Expert Review of Auditory-Motor Mapping Training for Speech Therapy
Natalie Fitzgerald SLP
May 13, 2024
Auditory motor mapping training (AMMT) is an intonation-based therapeutic technique that is primarily used in speech therapy. Derived from Melodic Intonation Therapy (MIT), AMMT involves singing and tapping on toned drums to associate sounds with corresponding motor movements that are used in speech production. Most of the recent research regarding AMMT has focused on its benefits for non-speaking autistic children, though there may be benefits for other populations as well. Drawing upon expert insights and experiences, this comprehensive auditory-motor mapping training review aims to offer a detailed analysis of the approach.
What is the Auditory-Motor Mapping Training Approach?
Auditory-Motor Mapping Training is a technique that claims to improve speech production by strengthening the connection between auditory perception and motor control to help individuals better plan and coordinate their motor speech movements. This training pairs singing and a pair of tuned drums to facilitate auditory-motor mapping. Presently, there is not a specific certification offered for AMMT but, as with all other therapy techniques, it should only be carried out by a licensed speech-language pathologist (SLP).
How it Works
AMMT is a highly structured therapeutic technique that typically involves the following steps:
- Auditory Input: Listening to various speech sounds or words presented through singing while tapping the drums.
- Motor Output: Attempting to imitate the sounds or words by practicing the corresponding motor movements.
- Feedback and Correction: The therapist provides feedback on the sounds produced.
- Repetition and Reinforcement: The process is repeated intensively with different sounds and words that gradually increase in complexity.
In several research studies, significant results were demonstrated with AMMT over 12-40 intensive therapy sessions, depending on the study. However, the total duration of AMMT will vary based on a child’s needs and response to treatment.
Target Audience
Auditory Motor-Mapping Training is primarily provided as a speech-language intervention for children and it has been most widely studied on minimally speaking autistic children in the 4-10 year old age range. This is due to several factors including the intensity and repetitiveness of the training (autistic children tend to do well with repetition) as well as the musical aspect of the training. Some emerging research for a similar treatment, Melodic Intonation Therapy, has also targeted adults with aphasia or acquired speech-language disorders, such as through a stroke or TBI. Additionally, there is the potential for AMMT to be used for other speech-language disorders as well, such as apraxia.
Benefits
Recent studies into AMMT have largely focused on the benefits for autistic children who are minimally speaking. These studies have revealed the following benefits:
- Improvement in the ability to produce consonant-vowel syllables.
- Gains in spoken communication in more verbal children.
- Improvement in the ability to produce novel words and phrases (that were not addressed directly in treatment).
- A faster acquisition of speech and word learning compared to other intervention techniques.
Auditory-Motor Mapping Training: An SLP’s Review
As a speech-language pathologist, I wrote this review of Auditory-Motor Mapping Training (AMMT) drawing on my personal expert knowledge, as well as a thorough analysis of peer-reviewed studies and user reviews.
Methodology & Process
Auditory-Motor Mapping Training (AMMT) is based, in part, on the concept of neural plasticity, which is the brain’s ability to reorganize itself by forming new neural connections. AMMT combines auditory, visual, and motor stimuli to engage a network of brain regions, including the temporal area (which processes sound and language) and the frontoparietal areas (which are involved in movement and coordination). In short, by combining motor and auditory components, this technique engages multiple areas of the brain to enhance the learning and retention of speech and language skills.
Additionally, AMMT is also based on the auditory feedback principle. This principle refers to people using auditory information (what they hear) to shape their motor movements (what they say). This works with hearing other people’s speech as well as individuals hearing their own speech.
From a methodological standpoint, I find AMMT’s approach of integrating multiple sensory and motor pathways to reinforce speech and language learning to be highly innovative and effective. By leveraging the principles of neural plasticity and auditory feedback, AMMT promotes active engagement and repetitive practice and the result is a promising therapeutic technique for individuals with speech and language disorders.
Teaching Strategies
The strategies involved in Auditory-Motor Mapping Training, such as intonation and repetition, can be used by anyone! Many people use these strategies when communicating with children without even being aware of it. At its core, AMMT uses the principles of monitoring, comparison, adjustment, and reinforcement to improve speech sounds. When considering the musical component of the therapy, AMMT also draws on the concept of neural plasticity by strengthening multiple neural pathways to improve communication skills. A benefit of the teaching strategies for AMMT is its flexibility. AMMT is typically conducted in 1:1 sessions with a therapist, which allows for a high degree of responsiveness and the pace of therapy can be adjusted for each individual.
