Nathan Waller, SLPD, CCC-SLP, MM: Northwestern University: Financial - Speaking Fee (Ongoing). No non-financial relationships to disclose
Abstract: Evaluative techniques and treatments that reflect evidence-based practice in the management of voice disorders continue to advance. This course will provide an up-to-date, comprehensive review of assessment and treatment methods using case-based learning and hands-on application. Challenging diagnoses of muscle tension dysphonia and common airway disorders will also be examined.
Summary: Evidence-based practice continues to expand in the areas of voice and upper airway disorders. As more research is published and demand for speech-language pathologists to provide evaluation and treatment in these areas increases, it is imperative we remain informed of the leading science that supports our work. Resources surrounding practice standards, instrumental assessment and clinical practice guidelines exist for the voice clinician and can ensure we are executing best practice when working with the voice patient. Review of these resources however requires frequent revisiting given that the science in voice physiology, pathology and treatment continues to expand and gain ground. Research and treatment recommendations for more challenging populations have also progressed. Muscle tension dysphonia, which comprises up to 40% of a voice clinician’s caseload (Spencer, 2015) is often a complexing diagnosis yet recent evidence provides further clarification on how we may best treat this condition. The same is true for upper airway disorders including exercise induced laryngeal obstruction, paradoxical vocal fold movement and chronic cough. When developing a treatment plan for our patients, we are mindful of evidence-based therapy techniques, frequency of sessions and duration of time for patient visits. However, the teaching, modeling and modification needed for voice therapy is often challenging. A review of motor learning principals can provide a roadmap for how to successfully administer each therapy target successfully. The science behind motor learning we know is effective in the treatment of many of the conditions a speech-language pathologist may manage, however, it was not until recently that more substantial research in the area of voice disorders has been explored. A review of the motor learning framework when working with the voice patient will further enhance the implementation of evidence-based care and result in improved treatment outcomes. Lastly, multidisciplinary care is critical in the successful treatment of dysphonia and indeed there has been an increase in data that supports this clinical model when working with our voice patients. Understanding how to navigate this model and what is expected of each health care provider is essential in our practice and will result in comprehensive diagnoses and treatment plans.
Learning Objectives:
At the completion of this activity, participants should be able to:
Outline a complete voice and upper airway disorder evaluation protocol and identify clinically appropriate assessment tools.
Identify evidence-based treatment approaches for voice and upper airway disorders across phonotraumatic, neurological, muscular tension and irritable larynx diagnoses.
Describe the core motor learning concepts behind the treatment of voice and upper airway disorders.