Singing Voice Specialist Singing Voice Specialist The singing voice specialist is a singing teacher with special training equipping him or her to practice in a medical environment with patients who have sustained vocal injury. Nearly all have professional performance experience, as well as extra training in laryngeal anatomy and physiology of phonation, training in the rehabilitation of injured voices, and other special education. The fundamental approach to training the singing voice is different in important ways from that usually used with healthy students in a singing studio. Hence, even an excellent and experienced voice teacher may harm an injured voice if he or she is not familiar with special considerations for this population. In addition, most voice teachers do not feel comfortable working with a singer who has had a vocal injury or surgery. Virtually all singing voice specialist not only work with singers, but also with other patients with voice disorders. For non-singers, supplementing traditional voice therapy (by the speech-language pathologist) with singing voice training often facilitates and expedites therapy. There are many differences between singers and typical speakers. For example, the pith range of conversational speech usually encompasses about a major sixth. Most singers possess at least a 2-octave range. Interestingly, physiological frequency range is about 31/2 octaves in both singers and non-singers, so most people have more potential than they realize. Pulmonary demands are also much greater during singing than speaking. In speech, we typically use 10% to 25% of vital capacity. The singer frequently uses closer to 65% of vital capacity. In many ways, singing is to speaking as running is to walking. In rehabilitating a patient who has difficulty walking, once a patient has learned to jog and run, walking becomes relatively trivial, since the patient is not working at his physiological limits during this activity. Likewise, once patients have acquired some of the athletic vocal skills employed routinely by singers (including increased frequency range, frequency and intensity variability, prolonged phrasing, breath management and support, etc.), the demands of speech seem much less formidable. In many cases, even non-singers utilize a more relaxed and anteriorly placed voice while performing sung or chant-like exercises. This helps facilitate a more resonant voice quality in the speaking voice, while eliminating pressed phonation. The singing voice specialist applies similar principles to voice rehabilitation in collaboration with the speech-language pathologist and other voice care team members.

Peripheral Paralysis and Paresis Peripheral paralyses are the result of a severe failure of nerve impulse conduction to muscle tissue, with subsequent loss of voluntary movement. Paresis is a relatively lesser degree (partial) nerve impulse failure. In the larynx, peripheral paralyses and pareses usually affect only one vocal fold. Sometimes, these conditions are caused by local trauma from accidents, from neck or heart surgery, by viral processes (such as cold), or by heart disease. The relation to heart disease is that the recurrent laryngeal nerve, a branch of the vagus nerve, innervates the left side of the larynx, after coursing into the chest and underneath the aorta. The right side nerve travels more directly into the larynx and does not course through the chest. Sometimes, however, paralyses and pareses occur in isolation, with no discoverable connection to any other physical disorder or disease. Theoretically they could affect any of the laryngeal muscles. However, by far the most commonly encountered cases involve a compromise in the laryngeal adductory muscles, all of which are innervated by the recurrent laryngeal nerve. Assuming that a paralysis or paresis leaves the affected vocal fold in a somewhat abducted position, the ability to bring that fold to the middle of the glottis is impaired. Over time, function may return, although no data are presently available about how often spontaneous recovery is observed. Usually, the unaffected vocal fold compensates to some degree by crossing the midline of the glottis during phonation.

Keiz Marshall Voice & Speech Center

Children with disabilities

Assistance to Children with Severe Disabilities (ACSD), Ministry of Community and Social Service The Assistance to Children with Severe Disabilities Program helps parents with some of the extra costs of caring for a child who has a severe disability. Parents can get between $25 and $440 a month to help with costs such as travel to doctors, parental relief, special shoes and clothes, assistive devices, and prescription drugs. Qualifications: A parent or a legal guardian whose child is under 18 years of age, lives at home, and has a severe disability may be eligible. How to Apply: Contact your regional office and ask them for an application form. Complete the application form and return it to the regional office along with any documentation required. A Special Agreements Officer will review your application and will contact you if they need more information. You will receive a letter saying whether or not you qualify for a grant and, if so, how much you will receive. For more information, visit: http://www.children.gov.on.ca/htdocs/English/topics/specialneeds/disabilities/index.aspx