Vocal fry: Trendy or Damaging?

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Vocal fry

Vocal fry is a term used to describe the low “creaky”, back focused voice quality that is produced with more tension and pressure than is modal voice ( a person’s average, comfortable speaking voice). With “normal” voice production at modal levels, vocal cords come together and open in a wave undulation via the power of breath support through our airway.  When we speak in vocal fry, pressure is dropped and there is more tension in the voice so the wave motion is halted and the cords move in a more irregular/chaotic pattern.

Why Do People Use Vocal Fry?

Everyone uses vocal fry sometimes, especially at the end of sentences – when tired or trying to get a point across in a lecture or presentation.  In the past few years, this register has been more popular with women aged 18-25.  Some famous actresses and singers have been known to use this register to make their voice sound “cool”, or “sexy”.  Researchers are still trying to determine what made this trend so popular and why so many young women have taken on this vocal habit.

Why is Vocal Fry Harmful?

The voice is best produced at its’ modal register (comfortable speaking/singing range).  When we move it out of that range for a period of time (high into falsetto or low into fry), the vocal musculature can become strained and stressed as they work harder to achieve the vibratory cycle they are used to.  This may not cause immediate damage to the cords themselves but is a vocal use problem that should be changed, or it may lead to damage down the road.

LindaSaarenvirta-220Linda Saarenvirta has been practicing for 11 years as a registered Speech-Language Pathologist at S. L. Hunter SpeechWorks.  For the past 5 years, Linda has focussed in the area of vocal rehabilitation including the use of videostroboscopy as well as the Visi-Pitch program.  She enjoys working with all clientele and believes strongly in the client centered approach that S.L. Hunter SpeechWorks provides.

Never underestimate your non-verbal clients!

It can be very challenging to work with clients who are non-verbal, behaviourally unstable, physically impaired and suffering from severe cognitive impairments. As clinicians we may struggle to gather a true sense of their understanding, and it is easy to feel as though their comprehension and thinking skills are as impaired as their ability to communicate. At times like these, speech therapists need to think outside-the-box when developing goals and therapy activities. Keeping things personally meaningful or functional for clients is so important.

My personal experience – let me introduce you to Hector…

I have been providing speech therapy to an individual – let’s call him Hector – for 2½ years. Hector continues to amaze me by his level of understanding, despite his severe brain injury. It is so easy to underestimate clients like Hector due to his physical, behavioural and communication skills. Months of treatment has focused on training Hector to communicate by raising his left arm for “yes” and lowering it for “no”. Even this basic form of communication is, at times a major feat for Hector.

His poor attention and varying motivation, and extreme behavioural problems are additional factors contributing to inconsistency in participation and responses to speech therapy efforts. In addition, Hector’s first language is not English. I have needed to learn phrases in Spanish, as well as utilize a translation app during speech therapy sessions. To add insult to injury, Hector needed a tracheostomy inserted and thus needed soft restraints to prevent him from accidentally taking out this important device that keeps his airway clear.

Introduction of technology with non-verbal clients

Recent efforts have been focused on teaching Hector to use an iPad with a stylus that wraps around his hand and creates a finger extension, so that he can access a yes/no array and picture choices. This process required collaboration with the Occupation Therapist to ensure the best fit for Hector. Communication using this new process has also been difficult for Hector and is still in the beginning stages.

Guess I need to sharpen up my Spanish

One amazing moment I experienced with Hector, was on a day he had been communicating very poorly in response to all of my questions. He became very upset when his Spanish speaking rehab therapist became involved. I attempted to find out why he was upset, to no avail, with a continued lack of response to my questions.  I then began to explain that the rehab therapist was just trying to help me because my Spanish is not very good. Almost instantly, Hector raised his arm as high as it could go (his “yes” response) in agreement. I was speechless! I had definitely underestimated his sense of humor!

Determination!

On another occasion, Hector had responded on his iPad, using the yes/no choices, that he was tired and wanted to go to bed. This is very unusual for Hector, so I assumed he had made an error. I asked him if he wanted to go outside and Hector responded by using the stylus to flip the pages on the iPad until he got to the picture of a bed. Hector had been shown this feature and function of the iPad, but had not yet been trained to use it.

