Tuesday, May 29, 2012

Child's Speaking Voice

My 11 year old son has an odd cadence in his speaking voice. He also speaks very loudly, will sometimes stutter (repeat a phrase several times or fill in gaps with an "em" sound), and often becomes breathless when talking. He also has threads of aspergers but has been seen by a therapist who does not feel that he is autistic. He is extremely intelligent and uses a vocabulary way past his age group. His manner of speech however can be difficult to listen to. Would he benefit from speech therapy? Thank you.

Melissa Kim M.S., CCC-SLP replies... 
From your description, he certainly would benefit from an evaluation with a speech-language pathologist. Only after a thorough evaluation would it be determined if he would be a candidate for improvement in speech and/ or voice therapy.

Thank you for your question.

Right Vocal Chord Paralysis

My right Laryngeal Nerve was damaged during Carotid Artery surgery on 10/07/2011 causing my right vocal chord to become paralized and greatly affecting the quality of my voice. The doctor who performed the surgery all but admitted he was responsible and sent me to an ENT who told me to wait several months and my voice might get better. Well it's been 8 months and my voice is still the same. Can you suggest what my options might be, if any? I'm getting desperate.

Melissa Kim M.S., CCC-SLP replies... 
Most Ear, Nose, and Throat physicians would agree that a one year waiting period is appropriate in cases where recovery of a vocal cord paralysis is possible or even anticipated before pursuing any permanent surgical options for voice improvement. However, there are temporary options for voice and/ or swallowing improvement available. One such option is the injection of a filler material (e.g., Radiesse Voice Gel) into the paralyzed cord to bring it closer to midline, thereby improving the quality and strength of the voice. This type of procedure can be done in either the operating room, or awake in an office setting, depending on the experience of the physician. It is a well-tolerated procedure, and most patients will experience a good deal of improvement. I see that you live in South Carolina... there is an excellent voice center at MUSC, the Evelyn Trammell Institute for Voice and Swallowing. Consult with a laryngologist (an Ear, Nose, and Throat physician) who specializes in the treatment of voice disorders for further evaluation and more information about possible treatment.

Best of luck to you.

Monday, May 14, 2012

Trouble Speaking


In March of 2011, I had an upper respiratory infection and I noticed a couple of weeks later that my voice would give out at the end of my shift at work. I work in customer service and talked on the phones for 8+ hours per day. It was like I had laryngitis. As days went on, I began to lose my voice earlier in my shift. I went to my doctor and she took me off the phones for 2 weeks. It didn't make a difference. It then progressed to where I could only do about 1 hour on the phones per day. I had gone to one ENT and he said everything looked fine and that he could do surgery but that would probably make it worse. I didn't seem too confident with his answer. I went to another ENT and he said he couldn't find anything wrong but he sent me to a speech therapist. I went through many sessions with zero improvement. I went back to the ENT and he referred me to a speech pathologist. Again, I went through many sessions with no improvement. The speech pathologist referred me to another specialist to do Myofascial Release. It seemed like a gimmick but I went through this for several weeks and notice no improvement. My AP and ENT thought it might be due to acid reflux, so I was taking a couple of Nexium's per day and cutting out caffeine but that didn't work either. My job has allowed me to return to work to perform other duties but it will soon end and I still cannot hardly speak. This has ruined my life as I am about to lose my job and can find any other employment that does not require the use of my voice. Is there anything else that can be done or am I stuck with this for the rest of my life?

Melissa Kim, M.S., CCC-SLP replies... 
If several examinations by an otolaryngologist have not resulted in an explanation for your ongoing difficulties, I would suggest that you consult a laryngologist (an Ear, Nose, and Throat physician fellowship trained specially in the treatment of voice disorders). From your description, I would certainly suspect that you have at least some component of what is referred to as muscle tension dysphonia, or excessive strain of laryngeal muscles that may result in poor vocal quality and performance. The treatment for this condition is voice therapy with a speech pathologist who specializes in the treatment of voice disorders; if you have been seeing speech pathologists who are more generalists in the field, you may want to seek out a more appropriate specialist.

Best of luck to you.

Tuesday, May 8, 2012

Esophageal Disorders - Continuing Education



This course consists of one presentation with supporting documents.

CEU Credits and Prices
  • This course is offered for 0.2 ASHA CEUs (Intermediate Level; Professional area).
  • You must complete presentation.
  • You will receive a certificate of completion from BRS-S within three weeks of completing the application and submitting to BRS-S.
  • Your ASHA CEU credits will be processed through the Specialty Board on Swallowing and Swallowing Disorders and submitted to ASHA three times per year in June, September, and January.
  • The regular price for the course is $50.00
    • BRS-S members get a 25% discount - get the coupon code by logging onto your account at swallowingdisorders.org.
    • Students get a 50% discount, contact Karen Schnieder karen@badgerbay.co This e-mail address is being protected from spambots. You need JavaScript enabled to view it for the coupon code.
    • Groups of four or more get a 50% discount, contact Karen Schnieder karen@badgerbay.co This e-mail address is being protected from spambots. You need JavaScript enabled to view it for the coupon code.
Course Description
This two-hour session will include a discussion of the anatomy and physiology of the esophageal phase of deglutition. A review of the reflexes that may facilitate clinical symptomatology will be included. A discussion of the opening mechanism of upper esophageal sphincter during swallowing will be reviewed as well as current techniques used to evaluate, manage and treat disorders of the upper esophageal sphincter. A systematic classification of esophageal disorders with typical presenting symptoms will be included as well as a discussion of the latest technology used to diagnose esophageal disorders, possible management and treatment techniques used by the treating physician.