Perspective-Taking for Neurotypicals

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By Stephanie D. Sanders, MA, CCC-SLP, author of The FILTER Approach: Social Communication Skills for Students with Autism Spectrum Disorders

While creating The FILTER Approach, I took exhaustive measures to help students with Autism Spectrum Disorders (ASD’s) identify, comprehend, and explain essential social skills, while putting them into practice.  As I implemented this curriculum, it began a personal perspective-taking opportunity for me.  I noticed weaknesses within my own communication skills in specific situations. A perfect example is my inability to Listen to my family with technology distractions in view (thank you, Pinterest).  Demonstrating social errors as a neurotypical Speech-Language Pathologist (SLP) could likely justify a new DSM-5 diagnosis of “social skills hypocrite.”

The truth is that most of us have room for improvement socially and in considering the perspectives of those with social impairments.  Perspective-taking tasks usually present a challenge to individuals with ASD, due to Theory of Mind.  I’ve frequently referenced the idiom “put yourself in my shoes” with students during these activities. However, SLP’s can also struggle with taking perspective when driven by accountability for pragmatic language goals printed on a report. I become frustrated when my student resists the educationally relevant IEP goals that will undoubtedly transform him or her into a social skills superhero.  An epiphany soon occurred with a hint of witty wordplay.  My mission: try taking a new perspective on perspective-taking.

I began investigating:

  • How do those with social impairments perceive conversation?

I asked students individually, “Why are conversations important?”  The same response was consistently given, “To find out information.”  This perspective came across as task-driven, lacking any element of enjoyment.  Some interrogation sessions I’ve witnessed appear to be information-seeking at its finest.  In other instances, my students feel obligated to be the source of information.  They lecture peers regarding topics of interest, rather than seeking to find out information.  We’ve discussed how obsessive interests and “conversation hog” habits will cause one to miss the Target, socially.  I’ve also taught this concept in the middle school gifted-student classroom during monthly F.I.L.T.E.R. lessons.  Luckily, the “conversation hog” reference hasn’t triggered any speeches about swine or guinea pig fixations!

Other questions on my mind:

  • How are common rules of social language perceived?
  • What are the most stressful things about social situations?

My little brother Zach was diagnosed with an ASD at the age of thirteen and was my primary inspiration for “The FILTER Approach.” As part of this perspective-taking endeavor, I knew it would be beneficial to get Zach’s viewpoint on social rules.  I asked him to speak freely, without concern of giving a wrong answer.

Me: What do you think the expression, “Put yourself in his/her shoes” means?

Zach: It means you should consider the other person’s feelings.

Me: Exactly.  I want to put myself in your shoes to find out what conversation is like for you, having an ASD.  I want to know your perspective about some social rules in conversation.

Zach: Okay.

Me:  What do I mean when I tell you to “use your filter” in conversation?

Zach: It’s what you should or should NOT say in conversation.  If you always say what you’re thinking, then you could look bad as an employee, lose respect, and look unconcerned about feelings.

Me: Great explanation!  Now I want your perspective on some social rules from my book.  How do you feel about making eye contact and looking for Facial clues?

Zach: A little uncomfortable.  A symptom of people with Autism is sometimes having a hard time with eye contact.  I don’t want to give too much and it’s hard for me to know.

Me: Very true.  We’ve talked about glancing, which works.  You’ve done a nice job of avoiding inappropriate topics in person.  However, you and many other people might post strong opinions on Facebook.  Why do you think that is?

Zach: On Facebook, it’s virtual and like your own little world, so it’s not as real.  It’s uncomfortable in person because you’re actually with them.

Me:  I see what you’re saying.  Do you think it’s hard to Listen during a conversation with someone and why or why not?

Zach: It can be a lot of work. Sometimes I run out of things to say or my mind is off-topic while I’m trying to listen.  The conversation gets stressful if it’s too long and boring.  Sometimes, I think about something totally unrelated, like a conversation with someone earlier.

Me:  Staying focused probably does feel like a lot of work. Why do you think we should try to “hit the Target” socially and what did we talk about for your target?

Zach: We should make goals to be successful. I need to close my conversations with “See you later” and ask about someone else’s interests.

Me: Excellent. Is it awkward for you to End conversations with people at places like church or work?

Zach: Yes, because I run out of things to say.  It’s also difficult to end things at work when my shift is over.  I want to tell my manager I’m ready to leave, but he’s usually busy.  If I just leave, I might look disrespectful like I’m trying to get out of my job.

