Featured Article- Choral Pedagogy, Third Edition


CHORAL PEDAGOGY, 3RD edition

Brenda Smith, DMA and Robert T. Sataloff, MD, DMA

Choral Pedagogy 3rd

Singing is known to every culture around the world.   For most of us, singing skill is learned collaboratively in choirs.  To participate in a choir throughout a lifetime, we must adjust our vocal expectations and maintain a dynamic sense of readiness for the changes that occur from year to year.  The choral conductor must work nimbly to accommodate the vocal needs of each age group, including all singers at all times in assignments appropriate to the contributions they are able to make.  There are many challenges, but choral pedagogy, voice science and medical resources are equipped to assist the choral conductor in the creation of a dynamic rehearsal and performance plan.

Lifelong Singing

For the training of vocal skill, trained and amateur singers of any age benefit from the personal attention of a voice builder or choral conductor.  Each voice presents with a specific complement of unique set of vocal, aural, rhythmic and interpretative gifts.  Because singers perceive their voices differently the way they are perceived by their listeners, singers at any age rely on constructive feedback generated by the trusted ears and eyes of a qualified person.

choirChanges in range are a natural part of the aging process and are due to the loss of muscle bulk and alterations in connective tissue in the vocal fold, as well as to respiratory changes, blood flow and alterations in body muscle nerve condition, and other alterations.  Another factor is the ossification of laryngeal cartilages.  The degree of aging changes varies from singer to singer.  People who love to sing wish to be included in choral activities as long as possible.  Choral singing can be particularly beneficial for the preservation of vocal skill and for delaying the inevitable losses of range, control and agility.

 

Medical Aspects

While choral conductors are not expected to have the medical knowledge of physicians, they should have sufficient familiarity with vocal health problems to recognize at least obvious voice dysfunction and suggest that afflicted singers seek medical attention.  Medical voice care has advanced markedly over the last few decades.  Voice is now an established subspecialty of otolaryngology (ear, nose and throat), and expert care for singers is available much more widely than it used to be.

Good medical diagnosis in all fields often depends on asking the right questions and then listening carefully to the answers. This process is known as “taking a history.” Recently, medical care for voice problems has utilized a markedly expanded, comprehensive history, recognizing that there is more to the voice than simply the vocal folds. Virtually any body system may be responsible for voice complaints. In fact, problems outside the larynx often cause voice dysfunction in people whose vocal folds appear fairly normal and who would have received no effective medical care a few years ago.

Physical examination of a patient with voice complaints involves a complete ear, nose, and throat assessment and examination of other body systems as appropriate. In the last few years, subjective examination has been supplemented by technological aids that improve the ability to “see” the vocal mechanism and allow quantification of aspects of its function. With phonation at middle C, the vocal folds come together and separate approximately 250 times per second. Strobovideolaryngoscopy uses a laryngeal microphone to trigger a stroboscope that illuminates the vocal folds, allowing the examiner to assess them in “slow motion”. This technology allows visualization of small masses, and other abnormalities that are simply missed in vocal folds that looked “normal” under continuous light. The instruments contained in a well-equipped clinical voice laboratory assess six categories of vocal function: vibratory, aerodynamic, phonatory, acoustic, electromyographic, and psychoacoustic. State-of-the-art analysis of vocal function is extremely helpful in the diagnosis, therapy, and evaluation of progress during the treatment of voice disorders.

