Conversation Training Therapy: Let's Talk It Through

2021 ◽  
Vol 42 (01) ◽  
pp. 032-040
Author(s):  
Jackie Gartner-Schmidt ◽  
Amanda I. Gillespie
Keyword(s):  
Voice Therapy ◽  
Medical Documentation ◽  
Treatment Programs ◽  
Efficacy Study ◽  
Conversational Speech ◽  
Perceptual Awareness ◽  
Voice Production ◽  
Therapy Approach ◽  
Novel Approach ◽  
Training Therapy

AbstractThis article introduces a novel approach to voice therapy called conversation training therapy (CTT). CTT is the first voice therapy approach to remove the therapeutic hierarchy common in most treatment programs. Rather, CTT uses patient-driven conversation as the sole stimuli in therapy to increase perceptual awareness of voice production in conversational speech. The genesis as to why CTT was developed, as well as the conceptual, theoretical, and component parts of CTT, will be explained. In addition, this article will offer examples of the language of therapy, as it applies to CTT and how to trouble-shoot if problems arise. Medical documentation relevant to CTT will also be outlined. Last, results from a recent efficacy study on CTT will be reported.

scholarly journals A Fast Semiautomatic Algorithm for Centerline-Based Vocal Tract Segmentation

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Anton A. Poznyakovskiy ◽  
Alexander Mainka ◽  
Ivan Platzek ◽  
Dirk Mürbe
Keyword(s):  
Major Part ◽  
Vocal Tract ◽  
Active Contours ◽  
Three Dimensional ◽  
Voice Therapy ◽  
Segmentation Method ◽  
Voice Production ◽  
Medical Issues ◽  
Dimensional Measurements ◽  
Spatial Geometry

Vocal tract morphology is an important factor in voice production. Its analysis has potential implications for educational matters as well as medical issues like voice therapy. The knowledge of the complex adjustments in the spatial geometry of the vocal tract during phonation is still limited. For a major part, this is due to difficulties in acquiring geometry data of the vocal tract in the process of voice production. In this study, a centerline-based segmentation method using active contours was introduced to extract the geometry data of the vocal tract obtained with MRI during sustained vowel phonation. The applied semiautomatic algorithm was found to be time- and interaction-efficient and allowed performing various three-dimensional measurements on the resulting model. The method is suitable for an improved detailed analysis of the vocal tract morphology during speech or singing which might give some insights into the underlying mechanical processes.

scholarly journals The Impact of Communication Modality on Voice Production

2020 ◽  
Vol 63 (9) ◽  
pp. 2913-2920
Author(s):  
Lauren F. Tracy ◽  
Roxanne K. Segina ◽  
Manuel Diaz Cadiz ◽  
Cara E. Stepp
Keyword(s):  
Technology Use ◽  
Voice Quality ◽  
Voice Therapy ◽  
Social Environments ◽  
Audiovisual Communication ◽  
Remote Communication ◽  
Voice Production ◽  
Vocal Effort ◽  
Communication Modalities ◽  
The Impact

Purpose Communicating remotely using audio and audiovisual technology is ubiquitous in modern work and social environments. Remote communication is increasing in medicine and in voice therapy delivery, and this evolution may have an impact on speakers' voices. This study sought to determine whether these communication modalities impact the voice production of typical speakers. Method The speech acoustics of 12 participants with healthy voices were recorded as they held standardized conversations with a single investigator using three communication modalities: in-person, remote-audio, and remote-audiovisual. Participants rated their vocal effort on a 100-mm visual analog scale. Results Compared to in-person communication, self-ratings of vocal effort were statistically significantly increased for remote-audiovisual communication; vocal effort during remote-audio and in-person communication were not significantly different. In comparison to in-person communication, vocal intensity and smoothed cepstral peak prominence (CPPS) were statistically significantly higher during remote-audio and remote-audiovisual communication. Effect sizes for CPPS changes were larger than for sound pressure level (SPL), and changes in CPPS and SPL between in-person and remote-audiovisual communication were not significantly correlated. Conclusions Vocal effort and SPL were increased when using remote-audio and remote-audiovisual communication in comparison to in-person communication. Voice quality was also impacted by technology use, with changes in CPPS that were consistent with, but not fully explained by, increases in SPL. This may impact the telepractice delivery of voice therapy, and further investigation is warranted.

