What is Neurologic Music Therapy?
Neurologic Music Therapy (NMT) is an evidence-based approach to research and clinical practice that is based in neuroscience models of treatment and rehabilitation. The Neurologic Music Therapy System of Techniques is a standardized evidence-based clinical treatment system of 20 techniques that is driven by advances in applied auditory music neuroscience and the clinical understanding of music perception, production, and cognition. Unlike traditional music therapy, which emphasizes emotional and psychosocial outcomes, NMT is driven by advances in neuroscience and the understanding of the perception, production, and performance of music and how music can influence and change non-musical brain and behavior function. The NMT System targets specific functional behaviours in the areas of cognition, sensorimotor, and speech and language based on a client’s diagnostics and treatment goals.
NMT operates on the principle of auditory-motor entrainment and neuroplasticity—the ability to perceive music and to engage in musical experiences is often still intact even when the central nervous system is damaged by injury or disease, thus NMT techniques produce specific and functional outcomes for patients with neurologically based deficits. Processes in the brain activated by the influence of music can be generalized and transferred to non-musical functions, and in clinical practice, the translation of non-musical therapeutic exercises into analogous, isomorphic musical exercises is performed.
Origins & Lineage
Professor Michael Thaut and his team developed the clinical system of Neurologic Music Therapy, which is applied worldwide in neurorehabilitation, and endorsed as evidence-based by the World Federation of Neurorehabilitation. Thaut has been the Director of the Center for Biomedical Research in Music since 1994 at Colorado State University, and is now at the University of Toronto.
The discovery of rhythmic auditory-motor entrainment in clinical populations was a historical breakthrough in demonstrating for the first time a neurological mechanism linking music to retraining brain and behavioral functions; early pilot studies from this research center were followed up by a systematic line of research studying rhythmic auditory stimulation on motor therapies for stroke, Parkinson’s disease, traumatic brain injury, cerebral palsy, and other movement disorders. This research in the early 1990s established the foundation for what became NMT.
Modern music therapy, starting around the middle of the twentieth century as an organized profession, has traditionally been rooted in concepts of social science; the basic value of music in therapy was considered to derive from emotional and social functions in personal life experiences and a society’s culture, including emotional expression, social roles to facilitate group association, integration, and relationship building, as well as general concepts of well-being and health; however, driven by new insights from research in music and brain function, a new understanding of the capabilities of music as a complex auditory language in therapy and rehabilitation has emerged over the past 25 years.
Over 6,000 NMT Professional Affiliates have been trained by the Academy of Neurologic Music Therapy since 1999. The NMT Academy training is endorsed by the World Federation of Neurorehabilitation, the European Federation of Neurorehabilitation Societies, and the International Society for Clinical Neuromusicology; the NMT Academy is approved by the U.S. Certification Board of Music Therapy as an advanced provider for Continuing Music Therapy Education credits.
How It’s Practiced
NMT employs 20 standardized techniques organized into three domains: sensorimotor, speech and language, and cognitive. These techniques include Rhythmic Auditory Stimulation in gait training, Vocal Intonation Therapy to enhance speech production, and Musical Neglect Training for redirection of spatial awareness.
Rhythmic Auditory Stimulation (RAS) is a neurologic technique employed to aid in the rehabilitation of rhythmic movements, particularly gait, in individuals with neurological impairments; RAS leverages the impact of auditory rhythms on the motor system to enhance the control of movement and foster the development of functional, stable, and adaptable gait patterns. Patterned Sensory Enhancement (PSE) uses the rhythmic, melodic, harmonic and dynamic-acoustical elements of music to provide temporal, spatial, and force cues for movements which reflect functional exercises and activities of daily living; PSE is broader in application than RAS, because it is applied to movements that are not rhythmical by nature (e.g., most arm and hand movements, functional movement sequences such as dressing or sit-to-stand transfers) and it provides more than just temporal cues.
