• Karina Erland Jensen
4. term, Music Therapy, Master (Master Programme)
This Master’s thesis is a single case study of voicework in music therapy with a client presenting with Non-fluent Aphasia and Apraxia of Speech (AOS) caused by acquired brain injury. The single case study is applied in retrospect on data I collected during my 16-week internship in autumn 2013 at Center for Rehabilitation of Brain Injury (Center for Hjerneskade) in Copenhagen S.
The primary aim of the case study was to explore in a broader matter how voicework can contribute to the rehabilitation process, and to investigate if voicework can facilitate improvement in phonation and voice function and cause change over time, when applied with a client presenting with non-fluent aphasia classified as Broca’s aphasia and AOS. It is further investigated if an improvement in phonation and voice function can promote articulation and the speech rehabilitation, and last if a theoretical comprehension of voicework can be generated from the results and findings in the case study and existing theory.
The methodology of the study was flexible design research as defined by Robson (2002) applying a single case study with an embedded design. Overall the study can be termed a mixed-method study as quantitative and qualitative research methods is mixed and combined in the analysis.
A thorough process of analysis was conducted on selected voice data and to kinds of voice exercises were selected: The Glissando Exercise and The Vowel Exercise. Three Glissando exercises and two Vocal Exercises representative for the music therapy were subsequently selected from inclusion and exclusion criteria.
The methods chosen for the analysis were:

1. Voice Assessment Profile (VOIAS) developed by Wich (2013) – a quantitative profile to assess the human voice consisting of two assessments VOIAS 1: a subjective approach to assess vocal sounds and VOIAS 2: an objective approach (psychoacoustic).
2. Principles from: Model for Video Microanalysis developed by Holck (2002) and Ferraras Eclectic Model for Music Analysis (1991) – two qualitative methods – an ethnographic descriptive approach and a phenomenological approach.

The results of the case study suggest that:

1. Voicework can cause positive change in the client’s communicative, social and psychological functioning and thus contribute to the rehabilitation process. The music, more specifically the melody and rhythm plays and essential part in the clients experience of being able to express himself and to mobilise words and sounds. The voicework additionally shows that it is recommendable, that the voice exercises are performed by the music therapist and the client and then by the client alone in order to be able to study the client’s internalization of the voice expression in relation to the voicework and provide a more valid evaluation of the effect of voicework on the human voice.
2. Voicework can facilitate improvement in specific voice parameters in phonation such as pitch range, the duration of vocal sounding and intensity and in voice function such as: voice fluctuation and fluency.
3. The case study suggests that voicework can improve articulation, which is a fundamental function in to be able to produce speech. Also from a neurologic perspective music can have a potential to promote speech rehabilitation. Especially rhythm appears to be a significant element in the facilitation of vocal sounding in this case study, which is supported by other research findings, other clinical voicework interventions and neurological theory.
4. A theoretical comprehension of voicework has been generated from the results and findings in the case study and existing theory.
Publication date31 May 2014
Number of pages80
ID: 198352621