Me:  Later, we’ll make a plan for leaving work.  Is it difficult for you to Repair conversation mistakes you’ve made and have you used some of the Repair tools we’ve talked about?

Zach: I’ve used some.  Apologizing can be hard and it’s hard to admit you’re wrong.  I’ve asked, “Should I stop now?” when the person was being quiet. I also messaged, “Did I say something wrong?” two times to someone on Facebook who quit talking to me.  He never responded, so I didn’t ask anymore.

Me: I’m so proud of you for trying to Repair social mistakes.  You made a good choice to quit asking when the person on Facebook never responded.  At least you tried.

Me: Overall, what are the most stressful things for you in social situations?

Zach:  It’s stressful because:

  • I don’t know what the other person is thinking.
  • I don’t know if I’ve said something wrong.
  • I don’t know what will happen to that friendship (in the future).
  • It’s tough to start new friendships as an adult.
  • Losing a childhood friendship is discouraging and can’t be replaced.
  • I’ve become shy as an adult.

Me:  Thanks for sharing, Zach.  Therapists need to consider what it’s like for someone with ASD to follow these rules.  It has really helped me to hear your perspective.

From Zach’s outlook, it must be draining to worry about confusing social cues and potential negative outcomes.  If someone repeatedly struggles to use verbal and nonverbal social behaviors in conversation, then it could become a losing battle.  Isn’t it easier to retreat into a virtual world where at least all of the nonverbal challenges are removed?  Many of our students/clients with ASD’s could perceive communication as a lot of effort with little worth.

The challenge is to find pragmatic goals that are realistic, beneficial, and meaningful for our students/clients.  The perspectives of these individuals are usually disregarded as wrong with an immediate need for change. If I truly listen to the individual’s perspective, I can not only set an example of showing interest, but also ensure my therapy approach remains individualized.  I can clearly and personally define the advantages of practicing good social habits now in order to make future social success a possibility. Taking the student’s perspective increases my chances of enlisting him or her in therapy, which will result in a more socially responsible individual. Early investment in the views of my students could allow the opportunity to become an influence in rewriting a lifelong story filled with social struggles and disappointments.

Book Review: Auditory Verbal Therapy: For Young Children with Hearing loss and Their Families, and the Practitioners Who Guide Them

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Reviewed by Estelle Roberts, Speech-Language Therapist, Jhb Cochlear Implant Programme, Johannesburg, South Africa

Advances in technology have increasingly cast a spotlight on the possibilities for children with hearing loss, however severe, to learn to listen and use spoken language as their preferred mode of communication.   Auditory Verbal Therapy (AVT) has gained prominence as the intervention of choice for these families and their practitioners.  Auditory Verbal Therapy: For Young Children with Hearing loss and Their Families, and the Practitioners Who Guide Them provides a current, comprehensive and evidence-based text with appeal for a broad spectrum of professionals. The editors’ global experience reflects in, and influences the text, as does the work of 29 contributors, all international experts in their fields.

This is a substantive book:  seventeen chapters spanning 600 pages.  While this might initially seem daunting, the text makes for absorbing reading.  Much of the information is presented to encourage a fresh look at familiar topics. Throughout the text, the latest thinking and research is applied to AVT. In Chapter 2, hearing and listening are naturally paired with thinking and its accompanying research.  In Chapter 8, extensive and relevant information covering auditory processing, speech, language, emergent literacy and play is linked to developmental scales to provide diagnostic guidelines for practitioners.  Chapter 9 explores emergent literacy and provides compelling data that highlights the importance of early and effective access to sound for infants with hearing loss.  Very topically, it includes a balanced perspective on digital literacy.  For students and practitioners seeking practical knowledge in skill development, there are a number of ‘How to…’ chapters that have the potential to be used as ‘templates’ for acquiring skills or refining professional practice.

Unlike most texts, where the emphasis is directed at a particular group of practitioners, this inclusive text speaks to a broader audience within the field.  The material presented in chapters 4 – 7, covering audiology, hearing aids, implantable hearing technologies and assistive and access technologies, balances the next chapters, which provide greater depth for Auditory Verbal practitioners in particular. This balance between depth and breadth creates a must-have reference for the broader professional community interacting with cochlear implants.

The final chapter presents the voices of families from twelve countries as they reflect on their journeys with their children with hearing loss. Their reports, told from this powerful perspective, bear touching and convincing testimony to the global reach of AVT.

