Instructor:  Dr. Nancye Roussel
Office: Burke-Hawthorne Hall, Room 215
Office Phone: 482-6727
E-mail: ncroussel@louisiana.edu
Website:  http://www.ucs.louisiana.edu/~ncr3025/roussel/homepage.htm

Texts:
1.  Deem & Miller (2000) Manual of Voice Therapy (2nd Edition).  Austin, TX: Pro-Ed

2.  Awan, S. (2001).  The Voice Diagnostic Protocol.  Gaithersburg, MD: Aspen Pub.

Course Description:
An intensive study of voice and resonance disorders associated with laryngeal anomalies, disease processes and trauma affecting laryngeal function.  Management of dysphonias associated with organic and psychogenic etiology.

Specific Course Objectives:

1.    Provide information on the anatomy and physiology of the respiratory, laryngeal and upper vocal tract structures involved in voice production.
2.    Present the most current information on theories of vocal fold vibration, pathogenesis of laryngeal pathologies, impact of neurological deficits on voice production and the role of pyschogenic factors in causing/maintaining voice disorders,
3.    Provide sufficient information and experiences to allow the student to conduct assessment/evaluation of vocal parameters and design appropriate intervention programs in a variety of medical, school and community-based settings with emphasis on collaboration with ENT departments/offices as part of a comprehensive vocal rehabilitation team.
4.    Discuss the physical (biological), social/cultural, emotional(affective) and economic impact of voice disorders on the lives of a diverse population.

Learner Outcomes:
Upon successful completion of this course, the student will be able to:

1.    Identify verbally and/or in writing the anatomical structures and nerve supply of the larynx.
2.    Describe the function of the pulmonary system in the generation of air pressures and flows necessary for the production of voice
3.    Discuss current theories of vocal fold oscillation.
4.    Demonstrate understanding of the physiology underlying the modification of fundamental frequency, vocal intensity, vocal attack, vocal quality and vocal resonance.
5.    Differentiate among various vocal fold pathologies and recommend appropriate management/treatment options for each.
6.    Identify risk factors associated with both organic and psychogenic voice disorders.
7.    Collect both perceptual and instrumental data on voice production and conduct an appropriate analysis of collected data in order to plan effective treatment programs.
8.    Employ effective tools and techniques for the improvement of voice production.
9.    Establish procedures to monitor the effectiveness and efficacy of the interventions used.

COURSE REQUIREMENTS:

In order to be successful in this course, students must fulfill the following requirements.  Students progress toward the specific objectives of the course will be evaluated using both written and oral communicative tasks to ensure appropriate application of the presented material.

    1.    Complete reading assignments from the course textbook and any outside readings assigned by the instructor.  Many of the additional readings will be placed on reserve at  Dupre Library.

    2.    Successfully complete class exams.  There will be  2  exams of approximately 100 pts. Quizzes covering specified lectures and/or reading assignments will also be given throughout the semester.  Three written quizzes will be given on the dates designated in the syllabus (see topic outline below).  In addition, oral quizzes will be used to test for knowledge obtained from outside readings, understanding of concepts presented in class or laboratory assignments and may be given at anytime.  Students’ performance on oral quizzes will contribute to their class participation grade.

    3.    Complete laboratory assignments.  These assignments will require the student to spend time in the voice diagnostic lab outside the scheduled class times.  Each lab assignment will be graded.   Students will be informed at the time of the assignment the point value for the exercise and due date.  Points will be deducted for assignments returned after the announced due date.  Data from the laboratory assignments will be compiled in the form of a diagnostic report along with case history, clinical interpretations and treatment recommendations.  This 100 point assessment project will serve as a portion of a student’s formative assessment and will be included in their Portfolio.

Grading

    Students will receive numerical grades for exams, quizzes, lab assignments and the assessment project. Grades will be based on the percentage of the total possible points acquired by the student on exams, quizzes, lab assignments and projects. Letter grades will be assigned using the following percentage scale.

            91 - 100  = A
            82 - 90   = B
            73 - 81   = C
            68 - 72   = D
            below 68 = F

Course Evaluation:  Students will have the opportunity to evaluate the course by completing the Student Evaluation of Instruction administered  by USL near the end of the semester.

