Let’s take the “scary” out of treating voice disorders in children!  Children with vocal nodules or polyps don’t usually get to have fun materials to help reduce poor voice patterns and phonotrauma. Plus, we don’t always feel competent in treating voice disorders because, let’s be honest, grad school was a long time ago!  Kristie Knickerbocker from A TEMPO Voice Center joins us in this video to share 5 fun tips for working with pediatric voice clients.

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Welcome to the Speechie Show! Being a speech language pathologist often means having too much work and not enough planning time. To beat the overwhelm, we’re bringing you the tricks and tools that will make your job a little bit easier.

Carrie:  Hey everybody, welcome to the Speechie Show. I’m Carrie Clark from speechandlanguagekids.com and we are here with Kristie Knickerbocker from A Tempo Voice Center. How are you Kristie?

Kristie:  I’m well, Carrie, how are you?

Carrie: I’m good. We’re so glad to have you here. Today we are talking about what to do if you are not super jazzed about treating voice disorder children. So, if you have some children on your case load with voice disorders and maybe it’s been awhile since you’ve talked about that in grad school, we’re going to give you some tips today to help you with the voice disorders. If you are new to the show, this is the Speechie Show. We do this once a week. I get on with another speech language pathologist and we talk about whatever comes up. We talk about one topic each week and try to share about 5 tips with you. So today we’re here with Kristie. We’re going to have some giveaways here in a minute if you are watching on Facebook Live. So stay tuned and while we are getting started here, go ahead and type in what kinds of voice problems are the children that you work with having. So are you having problems with nodules or polyps or maybe you don’t even know. You’re just having some voice problems with your students and you’re not even sure what’s going on. Go ahead and type that in so that we know what we’re looking at today and if you have any specific questions we can answer those as well. While people are doing that, Kristie, why don’t you go ahead and introduce yourself and your business.

Kristie:  Thanks, Carrie. So my name is Kristie Knickerbocker. I am a speech language pathologist and I specialize very specifically in voice disorders. I was a classically trained singer in college and I had a voice disorder myself. I had a cyst on my left vocal cord and I had to get it surgically removed and I had voice rehabilitation before and after surgery and I really liked what my voice therapist had done for me. So I decided that I wanted to change majors and wanted to give back to everybody. And I could do such a good job with that because I had been a patient and I can really understand. Maybe not every disorder everybody has, but I can understand how frustrating it can be and how scary it can be.

Carrie:  Absolutely. Being able to take that perspective with a patient is huge.

Kristie: Yeah. And so I run my own private practice in Fort Worth, Texas. It’s called A Tempo Voice Center. I am currently setting up a mobile video stroboscope and fees clinic called Voice Diagnostics. It’s in the pre-stages and so we’re looking to grow that within this next year, as well.

Carrie:  Fantastic. Wow that sounds fun. Very cool. Alright let’s see, so we’re going to talk about these 5 tips to share with you today. We’re working with children with voice disorders. Go ahead and share this on Facebook so that other people who are also working with voice disorders can see this, as well. And if you guys have any questions as we’re going along, go ahead and type those in. Don’t forget to be typing in what kind of voice disorders your students are working or dealing with right now. Ok, the first point we’re going to be talking about today, the first tip is flow phonation. Kristie, can you tell us about flow phonation?

Kristie: So flow phonation is a type of intervention that is really helpful with your children with hyper function and what I mean by that is that they’re squeezing too tightly with their vocal cords and their voice box to try and get the sound to come out. And sometimes that’s what they’re doing and that’s the weird behavior or sometimes that has resulted in some physiological changes like vocal modules or a polyp or even a hemorrhage. So this type of therapy you can use visual feedback for in the form of a Kleenex. And so all we do is we tear down the side of a Kleenex where the fold is. Here I can demonstrate that. So you’re just tearing it like this about an inch in width and you’re working on going from just air flow to blowing a little bit of air and sound-about 20% sound kind of like the sound over a coke bottle would make if you were to blow and make noise and it sounds like this. And then you work to add that sound to rote tasks like counting. And the idea is to get the child to be voicing and making noise without doing this breath whisper type of thing or a breath talk, kind of like this. So doing it with or without this visual aid and really trying to help kind of circumvent the child’s phono Tory patterns that they are using to speak and introducing something that they can do that’s fun and visual. But hopefully getting them to practice and have that be their new normal.

Carrie:  Awesome. So do you do that as like activities that you’re doing in the therapy and then you expect them to carry it over or is this just king of to show them the opposite side of that phonation that they’re doing?

Kristie:  So, both. Using the technique in therapy secessions with different words and then sending home words, sentences and things, whatever they advance to that day. You don’t want to send them home with sentences they couldn’t even get past the initial sound because parents would be frustrated and the child would not practice. And if you’re wondering how to do that, in my voice agenda for pediatric clients, it has plenty of flow voice tasks in very easy to follow how-to’s on that. Step one, step two, phase one and two. And then things to help carry over with voice journals.

Carrie:  Oh awesome. Ok so if you’re watching, that is an activity book. We’re going to be giving one away here in just a little bit. Hang tight and you can get access to that activity book and we’ll show you how to get a hold of that. Ok one additional question I have on this…Do you need to wait, let’s say they have nodules or hemorrhage or something like that, do you need to wait until that’s cleared up before you do this therapy or can you do that while they’re still healing from the other things?

Kristie:  So, two-part answer to that question. You should not begin any intervention until you’ve had an examination from an otolaryngologist, the fancy word for and Ear, Nose, Throat doctor. If they can do visual if you have access to at least a nasoendoscopy where the camera is going in through the nose to see the vocal folds or at best a video stroboscope where the flashing light shows the vocal cords in slow motion. So you can actually see what’s really going on and how they’re preforming during a phono Tory task. When you’re doing that you’re helping…—>click here to read the full transcript.

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