Therapeutic Instrumental Music Performance (TIMP) uses the playing of musical instruments to facilitate movement patterns, while speech and language techniques include Melodic Intonation Therapy and Therapeutic Singing. Cognitive techniques address attention, memory, and executive function deficits.
NMTs work on functional non-musical goals through structured musical interventions in neurologic rehabilitation, neuropediatric, neuropsychiatric, and neurodevelopmental settings; they often work in conjunction with other health care professionals including physical therapy, speech/language pathologist, occupational therapy, neuropsychologist, and neurologist in order to address rehabilitative, adaptive, and developmental goals.
Neurologic Music Therapy Today
NMT is practiced in hospitals, rehabilitation centers, outpatient clinics, and private practice settings worldwide. NMT Professional Affiliates can be found working in 67 countries around the world. Communities served by NMT include: acquired brain injury, movement disorders, developmental and autism spectrum disorder, Alzheimer’s disease and other related dementia, and mental health.
A music therapist must complete the 4-day, 30-hour training institute at the Academy of Neurologic Music Therapy, which allows the board-certified music therapist to practice and use the professional designation of Neurologic Music Therapist (NMT) for five years while participating in NMT Professional Development such as NMT Academy Global Support Groups, Academy-endorsed NMT local support chapters, Academy sponsored symposiums, and other affiliate determined professional development. Allied Professionals who have taken the NMT training may also use the principles and NMT techniques within their own professional scope of practice.
The practice is integrated into stroke best practice guidelines in Canada and the VA/DoD Clinical Practice Guideline for the Management of Stroke Rehabilitation. Research continues to demonstrate effectiveness across conditions including Parkinson’s disease, cerebral palsy, traumatic brain injury, aphasia, and cognitive impairments following stroke.
Common Misconceptions
NMT is not recreational music or passive listening. Neurologic Music Therapy is an evidence-based treatment system that uses standardized, research-based techniques to treat the brain using specific elements of music such as rhythm, melody, dynamics, tempo; the Neurologic Music Therapist is a stimulus specialist who is trained in the neuroscience of music perception, music production/creation, and music cognition; the therapist uses standardized techniques to address non-musical goals such as speech, physical movement, cognition and other functional abilities, focusing on the music as therapy, emphasizing specific elements of music in the construction of therapeutic exercises as research indicates, in order to optimize function and/or reroute neuropathways to achieve functionality.
NMT is not interchangeable with general music therapy. While general music therapy seeks to treat many different aspects of patient need (emotional, physical, mental) through playing, listening to and/or writing music, Neurologic Music Therapy is an evidence-based treatment system in which not only NMTs are trained but also other allied professionals such as PTs, OTs, SLPs, neuropsychologists. The two approaches have different theoretical foundations, assessment methods, and outcome measures.
NMT does not replace conventional rehabilitation therapies; rather, it functions as a complementary approach integrated into interdisciplinary care teams. It requires specialized training beyond standard music therapy certification and is not simply “playing music” for patients.
How to Begin
For those seeking NMT services, the Academy of Neurologic Music Therapy maintains a searchable directory of certified practitioners at nmtacademy.co. Services are typically covered by insurance when provided by board-certified music therapists in medical settings.
For clinicians, the pathway requires first obtaining board certification as a music therapist (MT-BC) through completion of an accredited music therapy degree, clinical internship, and national examination. Advanced training is then obtained through the Academy’s international training institutes—intensive 4-day programs covering neuroanatomy, neuropathology, the 20 NMT techniques, and the Transformational Design Model for clinical assessment and treatment planning.
Key texts include the Handbook of Neurologic Music Therapy (2nd edition, Oxford University Press, 2014) edited by Michael H. Thaut and Volker Hoemberg, and Thaut’s Rhythm, Music, and the Brain: Scientific Foundations and Clinical Applications (2005). Both provide comprehensive coverage of the neuroscience foundation and clinical applications of NMT techniques.