June '22 - Children Development and Voice Therapy

☀️ "Every summer has a story" and we are just getting started - summer is around the corner, as well as with noala's first birthday, we gear up for an eventful next few months

🖥 Highlighting this past month, Noala Club was another success as we welcomed our noala ambassador and voice expert, Tor Spence. The discussion revolved around voice therapy focused on paediatrics - see the key takeaways below

👩 We published our first guest blog feature, talking more about, New York based SLP, Sharon Baum's road to speech therapy and key advice

💙 Step by step, working together with our community, we achieve greater heights 

For Noala Club, we discussed evidence-based research on voice, see the links and takeaway below:

Takeaways: 

• A voice disorder can have a significant impact on a child’s self-esteem. Research has shown that both direct and indirect voice therapy approaches can improve a child's quality of life.  
• For diagnosis prior to voice therapy, clear visualisation of the larynx is essential, usually by an ENT practitioner. If a child can't cope with an outpatient assessment of the larynx, a general anaesthetic may be required. If a child has dysphonia, general advice isn’t always appropriate. Hence there needs to be a thorough visualisation of how the larynx looks to inform treatment.
• It's important to use a variety of perceptual and objective assessments of the child's voice. This includes informal symptom severity scales, perceptual ratings of voice quality and patient rated outcomes measures. Sometimes a bullying questionnaire can be helpful as this could be affecting the child as well.
• Optimal frequency of therapy sessions is dependent on many factors including how often the child practices voice therapy techniques at home. It is very difficult to be prescriptive. It's important to set realistic goals and boundaries. Studies have shown that two 30 minute therapy sessions a week with daily practice at home have led to significant improvements to voice quality and related quality of life. 
• When treating a child with vocal cords nodules; treatment is a balancing act and requires voice rest, changing behaviour and educating the child about the cause and risk

Research: 

• Royal College of Speech and Language Therapist - RCSLT Voice Clinical Guidelines
• Voice Centre - Ricci-Macarinni et al. Development and Validation of the Childrens Voice Handicap Index-10 CVHI-10. 2013. Journal of Voice Vol 27(2) 
• Jama Network - Hartnick et al. 2018. Indirect vs direct voice therapy for children with vocal nodules. JAMA Otolaryngol Head Neck Surgery 144(2); 156-163
• Wiley Online Library - 2018. Effect of three semi occluded vocal tract therapy programmes on the phonation of patients with dysphonia: lip trills, water resistance therapy and straw phonation. International journal of language and communication. Vol 54. Issue 1 p. 50-61

We would love to hear from you! Feel free to share your experience working with children, schools, families and communities with the Noala community on our forum

Join the next Noala Club, 5 July

‍‍

We warm heartedly introduce Louise Lim to you 

Speech and language therapist, based in Norwich, England, specialising in Adult Acquired Communication Difficulties with a Neurological Basis

I have worked a lot with people with aphasia including in a research role on the PLORAS project at University College London and envisaged this would be the main focus of my work going forwards. Since opening my own private practice in Norwich a few years ago however I found that lots of people with Parkinson's were getting in touch and looking for therapy.

This led me to undertake training in SPEAK OUT! with the Parkinson Voice Project who are based in the USA. SPEAK OUT! is an evidence based approach. With similarities to LSVT and has been designed to be efficient for speech and language therapists with a very structured way of delivering sessions and recording results and outcomes. In addition to intensive sessions with me, patients can join live (or watch later) Facebook sessions daily with the Parkinson Voice Project Team. This helps with motivation to practice and means they can follow a correct model when doing homework between sessions. I find the whole approach has such a positive effect on patient's lives and it's wonderful to see them get their confidence back. They return to interactions they'd been avoiding due to their dysarthria, such as ordering in a restaurant or having a phone-catch up with a relative.

The best piece of feedback recently was a patient telling me that their partner said to them they felt they had 'got them back' as they sounded like their 'old-self' again. It's really heartening to see patients make progress and to have the tools to keep their voice strong despite the general progression of their Parkinson's and as one patient puts it gain 'vocal independence and autonomy'. I will soon be working with the Highly Specialist SaLTs on the Movement Disorders Team at the National Hospital for Neurology and Neurosurgery. I am looking forward to reaching even more patients with Parkinson's.

Other news we've been reading

👀 The Telegraph publishes "Covid lockdowns left toddlers unable to speak or play properly" giving insight to how the pandemic has delayed children communication development and how they need more support than ever

📄 MSN shares "'I struggle' Bruce Willis' wife Emma Heming Willis on the 'toll' of caring for ill husband" explaining the experience of Aphasia, how it can affect individuals and how the condition can progress over time

🌈 At Noala, we are soon celebrating our 1 year birthday in London and uniting SLPs for a New York brunch - if you are interested in joining us at either, please send us an email

New York Brunch, 4 June

London Birthday, 2 July

Noala Updated Features 

📑 Clinical Note Templates

We know how much you like the S.O.A.P clinical note template, so we added this to your clinical note as a structured option

🗓 Calendar Events

Your calendar view has now been updated to being editable, as well as being able to add events other than patient sessions, try it out

💸 Invoicing

You now have the ability to invoice on a monthly basis and edit where need be

👀 Sharing to Patients

When sending notes after session to a patient, the clinical note exported PDF is editable to what you want to share for confidentiality purposes

Find out more on our website