Student Training in a University Setting Voice Clinic- How do we do it?

This presentation will discuss the challenges that clinical supervisors face when trying to balance efficient graduate student training and patient welfare in university voice clinics. We will propose a model in which we seek to balance the needs of the patient, student clinician, and clinical instructor

Vocal Fatigue- Role of Aerobic Conditioning in Metabolic Cost and Recovery from Reading

Vocal fatigue is among the most debilitating conditions affecting individuals with voice disorders, with little known about its actual metabolic mechanisms. The current study aims to address this issue by investigating the hypothesis that neuromuscular inefficiency, cardiovascular recovery deficits, or both, may play a role in vocal fatigue

Past Speech Therapy Experiences of Individuals Exploring a New Stuttering Treatment

Perceptions of benefits of speech therapy, success of therapy across clinical settings, reasons for returning to therapy, client-clinician relationships, and clinicians\u27 competency were assessed in 57 participants (47 men, 10 women; M age = 34 yr.) trying a new therapy. A majority of respondents had cumulatively five or more years in therapy and at least two stuttering therapies. Respondents rated university or hospital settings as more successful than services in public schools. 70% of the respondents noted difficulty communicating basic needs; they blamed themselves for inability to maintain posttherapeutic gains while perceiving their clinicians to be competent and attentive ? although 47% of the respondents had minimal to no contact with their therapist after therapy

Metabolic Mechanisms of Vocal Fatigue

Objective This study aimed to identify potential metabolic mechanisms including (1) neuromuscular inefficiency, (2) cardiovascular recovery deficits, or (3) both, in individuals with complaints of vocal fatigue

The Effect of Static and Dynamic Visual Gestures on Stuttering Inhibition

The aim of the study was to evaluate the role of steady-state and dynamic visual gestures of vowels in stuttering inhibition. Eight adults who stuttered recited sentences from memory while watching video presentations of the following visual speech gestures: (a) a steady-state /u/, (b) dynamic production of /a-i-u/, (c) steady-state /u/ with an accompanying audible 1kHz pure tone, and (d) dynamic production of /a-i-u/ with an accompanying audible 1kHz pure tone. A 1kHz pure tone and a no-external signal condition served as control conditions. Results revealed a significant main effect of auditory condition on stuttering frequency. Relative to the no-external signal condition, the combined visual plus pure tone conditions resulted in a statistically significant reduction in stuttering frequency. In addition, a significant difference in stuttering frequency was also observed when the visual plus pure tone conditions were compared to the visual only conditions. However, no significant differences were observed between the no-external signal condition and visual only conditions, or the no-external signal condition and pure tone condition. These findings are in contrast to previous findings demonstrated by similar vowel gestures presented via the auditory modality that resulted in high levels of stuttering inhibition. The differential role of sensory modalities in speech perception and production as well as their individual capacities to transfer gestural information for the purposes of stuttering inhibition is discussed

Autonomic and Emotional Responses of Graduate Student Clinicians in Speech–Language Pathology to Stuttered Speech

Background: Fluent speakers and people who stutter manifest alterations in autonomic and emotional responses as they view stuttered relative to fluent speech samples. These reactions are indicative of an aroused autonomic state and are hypothesized to be triggered by the abrupt breakdown in fluency exemplified in stuttered speech. Furthermore, these reactions are assumed to be the basis for the stereotypes held by different communicative partners towards people who stutter. Aims: To examine the autonomic and emotional reactions of graduate student clinicians in speech–language pathology as they viewed fluent and severe stuttered speech samples. Methods & Procedures: Twenty-one female graduate student clinicians in speech–language pathology participated in this study. Each participant viewed four 30-s video samples (two fluent and two stuttered speech samples) while their autonomic responses (skin conductance response (SCR) and heart rate (HR)) were concurrently captured. Furthermore, emotional responses to stuttered and fluent speech samples were captured using the self-assessment manikin (SAM) and a rating scale with nine bipolar adjectives reflecting one\u27s feelings. Outcomes & Results: An increase in SCR and deceleration in HR was observed as graduate clinicians viewed stuttered speech samples versus fluent speech samples and the differences were statistically significant. In addition, results from the self-rating scales showed that participants had negative feelings (e.g., emotionally aroused, unpleasant, embarrassed, uncomfortable, etc.) while viewing stuttered speech. Conclusions & Implications: Findings suggest that graduate student clinicians in speech–language pathology demonstrated altered autonomic and emotional responses similar to those manifested by fluent and stuttered speakers as they viewed stuttered speech samples. Collectively, these findings support the contention that the inherent nature of stuttered speech triggers a visceral reaction in a listener, irrespective of their background and knowledge about the disorder

Understanding Role of Occupational Risk Factors in Voice Problems of Teachers

A survey was distributed to teachers in the East Tennessee Tri-Cities area to determine impact of occupational risk factors including voice use, work related factors and common practices of teachers’ everyday lives on the presence or absence of voice problems. Preliminary results regarding voice problems and potential factors are discussed

Effects of Biofeedback on Vocal Behavior on a Child with a Unilateral Vocal Fold Lesion

At any given time, 3-9% of the general population experiences a voice problem. The incidence of voice disorders in children can vary anywhere between 6 and 23%, yet, only 2-4% of the population are seen by speech-language pathologists for further assessment and treatment. Voice disorders have negative effects on the social, emotional, and physical functioning of the child. Unfortunately, there is little known about the appropriate management of children with voice disorders. Depending on the nature of the voice disorder, different approaches, including behavioral voice therapy, vocal hygiene management, or medical intervention, are available. However, a concern with behavioral voice therapy is the ability of the child to transfer skills learned in clinic to an outside setting - limiting generalization and adaptation of the new behavioral approach. Biofeedback has been successfully used in adults with voice disorders to help generalize new vocal behaviors. Such data is lacking in the treatment of voice problems in the pediatric population. The current case study aimed to understand the use of biofeedback in an eight-year-old male who was diagnosed with a unilateral vocal fold lesion, who exhibited difficulty maintaining and generalizing his new vocal behaviors. It was hypothesized that the child would benefit from biofeedback and would maintain new vocal behaviors including the use of a safe and efficient voice pattern outside the clinic setting. Longitudinal data on vocal parameters including the pitch, loudness, and vocal fold vibration were obtained over a period of five weeks using an ambulation phonation monitor (APM). The APM uses an accelerometer attached to the sternal notch and measures pitch, loudness, and vocal fold vibration, which helps determine an individual’s daily voice use pattern and thereby determines the appropriate biofeedback setting. The five week period included (a) a week of pretesting, (b) two weeks of biofeedback, (c) a week of post-testing immediately following the week of biofeedback, and (d) a generalization testing two months post-study. During the five-week period, vocal parameters were monitored for an average of 7- 10 hours for 2-3 days each week. On weeks two and three, the child was provided with biofeedback on loudness levels based on his data from the pretesting week. Results indicated change in vocal parameters including loudness and vocal fold vibration patterns during the weeks of biofeedback. However, such generalization was not observed neither during immediate post feedback monitoring nor two months following the study protocol. Such data provide immediate effects from biofeedback on vocal behavior, however, motor learning principles, dose, and frequency of biofeedback will be discussed to further understand the long-term effects of biofeedback in children with voice problems