The lay-out of the book contributes to an ease of understanding that would be appreciated by parents, students and others not wholly familiar with the field.  Generous spacing, bulleting and frequently highlighted sub-sections creates a navigable reading experience and serves as a useful reference for those who prefer to use the text as a ‘dip-in’ resource.

Given its broad appeal to professionals and families, its presentation of extensive current, researched information and practical application to AVT, as well as its easy navigability, this resource may well replace existing texts to become the favoured ‘go-to’ resource for practitioners, students, families and the broader CI community seeking exploration and guidance in the field of AVT.

Speech-Language Pathologists Climbing the Steps to Mastery

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Speech-Language Pathologists Climbing the Steps to Mastery
By Lydia Kopel
Co-author of IEP Goal Writing for Speech-Language Pathologists: Utilizing State Standards

Facing the mountain
As a speech-language pathologist (SLP), you are forever tackling a huge mountain called language. There are peaks at the top that you are trying to help your students/clients reach. Do you ever find yourself working on a skill with a student/client who does not seem to be making progress? That peak didn’t seem so far away, but along the way, you encounter twists and turns, making it around one corner only to face an obstacle around the next bend. Frustrating, right? On the inside you’re screaming, “Why can’t he get this? How can I approach this in a different way? What am I doing wrong?”

You’ve set your goal(s) for this individual carefully choosing the target skill(s). But, did you think about prerequisite skills? Prerequisite skills are all the skills that lead up to the targeted skill; the building blocks. Every skill has several prerequisite skills; each prerequisite skill has prerequisite skills. With language learning there is a great deal of scaffolding – one skill builds upon another skill, builds upon another skill, and so on. Let’s look at an example related to the skill of the main idea.

To be able to identify the main idea when it is not stated in a text, one has to have success with many other language skills. These include being able to answer factual questions, determine important details from unimportant details, determine how the details go together in the sequence of events, and be able to draw inferences. Of course, each one of these skills has even more prerequisite skills! And it doesn’t end there!

Each target skill also has several steps to mastery. With the same example of the main idea, we probably shouldn’t expect that a 6th grade student will learn the prerequisite skills outlined above and be able to identify the main idea and supporting details from a grade level text in one year. It is more likely that additional scaffolding and instruction will be needed at various steps. The student may first need to identify a supporting detail when given a choice of three and given the main idea in a 5th grade text. Maybe then you can move them to identifying three details that support a given main idea in a 5th grade text. With further scaffolding, this student may move toward identifying the details in a 6th grade text when the main idea is unknown. Going through these prerequisite skills and steps to mastery can increase an individual’s success and decrease therapist and client frustration—making for a much smoother climb up that language mountain.

Peaks and valleys
We all encounter those individuals who have splinter skills.   They have some of the language skills in the developmental continuum but are missing others. There may be no specific order, no rhyme or reason, to what they can and cannot do. If we can tap into the skills that haven’t fully developed, we can help increase performance on the target skills that are lacking.

Let’s look at the semantic skill of compare/contrast. Perhaps you have a client who can label pictures of nouns and verbs. He can tell you the color, size, and shape of single pictured items. He may be able to use comparatives and superlatives. However, he can’t sort items by attribute, identify things that do not belong, or state category labels. His describing skills are limited because he breaks down when more than one item is pictured together in a scene and more than two descriptors are expected.  Would it be reasonable to expect this client to state how two or more items are the same or different? It seems like there may be numerous gaps in his semantic skills that would be imperative to the skill of compare/contrast.

Reaching the peak
As an SLP, do you have students/clients who are lacking some of the necessary prerequisite skills? Taking the time to figure out what prerequisite skills are needed can lead to success with the target skill(s).   Take a step back and work on the missing skills. Sometimes we need to go backward in order to move forward.

When setting goals, consider the amount of prerequisite skills needed and how fast you anticipate the student to progress. Is your anticipated target skill too high? Maybe you need to aim for a smaller peak. Maybe the goal needs to be one of the prerequisite skills. Take it one step at a time and you’ll soon find the individual standing at the peak.

Prerequisite skills, goal writing, and much more are discussed and outlined in the book IEP Goal Writing for Speech-Language Pathologists:  Utilizing State Standards. Check it out!

