This morning I was reading an article about a community leader who died this past week. The article described a gold pin that she wore, with the word: "Endesha", a Swahili word that means "to move forward with purpose," or "to set in motion."
I love the visual imagery that the word conveys, as it embodies the feeling I try to convey to patients when speaking to them about healthy use of their voice.
In particular, when demonstating resonant voice exercises (RVT), I encourage patients to use the support of their breath to drive their voice forward in motion. To feel the sound of their voice resonating on their lips and face. Resonant voice has been studied and described by several researchers.
Dr Kittie Verdolini, a voice scientist, describes resonant voice this way:
* the prescence of oral vibrations or easy voice;
* an association with vocal folds that are barely touching;
* a relatively strong and clean voice, or what we hear as a "healthy" voice.
We are always speaking on the breath going out,(exhalation). Once you begin to exhale, it's important to maintain a relaxed vocal tract, including your throat muscles, your jaw ,and tongue, delivering your voice, on the breath, to the listener. I find RVT especially appealing to use with patients, because without much effort on the part of the person, they are often able to feel and hear their "best" voice. Questions I might ask: "do you feel the buzz on your lips? "does it feel easy?"
When our voice is supported by our breath and resonating in our oral cavity, it does sound and feel natural. Try it yourself:
Sit up straight. Vocalize a humming sound. Lips lightly touching. Feel the vibration? Pick a point or an object in the room, and send your voice to it. Feel the energy of your voice as it travels around the room supported on the breath.
ENDESHA
she who drives herself and others forward...
set in motion ...
start...
continue to do something...
Friday, June 25, 2010
Saturday, June 19, 2010
What I Learned From My Dad
I think about my dad alot, and of course, tomorrow, Father's Day, I will long for his voice on the other end of the phone. At times I feel his presence and protection when on a long car trip... at times I see him in the face of a patient and I am reminded of his physical struggles near the end of his life....and always, I am mindful of his constant advice regarding career choice: "Mary, if you don't love what you do, it doesn't matter."
My dad did love his work. He retired at the age of 80, served as Mayor of the Village of North Randall in Ohio for 42 years. That is a long tenure for any politician, and had my dad's physical health not begun to fail, I suspect he would have continued to work well into his 80's.
But, in the years shortly before his retirement, his physical health began to decline. Occasional falls were followed by some subtle changes in speech, I suspect, the result of some mini-strokes. Being the dutiful daughter, AND a speech pathologist, I armed my father with audio-tapes of speech and voice exercise, lectured him frequently, and scolded him occasionally when my mother reported that he was not doing his exercises. I violated the advice I often give to patient's family members, which is not to be a therapist. The tendency, however, I'm afraid is quite strong, when each slurred word, cough and sputter, or stumble, represents some aspect of physical decline that we, the family, the observers, cannot control. I see that challenge played out frequently in my private practice when interacting with patients in their homes. Spouses, children, and significant others often coach, nag, and support from the sidelines, in an attempt to interrupt the destiny of some disease or illness.
On a positive note, however, I am grateful that the last few years of my father's life provided me an opportunity to give back to him in some way. To leave no words unspoken ,and to tell him frequently that I loved him. Many people never get or take that opportunity with their parents or others in their lives.
So, what I learned from my father:
Do work that you love, and be of service to others.
My dad did love his work. He retired at the age of 80, served as Mayor of the Village of North Randall in Ohio for 42 years. That is a long tenure for any politician, and had my dad's physical health not begun to fail, I suspect he would have continued to work well into his 80's.
But, in the years shortly before his retirement, his physical health began to decline. Occasional falls were followed by some subtle changes in speech, I suspect, the result of some mini-strokes. Being the dutiful daughter, AND a speech pathologist, I armed my father with audio-tapes of speech and voice exercise, lectured him frequently, and scolded him occasionally when my mother reported that he was not doing his exercises. I violated the advice I often give to patient's family members, which is not to be a therapist. The tendency, however, I'm afraid is quite strong, when each slurred word, cough and sputter, or stumble, represents some aspect of physical decline that we, the family, the observers, cannot control. I see that challenge played out frequently in my private practice when interacting with patients in their homes. Spouses, children, and significant others often coach, nag, and support from the sidelines, in an attempt to interrupt the destiny of some disease or illness.
On a positive note, however, I am grateful that the last few years of my father's life provided me an opportunity to give back to him in some way. To leave no words unspoken ,and to tell him frequently that I loved him. Many people never get or take that opportunity with their parents or others in their lives.
So, what I learned from my father:
Do work that you love, and be of service to others.
Tuesday, June 15, 2010
BADA BOOM!! Baby Boomers Do Speech Therapy...
