Meeting Industry Demands of the 21st-Century Vocal Athlete

By Wendy D. LeBorgne, PhD, CCC-SLP and Marci Rosenberg, MS, CCC-SLP

hy•brid sing•er- (n). Refers to the vocal athlete who is highly skilled performing in multiple vocal styles possessing a solid vocal technique that is responsive, adaptable, and agile in order to meet demands of current and ever-evolving vocal music industry genres.

Through our years of professional singing, training, and performance (resulting in an evolution to become voice pathologists and singing voice specialists), we have encountered a transition in the industry demands and injuries of the 21st-century vocal athlete. Today’s commercial music industry demands versatility of vocal athletes who are now expected to be skilled in multiple styles of singing. Not only are these singers asked to perform vocal gymnastics on an eight-show per week schedule, these vocal athletes must also possess excellent acting skills and strong dancing ability to be competitive. These demands on the voice, body, and psyche necessitate a physically, vocally, and mentally fit singer who is agile and adaptable.

In a time when major opera companies are closing their doors, the commercial music industry boasts millions of viewers on a weekly basis through mainstream media outlets (e.g., “The Voice,” “American Idol,” “X-Factor”). Broadway shows grossed over $400 million dollars in 2012. And in the pop music market, in 2012 alone, physical albums, digital albums, and digital songs surpassed 1.65 billion units indicating a strong public desire and potentially lucrative business for commercial music singers. Yet, there are only two exclusively non-classical vocal pedagogy training programs in the United States as of this writing. Therefore, these vocal athletes learn their craft by relying on God-given talent, they make their way by imitation, or they study with a voice teacher who may or may not have experience or training in the commercial music genre. Some of these choices may unfortunately lead to vocal problems if they cannot withstand demands of the profession. By no means do we suggest that classical voice pedagogy is not a valid and proven effective method of vocal training. However, even though running is part of a gymnastics floor routine, it would be unlikely that an Olympic gymnast would train exclusively with a running coach when he or she is required to perform backflips on a balance beam.

The Vocal Athlete

The Vocal Athlete by Wendy LeBorgne and Marci Rosenberg

The Vocal Athlete: Application and Technique for the Hybrid Singer

The Vocal Athlete: Application and Technique for the Hybrid Singer

Similarly, The Vocal Athlete (LeBorgne & Rosenberg. 2014) and its companion workbook The Vocal Athlete: Application and Technique for the Hybrid Singer (Rosenberg & LeBorgne, 2014) were developed to aid singing teachers (of all genres), voice pathologists who work with singers, and the singers themselves in their understanding of the vocal mechanism, specific care of the body and instrument, and the science behind how we learn and how we can maximize performance for longevity in a commercial music market.

Whether at the professional or novice level, or somewhere in between, there are limited resources for training commercial vocal styles relative to the number of singers who desire to sing. This book and companion workbook aim to provide scientifically based information without usurping the art of singing pedagogy to provide the 21st-century hybrid singer with a guide toward their goal of becoming a proficient and healthy CCM vocalist. This brings us back to the necessity for sound vocal instruction and technique to allow these singers to use their voices as safely as possible in order to promote vocal health in this group of singers who may already be at high-risk for encountering vocal problems. This is now more important than ever, as musical theater and other CCM styles will continue to raise the bar for vocal performance demands. Composers will continue to be commissioned to write shows that will make money, especially during current economic strains when there is less willingness to finance works that are not going to assure financial payoff. Therefore, singers will continue to be asked to “defy gravity” and generate more complex vocal acrobatics in order to stay employed. Ultimately, the CCM vocal athlete and teachers are charged with the task of providing voice students with a sound pedagogical technique that will (1) serve them well in their chosen vocal style, (2) allow the singer to cross over to varied vocal styles as demanded, and (3) promote vocal longevity and health.

Ground-Breaking Book on the Mind-Body Link in Singers

Mind-Body Awareness for Singers by Karen Leigh-Post

Mind-Body Awareness for Singers by Karen Leigh-Post

For Immediate Release (San Diego, CA – June 25, 2014) – Mind-Body Awareness for Singers: Unleashing Optimal Performance provides a fundamental understanding of functional anatomy and cognitive neuroscience to guide singers and teachers of singing to unlocking the mystery of the mind-body link involved in the complex audio-motor behavior that is singing.

