Background: Several studies using musical elements in the treatment of neurological language and speech disorders have reported improvement of speech production. One such programme, Speech-Music Therapy for Aphasia (SMTA), integrates speech therapy and music therapy (MT) to treat the individual with Apraxia of Speech (AoS) and aphasia. We have observed encouraging results in clinical practice, but there is still no empirical evidence of the effect of SMTA. Aims: The current study investigated the effectiveness of SMTA on verbal communication in daily life. Methods & Procedures: Five participants with AoS accompanied by aphasia were included in an efficacy study using a case series design with multiple measurements. All participants received 24 SMTA sessions including two 30-min sessions per week. Pretreatment and posttreatment (immediately and 3 months after treatment stopped), verbal communication (intelligibility and comprehensibility) were tested with the Amsterdam-Nijmegen Everyday Language Test. The Aachen Aphasia Test (AAT) and the Diagnostic Instrument for Apraxia of Speech (DIAS) were also administered. The participants were tested four times before the start of the treatment (baseline) with a related test for progress on articulation (Modified Diadochokinesis Test (MDT)) and once with an unrelated control test (Psycholinguistic Assessment in Language Processing of Aphasia 12; repetition of number series). During the treatment, both tests were administered weekly. Outcomes & Results: Intelligibility of verbal communication for all participating individuals, as well as comprehensibility in four out of five participants, improved after 24 SMTA treatment sessions. All measures of MDT and repetition of AAT showed significant improvement for all participants. Four participants also improved on the test for articulation of phonemes and the diadochokinesis test of the DIAS. Furthermore, two participants improved on the articulation of words (DIAS). The improvement remained stable after treatment ended (follow-up). For three out of the five participants, no improvement was found on the control tests. Two participants also showed improvement on almost all outcome measures, but also improved on the control tests. SMTA not only affected articulation but also positively influenced the severity of the aphasia in four out of five participants. Conclusions: SMTA seems an effective treatment programme for at least three of the five individuals that were treated in the current study. This treatment led not only to better articulation, but more importantly, also to improvement in communication in daily life.

Objectives: To explore job adjustments, job satisfaction, and health experience among employees with an upper limb amputation and to compare the results with those of lower limb amputees and control subjects. Methods: Amputees were recruited from data files of a large European University Medical Centre and orthopaedic workshops. Controls were matched colleagues of the lower limb amputees. All participants filled out the VAG questionnaire (Vragenlijst Arbeid en Gezondheid), assessing job satisfaction and job adjustments, and the RAND-36. Results: 28 upper limb amputees were compared to 144 lower limb amputees and 144 controls. Job adjustments were necessary in 38% and 28% of upper and lower limb amputees, respectively. All three groups were equally satisfied with their jobs (p ¼ 0.90). Vocational rehabilitation was applied to 26% and 8% of upper and lower limb amputees, respectively. Upper limb amputees rated their general health worse (18 points, 95% CI: 12-25) compared to lower limb amputees, corrected for effects of confounders (age and co-morbidity). Conclusions: Upper and lower limb amputees have high job satisfaction and a minority need job adjustments. In upper limb amputees, the causes of the worrisome general health experience need further investigation. In upper and lower limb amputees, vocational rehabilitation deserves additional attention.