. Following this, the therapist must complete specialized, advanced training solely provided by the Academy of Neurologic Music Therapy. This advanced training provides the therapist with the license and designation to apply the standardized NMT techniques and methodology. When seeking treatment, it is important to verify that the professional is a current affiliate of the Academy of Neurologic Music Therapy.