“There is great satisfaction in bringing hope and relief to the vocally unhappy, challenged or afflicted. It is, without doubt, my vocational calling in life”
– Christella Antoni
One week in voice consists of many voice clients with varied diagnoses and vocal needs. This kind of mix stokes my voice passions and fires 🔥 me to achieve better voice outcomes for clients, not least, those with long-term unresolved voice conditions. I’m going to turn a spotlight on two different cases where constriction of the voice was the dominating feature.
Spotlight On:
A case of Spasmodic Dysphonia
Let’s take the case of the 28 year old barrister with spasmodic dysphonia. If you haven’t heard a spasmodic voice before, it can be quite a hard listen. For the sufferer, the condition can be debilitating or at least socially, personally and often professionally limiting . In most cases , sufferers have no idea where, when or how their voice began to go wrong. In the most common type, adductor spasmodic dysphonia, (where the vocal cords press together too firmly), the voice goes croaky and then increasingly strained with a strangled like quality . The client typically reports a good deal of effort just to voice and voice projection becomes impossible.
Traditionally the cause of spasmodic dysphonia was often reported as being psychological in origin but in recent years, the cause is thought to be of unknown neurological origin . Most clients report voice variability with periods of normal voice, and often no problem with laughing or singing. Commonly, clients tell me that stress can make things worse usually compounded by worrying about how their voice will come out.
In a very full session with the above client, I carried out an assessment, and made recordings whilst practicing 4 different voice therapy techniques with her. There were promising vocal improvement signs for the client who expressed relief at finding an easier way to voice.
For her second session I recorded her voice again:
The improvements continued. In the 3rd session, I took another recording:
In cases that do not respond to therapy, botox injection to prevent laryngeal muscles spasming is often a very effective option. Increasingly though , I’m noticing a trend of clients who’ve tried botox more than once and found that they did not see any improvement. Others tell me that Botox brought some or good improvement but they no longer wanted to have repeat injections every 4-6 months).
EXTRA FOCUS: Students
“Inspiration, both respiratory and aspirational is the basis of all human functioning.”
– Christella Antoni
It’s always hard to accommodate students when there is a busy practice to manage so I say ‘yes’ only when I can give some time for feedback, discussion…. and questions. My preferred method now, to accommodate as many requests as possible, is to offer a whole study day to students with organised content, reference lists and plenty of question and answer time. All good observation placements, work experience or teaching require at least some time for the latter. I’ve always believed that part of a teachers role, perhaps the most important part, is to inspire. Observation placements and teaching courses are successful for me if the attendees were both educated in some way and inspired at the same time. After all, inspiration, both respiratory and aspirational is the basis of all human functioning.
Grant 3 Wishes: From Germany to Palestine (via London)
- 2 SLT students from Bonn in Germany given a week long observation placement in response to their request earlier this year.
- A request has come through to teach voice skills to a group of SLTs based in Bethlehem hospital in Palestine. If I can’t go there, some of them will come to my Vital Voice Skills course in London. We are continuing our international negotiations on this……
- Would be SLT student Rose 🌹 contacted me seeking any kind of work experience I could offer and will become a volunteer admin assistant from mid-August. Rose attended the free study day I offered for SLT students/ would be students last month aimed at providing attendees with advice and information about working as an SLT. 4 qualified SLTs described their varied and career paths and job roles. A successful day for all and, for would be student Rose, inspiring enough to seek further opportunities in speech & language therapy.
Top Notes
“That Indigo Girls song, ‘Closer to Fine’ ….it surely contains some of the best lyrics for life. “
– Christella Antoni
The Cambridge folk festival this month featured the Indigo Girls as one of the main acts. I caught a radio 2 broadcast whilst cooking in the kitchen – an interview with the band members and then the song that transported me back in a full circle to my own student days. Sometime around 1994, my 2 fellow MSc students Lizzie and Merida introduced me to this track . We practiced it together and I was nominated to sing the lead while they took on the harmonies. Quite often, in the dingy common room of the National Hospitals College for Speech Sciences, we sang that song for our fellow classmates; it became a kind of anthem for us . Once we sang it for the tutors in their less dingy staff room.
Abandoning my cooking, and any care I had in the world, I sang along with the Indigo Girls, remembering all the words, now 23 years later.
That Indigo Girls song, ‘Closer To Fine’, … it surely contains some of the best lyrics for life . And as I began this post with the value of variety in my voice work, it seems only fitting that I repeat the revered song lyrics again now.:
” And the less I seek my source from one definitive, the closer I am to fine, yeah …..the closer I am to fine.”