A case story from supervision exploring how novelty opened new doors for speech development
By: BriAnne Weaver, MM, MT-BC & Michelle Hintz, PsyD, MT-BC
When we meet children in therapy, we often start with what feels safe and familiar. For music therapists, that might mean choosing a well-loved nursery song or a favorite tune from the child’s playlist. Familiarity is comforting — it helps build rapport, provides structure, and signals safety. But sometimes, what feels like the best way in can become the very thing that holds a child back.
This became clear during a series of supervision meetings with BriAnne, one of our music therapists, as we discussed Alyssa (name changed for privacy). Alyssa was a bright, curious preschooler who loved music and was referred to music therapy because of that love. She was already receiving speech therapy, as her articulation was poor and her verbal communication was often unclear. Music seemed like a natural complement to support her speech goals. In her early sessions, Alyssa gravitated toward the ABC song and other familiar tunes, lighting up with joy as soon as she heard the opening notes. BriAnne skillfully incorporated those songs into Alyssa’s therapy sessions at first, using them to establish trust and engagement.
But after a few weeks, BriAnne began noticing a pattern. Whenever they used familiar lyrics, Alyssa would get stuck — looping the first part of the song, laughing, and sometimes substituting unrelated sounds for the lyrics. During a farm song, she would respond to every animal prompt with “moo,” even though she could imitate other animal sounds in other contexts. In supervision, BriAnne and I reflected on how these moments were both playful and limiting. The familiar lyrics seemed to pull Alyssa into a pre-set groove that left little room for new speech targets to emerge.
Understanding What Was Happening
Together, we explored research on Childhood Apraxia of Speech (CAS) to better understand what might be happening. CAS is a motor-planning speech disorder in which children know what they want to say, but their brains struggle to coordinate the precise movements needed for speech. It is not a muscle weakness problem — it is about planning and sequencing.
Children with CAS often: – Make inconsistent errors (the same word may sound different each time). – Have difficulty transitioning between sounds or syllables. – Show atypical prosody — unusual stress or intonation patterns.
When a child with CAS hears a familiar song, their brain may default to an overlearned, automatic motor plan. Rather than planning each sound carefully, they produce an entire phrase as one unit. This is efficient but can undermine therapy that is targeting flexible speech production. Importantly, we also noted that this phenomenon isn’t limited to CAS — many children with autism, ADHD, or other communication profiles show stimulus overselectivity (focusing on one salient cue and repeating it rigidly), which can interfere with learning.
How We Shifted Alyssa’s Therapy
Armed with these insights, BriAnne and I decided to experiment. Instead of using the same familiar songs, she created short, novel chants with a steady rhythm, intentionally designed to match Alyssa’s speech targets. The results were striking: Alyssa’s speech clarity improved almost immediately. She began producing target words more accurately and was able to carry them into new activities. The playful energy of music was still there — but now it was paired with greater focus and intentionality.
BriAnne shared that she began composing tiny, personalized songs that included Alyssa’s favorite toys and family members, and paired them with movement games. For example, instead of singing “Old MacDonald,” she created a new chant about Alyssa’s own stuffed animals, giving each one a sound Alyssa could practice. These small, novel songs became powerful tools: Alyssa stayed engaged, but she was no longer locked into a loop of automatic responses.
When Familiarity Becomes a Barrier
Over time, we learned to watch for key red flags that indicated familiar music was no longer helping Alyssa’s progress: – Repeating the opening line of a song without moving forward. – Less accurate speech during familiar songs than during novel phrases. – Global substitution of one overlearned word (e.g., saying “moo” for all animals). – Better clarity and engagement with newly composed chants.
When we saw two or more of these patterns, we shifted toward novelty and structured rhythm work.
BriAnne described the change beautifully: “The first time I tried one of the new chants, Alyssa stopped giggling, looked me right in the eye, and joined in. It was like she realized, ‘Oh, this is something new I get to do.’ Her speech sounded clearer — and she seemed proud of herself.”
What was most encouraging was watching how Alyssa responded to these changes. The moment we swapped a well-known song for a therapist-created chant, her whole body seemed to focus. She leaned in, listened, and joined in with intention. The playfulness of music was still there, but it was now a bridge to new speech rather than a comfortable loop that kept her stuck.
Practical Tips for Therapists and Parents
- Compose short, novel chants with a beat that maps clearly to each syllable.
- Use rhythm and pacing to slow down speech enough for motor planning.
- Vary one element (word, tempo, prosody) each trial to encourage flexibility.
- Transition from singing → rhythmic chanting → spoken phrases to support carryover.
- Track progress and share with families when clarity improves with novel material.
A Collaborative Lesson
This experience with Alyssa reminded both of us that familiarity isn’t always the friend we think it is. By stepping back and noticing when our interventions were unintentionally limiting progress, we were able to adjust and open new pathways for growth. Alyssa now enjoys music therapy sessions that are still fun and engaging — but also rich with opportunities for genuine speech development.
In the end, this was a collaborative learning moment — for Alyssa as well as for both BriAnne and myself as a supervisor. It was a reminder that even the most familiar song can become a barrier if we don’t stay curious, reflective, and willing to adapt.