New theories and concepts, rooted in both the wisdom of masters in the field and current scientific research, are introduced from the unique perspective of the performer. Practical application exercises train the singer to work with, rather than against, the systems of singing to integrate the cognitive and conscious with the unconscious sensory and motor processes of our nervous system.

By mapping not only the body’s musculoskeletal structure, but also the body’s voluntary and involuntary behavioral responses, the vocal artist is empowered with an ability to maintain the following with ease:

• Optimal performance, characterized by elite execution, coordination, and self-correction.
• An ideal performance state, characterized by heightened awareness, vigilant attention, and autonomic balance/an absence of anxiety.
• Imagery or manipulation of a mental representation of a sensory event, characterized by an ability to express one’s thoughts and feelings through an infinite supply of phenomenal images.

For more information visit:  http://www.pluralpublishing.com/publication_mbas.htm

If you are interested in receiving a complimentary copy of this book for review in your publication, please contact Jessica Pollard at Jessica@pluralpublishing.com.

Karen Leigh-Post, DMA

Karen Leigh-Post, DMA

About The Author
Karen Leigh-Post, DMA, is on the voice faculty at the Lawrence University Conservatory of Music, Appleton, WI, and was invited to present her research at the National Conference of the National Association of Teachers of Singing (NATS) in 2010. In keeping with the liberal arts tradition, Dr. Leigh-Post has engaged in interdisciplinary studies throughout her performing and teaching career. Her extensive study of the interaction of mind and body includes first-hand work with Alma Thomas, Barbara Conable, Ryugin Myo-O, and Wesley Balk, and spans a broad range of disciplines, including the Alexander Technique, the Feldenkrais Method, yoga, fencing, Chi Qong, and dance.

Critics describe her mezzo-soprano as “striking” with “well-formed supple lines,” and in her dramatic portrayals, “Leigh is brilliant in her depth of character, her pacing, her facial expressions, her gestures….” Her rich and varied performing career includes the roles of Carmen, the Composer in Ariadne auf Naxos, Rosina in Il barbiere di Siviglia, Venus in Tannhäuser, Jenny in Die Dreigroschenoper, Suzuki in Madama Butterfly, Orlofsky in Die Fledermaus, Pitti-Sing in The Mikado, and Anita in West Side Story, as well as the premieres of A Death in the Family and Animalen. Leigh-Post’s concert appearances include several PBS broadcasts, from the tradition of Mozart with the St. Paul Chamber Orchestra to the songs and arias of Bernstein at Lincoln Center, and embrace the intimate chamber works of Loeffler, Respighi, and Ibert as well as the orchestral settings of Ravel’s Shéhérazade and Martin’s Cornet, to name but a few.

About Plural Publishing, Inc.
Plural Publishing produces leading academic, scientific and clinical publications in the fields of speech-language pathology, audiology, and otolaryngology. Plural Publishing, Inc. aims to fill a space in the field of communication sciences and disorders that will help meet the needs of professionals, clinicians, professors, and students. Plural’s objective, consistent with the past publishing ventures of its founders, is to meet authors and customers eye-to-eye and reduce the “ivory tower mentality” from the professional publishing world. Plural Publishing prioritizes the intellectual growth of the disciplines it serves and strives to improve and advance these fields through its publications.

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Brand New Practical Resource for Voice Coaches

Body and Voice: Somatic Re-education by Marina Gilman

Body and Voice: Somatic Re-education by Marina Gilman

For Immediate Release (San Diego, CA – June 23, 2014) – Body and Voice: Somatic Re-education by Marina Gilman, MM, MA, CCC-SLP, is an excellent resource for teachers of singing, voice coaches, and speech-language pathologists who work with singers and other voice professionals. It provides a new paradigm for working with singers in a way that allows for improved kinesthetic awareness needed to work with their body rather than against it. The text contains a series of lessons designed to train singing teachers, coaches, and voice therapists to recognize in their students the patterns of use and posture that interfere with respiration, phonation, and/or resonance. In addition, it provides tools for the teacher to guide the student to a level of self-awareness of habituated patterns along with strategies to implement change from the inside out.

