The Role of the Speech-Language Pathologist in the Schools for the Treatment of Voice Disorders: Working within the Framework of the Individuals with Disabilities Education Improvement Act

The role of the speech-language pathologist (SLP) has developed considerably over the past 20 years given the medical and technological advances in life-sustaining procedures. Children born with congenital, surgical, or medically fragile conditions become mainstreamed into regular school-based settings, thus extending the traditional role of the treating SLP and multidisciplinary team. Understanding the impact of associated voice disorders on educational performance requires dissemination of additional and important information, as eligibility decisions for students in school-based settings must be made within the framework of the federal legislation and regulations governing the provision of services for students with disabilities. This article discusses how to identify children with voice disorders under the Individuals with Disabilities Education Improvement Act (IDEA), the role of the SLP in various triaging scenarios, and how models of voice therapy can be integrated in a school-based setting

Quantifying Laryngopharyngeal Reflux in Singers: Perceptual and Objective Findings

This study examines the relationship between laryngopharyngeal reflux (LPR) symptoms and oropharyngeal pH levels in singers. We hypothesized that reported symptoms would correlate with objective measures of pH levels from the oropharynx, including the number and total duration of reflux episodes. Twenty professional/semiprofessional singers completed the Reflux Symptom Index (RSI) and underwent oropharyngeal pH monitoring. Mild, moderate, or severe pH exposure was recorded during oropharyngeal pH monitoring. Correlations were performed to examine potential relationships between reflux symptoms and duration of LPR episodes. Symptom severity did not correlate with pH levels; however, we found a number of covariances of interest. Large sample sizes are necessary to determine if true correlations exist. Our results suggest that singers may exhibit enhanced sensitivity to LPR and may therefore manifest symptoms, even in response to subtle changes in pH. This study emphasizes the importance of sensitive and objective measures of reflux severity as well as consideration of the cumulative time of reflux exposure in addition to the number of reflux episodes

Treating Voice Disorders In The School-Based Setting: Working Within The Framework Of Idea

The role of the speech-language pathologist (SLP) has developed considerably over the last 10 years given the medical and technological advances in life-sustaining procedures. Over time, children born with congenital, surgical, or medically fragile conditions have become mainstreamed into regular school-based settings, thus extending the traditional role of the SLP and multidisciplinary team. Understanding the impact of these voice disorders on the child\u27s educational performance has been a struggle for many clinicians because the eligibility decisions for students in school-based settings must be made within the framework of federal legislation and regulations governing the provision of services for students with disabilities. This article discusses how to identify children with voice disorders under the Individuals With Disabilities Education Act (IDEA) definition, the role of the SLP in assigning priority in various voice management scenarios, and how models of therapy can be incorporated in the school-based setting

Behavior Assessment Battery: A Pilot Study Of The Affective, Behavioral, And Cognitive Correlates Surrounding Spasmodic Dysphonia

Objective/Hypothesis This study investigates if adults with adductor spasmodic dysphonia (ADSD) report to experience anxiety and voice problems in particular situations, indicate the presence of negative speech-associated attitude, and/or the use of coping behaviors, by means of the Behavior Assessment Battery (BAB) modified for voice. Methods Thirty-two participants with ADSD and 32 adults without a voice disorder participated in this study. Each person completed four different BAB-Voice subtests. These standardized self-report tests are adaptations of the original BAB for people who stutter and explore an individual\u27s speech-related belief, negative emotional reaction to and speech problems in particular speech situations, and the use of concomitant behaviors. Results Individuals with spasmodic dysphonia (SD) scored statistically significantly higher compared to typical speakers on all BAB subtests, indicating that individuals with SD report being significantly more anxious and experiencing significantly more voice problems in particular speech circumstances. They also reported a significant amount of negative speech-associated attitude and the use of a significant number of coping behaviors. Internal reliability was good for three of the four BAB subtests. Conclusions The BAB is capable of reflecting the dimensions that surround the disorder of SD. The self-report measures have the potential to augment the observations made by the clinician and may lead to a more diverse and all-encompassing therapy for the person suffering from SD. Future research with a revised version of the BAB-Voice will continue to explore the validity, reliability, and replicability of the initial data

Laryngeal Structure And Function In The Pediatric Larynx: Clinical Applications

This article presents an overview of the normal anatomy and physiology of the pediatric larynx, followed by some examples of pediatric voice disorders that were chosen to exemplify the alterations to the laryngeal anatomy and the subsequent modifications to laryngeal function. Vocal fold nodules are primarily reviewed due to their high incidence in the pediatric population. Three other disorders, including laryngeal hyperfunction, unilateral vocal fold paralysis, and bilateral abductor vocal fold paralysis, are discussed because of their more common occurrence and the uniqueness of their etiology and intervention, particularly for the case of bilateral abductor vocal fold paralysis

Case Report Management of Dysphagia Pre-and Postoperatively in a Case of Eagle's Syndrome

Eagle's syndrome (ES) is rare condition, most frequently described within the context of case study presentation. ES results from elongation of the styloid process, contributing to symptoms such as globus sensation in the throat, as well as pain localized to the ear, neck, face, or tongue. Additional symptoms can include hypersalivation, change in vocal quality, submandibular swelling, and dysphagia. This report discusses evaluation, diagnosis, and surgical intervention with respect to Eagle's Syndrome in a patient presenting with moderate-severe dysphagia

Management of Dysphagia Pre- and Postoperatively in a Case of Eagle’s Syndrome

Eagle’s syndrome (ES) is rare condition, most frequently described within the context of case study presentation. ES results from elongation of the styloid process, contributing to symptoms such as globus sensation in the throat, as well as pain localized to the ear, neck, face, or tongue. Additional symptoms can include hypersalivation, change in vocal quality, submandibular swelling, and dysphagia. This report discusses evaluation, diagnosis, and surgical intervention with respect to Eagle’s Syndrome in a patient presenting with moderate-severe dysphagia

An Adaptive Driver And Real-Time Deformation Algorithm For Visualization Of High-Density Lung Models

Technological advances in Augmented Reality (AR) and extraction of 3D patient specific medical data led to the creation of medical visualization using AR environments, in which the 3D data is registered and synchronized with the position of the patient. One of the challenges in such visualization environments is maintaining an accurate shape of the 3D data for self-deformable models such as lungs. An accurate deformation of lung model with 3D visualization may significantly increase the teaching and diagnosing ability of physicians. Modeling the deformation of lungs primarily involves the accurate representation of Pressure-volume relationship and the hysteresis in the relationship during inhalation and exhalation. This paper explains a real-time physiologically accurate deformation algorithm and its hardware rendering. We then introduce a novel approach for the representation of accurate pressure-volume relationship based on an analogy with classical mechanics. Our simulation results show that the hysteresis obtained is more accurate as compared to current lung models. Thus in our approach a physically realistic deformation of lung model is obtained by the integration of the accurate PV relationship with real-time deformation method