140 likes | 389 Views
ADVENTURES IN VOICE A Whole New Way of Doing Things for Kids!. OVERVIEW OF PROGRAM K. Verdolini Abbott, Ph.D., CCC-SLP Rita Hersan , M.S., CCC-SLP David Hammer, M.A., CCC-SLP Jan Potter Reed, M.S., CCC-SLP September 2010. Which children are appropriate? .
E N D
ADVENTURES IN VOICEA Whole New Way of Doing Things for Kids! OVERVIEW OF PROGRAM K. Verdolini Abbott, Ph.D., CCC-SLP Rita Hersan, M.S., CCC-SLP David Hammer, M.A., CCC-SLP Jan Potter Reed, M.S., CCC-SLP September 2010
Which children are appropriate? • Children with phonogenic voice problems (phonotrauma, MTD) • Generally ages 4-11 • Generally cognitively intact • http://www.babyboomercaretaker.com/images/Who-Is-More-Important-Your-Own-Child-Or-Grandchild.jpg • http://thebeautifulstruggler.com/wp-content/uploads/2010/04/black-girl-with-beautiful-eyes-horiz.jpg • http://www.harrycutting.com/graphics/photos/children/african-american-girl-white-boy-FC5143-73.jpg • http://www.saintbarnabas.com/hospitals/monmouth_medical/childrens_hospital/images/adolescent.jpg
Other children • Program may be applicable with minor adaptations • Generally children with voice problem who would benefit from a change in VF adduction • Clinician’s discretion http://www.stammeringlife.com/Images/Vocal%20Folds%20(vf)%20Opening%20and%20Closing.JPG
Who may provide the program? • SLP (CCC or otherwise licensed) • Received 2-day training in AIV from Verdolini & associates • Passing knowledge test receives additional certificate • http://www.280group.com/ptgraphics/training.jpg
Fundamental framework • “What” of training • “Easy vibrations voice” • Defined as easy voice produced with perceptible anterior oral vibrations • Likely corresponding with • Barely ad/abducted vocal folds • Large-amplitude, low-impact vocal fold oscillations • Large AC flows, small DC flows, and small PL • Relatively intense voice http://www.stammeringlife.com/Images/Vocal%20Folds%20(vf)%20Opening%20and%20Closing.JPG
Fundamental framework • “How” of training • Motivation/remembering: • Setting the stage with elaborated stories • Learning principles • Engage child’s active (cognitive and physical) participation in the therapy process. • Allow child to explore; don’t hover; provide feedback but not too much and not too quickly. • Direct child’s attention and active responses to sensations, perceptions related to output in self and others, not biomechanics. • Work on voice production as a whole, not component pieces. • Make goals for advancement in the program specific. • Mix up simple/complex tasks. • Provide opportunity for child to explore vocal target in numerous contexts relevant to the child. http://www.askrogerdrummer.com/healingherbs/wp-content/uploads/2010/02/children-being-active.jpg
Fundamental framework • “If” of training • Numerous principles including • Engage the child • Involve the parent • Written/audio instructions • Accountability (follow-up monitoring) • Clinician presence http://www.thenaberhood.com/about/homework.gif
Progression through program • Competence should be shown for goals in each lesson before proceeding to the next session (~90%, i.e. “quite well”) • If not, back up and re-do • http://betalabs.nokia.com/files/blog/2008/12/steps.jpg
Program duration • Depends on child and setting • Created to be 8-12 sessions (weeks)
(In case you wonder) • Relation to LMRVT • Adult LMRVT modified for children • Theory: Verdolini Abbott • Practice: Road testing and brainstorming Hersan, Hammer, Kessler • However • Programs are sufficiently different one can no longer be trained in one and “invent” the other http://www.pluralpublishing.com/img/books//book_lmrvt.jpg
“Data” • http://www-dse.ec.unipi.it/persone/ricercatori/Guerrazzi/Pictures/Data.jpg • Uncontrolled • Small N • Retrospective • From clinical practice using related program (Buzzy Child) • (next p.)
“Data”(from Kessler patients; representative; more forthcoming)(G3 worst rating; G0 best rating; BN bilateral nodules; NL normal larynx)