Emergency Evacuation Procedures:  A map of this floor is posted near the elevator marking the evacuation route and the Designated Rescue Area.  This is an area where emergency service personnel will go first to look for individuals who need assistance in exiting the building.  Students who may need assistance should identify themselves to the teaching faculty.

Course Outline with Dates, Topics and Reading Assignments (Subject to change - dates are only approximate)

8/19 - 8/26   Review of  Anatomy/Physiology

   *  Hard tissues - bones and cartilages
   *  Muscles
   *  Morphology of vocal fold soft tissue
   *  Vascularity and innervation of the larynx
Readings:  Chapter 2

8/28 -9/2  Respiratory Function for Voice Production

   *  The pulmonary system
   *   muscles of respiration
   *   generation of air pressures & flows
Readings:  Chapter 2

* respiratory patterns
*continuous speaking on 1 breath
* 5/5 task
* vital capacity
* MPT, S/z ratio
   Readings: pp 44-49 (Deem and Miller) & Chapter 5 (Awan)

    * theories of vocal fold oscillation
    * vocal registers
    * modification of fundamental frequency
    * modification of vocal intensity
    * vocal attack/quality

Resonance componants of voice
* supraglottic control of voice quality
* nasal resonance
  Readings:  Chapter 2

* perceptual assessment of pitch
* mean speaking frequency
* frequency standard deviation/pitch sigma
* speaking range
* maximum phonational grequency range
   Readings:  pp.49-54 (Deem and Miller) & chapter 2 ( Awan)

* perceptual assessment of loudness
* habitual intensity
* total intensity range
* "high-quiet" singing
   Readings:  pp.54-55 (Deem & Miller) & Chapter 3 (Awan)

*perceptual assessment of quality
*jitter, shimmer, NHR
*MDVP
*perceptual assessment of resonance
* instrumental assessment of resonance

   Readings pp.56-63 (Deem and Miller) & Chapter 4 (Awan)

9/30 - 10/16  Voice disorders

    * functional etiologies
    * neurologic etiologies
    * organic etiologies
Readings:  Chapter 4, 6, 7, 8 (pp.171-189)  & McFarlane & Watterson - “Vocal Nodules: Endoscopic Study of Their Variations & Treatment” (on reserve)

10/21- 10/23  The Voice Evaluation

* medical history/laryngoscopic exam
* case history
*  CAPE-V
* Voice handicap Index
* Assessment of Musculoskeletal Tension
* Interpretation of assessment results
* Prognosis/recommendations
Readings:  pp. 35-44 (Deem & Miller); Chapter 1 (Awan); Chapter 6 (Awan)  & Jacobson et al. “The Voice Handicap Index (VHI): Development and Validation”  (On reserve)

* symptomatic voice therapy
* physiologic voice therapy
* life style and environmental modification
* psychodynamic voice therapy

 Facilitating techniques
Readings:  Chapter 6  Boone & McFarlane (On Reserve)

10/30  Projects Due

10/30  - 11/11   Therapy for dysphonia related to laryngeal hyperfunction (phonotrauma); faulty voice usage & vocal fold lesions

Readings: Chapter 5 (pp.103-132) & Stemple, et. al. “Efficacy of Vocal Function Exercises as a Method of Improving Voice production” (on reserve)  

11/13 - 11/18    Therapy for spasmodic dysphonia, vocal fold paralysis & PCVM

Readings:  Chapter 6 (pp. 151- 156), Chapter 8 (pp.179-180); Mathers-Schmidt "PCVM:  A Tutorial on a Complex Disorder & the Speech-Language Pathologist's Role

* geriatric voice change
* voice changes at puberty
* professional voice users
* transgender
* people with AIDS
* people with hearing impairment
Readings:  Chapter 5 (pp. 132-138); Chapter 6 (pp.145-147); Chapter 9 (pp.253-256)  

11/25  Efficacy of voice therapy techniques

Readings:   Pannbacker - AJSLP, Aug., 1998 (on reserve) & Ramig and Verdolini - JSHR, 41, s101-s116 ( on reserve)