Few pedagogical or therapeutic approaches provide any training in the recognition of the subtle, indirect patterns of use, stance, or tension that prevent students from relaxing the jaw, releasing the breath, lifting the palate, or any of the other demands teachers make to get them to sing well. Even when the teacher recognizes that there is a problem, the knowledge of how to retrain the student’s neuro-musculo-skeletal system in order to effect real change and self-awareness by the student is often limited or lacking. Body and Voice: Somatic Re-education addresses this need.

This book begins with a brief definition and theoretical overview of body reeducation, its principles and applications. Subsequent chapters teach how to recognize poor body dynamics. The final chapters provide specific lessons as well as guidance for independent explorations that will increase the student’s kinesthetic and body awareness. A DVD containing the lessons described in the book is included.

Body and Voice contents:
PART I
Chapter 1. The Somatic Awareness: Body and Voice
Chapter 2. Body and Voice: Somatic and Physiologic
Chapter 3. The Significance of the Unremarkable
PART II
Introduction
Chapter 4. Diversionary, Parasitic, or Other
Chapter 5. Releasing for Breathing
Chapter 6. Mobilizing the Pelvis
Chapter 7. Improving Stability
Case Studies

DVD Table of Contents:
Chapter 4, Lesson 1: Bringing the Head Forward and Back
Chapter 4, Lesson 2: Lifting and Lowering the Shoulders
Chapter 4, Lesson 3: Freeing the Jaw
Chapter 4, Lesson 4: Anchoring the Tongue
Chapter 5, Lesson 1: Release of the Breath
Chapter 6, Basic Lesson: Rolling the Pelvis
Chapter 6, Variation 1: Hand on Head
Chapter 6, Variation 2: Hand on Head, Head Tilts
Chapter 6, Variation 3: Standing Variation
Chapter 7, Lesson 2: Circles Over the Feet
Chapter 7, Lesson 2: Pencil Lesson

For more information visit: http://www.pluralpublishing.com/publication_bv.htm

If you are interested in receiving a complimentary copy of this book for review in your publication, please contact Jessica Pollard at Jessica@pluralpublishing.com.

Marina Gilman, MM, MA, CCC-SLP

Marina Gilman, MM, MA, CCC-SLP

About The Author
Marina Gilman, MM, MA, CCC-SLP, holds an MM in Vocal Performance (Ithaca College) and an MA in Communication Disorders (Northwestern University). She is a singing voice teacher, performer, Guild Certified Feldenkrais® Practitioner, and licensed speech pathologist with specialization in the singing voice. In addition to serving as head of the Vocal Coaching Program at Cornell University, Adjunct Professor of Voice at Syracuse University, and Adjunct Professor of Voice and Speech at the DePaul University Theater School, she has maintained a private voice studio for over 35 years.

About Plural Publishing, Inc.
Plural Publishing produces leading academic, scientific and clinical publications in the fields of speech-language pathology, audiology, and otolaryngology. Plural Publishing, Inc. aims to fill a space in the field of communication sciences and disorders that will help meet the needs of professionals, clinicians, professors, and students. Plural’s objective, consistent with the past publishing ventures of its founders, is to meet authors and customers eye-to-eye and reduce the “ivory tower mentality” from the professional publishing world. Plural Publishing prioritizes the intellectual growth of the disciplines it serves and strives to improve and advance these fields through its publications.

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Invaluable Resources for Anyone Who Uses or Trains the Singing Voice

The Vocal Athlete

The Vocal Athlete by Wendy LeBorgne and Marci Rosenberg

For Immediate Release (San Diego, CA – June 18, 2014) – The Vocal Athlete and the companion workbook The Vocal Athlete: Application and Technique for the Hybrid Singer are written and designed to bridge the gap between the art of contemporary commercial music (CCM) singing and the science behind voice production in this ever-growing popular vocal style. These books are a must have for the speech pathologist, singing voice specialist, and vocal pedagogue.

The Vocal Athlete is the first book of its kind to address the unique vocal and physiologic demands of commercial singing from a sound scientific and pedagogical standpoint. Historical review of classical vocal pedagogy is interwoven and transitioned to current pedagogy of CCM. Anyone who trains singers will gain insight into the current research and trends regarding the commercial music artist.

