Q: Your Vowel Tracks program was great and the child I am writing about now has all his vowels. His language is improving but most staff cannot understand him because his prosody is drawling, singsong-ish, and inflection is always up at the end of each statement like a question. Any thoughts about how to approach this?

The interesting thing about this rising intonation pattern used on statements is that I hear many young people use this today. They say things like: “I went to the mall and I was thinking about trying to get a job there?” It is as if they are unsure about everything they are doing, and they are always asking for approval.

I also have seen a variety of clients with inflection problems like this. These mostly have been kids diagnosed with ADD, auditory processing deficit, and autism spectrum disorders. Honestly, I do not think I ever have been able to change one. It’s like their brain can only process language when it is used with this inflection.

When addressing intonation, however, I always start with what a music teacher friend of mine calls the “Na-na Sound.” This is the sound that children use when they are beginning to taunt one another. “Na-na-na-na-na-na… I don’t like you… cause you are stupid…” You know, normal child taunts… My music teacher friend told me this is the first melody that children can hear. High-low. That is the basic pattern. I am not sure if there is data to back that up or if it was just his working experience. I do know, however, that this is the basic musical pattern that occurs in elementary tunes like “Twinkle, Twinkle, Little Star,” “Row Your Boat,” and the “A-B-C Song.” This basic low-to-high and high-to-low pattern has been attributed to Mozart, but I believe there is some controversy about that.

I teach high-low on single words like “mama” with a high tone on the first syllable, and a low tone on the second. Then we transfer this to two-word combinations, with a high tone on the first word, and a low tone on the second word. Then we move on to sentences like “I am walking.” The high-low tone occurs twice, with high tones on “I” and “walk,” and low tones on “am” and “-ing.”

All of this is a modification of the basic intonation work done in the speech-language program called “Melodic Intonation Therapy.”

References on Melodic Intonation Therapy

• Albert, M., & Sparks, R., & Helm, N. (1973) Melodic intonation therapy for aphasia. Archives of Neurology, 29, p. 130–131.
• Helfrich-Miller (1994) Melodic intonation therapy for developmental apraxia. Clinics in Communication Disorders, 4, p. 175-182.