Story of Hope
Singing Therapy Helps Young Stroke Survivor Speak Again
When we think of stroke patients, we typically think of older men and women — those who smoke or are overweight, or often those with heart disease. Having a massive stroke at the age of 11 is not something you would imagine happening to your child.
But that’s exactly what happened to Laurel Fontaine (right) about seven years ago. After a massive stroke destroyed most of the left side of her brain, doctors told Laurel’s parents that she would never speak again. Now 18, she has spent the last seven years proving everyone wrong.
Before her stroke, Laurel was a healthy, athletic 11-year-old celebrating Memorial Day weekend by playing a friendly game of tag with her twin sister Heather. Partway through the game, Laurel's head started to ache, so she ran over to her mother, said she felt sick, and then collapsed on the ground.
Her mother called 911. Within minutes, a medical helicopter landed in the park where the girls had been playing and airlifted Laurel to the hospital. (Laurel was not treated at Beth Israel Deaconess Medical Center.) While she spent the next 10 days in a coma, doctors gave her parents a very grim scenario: If she was to survive, Laurel would probably never be able to walk, talk, or care for herself again. One of her doctors said it was the biggest stroke he'd ever seen.
"My doctor told me I'm not going to talk, I'm not going to walk, I'm not going to, like, do anything ... press buttons ... ever," she says.
Because the stroke had destroyed most of the left side of Laurel's brain, including the area that controls speech production, talking was one of her biggest challenges. After a year of conventional speech therapy, Laurel could produce only one or two words at a time.
Fifteen months after the stroke, a relative saw a news story about the melodic intonation therapy research being conducted at Beth Israel Deaconess Medical Center (BIDMC). Laurel’s mother immediately contacted the researchers, asked them to evaluate her, and persuaded them to apply for the special permission that would allow a 12-year-old to participate in a trial designed and approved for adult stroke survivors. Permission was granted and Laurel was enrolled.
While traditional speech therapy can effectively target the left side of the brain to help patients with small strokes regain their speech, a different approach is needed for those with very large strokes like Laurel’s. Because melodic intonation therapy trains the right side of the brain (where singing is controlled) to take over for the damaged left side, with intensive treatment and ongoing practice, patients can learn to produce speech by singing the words and phrases rather than speaking them.
Laurel proved to be a perfect subject for the research study led by Dr. Gottfried Schlaug, Chief of Stroke Recovery and Neurorestoration, and Director of the Music, Stroke Recovery & Neuroimaging Lab at BIDMC.
In addition to the hard work, dogged determination, and perpetually positive attitude Laurel brought to her daily sessions, her identical twin sister, Heather, was willing to undergo the same study-related brain scanning so her images could be used for comparison with Laurel’s. That comparison would enable the research team to document the functional and structural changes that her brain would undergo as part of the intensive therapy and relearning how to speak again. Her sister was a perfect control subject for this study to rule out that changes observed in the brain were not due to normal developmental changes.
Laurel participated in the therapy every day for four months. Her fluency improved and she began rebuilding her vocabulary. Now, she doesn't even need to sing the words out loud, but does so quickly in her head if she is having a hard time producing the words to express her thoughts.
"On her first day, she started with about eight words,” David Fontaine says of his daughter's progress. “Now she has about 8,000."
And Laurel continues to improve. It's possible, Schlaug says, that when Laurel is in her 20s, someone who didn't know any better would never suspect that she’d had a massive stroke that left her unable to speak.
In the meantime, Laurel plans to use her experience to inspire others. The North Attleboro High School senior has a goal of becoming a motivational speaker and is now well on her way to doing just that — she recently gave a speech focused on gratitude at a gala event honoring 250 BIDMC donors, some of whom had contributed to the very research that helped her recover her speech.
"I thanked them for helping me find my voice," she says. "They were so kind to help me out, so I just wanted to thank everybody."
Laurel now has her own business card that identifies her as an "inspired stroke survivor," and she hopes to participate in a program that will allow her to talk to and encourage others who have had strokes as they begin the long road to recovery.
"I want to give others hope,” she says, “so they understand with hard work and a positive attitude, things can get better."
Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted January 2014