However, it is important to remember that Auditory-Motor Mapping Training is a specialized training and should only be implemented by a licensed professional, typically a speech-language pathologist who has experience with the technique.
Impact
The positive impact of Auditory-Motor Mapping training on its participants has been proven repeatedly in numerous studies spanning the last 13+ years. Some of the ways AMMT has helped children who have enrolled in the program include:
- AMMT significantly improves speech and language abilities. By engaging multiple areas of the brain, it helps individuals develop clearer articulation, better understanding of language, and more effective communication.
- The multi-sensory approach of AMMT enhances memory and retention of language skills. Children are able to recall and use what they have learned more effectively, which supports ongoing learning and development.
- The impacts of AMMT are not just immediate but also long-term. Multiple studies have found that the gains made in AMMT have lasted beyond the conclusion of treatment and that skills also generalize to words or sounds not directly addressed in therapy.
- Though AMMT is primarily used with autistic children right now, AMMT’s adaptability means it can be used with a wide range of disorders, including those with varying degrees of speech and language difficulties. This inclusivity ensures that more individuals can benefit from its approach.
Cost
AMMT is provided by licensed speech-language pathologists, and the cost of therapy is likely dependent on your insurance coverage and physical location. For example, in the United States, the cost of speech therapy can vary widely based on who is in-network with your insurance provider. Under some plans, such as Medicaid plans, the cost of AMMT may be covered completely by insurance with no out-of-pocket cost. Under other private health plans, the cost could be up to $100/session (or more, depending on the clinic).
Support
When an individual is receiving AMMT therapy, support can take several forms. For example, therapists may provide caregivers with strategies and techniques they can use at home to encourage carryover and generalization of skills outside of direct treatment. In some practices, participants may also be provided the opportunity to interact with peers which can enhance learning through socialization.
However, if you are considering AMMT therapy for your child, it is also important to remember that it is not yet widely implemented and locating providers who are experienced with the technique is likely to be difficult and time-consuming. Based on what I have found in my research, the most likely place to find a provider trained in AMMT therapy is through a university that is currently involved in researching it as a technique.
User Reviews
User reviews and scientific studies highlight the effectiveness of Auditory-Motor Mapping Training (AMMT) in improving speech and language skills:
- Wan et al. (2011): In a study with 6 children, AMMT led to significant improvements in speech production over 40 sessions. Notably, the children were able to generalize these improvements to new words not directly practiced during therapy, indicating a broad enhancement in their speech capabilities.
- Chomsky, Norton, and Schlaug (2017): This study compared AMMT to Speech Repetition Therapy (SRT) in a group of children. After 25 sessions, the AMMT group produced a higher percentage of correct syllables than the SRT group, demonstrating the superior effectiveness of AMMT in improving speech accuracy.
- Yan, Chen, Gao, and Peng (2021): Conducted in China, this study found that children receiving AMMT showed greater improvements in speech and language skills compared to those receiving SRT, reinforcing the efficacy of AMMT across different cultural contexts.
- Chenausky, Norton, Tager-Flusberg, and Schlaug (2022): Involving 15 participants, this study found that the AMMT group achieved significantly greater gains in speech production compared to the SRT group, further validating the benefits of AMMT.
As an SLP, I find the research supporting AMMT’s effectiveness for autistic children to be very compelling and I feel that AMMT shows promise as a therapy technique to increase spoken communication and intelligibility in autistic children who are non- or minimally speaking.
Strengths of the Auditory-Motor Mapping Training
One of the main strengths of Auditory-Motor Mapping Training, particularly for autistic individuals, is the incorporation of intonation (music) into the treatment. Autistic children often have musical abilities that are “intact” even when their language abilities are delayed. Using music to facilitate spoken communication is, in my opinion, an excellent way to provide therapy in a more naturalistic and meaningful way. Furthermore, AMMT is often provided in a very intensive setting, which is beneficial for this specific population.
Areas for Improvement
Despite all the promising research, there are currently several drawbacks to AMMT as a therapeutic option.