A funny thing happened while living in Florida...I have aged into the population... the baby boomers have arrived.... and my patients are my peers
This winter and spring, I have had the most interesting patients referred to my speech pathology private practice. Many of them with a medical diagnosis of Parkinson's, most of them in their 50's or 60's, some of them still working, and all of them experiencing changes in their speech and/or voice. Having spent much of the last 20 years of my career working with retirees in their 70's and 80's, I am enjoying this change in the demographics.(despite the fact that it reflects my own aging).
Most of the speech complaints are described by patients as: "I talk too fast," I mumble,""I sound drunk," "My wife/husband is always asking me to repeat," and so on. Most have a clinical diagnosis: dysarthria. Dysarthria refers to a disturbance of the motor supply of the muscles of the speech mechanism. It can emerge as the result of damage to the brain from a stroke or head injury,from a lesion of the motor pathways or of the muscles themselves. Changes in speech can frequently be the first symptom of a progressive neurogenic disease, such as ALS . Muscles can be weak or spastic (tight),movement can be sluggish or excessive, and all aspects of speech can be affected, including: pronunciation, respiration, voice, pitch, and loudness.
Ultimately, for the person having the problem, their speech just no longer sounds like them. Since we can never hide how we sound,changes in speech may begin to create a disconnect with one's self-image and individuals may begin to feel self-conscious or become withdrawn.
So, what do a salesman, a trainer, a professor, a physician, with dysarthria resulting from Parkinson's all have in common? For all of these people, continuing to speak clearly and having a voice that sounds healthy and energetic is important to their careers , their self-esteem, and their relationships.
So, if you are struggling with changes in your speech from any of the conditions mentioned above, here's what you can do:
*If you have not yet seen a physician regarding your speech changes, of course, this is your first step.
* Request a referral for an evaluation by a licensed speech-language pathologist who is familiar with your condition.
* Ask your speech pathologist to develop a treatment program that incorporates current research but that also is designed to address your specific problem/complaints and which considers your goals.
* Ask for exercise that you can perform on your own, at home. Repetition and redundancy is often the key to improving various aspects of speech production.
* Ask your therapist or a friend to video-tape you for analysis and feedback, and also to create a record of where you are when you begin treatment.
Whatever you do,have fun, laugh, sing, chew bubble gum, play a kazoo, do all sorts of things that exagerrate and move the muscles of your lips, tongue and face.
This winter and spring, I have had the most interesting patients referred to my speech pathology private practice. Many of them with a medical diagnosis of Parkinson's, most of them in their 50's or 60's, some of them still working, and all of them experiencing changes in their speech and/or voice. Having spent much of the last 20 years of my career working with retirees in their 70's and 80's, I am enjoying this change in the demographics.(despite the fact that it reflects my own aging).
Most of the speech complaints are described by patients as: "I talk too fast," I mumble,""I sound drunk," "My wife/husband is always asking me to repeat," and so on. Most have a clinical diagnosis: dysarthria. Dysarthria refers to a disturbance of the motor supply of the muscles of the speech mechanism. It can emerge as the result of damage to the brain from a stroke or head injury,from a lesion of the motor pathways or of the muscles themselves. Changes in speech can frequently be the first symptom of a progressive neurogenic disease, such as ALS . Muscles can be weak or spastic (tight),movement can be sluggish or excessive, and all aspects of speech can be affected, including: pronunciation, respiration, voice, pitch, and loudness.
Ultimately, for the person having the problem, their speech just no longer sounds like them. Since we can never hide how we sound,changes in speech may begin to create a disconnect with one's self-image and individuals may begin to feel self-conscious or become withdrawn.
So, what do a salesman, a trainer, a professor, a physician, with dysarthria resulting from Parkinson's all have in common? For all of these people, continuing to speak clearly and having a voice that sounds healthy and energetic is important to their careers , their self-esteem, and their relationships.
So, if you are struggling with changes in your speech from any of the conditions mentioned above, here's what you can do:
*If you have not yet seen a physician regarding your speech changes, of course, this is your first step.
* Request a referral for an evaluation by a licensed speech-language pathologist who is familiar with your condition.
* Ask your speech pathologist to develop a treatment program that incorporates current research but that also is designed to address your specific problem/complaints and which considers your goals.
* Ask for exercise that you can perform on your own, at home. Repetition and redundancy is often the key to improving various aspects of speech production.
* Ask your therapist or a friend to video-tape you for analysis and feedback, and also to create a record of where you are when you begin treatment.
Whatever you do,have fun, laugh, sing, chew bubble gum, play a kazoo, do all sorts of things that exagerrate and move the muscles of your lips, tongue and face.
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