What’s going on with my voice? Videostroboscopy can help!

Is your voice not what it used to be?

Are you losing your voice frequently, experiencing hoarseness, or persistent strain?

Has an Ear, Nose, and Throat doctor (ENT) indicated that nothing is wrong with your vocal cords themselves?

A videostroboscopy assessment will provide a more detailed analysis of your vocal cords while you are producing sound and will help give you information on what is causing your voice issues so that changes can be made.

What Exactly is Videostroboscopy?

Videostroboscopy is a much more sensitive tool and more helpful in identifying subtle issues happening with the voice compared to other techniques, such as rigid or flexible transnasal laryngoscopy with continuous light sources (these tools are used through the nasal cavity). Videostroboscopy (through the mouth) provides a more detailed view than these other techniques and can reveal problems with the vocal cords such as growths, or irregularities in the vibration pattern or movement of the cords themselves.  Muscles surrounding the cords are viewed to see if they are working when voicing occurs.  The color of the cords and surrounding muscles is viewed to see if there is redness or swelling, and you can see if one cord is engaging more than another to make the voice work.  Videostroboscopy provides key elements in voice assessment to assist in a plan for voice recovery.

How Does Videostroboscopy Work?

Videostroboscopy uses a flashing light source to create a slow motion view of vocal cord vibration. Vocal cord vibration is very fast – the “slow motion” view is actually taken from many successive rounds of vibration. This unique viewing allows the voice care team to look at how each vocal cord vibrates during the different phases of the vocal cord’s vibration cycle, allowing for clear identification of smaller abnormalities in vocal cord movement that are unable to be observed using any other technique. From this information, therapy sessions to improve voice use can be prepared so that your intervention can be individualized and suited to your own specific needs.

Here is an example of a videostroboscopy analysis and how it looks when the vocal cords are viewed this way.

Who is a Candidate for Videostroboscopy?

Videostroboscopy is highly recommended when a voice disorder is due to abnormalities that affect vocal cord vibration. These abnormalities can include:

  • vocal cord scarring
  • a mass (cyst, polyp, nodule)
  • incomplete closure of the vocal cords
  • abnormal vocal cord vibration
  • asymmetrical/uneven movement of the vocal cords

At S.L. Hunter SpeechWorks we have a comprehensive Voice Lab where our voice team will assess your needs using both instrumental and non-instrumental equipment.  Our Voice Lab offers state-of-the-art videostroboscopy equipment to fully analyze your vocal issues.  Call us today or check out our voice lab for more information.

LindaSaarenvirta-220Linda Saarenvirta is a speech-language pathologist who has been practicing for over 20 years in the healthcare field.  She has worked with a variety of communication disorders and clients of all ages.  She is extremely passionate about voice therapy and enjoys helping clients achieve their vocal needs.  Her client centered approach to therapy ensures all clients maximize their potential and achieve their goals.

Difficulties with Social Skills and Autism

Throughout my career as a Speech-Language Pathologist, I have always had an interest in the role that social skills play in the social, emotional and academic successes of children and teens.  Over time, I started seeing more and more people who struggled with social confidence and social skills. Most of these children and teens had been diagnosed with autism spectrum disorder (ASD) and some simply felt or been told that they didn’t do well in social situations. This is definitely a common challenge faced by all people with autism no matter what their language or cognitive skills. No two people will share the exact same pattern of difficulties with social skills. This is why autism is now commonly referred to as a spectrum disorder which represents a large range of abilities and difficulties found with those who have autism.

Difficulties with Social Skills Across the Ages

Preschool   

Most social difficulties for many children with autism can be identified in early childhood or even infancy. Some of the earliest signs are:

  • Limited eye contact
  • Responding to their name
  • Sharing attention
  • Difficulties with imitating

These above signs can become worse and children might shy away from social situations or avoid them all together. On the other hand, some signs may go undetected because they are similar to the behaviours seen in typically developing children going through the regular tantrums or being defiant.

School-Age

For children who are unable to access early social intervention, the problems tend to develop as their social demands increase. They often have limited play skills and show little interest in playing with friends. Or, if there is an interest in engaging with other children, they may not have the appropriate skills to:

  • Initiate play
  • Respond to the play invitations to other children
  • Or to learn play through observations of other children
  • Attempts at social interaction is immature

When they do have friends, their friends tend to be very accommodating children who adjust to their need to control play. Difficulties with social skills and maintaining friendships as they get older can be very challenging given that typical children become less accepting of the one-sided nature of these friendships.

Teens

As children with autism age and move into high school, they continue to have difficulties with social skills and are likely to feel isolated from their peers. Schools often try to create an environment for acceptance and inclusion to help increase the potential for friendships. Often those who have high language abilities may have great self-awareness of their differences and a greater motivation to want to fit in. But, that being said, teens by this point may have faced social rejection and are more comfortable communicating with adults who encourage them in their specific interests or spend more time on their own.

What can you do to help someone with difficulties with social skills?

There are many different social skills interventions out there such as, video modeling, social stories and activity-based intervention to name a few. Cognitive Behavioural Training (CBT) can be used in teaching social skills, which involves increasing knowledge about the social world and at the same time increasing awareness of thoughts and feelings. One specific type of CBT is Social Thinking!

What is Social Thinking?

Social Thinking is what we do when we interact with people.  The Social Thinking approach (based on the work of Michelle Garcia Winner) focusses on helping individuals think strategically in social situations. It helps them to observe and consider their own and others’ thoughts and feelings.  It bridges the connections between thoughts, feelings and behaviours, paving the way for social skills that can apply to many situations.

Social Thinking also sheds light on academics; children who struggle in conversation, struggle to understand literature – not due to a lack of core skills in reading fluency and decoding – but rather, in perspective taking. Its main focus is on teaching individuals to think about how others perceive them.

When individuals are unable to interpret others’ perspectives, they may struggle with developing meaningful relationships. Social Thinking breaks down social concepts so that we can convey them in ways that are practical and logical.

Social Thinking is a language-based approach for individuals with social learning disabilities, not just specific to individuals with autism but anyone that may have ADD, ADHD, Nonverbal Learning Disabilities and/or Language Disabilities, ages 4 years through to adulthood.

For more information on Social Thinking or if you are interested in programming using Social Thinking contact us today about our March Break/Summer Camps or individual sessions!

AmyWebAmy Grossi is a pediatric Speech-Language Pathologist, practicing for over 10 years. Amy enjoys the area of early language, literacy development, apraxia and fluency. She has a passion for working with children with multiple developmental needs and implementing creative and interactive treatment sessions.