So You Think Your Clients Can’t Dance? Incorporating performances into treatment for aphasia helps participants relearn speech through the arts. In the Limelight
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In the Limelight  |   October 01, 2017
So You Think Your Clients Can’t Dance?
Author Notes
  • Shelley D. Hutchins is content editor/producer for The ASHA Leader. shutchins@asha.org
    Shelley D. Hutchins is content editor/producer for The ASHA Leader. shutchins@asha.org×
Article Information
Language Disorders / Aphasia / In the Limelight
In the Limelight   |   October 01, 2017
So You Think Your Clients Can’t Dance?
The ASHA Leader, October 2017, Vol. 22, 28-30. doi:10.1044/leader.LML.22102017.28
The ASHA Leader, October 2017, Vol. 22, 28-30. doi:10.1044/leader.LML.22102017.28
Name: Frederick DiCarlo, EdD, CCC-SLP
Title: Clinical supervisor and assistant professor, Nova Southeastern University, Ft. Lauderdale, Florida
Hometown: Miami
Twinkling lights glitter throughout the room as Frank Sinatra croons, “Fly me to the moon … let me play among the stars.” A woman’s soft voice joins in and clearly sings each word as she dances the foxtrot with her husband. As the last line fades, and the couple stops twirling, an audience of more than 50 bursts into applause.
Fred DiCarlo probably clapped the loudest on that day last December. The woman dancing and singing along to Sinatra has primary progressive aphasia (PPA). DiCarlo runs the aphasia group she attends at Nova Southeastern University’s (NSU) speech-language pathology clinic. He worked with four graduate students for two semesters organizing the event—“Dancing With the Aphasia Group Stars”—and was surprised by this particular contestant bursting into song.
“With this type of aphasia, you lose language quickly,” DiCarlo says. “But this woman loves Frank Sinatra, so she’s dancing with her husband and she just started singing the song—and we understood every single word clearly!”
Mixing performance with treatment
The moments leading up to this storybook event were not all as magical. DiCarlo, who minored in theater and dance as an undergraduate, conceived of this take on a popular TV dance competition not long after he began supervising this aphasia group in late 2015. Two members—and their respective spouses—happened to be competitive ballroom dancers. DiCarlo had used theater and music to successfully challenge and motivate patients in the past, so he didn’t hesitate to tap into his current clients’ talents as a way to focus treatment for the entire group.
“Creative ideas still need to relate to treatment,” DiCarlo says. “We created formal speech goals, but the material we used to achieve them was outside of the box.”
Official event planning began during the 2016 summer term. Graduate students produced speech and language materials centered on elements of ballroom dance—music, costumes, types of dances—and used these topics to get group members talking. DiCarlo helped his grad students devise questions to spark conversations about dancing in general and the event specifically: How do dancers move? What types of music do they use? Where can they get jobs? What colors do you want in your costume? What’s your favorite song?
Group members didn’t just talk about the performance—they also helped put it all together. One client painted cover art for the program booklet, another worked on costumes and someone else found recordings of everyone’s music selections. DiCarlo recruited fellow faculty members—an occupational therapist and two SLPs—as judges. The students took care of logistics, like advertising around campus, transforming the clinic’s biggest space into a ballroom and writing a script for the performance. They also raised money for the National Aphasia Association.
The fall semester was all about learning to dance. The two clients and their spouses who already knew the dances worked with the beginners. DiCarlo remembers highs and lows—one frustrated client even walked out of a rehearsal when the steps just didn’t click—just like with any artistic group. For the competition in December, couples performed their own chosen dance and their version of the same dance—a foxtrot. Judges selected a winning couple, but DiCarlo’s favorite moment was witnessing his client with PPA—also one of the beginners—dance and sing.
“She definitely did more in that performance and during those two semesters than anyone expected,” DiCarlo says. “Because this was beyond their daily routine, it really challenged everyone in the group.”

“Creative ideas need to relate to treatment. We still created formal speech goals, but the material we used to achieve them was outside of the box.”

Incorporating other art forms
Dancing With the Aphasia Group Stars wasn’t DiCarlo’s first live event—and it won’t be his last. The SLP ran a group for people with Parkinson’s disease soon after becoming a clinical supervisor for NSU in 2001. He fondly called this group the Parkinson’s Players. He wrote and adapted short plays for them, assigned parts and rehearsed during group sessions.
“We practiced good volume, articulation and other skills you’d normally do with drills,” DiCarlo says. “I just did them through the use of theatrical scripts geared toward adults.”
The group’s big finale was a performance called “The Parkinson Monologues.” Each of the eight members wrote their own monologue about living with Parkinson’s, practiced and then performed their personal stories. Writing and revising the monologues served as home practice and generalization. As for the dance event, six graduate students organized logistics during three semesters, with DiCarlo’s guidance. The students also directed the show, introduced the performers and again raised money for a related charity—The Michael J. Fox Foundation for Parkinson’s Research. The performance drew an audience of about 150 faculty, students, family and friends.
For a new project—focusing on the visual arts—DiCarlo is including all of the clinic’s aphasia groups. The 12 clients each created mixed media pieces expressing how they struggle with their disorder. DiCarlo plans to invite an art student to help assemble the individual works into a four-foot-by-six-foot mural for the clinic’s recently renovated lobby. The project includes a big final event in December to unveil the mural.
In addition, students and clients are organizing a reception and gallery showing of clients’ other visual art pieces, while a new member of DiCarlo’s aphasia group plays classical guitar in the background.
DiCarlo is also already percolating his next idea. NSU has multiple campuses and DiCarlo wants to produce a video newsletter/broadcast on the experience of living with a communication disorder. Once again, the project will involve students, clients, spouses and caregivers through telesupervision and practice. DiCarlo is figuring out a way his aphasia group and other NSU clinical groups can use technology to help organize and participate in this event. He also plans to incorporate interprofessional collaboration by including physical and occupational therapists.
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October 2017
Volume 22, Issue 10