Please visit our blog Living the Speech Life and feel free to contact us at livingthespeechlife@gmail.com

Lydia Kopel and Elissa Kilduff

Living the Speech Life

Book Review: Auditory-Verbal Therapy reviewed by Helen M. Morrison, Ph.D., CCC/A, LSLS Cert. AVT

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Auditory-Verbal Therapy: For Young Children with Hearing Loss and Their Families, and the Practitioners Who Guide Them, by Warren Estabrooks, Karen MacIver-Lux and Ellen A. Rhoades, Plural Publishing, 2016.

Reviewed by Helen M. Morrison, Ph.D., CCC/A, LSLS Cert. AVT

 

 

 

Auditory-Verbal Therapy provides a thorough, 21st century resource for professionals, families, and students. Each chapter is organized in a way that technical information is accompanied by suggestions for practical application, making it a likely “go-to” reference that will be consulted frequently.

The history of Auditory-Verbal therapy (AVT) described in the first chapter is comprehensive and much needed in order to ensure that the story of the approach is not lost to current and future generations of professionals and families. The book is clear about the principles of AVT, what it is and is not, all while demonstrating how AV therapy has evolved to apply evidence-based practices that meet the needs of today’s diverse families and children.

A highlight of the book is a systematic review of literature concerning AVT that utilizes the most current techniques and standards for scientific rigor to describe the state of evidence supporting the approach. The chapters that address audiological procedures and hearing technology are current and provide a basis for deeper reading of the topics discussed. The book addresses each of the knowledge domains that Auditory-Verbal therapists apply in practice, including comprehensive developmental milestones, emergent literacy, inclusion and specific strategies for parent coaching.

An important section of this book provides a rationale and framework for planning and implementing AVT sessions, followed by a series of case studies and lesson plans written by experienced AV therapists that apply this framework. The children and families in these case studies and lessons represent a range of ages, diagnoses, additional disabilities, and cultural/economic situations. The lesson plans at first glance may not seem like conventional lesson plans. They illustrate how important teaching within the conversational context is in AVT, beginning with initial greetings and entering the therapy room or home. Following the child’s lead and exploiting teachable moments are highlighted.

Finally, families from across the global community tell their own stories, demonstrating the universality of the approach. The families not only hail from many different countries, but they are each unique in their cultural and economic situations, types of hearing loss and the ages at which their children entered AVT. Many of the children in these families have challenges in addition to hearing loss.

This book is a must-have for anyone who works with children with hearing loss and their families. The information has value for professionals and families across the communication options that families might choose. This book is essential for professionals working to attain Listening and Spoken Language Specialist certification. It will guide their learning during their certification period and serve as a foundational source for examination preparation.

Nasal Emission Terminology Should be Evidence Based and Consistent with Physiology and Perceptual-Acoustic Characteristics

Nasal Emission Terminology Should be Evidence Based and Consistent with Physiology and Perceptual-Acoustic Characteristics (1)David J. Zajac, PhD, CCC-SLP, ASHA Fellow

Coauthor of Evaluation and Management of Cleft Lip and Palate: A Developmental Perspective

The term “cleft palate speech” has often been used to refer to hypernasality, nasal air emission, reduced oral air pressure, and compensatory articulations of speakers who exhibit velopharyngeal inadequacy (VPI). Hypernasality is defined as excessive resonance of the nasal cavity during production of vowels and voiced consonants. Nasal air emission refers to the audible escape of air during the production of high-pressure oral consonants, especially voiceless consonants. Reduced oral air pressure is the flip side of nasal air emission. When air escapes through the nose, some oral air pressure is lost. Thus, oral pressure consonantsespecially voiceless ones—may be produced with reduced oral air pressure and perceived as weak or reduced in intensity. Compensatory articulations are maladaptive gestures that are produced at the glottis or in the pharynx as a way to circumvent a faulty velopharyngeal valve. The use of glottal stops to replace oral stops is a classic example of a compensatory articulation. Hypernasality, nasal air emission, and reduced oral air pressure are passive (or obligatory) symptoms of VPI. This means that the symptoms occur as a direct consequence of incomplete velopharyngeal closure. Compensatory articulations, however, are active (or learned) behaviors and may not occur in every individual.

Although obligatory nasal air emission is a core characteristic of VPI, many confusing, overlapping, and inaccurate terms have been used to describe its perceptual manifestation. The literature is replete with terms such as audible nasal air emission, nasal turbulence, nasal rustle, and passive nasal frication. Because the velopharynx and nasal passage are complex anatomical structures— which may be significantly altered due to both congenital defects and surgical interventions associated with cleft lip and palate—the variety of terms used to describe nasal air emission should not be too surprising. Numerous other terms have been used to describe nasal air emission that is part of active (or learned) nasal fricatives and will not be discussed here. The reader is referred to Zajac (2015) for a discussion of active nasal fricatives as an articulatory error. Rather, this article will focus on terminology used to describe passive or obligatory nasal air escape.