The Vocal Athlete: Application and Technique for the Hybrid Singer

The Vocal Athlete: Application and Technique for the Hybrid Singer

The Vocal Athlete: Application and Technique for the Hybrid Singer is a practical array of vocal exercises and techniques described by experienced CCM vocal pedagogues. This book comes with a CD of the singing exercises to further enhance understanding of techniques and skills used in training these singers.

The Vocal Athlete contents:

Section I. Structure and Function of the Voice
Chapter 1. The Singer’s Body: Alignment, Movement, and Intention
Chapter 2. Respiratory Kinematics
Chapter 3. Laryngeal Anatomy, Physiology, and Function during Singing
Chapter 4. Neurologic Control of Voice Production
Chapter 5. Resonance and Vocal Acoustics

Section II. Vocal Health and Fitness
Chapter 6. Impact of Phonotraumatic Behaviors on Vocal Health and Singing
Chapter 7. Laryngopharyngeal Reflux: What the Singer Needs to Know
Chapter 8. The Singer’s Guide to Anesthesiology and Voice
Chapter 9. The Life Cycle of the Singing Voice
Chapter 10. Medicine, Myths, and Truths
Chapter 11. Multidisciplinary Care of the Vocal Athlete

Section III. Vocal Pedagogy for the 21st-Century Vocal Athlete
Chapter 12. History of Classical Voice Pedagogy
Chapter 13. Belting Pedagogy: An Overview of Perspectives
Chapter 14. Belting: Theory and Research
Chapter 15. Exercise Physiology Principles for Training the Vocal Athlete
Chapter 16. Application of Motor Learning Principles to Voice Training
Chapter 17. The Art of Perfection: What Every Singer and Voice Teacher Should Know about Audio Technology

If you are interested in receiving a complimentary copy of this book for review in your publication, please contact Jessica Pollard at Jessica@pluralpublishing.com.

About The Authors
Wendy DeLeo LeBorgne, PhD, CCC-SLP, is a voice pathologist, a singing voice specialist, and director of the Blaine Block Institute for Voice Analysis and Rehabilitation, and The Professional Voice Center of Greater Cincinnati. Additionally, she holds an adjunct faculty position at Cincinnati College-Conservatory. Dr. LeBorgne’s original, peer-reviewed research on the performing voice has been published in multiple scientific journals and she presents nationally and internationally on the professional performing voice.

Marci Daniels Rosenberg, BM, MS, CCC, is a trained singer and senior speech-language pathologist at the University of Michigan Departments of Otolaryngology and Speech-Language Pathology. As the lead speech pathologist and voice and singing specialist at the Vocal Health Center, Ms. Rosenberg rehabilitates injured voices. She lectures nationally in the areas of management of vocal injuries for professional voice users and vocal athletes, and application of exercise physiology and motor learning principals to voice therapy.

About Plural Publishing, Inc.
Plural Publishing produces leading academic, scientific and clinical publications in the fields of speech-language pathology, audiology, and otolaryngology. Plural Publishing, Inc. aims to fill a space in the field of communication sciences and disorders that will help meet the needs of professionals, clinicians, professors, and students. Plural’s objective, consistent with the past publishing ventures of its founders, is to meet authors and customers eye-to-eye and reduce the “ivory tower mentality” from the professional publishing world. Plural Publishing prioritizes the intellectual growth of the disciplines it serves and strives to improve and advance these fields through its publications.

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New Release of Counseling in Speech-Language Pathology and Audiology

Counseling in Speech-Language Pathology and Audiology

Counseling in Speech-Language Pathology and Audiology by Dr. Anthony DiLollo and Dr. Robert Neimeyer

For Immediate Release (San Diego, CA – June 6, 2014) – Counseling in the field of communication disorders is an essential dimension of professional practice, but just what it entails is often a bit of a mystery. Counseling in Speech-Language Pathology and Audiology: Reconstructing Personal Narratives addresses this common concern of students and practitioners by illustrating how to integrate the concept of counseling into clinical practice. Replete with a variety of case studies, clinical guidelines, and actual transcripts of counseling interventions with clients and their families, as well as a practical “toolbox” of specific counseling methods, Dr. DiLollo and Dr. Neimeyer offer a comprehensive, novel, and empirically informed approach to counseling, applicable to a broad range of speech, language, swallowing, and hearing disorders.

