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Flow Phonation

presented by Jackie Gartner-Schmidt

Accrediting Body:

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Disclosure Statement:

Financial: Jacqueline Gartner-Schmidt receives compensation from MedBridge for this course. She is the co-investigator on a R03 DC015305-01, an NIH grant on conversation training therapy. Non-Financial: Jaqueline Gartner-Schmidt has no competing non-financial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Accreditation Check:
This course introduces students and clinicians to flow phonation. Phonation is the generation of sound by way of vocal fold vibration. Flow phonation is a therapeutic concept, which focuses on airflow and the balance between airflow and phonation in sound production. Participants will classify the theoretical rationale for flow phonation from other voice therapy techniques and recognize how flow phonation is a prerequisite for resonant voice. Flow phonation, when produced correctly, decreases phonatory effort “in the throat” and relieves the patient of throat/vocal constriction, shortness of breath during speech, and increases clarity of sound.

Meet Your Instructor

Jackie Gartner-Schmidt, PhD, CCC-SLP, ASHA Fellow

Jackie L. Gartner-Schmidt, PhD, CCC-SLP, ASHA Fellow, is Co-Director of the University of Pittsburgh Voice Center, Professor of Otolaryngology, and Director of Speech-Language Pathology-Voice Division at the University of Pittsburgh Medical Center. Dr. Gartner-Schmidt’s 25-year clinical and research focus specializes on the care of the professional voice, as well as clinical effectiveness of voice therapy…

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Chapters & Learning Objectives

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1. Candidacy for Flow Phonation: Vocal Behavior

Clinicians will be taught how to recognize the signs of potential breath-holding both during phonation and non-phonatory (silent) times. This chapter covers the latest science detecting breath-holding both during phonation and in times of stress. In addition, clinicians will be introduced to specific aerodynamic measures designed to capture phonatory airflow during connected speech.

2. Skill Levels of Flow Phonation

Clinicians will summarize the conceptual framework of flow phonation and be able to articulate the framework to their patients. Clinicians will differentiate between all the skill levels and be able to execute and teach the “unarticulated and articulated” stimuli choices of all skill levels. Further, clinicians will discriminate via the sound and feels of voice production between breathy, flow, and pressed phonation. Lastly, clinicians will be able to demonstrate how all levels lead to articulatory precision in conversational speech.

3. Live Demonstrations: Language of Instruction for the Skill Levels

Clinicians will be shown via live demonstration the dialogue and reflective tasks asked of patients to best accomplish flow phonation to affect change in voice production. Clinicians will be given specific metaphors and descriptors relevant to flow phonation to shape their therapeutic response.

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Muscle tension dysphonia (MTD) is one of the most common voice disorders. It has classically been divided into primary and secondary types. Primary MTD, the focus of this presentation, is best defined as a multifactorial voice disturbance in the absence of structural or neurologic abnormalities. MTD, often a diagnosis of exclusion, is known by many names, which reflects the challenge in identifying one term for a disorder that encompasses a variety of patient-reported symptoms and subjective and objective clinical representations. In this course, Dr. Gillespie will present the historical context of MTD, provide students with an accessible overview of the MTD literature, and discuss current trends in MTD treatment.

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Conversation Training Therapy (CTT) is a new voice treatment approach based on theories of motor learning. CTT eliminates the therapeutic hierarchy and treats a patient’s voice problem using patient-driven conversation as the sole therapeutic stimulus. CTT has demonstrated efficacy in patients with muscle tension dysphonia and benign vocal fold lesions. This course will introduce the student to the scientific underpinnings of CTT and the primary therapeutic tenets of CTT, as well as provide practical troubleshooting tips.

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