A Brief History of Current Terminology

McWilliams, Morris, and Shelton in the first and second editions of Cleft Palate Speech (1984, 1990) described nasal air emission as occurring along a continuum. First, it could be visible but inaudible, detectable only by holding a mirror under the nostrils of a speaker to see fogging as a result of the air emission. In such a case, the nasal airflow is laminar, moving in relatively smooth fashion, and does not become turbulent, or noise producing. Clinically, visible nasal air emission typically occurs in speakers who have adequate but not complete velopharyngeal closure and normal resonance. Although visible nasal air emission should be noted when it occurs in a speaker, there are no treatment implications. Continue reading

Plural Supports Student Research Forum Awards at AudiologyNOW!

Each year, five recipients present their research findings at AudiologyNOW! and receive a $500 award from the Foundation as sponsored by Plural. We congratulate this year’s very deserving award recipients.

SRF Group Photo

Messages from the award recipients:

“It was a great honor and privilege to be selected and given the opportunity to present my research project and represent the University of North Texas in the Student Research Forum. From applying to presenting, the experience was full of nervousness. However, the possibility of presenting the research that I devoted so much time to in the last 3 years on a national stage was something I could not pass up. I am so very appreciative to the Foundation and Plural Publishing for allowing five students the opportunity to gain experience in public speaking and share the work that is so meaningful to them. I enjoyed meeting the four other students involved, Dr. Samuel Atcherson from the University of Arkansas, and other representatives from audiology programs and the Academy.  It would not have been possible for me to be selected without the hard work and dedication of my mentor, Dr. Amyn Amlani. The experience could not have been more perfect and I am appreciative for the award.”

Kyle Harber | Au.D. Student | University of North Texas

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Auditory-Verbal Therapy- Hearing, Listening, Talking, Thinking

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By Warren Estabrooks, M.Ed., Dip. Ed. Deaf, LSLS Cert. AVT, co-author of Auditory-Verbal Therapy: For Young Children with Hearing Loss and Their Families, and the Practitioners Who Guide Them

 

 

Globally, there is a great shift towards listening and spoken language for children who are deaf and hard of hearing.

Amazing auditory options, state-of-the-art hearing aids, and a variety of implantable hearing devices and the pursuit of excellent (re)habilitation by highly qualified practitioners working in partnerships with families, will hopefully become the standard of international health care and educational intervention for children with hearing loss around the world.

It is the work of therapists, teachers, audiologists, surgeons, social workers, and allied practitioners in health care and education to guide, navigate, and coach parents on their search for the treasure chest of spoken communication—to help them help their children discover the valued jewels of hearing, listening, and spoken conversation.  Practitioners everywhere form alliances of hope and trust with parents, and together we polish these precious gems until they sparkle and dance with life.

Why would one ever consider compromising when so much is possible?

We hope that one day we will look back and see an abundance of evidence-based outcomes, all barriers to equitable service gone, and a global focus on literacy with a deep understanding of powerful auditory access to the brain provided by state-of-the-art hearing technologies.

Renaissance man and mentor of many of today’s auditory-verbal practitioners, Dr. Daniel Ling, wrote that “auditory-verbal therapy… developed as a result of the natural outcomes of advances in knowledge, skills and technology.  As such advances occurred, new treatment strategies were devised to maximize their applications”.

Auditory-Verbal Therapy is now widely accepted because more children are acquiring, or have already acquired, the abilities to use spoken language, to interact more freely with other members of society, to obtain higher levels of academic education, and to have a more extensive range of careers, a greater security of employment and fewer limitations on the personal and social aspects of their lives” (Estabrooks, 2006).