Use of Imitation Training for Targeting Grammar: A Narrative Review

2020 ◽  
Vol 51 (2) ◽  
pp. 205-225 ◽  
Author(s):  
Sarita L. Eisenberg ◽  
Shelley L. Bredin-Oja ◽  
Kasey Crumrine
Keyword(s):  
Language Disorder ◽  
Narrative Review ◽  
Control Group ◽  
Conversational Speech ◽  
Language Therapy ◽  
Training Activities ◽  
Therapy Studies ◽  
And Linguistics ◽  
Training Therapy

Purpose The purpose of this narrative review was to examine the evidence for imitation training for targeting grammar in children with developmental language disorder. Method Studies investigating imitation training were compiled from two databases—PsycINFO and Linguistics and Language Behavior Abstracts—as well as from reference lists of several books and articles reviewing language therapy. Results Twenty-one studies were reviewed. We summarized the demographic and methodological characteristics of the included studies. We identified substantial differences in the implementation of imitation training across the studies and noted a lack of studies considering how those differences might affect therapy outcome. Studies showed a rapid increase in the production of grammatical targets during imitation training activities, higher performance relative to a control group that did not receive any therapy, and generalization to untrained exemplars. However, the studies did not unequivocally link the increased performance to the imitation training therapy. Studies also showed limited generalization to conversational speech. Conversationally based therapy resulted in faster or higher usage in conversational speech, while imitation training resulted in faster immediate gains in usage during therapy trials. Conclusion We believe that imitation training can continue to be a useful tool in a speech-language pathologist's toolbox, but with suggested modifications. Specifically, we suggest use of imitation training as a means for rapidly achieving production of previously absent grammatical targets. However, we do not recommend sole or long-term use of imitation training for working on grammar. Further research is needed to refine our use of the procedure.

scholarly journals Combining voice therapy and physical therapy: A novel approach to treating muscle tension dysphonia

2015 ◽  
Vol 58 ◽  
pp. 169-178 ◽  
Author(s):  
Jennifer Craig ◽  
Carey Tomlinson ◽  
Kristin Stevens ◽  
Kiran Kotagal ◽  
Judith Fornadley ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Muscle Tension ◽  
Voice Therapy ◽  
Muscle Tension Dysphonia ◽  
Novel Approach

Using Semi-Occluded Vocal Tract Exercises in Voice Therapy: The Clinician's Primer

2014 ◽  
Vol 24 (2) ◽  
pp. 71-79 ◽  
Author(s):  
Marci D. Rosenberg
Keyword(s):  
Vocal Fold ◽  
Vocal Tract ◽  
Voice Therapy ◽  
Exact Nature ◽  
Voice Production ◽  
Vocal Fold Vibration

Semi-occluded vocal tract (SOVT) exercises have long been used by voice trainers and pedagogues and have been particularly popular in Scandinavia dating as far back as the 1800s. Titze (1988, 1994, 2006; Titze, Riede, & Popolo, 2008; Titze & Verdolini-Abbot, 2012) has contributed significantly to the exploration of the SOVT and impact on voice production, and these types of exercise have become ubiquitous in the clinical voice arena. Although SOVT exercises are commonly used, there continue to be questions about the exact nature of how they impact phonation and improved vocal economy. This article aims to explore the physiology of a SOVT on vocal fold vibration and vocal output. Several variations are described within context of recent research.

Integrated Implicit-Explicit Learning Approach to Voice Therapy

2014 ◽  
Vol 24 (3) ◽  
pp. 111-118 ◽  
Author(s):  
Cari M. Tellis
Keyword(s):  
Motor Learning ◽  
Integrated Approach ◽  
Voice Therapy ◽  
Learning Theories ◽  
Published Data ◽  
Explicit Learning ◽  
Learning Approach ◽  
Voice Production ◽  
Therapy Protocol ◽  
Initial Instruction

This article is intended to define, compare, and provide outcomes for an integrated implicit-explicit learning approach to voice therapy related to current motor learning theories. Clients from the Misericordia University voice clinic have undergone therapy using this integrated approach. The article will review previous literature on motor learning theories related to voice, define the protocol used in the integrated approach, and highlight the diagnostic, clinical outcomes exhibited by these clients. Steps for the therapy protocol will be highlighted. Results indicate that individuals participating in an integrated implicit-explicit learning approach to voice therapy report that initial instruction and target production take increased effort to learn; however once acquired, targets are easily generalized to more complex speaking (e.g., conversation) tasks. Implicit-only voice therapy approaches are effective in treating voice disorders. Limited published data, however, has compared traditional, implicit-only therapy to other methods of voice therapy. Another approach may be one that employs more explicit teaching of the mechanics of voice production. The integrated implicit-explicit learning approach discussed in this article combines explicit instruction with implicit facilitators, and initiates simple and complex tasks from the start of therapy.

scholarly journals Efficacy of Conversation Training Therapy for Patients With Benign Vocal Fold Lesions and Muscle Tension Dysphonia Compared to Historical Matched Control Patients