I could not believe what I had just seen and again questioned if it was coincidental. Again, I had underestimated Hector. To be sure, I went back to the yes/no choices and asked: “Do you want to stay here?” – Hector selected “no”. Followed by: “Do you want to go to bed?” – Hector selected “yes”.

It is amazing what even the clients with the most difficulty communicating can accomplish when motivated by what is important to him or her. This is why it is so important to find activities that are relevant to clients to keep them engaged in their therapy! As therapist, it is equally important to never underestimate our client’s abilities.

AmandaBrown-220Amanda Brown is a Speech-Language Pathologist with nearly a decade of experience in providing assessment and treatment to clients in the clinic and community settings. Amanda enjoys working with clients of all ages and applies a strong client-centred approach to her therapy, balanced with family/team collaboration.

Classroom support for children with Autism

shutterstock_107801354Children with Autism Spectrum Disorder (ASD) generally find school a difficult place due to their challenges with communication, social skills and sensory integration.  As classroom sizes remain large (25 plus students) and Educational Assistants (EA) continue to be limited, these children also face challenges to learn and participate within the classroom. These children need classroom support.

Difficulties with not having classroom support

  • Communication difficulties with the teachers, EA’s and peers. Difficulties in understanding and expressing language will lead to problems explaining their needs or verbally answering a question. They may not understand or respond to a question unless it is asked in certain way. Classroom support can help these children.
  • Following classroom instructions. A child with Autism encounters difficulty processing language and therefore may have problems carrying out the teacher’s directions.
  • Following social rules within the classroom. Due to the difficulties with social skills, children with Autism have a hard time following the classroom rules (e.g. raise your hand to get the teacher’s attention), understand how they should behave (e.g. sit at their desk), and understand the feelings of their peers (e.g. why a classmate is crying). These children need classroom support to navigate the social world.
  • Difficulties with following the rules during a game may also occur during free time or recess.  A child with Autism may be only able to play a game exactly how it is learned (e.g. red piece always has to go before the blue). Sometimes they will not engage in following the rules or completing an activity due to the sensory restrictions (e.g. playing with sand).
  • Concentrating on a task. Blocking out the background noise in the classroom or switching attention between tasks is also a challenge. Providing a visual schedule will help the student transition to the next task.

How to help a child with Autism: Classroom support

Teachers, EA’s and peers can help to provide classroom support and provide opportunities to participate in class for children with Autism by implementing the following suggestions.

  • In order to assist the child with communication difficulties use simple language with visual prompts to help the child understand the message.
  • Ensure to understand the child’s method of communication. For example, a child with limited verbal output may be using Alternative Augmentative Communication (AAC).  AAC is any visual support used for understanding, to supplement existing speech or used as a means for expressive out-put for a child who is unable to produce speech (e.g. using an IPad or picture symbols). This is a great classroom support for a child who uses an AAC device.
  • It is important to provide the child with time to process the information as well as create the message if they are using an alterative means to speech. Allow at least 5 seconds for the child to respond. If they don’t answer right away, it may be easier to ask them a question which involves a yes/no answer, provide them with a choice or model the answer.

Take these suggestions as a starting point and then continue to create your own specific classroom support to meet the needs of the children in your classroom.

TeriLynam-220Teri Lynam is a registered Speech-Language Pathologist with ten years of experience working in the field of communication disorders. She has a special interest in early language, literacy development, acquired brain injury, motor speech and resonance disorders. Teri is committed to providing individualized family-centered therapy in a fun and supportive environment.

Friendship and Social skills: Why are they important?

shutterstock_50844475We, as humans, are in a world filled with people. We have no choice but to interact in some way throughout our lives. With increasing technology, there is a decreasing emphasis on social skills. I see people every day, both at work and in everyday life, that need some sort of assistance with social interaction. Whether we are interacting face-to-face or via text or some other online platform, we need to be able to communicate effectively.

Social Skills or Interaction skills

The skills I’m talking about aren’t necessarily something you need to think about. People over the age of around 30, don’t usually have difficulty in social situations. We learned from a young age how to interact because we did it regularly. Instead of texting our friends, we had to go knock on their door, say hello to their parents and ask if our friends could come and play. Little did we know that these skills were something we’d use throughout life in many situations! Greetings, salutations, taking turns, and asking questions are just a few of the skills that we learn through observation and imitation when we are young. Now that technology has seeped into our lives, things are a bit different. Texting has changed our dictionary – Yes, the acronym LOL is in the scrabble dictionary now!! With all of these changes, there has been a decrease in the emphasis of face-to-face social skills. Why or when are these important? We need these skills to get a job and interact with people every day – interviews, in a restaurant, at the movies, interacting with co-workers or class mates, just to name a few. If we don’t know what to do, then how will we do it?

