The Voice at Work – Optimization and Management
An information packed two days were spent in a lecture theatre listening to experts from around the world presenting their research on the monitoring and improvement of the vocal health of ‘occupational voice users’. This is the third Symposium of its kind, organised by Dr Ruth Epstein of The Royal National Throat Nose and Ear Hospital London.
‘Occupational Voice’ user is a term coined by voice experts to describe anyone who relies on their voice for work where there is high ‘vocal loading’ or voice use. #Singers, #Actors, #Teachers, #Lecturers and #Contact Centre Advisors all fall fairly obviously in to that category. But has anyone thought about hairdressers, sports coaches or tourist guides?
Whereas in previous symposia the focus had been on the relationship between occupational voice use and voice disorders, with discussion of the medico legal implications and the efficacy of ambulatory phonation monitoring, our focus was shifted this time to ‘interventions’ with discussions on the merits of telehealth (remote health monitoring and advice).
At the end of Day Two I presented my own MA research on possible prevention strategies for #Muscle #Tension #Dysphonia in Teachers. Delivering voice training that people enjoy is one thing. But how can that be sustained afterwards? It was officially titled #‘Are You Speaking Comfortably?’ which I quickly revealed as ‘It’s No Joke if You Croak!’ As we know, it is potentially very serious: …lose our voice, lose our job, lose ourselves…’ According to the British Voice Association (BVA) absence from work through dysphonia is costing the UK an estimated £200m a year. My study focused on a trial of some media I had designed to act a means of sustaining and embedding good practice learnt during direct voice training. The results showed promise, so I was pleased to share, and all the more so from the perspective of a #Practitioner, training a wide variety of willing though unwitting #professional voice users.
Big questions were raised around the evolution of #telehealth. America has already embraced the concept with The American Well (www.americanwell.com). Telecounselling and rapid advice are the two obvious benefits, but what, as I put it to the conference, do we risk losing without the benefit of touch in diagnosis? Abraham Verghese speaks eloquently on this subject in his TED Talk ‘The Power of Touch’. (www.TED.com)The conference broadly agreed it is a delicate course we will continue to negotiate between the remote and the personal approach in dispensing health care in 21st Century.
In addition to updates on voice dosimetry and the latest development in ambulatory monitoring of the voice, we were treated to other exciting interventions and demonstrations. These included the presentation of Opera VOX, a sleek new App designed and developed by otolaryngologist Owain Rhys Hughes, and colleague Anil Alexander. Owain’s research focuses on disorders that affect the head and neck, and developing new treatments. This new App is set to become a leading tool for communication the vocal condition of the occupational voice user to their clinician or consultant. The Pro Version permits the clinician to keep data on several patients at a time on one device. It is unashamedly an ‘Apple’ product simply because of the consistency of the platform Apple is able to offer across a variety of platforms (iPad, iPhone and iPod Touch). Personally I can’t wait to try it myself, but I will leave you to take a look yourselves!
Leslie Mathieson, co-author of the expert volume ‘The Voice and its Disorders’, presented her study and demonstration of Laryngeal Manipulation Therapy, to release muscular tension in the throat. I was struck again by the clarity, wisdom and logic of her words. A particular place she prefers to avoid is the thyro-hyoid space (the gap between the floating hyoid bone and the thyroid cartilage shielding the front of the larynx), which many concentrate on increasing, in order to relieve the excess throat tension. In fact, Leslie said, some people have a naturally small space between those two structures and so attempting to do this can be counterproductive.
Another delightfully simple and effective intervention was presented by Professor Susanna Simberg, known as #Resonance Tube Method in Voice Therapy. Ten of us were summoned to the front to blow through glass tubes into vessels of water whilst phonating to /u:/. Blowing bubbles, in effect! Amidst the laughter and splashes, the efficacy of this therapy was felt by us all through the vibration and back pressure to the vocal folds. This concept is also fundamental to the Accent Method. I have at least one client with whom this will be trialled! Professor Simberg was honest enough to say that having used it for the last 45 years, they know it works, even if they don’t fully understand why.
On day two we considered, among many other things, behaviour intervention therapies, including ‘Solution Focused Behaviour Therapy’, presented by Emma Osei-Mensah. It is a problem for many of us who are tackling psychogenic voice disorders which relate to a client’s habitual behaviours. How do we get people to register, own and change what they are doing in order to improve their voice? With similarities to Neuro Linguistic Programming as a coaching tool, Emma said that it had helped her patients achieve their goals remarkably well as a result.
A combined approach
Reflecting on all the many contributions to the conference, I came away more convinced than ever that the value of research is in supporting the people who are most in need of its discoveries. Scientific research supports the work of Speech Pathologists and Professional Voice Practitioners and vice versa. The #Voice is one domain where the art and science must perforce be combined in order to help patients. A holistic approach that focuses on prevention and sustainability will continue to underpin all our work at the Professional Voice Practice.
Will we one day see the formation of a Royal College of Occupational Voice #Therapists? It would certainly help concentrate the information and avoid duplication. But for now we will have to rely on the generosity and input of from everyone at the Occupational Voice Symposia, not least that of Dr Ruth Epstein, who organised the first one, in 2007. Our grateful thanks to her and all the team once again.