Book contents:

Part I: Getting Oriented
1. Counseling in Communication Disorders
2. What Does Counseling Really Mean for Speech-Language Pathologists and Audiologists?
3. The Leadership of Therapy: How to Integrate Counseling into Your Clinical Practice

Part II: Theoretical Foundations
4. Overview of Approaches to Counseling
5. Constructivism
6. Narrative Therapy
7. Evidence for a Constructivist Approach to Counseling in Speech-Language Pathology and Audiology
8. A Theory-Based Framework for Counseling

Part III: The Process of Counseling
9. Listening for Thick Descriptions
10. Facilitating Reconstruction
11. Externalization and Relative Influence Questioning: A Case Illustration
12. Adaptive Counseling and Innovative Moments: A Case Illustration
13. The Credulous Approach and Reconstruction: A Case Illustration

Part IV: The Clinician’s Toolbox
14. A User’s Guide to the Clinician’s Toolbox
15. Autobiography of the Problem
16. The Story Mountain
17. Drawing
18. Dear John Letter
19. The Downward Arrow
20. Self-Characterization
21. Experimenting with Experience
22. Chair Work
23. Play Therapy
24. Therapeutic Documents
25. Mindfulness

Part V: Paying It Forward
26. Teaching the Constructivist Counseling Framework to Students in Speech-Language Pathology and Audiology

If you are interested in receiving a complimentary copy of this book for review in your publication, please contact Jessica Pollard at Jessica@pluralpublishing.com.

About the Authors
Anthony DiLollo, PhD, CCC-SLP, is an associate professor of communication sciences and disorders at Wichita State University. He has published numerous articles and book chapters that cater to audiences in speech-language pathology, audiology, social work, and psychology. Dr. DiLollo is currently working to expand the application of constructivist counseling to populations dealing with issues of aging, autism, and human trafficking.

Robert A. Neimeyer, PhD, is a professor of psychology at the University of Memphis, where he also maintains an active clinical practice. He has published 28 books, including Techniques of Grief Therapy, and serves as editor of the Journal of Constructivist Psychology. Dr. Neimeyer is currently working to advance an integrative approach to counseling as a meaning-making process.

About Plural Publishing, Inc.
Plural Publishing produces leading academic, scientific and clinical publications in the fields of speech-language pathology, audiology, and otolaryngology. Plural Publishing, Inc. aims to fill a space in the field of communication sciences and disorders that will help meet the needs of professionals, clinicians, professors, and students. Plural’s objective, consistent with the past publishing ventures of its founders, is to meet authors and customers eye-to-eye and reduce the “ivory tower mentality” in the professional publishing world. Plural Publishing prioritizes the intellectual growth of the disciplines it serves and strives to improve and advance these fields through its publications.

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Bollywood comes to San Diego to raise money for the ASHFoundation

Angie making dinner at ASHFoundation fundraiser

Angie making dinner at ASHFoundation fundraiser

This past Saturday, June 7th, Plural President and CEO Angie Singh hosted a “Bollywood”-themed fundraiser at her home in La Jolla, CA, with proceeds benefiting the ASHFoundation. Created in 1946 by a visionary leader in the field of communication sciences, Wendell Johnson, the ASHFoundation is a charitable organization that supports the advancement of knowledge in this field and seeks to improve the lives of people with speech, language, or hearing disorders.

Angie Singh with friends at ASHFoundation fundraiser

Angie Singh with friends at ASHFoundation fundraiser

Guests were invited to dress in traditional Indian attire and come prepared to eat and dance. Famous for her cooking and her hospitality, Angie did not disappoint in either case and a good time was had by all. After a moving speech by the hostess on the work done by the ASHFoundation and her commitment to its cause, guests also heard the first-hand experience of guest and SLP, Jannet Jacobson, who spoke about the ways people are impacted by communication disorders and how the profession touches lives. Hearing this personal account from an SLP really helped illustrate the importance of the work done by the ASHFoundation and the need for continued support for the profession. To date, the ASHFoundation awarded $6,686,289 to 1,855 doctoral and post-doctoral researchers, graduate students, and leaders in the field. Learn how you can support the ASHFoundation or email Angie Singh find out how you can host your own ASHFoundation fundraising event.