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AudiologyNOW! 2016 Author Signing Schedule

AudiologyNOW! attendees – Meet our authors and connect with experts in the field! Stop by the Plural booth (#301) for the following Meet the Author sessions: 


Thursday, April 14, 11:00 am – 12:00 pm
Meet Marc Fagelson, BA, MS, PhD 
Co-editor of Tinnitus: Clinical and Research Perspectives

Marc Fagelson   Tinnitus


Thursday, April 14, 3:00 – 3:30 pm
Meet Mark DeRuiter, MBA, PhD and Virginia Ramachandran, AuD, PhD
Authors of Basic Audiometry Learning Manual, Second Edition 

Mark DeRuiter   Virginia Ramachandran   Basic Audiometry Learning Manual, Second Edition


Friday, April 15, 11:00 – 11:30 am
Meet Ruth Bentler, PhD, H. Gustav Mueller, PhD, and Todd A. Ricketts, PhD
Authors of Modern Hearing Aids: Verification, Outcome Measures, and Follow-Up  

Ruth Bentler   H. Gustav Mueller   Todd A. Ricketts  Bentler_MHA.jpg

Congratulations to Ruth Bentler, 2016 recipient of the Jerger Award for Research in Audiology. 


Friday, April 15, 1:00 – 2:00 pm
Meet Anne Marie Tharpe, PhD
Co-editor of Comprehensive Handbook of Pediatric Audiology, Second Edition

Anne Marie Tharpe   Comprehensive Handbook of Pediatric Audiology

Congratulations to Anne Marie Tharpe, 2016 recipient of the Marion Downs Award for Excellence in Pediatric Audiology. 

2016 Awards and Honors

We are thrilled to announce the winners of the 2016 Plural Publishing Research Awards given in honor of the late Dr. Sadanand Singh, Plural’s founder. These two scholarships are awarded by the Council of Academic Programs in Communication Sciences and Disorders and the honorees and their faculty sponsors will be acknowledged at the annual CAPCSD meeting award banquet, in San Antonio, TX on March 31.

At the MS/AuD level, the award went to Chelsea Hull of the University of Nebraska-Lincoln. Working with advisor Dr. Sherri Jones, Chelsea is researching the impact of Sound Field Amplification (SFA) devices, specifically the REDCAT amplification system, on student academic outcomes and teacher perspectives of this amplification system on academic improvement.

CAPCSD Scholarship Chelsea Hull

Chelsea Hull                                                         Au.D. Student                                             University of Nebraska-Lincoln

At the PhD level, the award was given to Nancy Quick of the University of North Carolina. Under advisor Dr. Melody Harrison, the focus of Nancy’s research is on investigating the impact of underlying linguistic sources of knowledge on spelling among children with hearing aids, cochlear implants and normal hearing, utilizing a multilinguistic analytic approach.

CAPCSD Scholarship Nancy Quick

Nancy Quick, M.S. CCC-SLP               University of North Carolina at Chapel Hill PhD Candidate in Speech and Hearing Sciences, Class of 2017

Congratulations Chelsea and Nancy on your achievements!


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Healing Voices

Healing Voices (1)By Leda Scearce, MM, MS, CCC-SLP author of Manual of Singing Voice Rehabilitation: A Practical Approach to Vocal Health and Wellness

Singing is a part of virtually every culture and is fundamental to our human experience. In the United States, singing is enormously popular, as evidenced by the vast number of people engaged in all kinds of singing activities. Over 30 million Americans participate in choral singing alone (Chorus America, 2009). Shows such as The Voice, America’s Got Talent, and American Idol illustrate how passionate we are about singing. From the amateur recreational singer to the elite celebrity, we sing as soloists and in ensembles, with instruments and a cappella, in classical and contemporary styles, on stage, in concert, and in the shower.

Every person’s voice is unique and identifiable, and our voices can be a big part of our identity and how we see ourselves in the world. This is especially true for singers, for whom the voice is not only intricately tied to self-image and self-esteem but also may be a source of income and livelihood, creative expression, spiritual engagement, and quality of life. For a singer, a voice injury represents a crisis. Because of the specialized needs of singers, it takes a team—including a laryngologist, speech-language pathologist, and singing voice rehabilitation specialist—to get a singer back on track following an injury or voice disorder. Singing voice rehabilitation is a hybrid profession, requiring in-depth clinical and scientific knowledge married with excellence in teaching singing.

Voice problems are rarely isolated in etiology—usually multiple factors converge to create an injury. These factors may include poor vocal hygiene, inadequate vocal technique, an imbalance in vocal load and medical problems (allergies and reflux are common in singers, but thyroid, pulmonary, neurologic, and rheumatologic conditions are among the illnesses that may affect the voice). The singing voice rehabilitation process must encompass all elements that may be contributing to the problem: medical factors, vocal hygiene, vocal coordination and conditioning, vocal pacing, and emotional factors. Continue reading