Following a thorough history, physical examination, and clinical voice laboratory analysis, it is usually possible to arrive at an accurate explanation for voice dysfunction. Of course, treatment depends on the etiology (cause). Fortunately, as technology has improved voice medicine, the need for laryngeal surgery has diminished. When the underlying problem is corrected properly, the voice usually improves, but collaborative treatment by a team of specialists is most desirable to ensure general and vocal health and optimize voice function. The choir director should be part of that team.  Details of medical problems associated with voice disorders may be found in other literature. 1-4

The Basics of Singing

Warm ups and cools downs are necessary for any singer.  Warm up and cool down exercises adjust the vocal instrument from speech to singing and from singing back to speech.  Warm ups and cool downs involve four elements: relaxation, posture, breathing and resonance.  Relaxation before and after singing contributes to vocal health.  The vocal mechanism and the extremities need to be stretched and warmed.  Good posture, both standing and seated, must be established in order to achieve a full breath.  Conductors should be mindful that singing in a seated position is not an easy task.  All singers should maintain an erect posture that allows maximum muscular freedom, flexibility and safety.   A buoyant, flexible approach to breath support during exhalation follows.  The final step to vocal readiness involves uniting the breath with the vocal sound.  Exercises that evoke resonant sounds, such as humming, trilling with the lips or sighing set the stage for a focused vocal tone.  In the process of cool down, singers return the voice to the speaking range by sighing, chanting or humming through the mid and lower registers.

singer

The role singing plays in the daily life of each singer is diverse and unique.  The rhythm and discipline of music learning sharpens mental acumen and memory. For choir members who maintain interests in acting and public speaking, singing can be a means of maintaining vocal strength and stamina.  For many, singing in a choir makes life worth living.  The overall musical results of a choir rehearsal may be of less importance than the good experience of being together for the task of singing.  Singers want to continue singing as long as they can and as well as they can.  Choral pedagogy is advancing to accommodate the special needs of singers of all ages.  By establishing good singing habits, remaining physically fit, setting reasonable goals, and attending to vocal health, choral singers can “stay in the game” for many decades.

References

  1. Sataloff, R.TProfessional Voice: The Science and Art of Clinical Care, Third Edition.  San Diego, CA: Plural Publishing, Inc.; 2005.
  2. Rubin, J., Sataloff, R.T. and Korovin, G Diagnosis and Treatment of Voice Disorders, Fourth Edition.  San Diego, CA: Plural Publishing, Inc.; 2013, in press
  3. Heman-Ackah, Y.D., Sataloff, R.T. and Hawkshaw, M.J.  Protecting the Vocal Instrument.  Narberth, PA: Science and Medicine; 2013.
  4. Smith, B. and Sataloff, R.T.  Choral Pedagogy and the Older Singer.  San Diego, CA: Plural Publishing, Inc.; 2012.

 

 

Australian Voice Association’s Student Encouragement Awards 2013 Winners

Australian Voice Association

Each year on World Voice Day, April 16th, the AVA presents their Student Encouragement Award to five national recipients. This year Plural sponsored the award by donating one of our books to each of the five winners.

This year’s winners are:

AVA-Clare-Eastwood-2013

Grace Smibert, Western Australian Academy of Performing Arts receiving her award from Judy Rough and Daniel Novakovic.

 

 

Grace Smibert and Caitin Cassidy

Caitlin Cassidy, Western Australian Academy of Performing Arts, and Clare Savina Eastwood, University of Sydney, are presented their awards by Ros Barnes and Julia Moody.

 

Eleanor Stankiewicz, National Institute of Dramatic Art (NIDA).

 

Michaela Brown

Michaela Brown, University of Queensland receiving her award courtesy of Adele Nisbet.

 

 

 

About the AVA Student Encouragement Award- Each year potential students are nominated based upon the following criteria:

  • Exemplary attitude and commitment to their particular program of study
  • Sound academic achievement
  • A genuine interest in learning about voice
  • Leadership in some manner with reference to vocal issues
  • Research achievement in voice
  • Vocal performance worthy of support

The winners receive:

  • Complimentary AVA membership for the year of nomination
  • Complimentary participation in one AVA Professional Development Event
  • A relevant textbook sponsored by Plural Publishing

World Voice Day 2013

About World Voice Day- World Voice Day is every April 16th. It is a worldwide annual event that celebrates the voice. It aims to demonstrate the importance and impact of the voice in daily life; as a tool of communication and as an application of a large number of sciences, such as physics, psychology, phonetics, art and biology.

