☀️ "Every summer has a story" and we are just getting started - summer is around the corner, as well as with noala's first birthday, we gear up for an eventful next few months
🖥 Highlighting this past month, Noala Club was another success as we welcomed our noala ambassador and voice expert, Tor Spence. The discussion revolved around voice therapy focused on paediatrics - see the key takeaways below
💙 Step by step, working together with our community, we achieve greater heights
For Noala Club, we discussed evidence-based research on voice, see the links and takeaway below:
A voice disorder can have a significant impact on a child’s self-esteem. Research has shown that both direct and indirect voice therapy approaches can improve a child's quality of life.
For diagnosis prior to voice therapy, clear visualisation of the larynx is essential, usually by an ENT practitioner. If a child can't cope with an outpatient assessment of the larynx, a general anaesthetic may be required. If a child has dysphonia, general advice isn’t always appropriate. Hence there needs to be a thorough visualisation of how the larynx looks to inform treatment.
It's important to use a variety of perceptual and objective assessments of the child's voice. This includes informal symptom severity scales, perceptual ratings of voice quality and patient rated outcomes measures. Sometimes a bullying questionnaire can be helpful as this could be affecting the child as well.
Optimal frequency of therapy sessions is dependent on many factors including how often the child practices voice therapy techniques at home. It is very difficult to be prescriptive. It's important to set realistic goals and boundaries. Studies have shown that two 30 minute therapy sessions a week with daily practice at home have led to significant improvements to voice quality and related quality of life.
When treating a child with vocal cords nodules; treatment is a balancing act and requires voice rest, changing behaviour and educating the child about the cause and risk
I have worked a lot with people with aphasia including in a research role on the PLORAS project at University College London and envisaged this would be the main focus of my work going forwards. Since opening my own private practice in Norwich a few years ago however I found that lots of people with Parkinson's were getting in touch and looking for therapy.
This led me to undertake training in SPEAK OUT! with the Parkinson Voice Project who are based in the USA. SPEAK OUT! is an evidence based approach. With similarities to LSVT and has been designed to be efficient for speech and language therapists with a very structured way of delivering sessions and recording results and outcomes. In addition to intensive sessions with me, patients can join live (or watch later) Facebook sessions daily with the Parkinson Voice Project Team. This helps with motivation to practice and means they can follow a correct model when doing homework between sessions. I find the whole approach has such a positive effect on patient's lives and it's wonderful to see them get their confidence back. They return to interactions they'd been avoiding due to their dysarthria, such as ordering in a restaurant or having a phone-catch up with a relative.
The best piece of feedback recently was a patient telling me that their partner said to them they felt they had 'got them back' as they sounded like their 'old-self' again. It's really heartening to see patients make progress and to have the tools to keep their voice strong despite the general progression of their Parkinson's and as one patient puts it gain 'vocal independence and autonomy'. I will soon be working with the Highly Specialist SaLTs on the Movement Disorders Team at the National Hospital for Neurology and Neurosurgery. I am looking forward to reaching even more patients with Parkinson's.