I find the primary drawback to be the limited accessibility of providers who are able to correctly and effectively use the technique. Along those lines, because AMMT is not yet widely practiced, the lack of user reviews makes it difficult to form a non-biased opinion of the technique.
Additionally, small sample sizes across multiple peer-reviewed studies make it difficult to say whether AMMT is truly effective across a wider range of demographics. Another drawback to the research surrounding AMMT is that the vast majority of research has been conducted on children with ASD, but other populations have not been as well-studied. For example, AMMT seems like it may also be an effective treatment option for apraxia of speech, but as of yet there is not sufficient research to support this. I would like to see AMMT applied across a wider variety of populations in future studies.
Bottom Line
Overall, I find Auditory-Motor Mapping Training to be a very compelling therapeutic option, and one that I would like to see implemented more widely. AMMT has a strong evidence base to support its efficacy. I think AMMT excels in its inclusion of intonation and music to appeal to autistic children and activate areas of the brain that are not activated by speech alone.
In my research, I have also found AMMT to be a very intensive therapy technique, which I think adds greatly to its effectiveness. As an SLP, I would like to see training for AMMT become more widely available so it can be offered to more families as a treatment option. I would also like to see studies that look into its use for different populations, such as children with apraxia, to see if it would be beneficial to a greater variety of individuals.
| Pros | Cons |
| ✅ Strengthens the connection between auditory perception and motor control. | ❌ Limited research on non-autistic populations. |
| ✅ Effective for minimally speaking autistic children. | ❌ Research primarily focused on small sample sizes. |
| ✅ Uses principles of neuroplasticity to support learning and retention. | ❌ No online user reviews. |
| ❌ Cost can be high if not covered by insurance. |
Our Methodology: How We Reviewed the Auditory-Motor Mapping Training
This AMMT review was completed by a speech-language pathologist who researched multiple factors related to the program. All opinions of the program in this article are based on an evidence-based approach and consider the following:
- Evidence-Based Approach: My number one consideration when reviewing AMMT was the evidence-base that supports it. I have found AMMT to have a very strong evidence base when considering it as a treatment option for autistic children.
- Detailed breakdown of key components: The components of the program were reviewed based on my experiences working with autistic children, and as an SLP with specialized training in the area of autism. I found the major components of the program, such as the inclusion of melodic techniques and high rate of repetition, to be in line with what I know to be effective when working with this population.
- Expert Involvement: AMMT was reviewed and this article was written by a certified and licensed speech-language pathologist with extensive experience in autism spectrum disorder and pediatric speech therapy.
- No fees associated with the review: I did not receive any compensation from companies or organizations affiliated with Auditory-Motor Mapping Training, and the opinions expressed in this article are my own.
Forbrain and Auditory-Motor Mapping Training as Complementary Speech Therapy Tools
Forbrain is an auditory feedback headset that uses bone conduction to allow the wearer to hear their own voice back at a faster speed. Both Forbrain and Auditory-Motor Mapping Training have the goal of improving speech skills, and both focus heaving on auditory processing to accomplish this goal. Forbrain can be used in conjunction with AMMT to provide the individual with enhanced auditory feedback which may result in increased attention and engagement.
When used together, they can complement each other and provide a more holistic approach to addressing the communication needs of students, particularly those with ASD or other speech and language disorders. However, it’s essential for therapists to carefully assess each individual’s needs and monitor their progress to ensure that the combined intervention is effective and beneficial.