ASHFoundation fundraiser

ASHFoundation fundraiser June 7th, 2014.

Henna tattooing at ASHFoundation fundraiser

Henna tattooing at ASHFoundation fundraiser, 2014.

Alphabet Soup: The SLP, CP, and NDT

Fran Redstone, Ph.D., CCC-SLP, C/NDT
Editor of Effective SLP Interventions for Children with Cerebral Palsy: NDT/Traditional/Eclectic

Effective SLP Interventions for Children with Cerebral Palsy

Effective SLP Interventions for Children with Cerebral Palsy by Fran Redstone, PhD, CCC-SLP, C/NDT

Is it reasonable to expect a child with shallow breathing, open-mouth posture, and a tongue thrust, whose body is fixed in extension, to manipulate toys or interact with peers in a stimulating home or school environment? Of course the answer is “no.” It is an exercise in frustration for the child and in futility for the child’s unprepared speech-language pathologist (SLP). I know this because I’ve been there.

When I am asked why I, as a speech pathologist (SLP), should “handle” the child’s body, I am reminded of a second grade class observation I conducted recently of a child with spastic diplegia. This child was ambulatory and cognitively intact but was in a small class for children with language disorders. He was helped to function within the classroom with a one-to-one aide. The youngster began to demonstrate some negative behaviors stemming from the frustration of not being understood. This had resulted from a loss of stability, which led to poor trunk support, leading to poor oral control. I quietly asked the aide if I could intervene and adjusted the foot support and pelvic positioning. The child sat upright and communicated better immediately.

In addition, over 80% of children with cerebral palsy demonstrate poor oral skills leading to dysphagia (Rogers, Arvedson, Buck, Smart, & Msall, 1994). Without head and trunk alignment coordination between the respiratory movements and the laryngeal movements, they are at risk which is a danger during feeding. While infants are protected during feeding due to their small structures (Wolf and Glass, 1992) and intact reflexes, maturation leads to a decrease of safety due to an increase of pharyngeal space. For physically typical children this is positive since it means an increase of movement options, but for the child with cerebral palsy and swallowing issues, this means a greater risk of poor nutrition and possible aspiration. If the SLP does not address alignment prior to feeding and during feeding, fewer oral movements for mastication and propulsion of food posteriorly will occur and safety during swallowing may be compromised.

Although speech and feeding are two different functions, both require integration of movements among several systems: respiratory, phonatory, and articulatory (Mysak, 1976). Without stability and alignment fast, coordinated movements among and within systems are not possible (Seilel, King, & Drumright, 2005). Children with cerebral palsy cannot always attain stability and alignment by themselves. It is up to the SLP to have the knowledge and skills to help young clients to function and participate in communicative activities typical for their peers. Neurodevelopmental Treatment (NDT) is one approach that acknowledges all of this and trains therapists, OTs, PTs, and SLPs in the skills to provide improved motor skills: gross, fine, and oral, to children with cerebral palsy (Howle, 2002). For the SLP, the goals of these improved motor skills are to benefit speech, AAC, and feeding. These are all within the scope of practice for the SLP and are important skills for active participation in peer activities. Graduate school prepares speech practitioners for dealing with the communication disorders of physically typical children, but this preparation seldom equips them to treat children with cerebral palsy who have motor impairments central to their speech/language/feeding disorder.

Nothing fully prepares a therapist for the child described in the first paragraph. Graduate training, continuing education, the reading of appropriate texts and journals, along with NDT, allowed me to problem solve and provide speech and feeding therapy to this child. Within a short period of time (6 months) the child was upright, eating solid food, vocalizing, beginning AAC, and enjoying interaction with peers in a classroom. Addressing stability and alignment, while working within the context of specific functions (speech, feeding, interaction, and communication) allowed the greatest participation in age-appropriate activities. Equally important was the inclusion of parent training in the program.

It has long been acknowledged that carry-over is difficult. This is often the primary purpose of homework. SLPs working on a team treating children with cerebral palsy and communication or feeding disorders need to address carry-over through parent and school staff training. For example, the SLP can suggest the appropriate positioning along with vocabulary that can be easily used by the child, either through AAC or through oral communication. SLPs should also suggest ways for this vocabulary to be used throughout the day. The important concept here is to make it easy for the child to communicate. Another example may entail the SLP suggesting the appropriate positions, foods, and procedures for the parent or school staff to use during feeding. The most critical concept here is safety as well as the ease and enjoyment of nutritional intake for the child.

