Friday, January 6, 2012

Choral Speech Pathology

An acoustic sample of "Silent Night"

Greetings readers,

I primarily discuss my choral experiences here on this blog, however, I rarely speak about the other dominant area of my life: Speech-Language Pathology (S-LP). In my program, you have the option to choose either a group project or an individual thesis and you need to decide, within the first month, which route you're going to take. Therefore, it's quite a significant program-altering choice. The department held a "research fair" where all of our faculty presented the projects which they were offering that year: studies involving fMRI neuroimaging to look at language processing in the brain, studies investigating the potential of noise-induced hearing loss from high iPod listening levels while exercising, looking at developmental language and vocabulary inventory of children with cerebral palsy... although they were all interesting in their own way... none of them really appealed to me. I knew that I would either choose a project that seemed straight-forward just to get it finished or develop my own thesis project. Since I have never been one to choose the path of least resistance, I chose the latter option. I rationalized that if I am going to spend two years on something--- I better enjoy it.

A year before entering the program, I remembered hearing about an S-LP, Merrill Tanner, from a fellow chorister's parent during a reception. Tanner was known to utilize singing techniques in her S-LP therapy practice. While I was contemplating project options, I googled her name and discovered that she was working on her PhD with the voice disorders professor in our department. I immediately arranged to meet with this professor. I didn't know what to expect when I walked into my soon-to-be-supervisor's office. At that point, I had already visited at least six other professors discussing their thesis projects but I didn't feel moved to accept any of them. This voice professor was interested to hear about my journey which led me to Tanner's research and said that I could formulate a project that that united my two interests. As well, she  knew of a set of unanalyzed data from a study in 2004 where persons with Parkinson's Disease had singing lessons with a music professor. A variety of measures were taken but the data was never analyzed. Five years later, there I was, an eager new graduate student who was willing to take on the analysis job. I spent a good two years designing a standardized analysis method and then analyzing the data.

Within Parkinson Disease, the main voice symptoms that occur are decreased loudness levels, weak and imprecise articulation, and a fast or "blurred" speech rate. Therefore, it can be hard to understand the speech of people with Parkinson's Disease. The implication of this is that a decreased ability to communicate effectively with others can lead to a gradual disengagement with others and with life in general. The muscular system in persons with Parkinson's is extremely rigid, which means that the respiratory, voice, and even facial muscles are stiff and aren't used to their full capacity or range. There's support for therapy practices which engage these muscular systems. Currently, the gold standard of Parkinson's voice therapy is called the "Lee Silverman Voice Treatment" (LSVT), which involves sitting in a room two times a day and holding the word "ah" at a comfortable pitch and volume for as long as a client can and doing this drill 15 times in a row, as well as other voice drills for an hour. While LSVT has great outcomes after 4 weeks, it's arguably not the most holistic or enjoyable way to spend a treatment session. That's why there has been an interest in relating Parkinson's voice therapy back to music since it still trains the same muscular systems as LSVT, however, the tasks are within an enjoyable musical context. Tanner's PhD work has already been noting the positive changes seen in patients participating in singing therapies and the results from my thesis show the same positive trend as well (which I'm excited to be presenting in a poster at the CASLPA conference in May 2012!). There's an argument for the fact that singing/choral voice treatment is a much more accessible (you can almost always find a choir in any rural or urban setting but you can't always find a LSVT certified S-LP) and a lower-cost therapy option for persons with Parkinson's.

I hope my previous paragraphs provided some context for the other things that are on my mind when I'm not singing in choirs. Below is a video of Tanner's research and an interview with some of her current Parkinson participants.

Until next time, take care readers!

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