Feature Article: Why Quality Matters: The Changing Healthcare Delivery Model

Brian Taylor

Why Quality Matters: The Changing Healthcare Delivery Model

By Brian Taylor, AuD

In fits and starts, physicians and other healthcare professionals are beginning to realize that the convergence of wireless sensors, social networking, mobile connectivity and robust data management systems will profoundly impact the future. This transformation of medicine is likely to put a premium on healthcare professionals that place the patient firmly in the center of the clinical experience. These same forces will undoubtedly affect audiologists and their support staffs, and quality is likely to be a key differentiator in a disruptive future.

In this new world, physicians and other healthcare professionals are more likely to be reimbursed for the quality of their results, rather than the sheer number of procedures they order. Hospitals and clinics that demonstrate higher-than-average patient satisfaction scores will enjoy higher rates of reimbursement from federally funded programs. Patients are even joining the quality bandwagon as many are demanding greater transparency when shopping for medical services. In essence, patients are demanding to be treated more like customers. Consumer-centered health care is gradually supplanting the antiquated, paternalistic model in which the practitioner is never questioned and has near omnipotent authority over the uninformed patient. Out of this paradigm shift comes the quality movement. For audiologists this means the use of report cards, key performance indicators, and other quality strategies and tactics, if they want to stay relevant in a highly competitive marketplace. If you are like the typical practitioner, there is a good chance these concepts related to quality sound a little strange to you now. This is why I wrote Quality in Audiology: Design and Implementation of the Patient Experience, to help you prepare for some of these changes.

Interestingly, hearing aid manufacturers are very familiar with many of these concepts. In an effort to rise above their fierce competition, manufacturers have been obligated to standardize quality within their production lines by using tools such as Six Sigma and Total Quality Management. At the heart of these quality tools is a drive to eliminate variance. Eliminating variance is a worthy goal for the optimization of medical devices, but clinicians know all-too-well that each patient has built-in variability. Thus, many of the quality concepts and tools device manufacturers have come to rely on to incrementally improve quality don’t work well with patients. This paradox of quality within healthcare, as the book suggests, can be overcome through the standardization of quality around six patient staging areas.

Taylor_QA

The purpose of this book is to bring a level of practicality to the implementation of quality within an audiology clinic. As the book proposes, quality is improved mainly through your grassroots initiatives: procedures, programs, and behaviors you implement, measure, and manage in your clinic. This grassroots perspective requires audiologists and other professionals associated with hearing heath care to reexamine the concept of quality. According to the International Standards Organization, which acts as a sort of quality police for device manufactures, quality is the totality of characteristics, including people, processes, products environments, standards, and learning, of an entity that bear upon its ability to satisfy stated and implied needs. This definition suggests we improve ourselves and our ability to create quality in the world around us through innovation and the judicious use of best practice standards.

From a workaday, clinical standpoint, quality is meeting the requirements and expectations of patients and stakeholders in the business. In short, quality is probably best defined as the standardization of individual excellence. Rather than rely on academic boards and government agencies, the quest for better quality begins with self-motivated and dedicated audiologists and support staff who can use data to make better decisions about their patients. Quality in Audiology will get you on the path to continuous improvement in your clinic.

Feature Article: Technology helps patients with hearing loss thrive

Seilesh BabuBy Seilesh Babu, M.D., Michigan Ear Institute

Hearing loss is one of the most common conditions affecting otology patients whether as a newborn or aging patient. Hearing loss can significantly impact one’s ability to communicate leading to reduced quality of life, isolation, and even depression. Seeking medical help to assist with this hearing loss can be the biggest obstacle for many patients who do not want to acknowledge a hearing issue. However, if the problem is properly managed with hearing aid assistance or surgical therapy, improvement in the patient’s quality of life including anxiety, depression, frustration, and social isolation will be positively impacted.