What has just been described is a two-pronged approach to therapy for a child with cerebral palsy. The therapist must be more than a coach. SLPs should use all of their training to push the child to the next level of functioning. Once the child reaches a higher level, the therapist should be prepared to suggest how these functional skills can be practiced and used in other settings and with other people. The therapist working with a child with cerebral palsy should never work in a vacuum and always work on functional skills.

I am fortunate to have received extensive, special training for working with youngsters with cerebral palsy. I have also researched posture and its influence on the respiration, speech, and AAC usage of this population. More importantly, I have worked as an SLP for more than 40 years and have used all of my skills to help children with cerebral palsy. I feel strongly that knowledge of movement, stability, and alignment are as important for the SLP working with children with cerebral palsy as they are for the other disciplines treating these children. I hope that I have been able to convince you of this as well.

References

Howle, J. M. (2002). Neurodevelopmental treatment approach: Theoretical foundations and principles of clinical practice. Laguna Beach, CA: NDTA.

Jones-Owens, L. (1991). Prespeech assessment and treatment. In M.B. Langley & L. J. Lombardino (Eds.), Neurodevelopmental strategies for managing communication disorders in children with severe motor dysfunction (pp. 49-80). Austin, TX: PRO-ED.

Mysak, E. D. (1976). Pathologies of speech systems. Baltimore, MD: Williams & Wilkins Company.

Rogers, B., Arvedson, J., Buck, G., Smart, P., & Msall, M. (1994). Characteristics of dysphagia in children with cerebral palsy. Dysphagia, 9, 60-73.

Seikel, J. A., King, D. W., & Drumwright, D. G. (2005).  Anatomy and physiology for speech, language, and hearing (4th ed.). Clifton Park, NY: Delmar, Cengage.

Wolf, L. S., & Glass, R. P. (1992). Feeding and swallowing disorders in infancy: Assessment and management. Tucson, AZ: Therapy Skill Builders.

Are Duty Hour Restrictions Making Residents Feel Better or Worse?

By Evan J. Propst, MD, MSc, FRCSC co-author of Airway Reconstruction Surgical Dissection Manual

In 2003, the Accreditation Council for Graduate Medical Education (ACGME) mandated an 80 hour work week limit for residents. In 2011, this same body mandated a 16 hour shift limit for first year residents. Both of these mandates were introduced to reduce resident fatigue with an eye towards improving patient safety, resident education and resident wellbeing. These regulations are enforced throughout the US and institutions can be fined if residents are found to be working beyond these duty hour restrictions.

Interestingly, a recent systematic review of the literature by Ahmed et al. (2014) revealed that resident duty hour restrictions may be more harmful than beneficial. In brief, the introduction of an 80-hour work week is perceived by health care professionals to have had a negative outcome on patient safety. Resident education appears to have worsened or remained unchanged. Resident wellness appears to be improved. The reduction to a 16-hour duty maximum also appears to have had a negative impact on patient safety, which is believed to be due to decreased continuity of care and an increased number of handovers. Resident education has also suffered due to poorer integration into teams, less opportunities for resident mentorship, increased patient handovers, decreased operative exposure and increased medical errors. Personal satisfaction, preparedness for more senior roles and senior trainee wellness have also been compromised. Many programs have developed a night float system to improve resident education for daytime residents. Unfortunately, the literature suggests a perception of worsening patient outcomes with an inconclusive effect on resident education. There was, however, a small perceived improvement in resident wellbeing. In short, only one objective of the resident duty hour restrictions appears to have been met (improved resident well-being), but this may be at the expense of patient safety and resident education.

The challenge for residency training programs is therefore to provide high impact learning activities in an efficient and effective manner. There are two overarching ways to achieve this: 1) Minimize tasks unrelated to the provision of medically necessary care to maximize the amount of hours available to learn necessary information, and 2) Maximize the amount of learning occurring during available hours. Among the options for achieving the second point are a more structured didactic training course or highly structured hands on surgical sessions on animal or cadaveric human models. Whichever methods turn out to be the most effective, they will likely vary depending on which type of residency training program is being investigated.

