Laura Cook – Choir Leader
As part of my second year clinical placement I was tasked with leading a choir for people with aphasia and their loved ones in Bath. The group had previously been run as a short term pilot project, led by two music therapists. The choir was the joint brainchild of Speech and Language Therapist Emma Richards, then part of the Virgin Care Bath and North East Somerset Community Stroke and Neuro Service, and Liz Jeggo, the local Stroke Association Stroke Communication Support Coordinator who is passionate about developing a local aphasia community and giving voice to stroke survivors with communication challenges. The project was very well received but ultimately too expensive to fund as an ongoing group.
Emma (a keen singer member of two choirs!) approached UWE Bristol and offered to supervise a UWE music therapy student in order to get the choir back up and running after many pleas from people who had been part of the pilot project in Bath. During my first year of training I had volunteered at the UWE ReVoice aphasia choir and had developed an interest in neurorehabilitation and the potential for singing to help people with aphasia, but had never led a choir myself. I was daunted but excited about the placement, particularly after meeting a very enthusiastic Emma and Liz and finding out about the singers I would be working with.
Emma taught me about the various subtypes of aphasia, techniques for using supported conversations in order to support the communication of people with aphasia, and how to make written and musical resources accessible through the use of layout, highlighting key words and using carefully chosen images. The initial rehearsals were a crash course in conducting, aphasia friendly communication and managing volunteers but I was encouraged by the enthusiasm and commitment of the participants. Musical supervision was provided by Dr Cathy Warner, Programme Leader for the UWE training.
During rehearsals I lead careful breathing and vocal warmups in order to safeguard voices which may be rarely used for speech, and focused on posture and diaphragmatic support. The choir sings a variety of traditional and pop songs, chosen either by the choir members or for their musical and lyrical content. We project aphasia friendly lyrics onto a screen to support both posture and comprehension.
Throughout my six month placement I developed my own abilities but more importantly witnessed a dramatic increase in the confidence and tonal quality of the choir. We were lucky to have some talented members, including a former musical director and local amateur dramatics star, and were able to welcome experienced singers who had been unable to participate in local choirs since their stroke. The placement concluded with a feedback session, including the use of an adaption of the AIQ-21 scale designed to make research accessible to those with aphasia (Swinburn et al., 2018). The choir members unanimously agreed that they had fun at choir, felt more confident singing and had more energy after the rehearsals. Members gave encouraging feedback such as “when I sing its perfect my words….I cannot do this when I speak” and “la, la, la perfect really…good I think”, while carers responded that “having words to sing takes away the stress of having to find the right words” and “choir gives him the opportunity to do something he is good at”.
A personal highlight was leading the choir in a performance at the Colston Hall as part of the UWE Festival of Sound in a joint performance with ReVoice – to my knowledge the first and only time two aphasia choirs have joined forces! I also felt a strong alliance and relationship building with the choir members and have cherished the opportunity to get to know them and their families. The work led to a lot of reflection and discussion around the links between ‘traditional’ music therapy, community music therapy approaches and speech and language therapy (Pavlecevic and Ansdell, 2004).
At the end of my placement the choir was continuing to grow in numbers and confidence and no one wanted it to come to an end. Emma successfully applied for startup funding from the Virgin Care Feel The Difference fund which allowed me to be employed as the choir leader and continue the valuable work of the group.
We knew that this funding would only be a short term solution and set about planning concerts and fundraising events. With the help of an experienced fundraiser, who is a friend of a couple who have sung with the choir since its inception, Liz and I applied for a funding grant from the St John’s Foundation who fund community projects in Bath. Thanks to the feedback and enthusiasm of our members we have now been awarded funding for the next three years and can now focus on growing the choir and reaching even more people with aphasia.
We hope that the growing trend of aphasia choirs continue to give voice to more people with aphasia and that music therapists and speech and language therapists can work collaboratively to ensure that such groups are truly accessible, participant-led and therapeutic.