In our practice at the Michigan Ear Institute, we see thousands of patients annually with hearing loss concerns in all age groups. Some of unilateral hearing loss and many have bilateral hearing loss, ranging from mild to profound. Unilateral hearing loss can be caused by not having an ear canal form (canal atresia) or, from nerve damage of unknown etiology. These patients have several options to improve their hearing such as using CROS hearing aids, bone anchored devices, dental implanted devices, or surgical repair of the poorly formed ear canal in the case of atresia. Many patients have significant improvement in their hearing in various situations using these technologies and surgeries.

Recently, a patient of ours received a scholarship from Cochlear Americas, the global leader in implantable hearing solutions. This scholarship recognizes bone anchored device and cochlear implant recipients who have shown academic accomplishments as well as a commitment to leadership and humanity. Using the technology of hearing devices, patients are able to complete advanced academic pursuits despite having hearing impairment that may have proven to be an obstacle. We are proud to be a part of this successful path for this patient who is currently enrolled in a Ph.D. program.

Hearing technology continues to improve. Advances in hearing aids have occurred with smaller, more powerful processors and noise canceling technology, as well as masking technology that treats tinnitus or ringing in the ear. Middle ear implants provide a surgical treatment option for patients who do not want to wear conventional hearing aids. Cochlear implantation has revolutionized the ability to treat patients with complete hearing loss either as a newborn or for patients in their 80s.

baby_hearing_aidChildren born with complete deafness are able to be treated with a cochlear implant with near normal function from speech and language development to academic performance. Adults with late onset profound hearing loss are also able to obtain a cochlear implant in order to maintain excellent quality of life, independence, and social interactions. Some elderly patients diagnosed with Alzheimer’s disease may in fact be suffering from severe hearing loss that needs to be diagnosed and managed.

In the future, advances in stem cell development and treatments will improve the quality of life of hearing loss sufferers. In addition to these new technologies, it is the collaborative effort of otologists, audiologists, and speech-language pathologists in treating patients with hearing loss that continues to have a positive impact in the lives of these patients every day.

FIRST LOOK: Sound Auditory Training – a new tool for treating patients with CAPD

By Dr. Gail Chermak

Coming soon: Web-based auditory training exercises—Sound Auditory Training—developed by Gail Chermak, Frank Musiek, and Jeffrey Weihing. Based on a wealth of empirical evidence on the neuroscience, diagnosis and treatment of central auditory processing disorder (CAPD), Sound Auditory Training is designed to train auditory processing skills in children, adults, and older adults with CAPD as well as other clinical populations, such as patients with cochlear implants. Sound Auditory Training (SAT) makes available well controlled stimuli that can be customized to exercise a number of fundamental auditory skills. In addition to training, SAT provides clinicians with a toolset to design one’s own training tasks and evaluate auditory skills, and provides clinical scientists with highly accessible stimuli to design psychoacoustic procedures. While the developers offer general guidelines for selecting specific tasks and setting parameters based on clinical profiles, SAT is not a program nor is it a test. Rather, SAT is toolset that includes adaptable auditory stimuli, a range of auditory tasks, and engaging graphic interfaces to meet the clinical or research needs of the professional.

The prevalence of CAPD is estimated at 5% of school-aged children and up to 70% of adults and older adults experiencing hearing and listening problems. The underlying impairments of individuals with CAPD are varied and not currently reducible to a single deficit.  Auditory processing deficits frequently are seen in a number of other disorders including learning disabilities, dyslexia, language impairment, attention deficit disorder (ADHD), and autism. In order to properly describe and treat basic auditory deficits that can affect listening, communication, and learning, one needs to have a flexible, but easy to use tool that spans temporal, spectral, and binaural processing.  The architecture of Sound Auditory Training incorporates the flexibility necessary to adapt stimuli for training regimens to meet the needs of particular individuals. The software provides the flexibility to train in either a game environment for children or a more standard psychophysical paradigm for adults.