The Use of AMMT with and without Forbrain
| Feature/Aspect | Forbrain | AMMT | AMMT with Forbrain |
| Functionality | Headset that helps with speech challenges by providing verbal memory, phonological awareness, and verbal processing speed improvements. The dynamic filter and bone conduction amplify the speaker’s voice, stimulating the auditory nerve for better brain processing. | Intonation-based therapeutic technique using singing and tapping on tuned drums. It aims to strengthen the connection between auditory perception and motor control. | Both Forbrain and AMMT use auditory feedback principles to enhance speech production. Combining Forbrain with AMMT may enhance auditory feedback, increasing attention and engagement during therapy. |
| Usability | Meant to be implemented into daily routines, for 10-20 minutes a day. Individuals simply need to wear the headset when reading or speaking. | Highly structured technique involving listening to speech sounds through singing, imitating the sounds by practicing corresponding motor movements, and receiving feedback. Typically involves 12-40 intensive therapy sessions. | Forbrain can be used during AMMT sessions to provide continuous auditory feedback, enhancing the learning experience and supporting the intensive nature of AMMT. |
| Target Audience | Suitable for 3+ and older individuals with speech challenges. | Primarily used for minimally speaking autistic children aged 4-10 years. | Both tools aim to improve speech skills, making them suitable for autistic children and individuals with other speech and language disorders. |
| Benefits | Forbrain helps to improve: – speech – communication – attention – focus – memory – learning | AMMT helps to improve: – speech production – motor coordination – auditory-motor mapping | The benefits of using AMMT are enhanced when combined with Forbrain, potentially leading to quicker and more significant improvements in speech production and intelligibility. |
| Limitations | Not appropriate for individuals with : – cochlear implant – severe hearing loss – epilepsy | – Limited accessibility to trained providers. – Small sample sizes in studies. – Primarily researched for autistic children, less evidence for other populations. | |
| Cost | $299 for the Forbrain headset and accessories, with a 2-year warranty. | Cost varies based on insurance coverage and location. Speech therapy can cost up to $100/session or more. | |
| Support & Resources | Forbrain comes with: – A secondary microphone that allows support from parents, therapists, or instructors. – A headphone jack for listening to recordings or participating in online therapy programs. | AMMT should be implemented by a licensed speech-language pathologist. Accessibility to trained providers is limited, often found in universities researching the technique. | Using both tools together provides robust support for improving speech skills. Forbrain’s technological edge complements AMMT’s structured approach, offering a comprehensive solution. |
| Clinical Evidence/Research | Forbrain uses neuroplasticity, which is the brain’s ability to rewire and change. Several scientific studies have shown the effects of using Forbrain or auditory feedback to improve the skills of those with reading or other deficits. | AMMT is based on neural plasticity and auditory feedback principles. Studies show significant improvements in speech production for minimally speaking autistic children. | Both tools leverage auditory feedback to improve speech production. Research supports their combined use for enhancing learning outcomes through improved auditory processing. |
Final Words
Auditory Motor Mapping Training presents a promising therapeutic approach, particularly for non-speaking or minimally-speaking children with autism spectrum disorder. AMMT utilizes singing and motor movements to strengthen the connection between auditory perception and speech production. The approach, supported by peer-reviewed research, shows significant potential in improving speech communication and intelligibility in autistic children.
However, accessibility remains a challenge due to the limited availability of trained providers and resources. The lack of widely-available certification programs or courses on AMMT poses a barrier to its widespread adoption. Despite these challenges, the evidence supporting AMMT’s efficacy is compelling, highlighting its intensive nature and incorporation of intonation and music as strengths.
As a speech-language pathologist, I advocate for the expansion of training opportunities and research efforts to further explore the potential applications of AMMT across diverse populations, including those with apraxia of speech. By increasing accessibility and expanding our understanding of its effectiveness, AMMT has the potential to become a valuable therapeutic option for improving speech and language skills in individuals with a range of communication difficulties.
References
Chenausky, K. V., Norton, A. C., & Schlaug, G. (2017). Auditory-motor mapping training in a more verbal child with autism. Frontiers in Human Neuroscience, 11. https://doi.org/10.3389/fnhum.2017.00426
Chenausky, K. V., Norton, A. C., Tager‐Flusberg, H., & Schlaug, G. (2022). Auditory‐motor mapping training: Testing an intonation‐based spoken language treatment for minimally verbal children with autism spectrum disorder. Annals of the New York Academy of Sciences, 1515(1), 266–275. https://doi.org/10.1111/nyas.14817
Wan, C. Y., Bazen, L., Baars, R., Libenson, A., Zipse, L., Zuk, J., Norton, A., & Schlaug, G. (2011). Auditory-motor mapping training as an intervention to facilitate speech output in non-verbal children with autism: A proof of concept study. PLoS ONE, 6(9). https://doi.org/10.1371/journal.pone.0025505
Yan, J., Chen, F., Gao, X., & Peng, G. (2021). Auditory-motor mapping training facilitates speech and word learning in tone language–speaking children with autism: An early efficacy study. Journal of Speech, Language, and Hearing Research, 64(12), 4664–4681. https://doi.org/10.1044/2021_jslhr-21-00029
Natalie Fitzgerald
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