About The Author

Evan Propst

Evan Propst, co-author of Airway Reconstruction Surgical Dissection Manual

Airway Reconstruction Surgical Dissection Manual

Airway Reconstruction Surgical Dissection Manual

Evan J. Propst, MD, MSc, FRCSC, is an otolaryngologist-head and neck surgeon at The Hospital for Sick Children in Toronto, and an assistant professor and clinician investigator at the University of Toronto. Dr. Propst has a clinical interest in complex open airway surgery, head and neck surgery, and advanced sleep surgery. He has developed the Disorders Relating to the Airway and Mouth in Sleep (DREAMS) clinic and the clinic for Complex Swallowing Disorders. His research interests include corrosion casting of the blood supply of the airway, tracheal transplantation, and novel treatments for head and neck tumors. Dr. Propst is the fellowship director and site director for residency and undergraduate education, and travels internationally teaching airway surgery through simulation.

References

Ahmed N, Devitt KS, Keshet I, et al. A systematic review of the affects of resident duty hour restrictions in surgery: impact on resident wellness, training, and patient outcomes. Ann Surg 2014;00:1–13.

Plural joins R2 Digital Library platform

We are pleased to announce that a select number of Plural’s books will now be available for purchase via Rittenhouse Book Distributors’ R2 Digital Library. Visit R2Library.com for the full list of titles currently available.

“The R2 Digital Library is committed to providing highly specialized health sciences content for institutional purchase,” said Jason Hafer, Manager of eContent and ePlatform Support at Rittenhouse. “Plural Publishing’s notable work in a variety of specialized disciplines alone would make them an asset to the platform – that they are also working with us to expand the video collection on R2 adds a great deal of value to the user experience.”

By partnering with the R2 Digital Library, we are now able to bring our content to medical and health science libraries using this platform to host their ebook collections. Many of our books feature video and multimedia content which can now be embedded in the text for a more integrated experience.

“Plural’s books are a natural fit for the R2 Digital Library with its focus on health science,” says Angie Singh, President and CEO of Plural. “The continued goal of our publishing program is to provide the most comprehensive support for education, research and advanced clinical breakthroughs for communication sciences and disorders and related fields. Making our content accessible on R2 will help us better achieve this.”

As a platform specialized for the health sciences, the R2 Digital Library continuously works with publishers to bring content onto a platform designed to enhance it. Plural Publishing’s arrival onto the platform continues this commitment.

2014 Awards and Honors

We are thrilled to announce the winners of the 2014 Plural Publishing Research Awards given in honor of the late Dr. Sadanand Singh. These two scholarships are awarded by the Council of Academic Programs in Communication Sciences and Disorders and honorees and their faculty sponsors are acknowledged at the annual CAPCSD meeting, taking place this year in Orlando, FL, April 10-12. Congratulations to Doreen Hansmann, the master’s level winner and to Meg Simione, the doctoral level winner.

Doreen Hansmann, Master’s level Research Award recipient

Doreen Hansmann, Master’s level Research Award recipient

Meg Simione, Doctoral level Research Award recipient

Meg Simione, Doctoral level Research Award recipient

We would also like to extend our congratulations to Plural author, Brook Hallowell, who will be receiving the 2014 Honors of the Council of Academic Programs in Communication Sciences and Disorders; one of the most prestigious awards recognizing lifetime professional achievements in communication sciences and disorders.  Dr. Hallowell has served the Council in a multitude of ways including extensive committee work and executive board membership in varied positions including the presidency in 2010-2011. In addition to her contributions to CAPCSD, her research in neurological disorders, in collaborations with professionals from around the world including Russia, China and India, Dr. Hallowell has made significant contributions to her profession. She is a Fellow of the American Speech Language and Hearing Association and has provided service to ASHA in various capacities.  Finally, Dr. Hallowell has mentored innumerable students, both in the United States and abroad. She has served the College in a variety of leadership capacities including in the school director and associate dean roles.

Brooke Hallowell, PhD, 2014 recipient of the Honors of the Council of Academic Programs in Communication Sciences and Disorders

Brooke Hallowell, PhD, 2014 recipient of the Honors of the Council of Academic Programs in Communication Sciences and Disorders