Sound Auditory Training relies on adaptive algorithms (i.e., the program changes in response to the user’s performance), flexible feedback to the user (via animations or counters), and flexible parameter settings for the clinician/clinical scientist, parents, educators, and users. Tasks train intensity, frequency, and temporal detection, discrimination, and identification using a variety of non-verbal (e.g., tones, noise) and minimally loaded verbal stimuli (e.g., consonant-vowel syllables). Immediate feedback (error correction and reinforcement) is provided through animations within the game. Skills are practiced intensively until they become habitual and automatic. The exercises are sequenced to challenge but not overwhelm the participant. The clinician can use the software to obtain a more comprehensive profile of an individual’s skill strengths and skill deficits in order to more efficiently and effectively target and train deficit areas on a variety of auditory tasks.

In addition to its usefulness to clinical professionals, Sound Auditory Training is designed to be accessible to parents and teachers so that the exercises can be administered in a non-clinical environment. It is also designed to meet the needs of researchers to serve as a tool for investigation of auditory psychophysics, especially with children.  The flexibility of the program allows updates based in research and thus promotes evidence-based practice.

Sound Auditory Training provides auditory training exercises that encompass a wide range of auditory processing skills. There is no other product like it! Most important, Sound Auditory Training exercises auditory skills which are most likely to have a meaningful impact on a person’s listening, communication, and learning.

Plural Community – April 2012

The April issue of Plural Community is here! In this issue you can:

– enter to win a copy of Clinical Management of Swallowing, Third Edition

– check out our new releases like Choral Pedagogy and the Older Singer

– read a great article by Linda I. Rosa-Lugo, Forin M. Mihai, and Joyce W. Nutta on language and literacy development for English learners with communication disordess

– see Plural’s upcoming events

– and more!

 

Check it out here: Plural Community – April 2012

 

February Plural Community

We are delighted to send you the February 2012 issue of our free content (and free to circulate) newsletter, Plural Community—featuring an article by Robert Goldfarb on problems of diagnosis in communication disorders.

Our regular features include our free-to-enter prize drawing, new books launched this month, and a listing of conferences where you can meet our people and browse our books. Click here to see the newsletter!

Don’t forget to follow us on Twitter and like us on Facebook!

January’s Plural Community

We are delighted to send you the January 2012 issue of our free content (and free to circulate) newsletter, Plural Community—featuring an article by James E. Peck on the little-understood issue of pseudohypacusis, or false and exaggerated hearing loss. Click here to read it!

Our regular features include our free-to-enter prize drawing, and a listing of conferences where you can meet our people and browse our books.

Thank you for reading on; we wish you and your families all the best for 2012.

December’s Plural Community Newsletter

The December issue of our free content (and free to circulate) newsletter, Plural Community, is now available—featuring articles by Karyn Lewis Searcy on child language development and Nancy J. Minghetti on the work of the American Speech-Language-Hearing Foundation. We also include some photographs from the recent ASHFoundation’s Elegant Oceanside Charity Event, held at the home of Plural owner, Angie Singh, last month. There are no incriminating shots there, we assure you!

Our regular features include our free-to-enter prize drawing and a listing of conferences where you can meet our people and browse our books. Click here to go to the December Plural Community Newsletter!

Thank you for reading on; we wish you all the best for the festive season and for a happy and peaceful new year.

Best wishes from the Plural team.

November’s Plural Community Newsletter

The November issue of Plural Community is here! Click here to read it!

In this issue you can:

– enter to win a copy of The Deaf Child in a Hearing Family

 

– see our new releases, like Janice Chapman’s Singing and Teaching Singing: a Holistic Approach to Classical Voice, Second Edition

- read an article about Uganda’s first Speech-Language Pathologists by Helen Barrett

– and find out about the ASHA Foundation fundraiser held at the home of ASHFoundation board member, and Plural CEO, Angie Singh!