Friendship

Friendship is just one part of social interaction.  I have had some young clients tell me “I don’t need friends”. I beg to differ! Our friends are the first extension of our family, especially early in life. We practice social skills with them and they are usually an unbiased and unjudging venue for that practice. This is also how we learn to interact with people outside of our family – we learn that although you might hug and kiss your mom and dad, you don’t do this with friends – we are learning socially acceptable boundaries. This also teaches us skills that will transfer over into working environments when we are older. It’s also the first avenue where we learn to negotiate, express our opinions and learn to argue our point of view as well as understand other’s point of view. All of these skills will help us become a good worker and an advocate for ourselves or others in the future. I’m not saying you need 1000 friends on Facebook, I’m saying you need a few close real-life friends that you trust and trust you to help navigate this crazy world of ours!

What do I do to help my kids learn these social skills?

Have a conversation with them. Set aside time to demonstrate these skills to them and show them what they should be doing. For example, make dinner time a “no technology” time so you can actually interact with each other. Ask them questions about their lives “tell me your favorite part of the day today”. Show them how to listen and answer “my favorite part was ____ because ____”. Play outside – no technology! Teach them the games you used to play, run, skip, jump, play hide-and-go-seek! Have your child interact with the people and things in their world and set a good example for them! Don’t sit on your device, actually interact with people, on the phone or in person and show your kids how, otherwise, they might not ever learn.

For more ideas or to ask questions, feel free to comment!

LynseyWilson-220Lynsey Wilson is a Communication Disorders assistant with experience treating a wide range of clients with varying ages and disorders. She also has her Early Childhood Educator certificate and specializes in working with pediatric clients. Lynsey enjoys working with a variety of age groups to keep her on her toes!

AUTISM AND BACK TO SCHOOL TRANSITIONS

shutterstock_130517294Back to school can be a time of year filled with mixed emotions for all children and parents. Children may be excited to move up a grade, yet fearful of a new teacher or their closest friends not being in the same class. Parents may be delighted that structure will soon return to their daily life, yet worried about challenges their children will face in the year to come. For children with autism spectrum disorder (ASD) and their parents, these negative emotions are often magnified and may very well outweigh the positives. Children with autism struggle with handling transition and change. It can evoke intense emotion and anxiety leading to behavioural issues and total meltdowns.

Why are transitions so difficult for children with autism?

The brains of individuals with autism process and interpret information in a way that is different from the average person. Particular environmental stimuli or the entire environment often present as overwhelming and confusing. Children with autism often attempt to implement repetition in their lives and resist change in order to minimize the chaos and uncertainty.

How might my child react?

A child with autism might become overrun with emotion and overreact to even a tiny change, such as mom forgetting crackers in the lunch bag. This overreaction could range anywhere from a 3 minute crying fit requiring verbal redirection, to a 1 hour tantrum involving flailing on the floor and throwing things, ultimately requiring physical, visual and verbal supports to get under control.  If such a small change or unexpected error can result in such an intense reaction, it is scary to even imagine how difficult starting a new school year might be, particularly for those children who may not have the ability to communicate their fears and frustrations. So many factors change – new teacher, new classroom, new peers, new schedule, new expectations etc…

How can I help with these back to school transitions?

While preparation and planning is good for any child, and in fact many adults, it is vital to successful back to school transitions with children with autism.  This involves the use of repeated visual and verbal supports, such as:

  • Photos to create familiarity with the unknown
  • Visual schedules to organize the daily routine
  • Social stories to address feelings, provide reasons, redirect  and offer resolutions
  • Select specific language and phrases then repeat, repeat, repeat

AmandaBrown-220Amanda Brown is a Speech-Language Pathologist with nearly a decade of experience in providing assessment and treatment to clients in the clinic and community settings. Amanda enjoys working with clients of all ages and applies a strong client-centred approach to her therapy, balanced with family/team collaboration.