2019 ◽  
Vol 62 (11) ◽  
pp. 4062-4079 ◽  
Author(s):  
Amanda I. Gillespie ◽  
Jonathan Yabes ◽  
Clark A. Rosen ◽  
Jackie L. Gartner-Schmidt
Keyword(s):  
Muscle Tension ◽  
Standard Of Care ◽  
Voice Therapy ◽  
Therapy Session ◽  
Muscle Tension Dysphonia ◽  
Benign Vocal Fold Lesions ◽  
Long Term Follow Up ◽  
Training Therapy

Purpose Conversation training therapy (CTT) is the 1st voice therapy approach to eliminate the traditional therapeutic hierarchy and use patient-driven conversation as the sole therapeutic stimulus. The purpose of this investigation was to determine the efficacy of CTT compared to standard-of-care voice therapy approaches for the treatment of patients with voice disorders. Method A prospective study of CTT treatment outcomes in adults with dysphonia due to primary muscle tension dysphonia or benign vocal fold lesions compared to age, gender, and diagnosis historical matched control (HMC) patients was used. The primary outcome was change in Voice Handicap Index–10 (VHI-10); secondary outcomes included acoustic, aerodynamic, and auditory-perceptual outcomes. Data were collected before treatment (baseline), at the start of each therapy session, 1 week after the final therapy session (short-term follow-up), and 3 months after the final therapy session (long-term follow-up). Results For the CTT group, statistically significant improvements were observed for VHI-10. Though statistically significant improvements were observed for the VHI-10 for the HMC group, the CTT group saw significantly greater improvement in VHI-10. Furthermore, equivalent gains were observed following only 2 sessions of CTT compared to 4–8 sessions of traditional therapy. Significant improvements in the CTT group were observed for cepstral peak prominence in a vowel, fundamental frequency, Cepstral Spectral Index of Dysphonia in a vowel and connected speech, vocal intensity, average airflow in speech in a reading passage, number of breaths and duration of reading passage, and auditory-perceptual measurement of overall voice severity. Conclusions Results support the hypothesis that training voice techniques in the context of spontaneous conversational speech improves patient perception of voice handicap and acoustic, aerodynamic, and auditory-perceptual voice outcomes both immediately following treatment and at long-term follow-up. CTT participants also demonstrated significantly larger decreases in VHI-10 compared to HMC participants who received standard-of-care, nonconversational, hierarchical-based voice therapy.

The Awareness Phase of Voice Therapy

1991 ◽  
Vol 22 (3) ◽  
pp. 158-162 ◽  
Author(s):  
Moya L. Andrews ◽  
Anne C. Summers
Keyword(s):  
Multiple Choice ◽  
Voice Disorders ◽  
Psychosocial Aspects ◽  
Voice Therapy ◽  
Voice Production ◽  
Adolescent Students

Adolescent students with voice disorders need information concerning the physiological, environmental, and psychosocial aspects of voice production. This paper describes a multiple choice quiz format that has been used effectively as part of the awareness phase of vocal reeducation.

Functional Aphonia in the Child and Adolescent

1983 ◽  
Vol 14 (4) ◽  
pp. 260-265 ◽  
Author(s):  
Sharon L. Murray ◽  
Mary E. Carr ◽  
Virginia Jacobs
Keyword(s):  
Peer Support ◽  
Family Environment ◽  
Academic Failure ◽  
Child And Adolescent ◽  
Voice Therapy ◽  
Therapeutic Management ◽  
Therapy Approach

Five cases of adolescents with functional aphonia are presented. The cases include four teenaged girls and one teenaged boy. Each was referred with the presenting symptom of "no voice." Indirect laryngoscopic examinations were normal. Therapeutic management is described which followed the symptomatic voice therapy approach. Four cases returned to use of full voice within two sessions, the fifth after five sessions. A consistent theme for four of the adolescents was stressful family environment, academic failure, and inadequate peer support. Referral for psychotherapeutic counseling was necessary for all but one.

The Relationship Between Voice and Breathing in the Assessment and Treatment of Voice Disorders

2016 ◽  
Vol 1 (3) ◽  
pp. 94-104 ◽  
Author(s):  
Ali Lewandowski ◽  
Amanda I. Gillespie
Keyword(s):  
Voice Disorders ◽  
Voice Therapy ◽  
Assessment Practices ◽  
Voice Production ◽  
Normal Voice ◽  
Assessment And Treatment ◽  
Laryngeal Physiology ◽  
Lower Airways ◽  
The Relationship

Coordination between the larynx and lower airways is essential for normal voice production. Dyscoordination may contribute to myriad voice problems. The current study provides an overview of respiratory and laryngeal physiology as it relates to normal and disordered voice production, as well as a review of phonatory aerodynamic assessment practices. Finally, the integration of voice and breathing in common voice therapy programs is explored.

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