RESUMO
El presente documento resume los principales aportes del conversatorio titulado "Trabajo interdisciplinario en las profesiones de la voz humana: retos, límites y proyecciones", organizado por Vocology Center el 18 de julio de 2023, que reunió a líderes y representantes de diversas agremiaciones relacionadas con la voz humana, incluyendo profesionales del ámbito clínico, artístico, rehabilitación vocal, voz ocupacional, pedagogía vocal y otras disciplinas afines. El propósito de este conversatorio fue promover un debate crítico sobre la naturaleza del trabajo interdisciplinario en el estudio de la voz humana. Se exploraron los desafíos que surgen al configurar equipos de trabajo que incluyan profesionales con diferentes enfoques y experticias en el abordaje de la voz, así como los límites inherentes a los diversos roles y funciones desempeñados por los profesionales especializados en este campo, junto con las cuestiones éticas emergentes en este proceso. Con un enfoque encaminado a fortalecer alianzas interdisciplinarias, el evento se centró en la búsqueda de una comunicación y colaboración más efectiva. Este documento marca un avance significativo en la comprensión y colaboración interdisciplinar en el cuidado de la voz humana.
This document summarizes the main contributions of the panel discussion titled "Interdisciplinary work in the human voice professions: challenges, limits and projections" organized by the Vocology Center on July 18, 2023. The event brought together leaders and representatives from various associations related to the human voice, including professionals from the clinical, artistic, vocal rehabilitation, occupational voice, vocal pedagogy, and other related disciplines. The purpose of this panel discussion was to promote a critical debate on the nature of interdisciplinary work in the study of the human voice. The discussion explored the challenges that emerge when teams that include professionals with different approaches and expertise address voice production, as well as the inherent boundaries of the various roles and functions performed by specialized professionals in this field, along with the emerging ethical issues in this process. With a focus on strengthening interdisciplinary collaborations, the event centered on seeking more effective communication and collaboration. This document represents a significant step forward in understanding and fostering interdisciplinary cooperation in the care of the human voice.
RESUMO
INTRODUCTION: Laryngeal dystonia (LD) is a focal dystonia affecting the intrinsic laryngeal muscles. Clinical diagnosis requires subjective evaluation by experienced clinicians and is primarily based on auditory-perceptual assessment. Several speech tasks are widely accepted to elicit diagnosis specific auditory-perceptual symptoms of glottal stops in adductor LD or breathy breaks in abductor LD in spoken English. With the growing Spanish speaking population in the US and lack of Spanish speech tasks to assist in identifying LD in Spanish speaking subjects, assessing the reliability of phonemically loaded sentences in Spanish for use by non-Spanish speaking providers is critical. The first aim of this study was to develop and assess the reliability of a set of Spanish language phonemically loaded sentences designed to elicit signs and symptoms of LD. The second aim was to determine the effectiveness of non-Spanish speaking speech-language pathologists (SLPs) in identifying LD in Spanish speaking subjects using these stimuli. METHODS: Phonemically loaded sentences were developed for this study following current guidelines for assessment of LD. Voice samples were obtained from native Spanish speaking individuals. Participant-speakers included 20 people with LD and 20 people without LD who served as controls. All participant-speakers were assessed by a Spanish-speaking laryngologist. Audio samples were presented to non-Spanish speaking SLPs with expertise in working with people with LD who served as raters and classified the samples as either presence or absence of LD. Kappa and the intra-class correlation coefficient were calculated and mixed effects logistic regression was used for prediction. RESULTS: The inter and intra-rater reliability indicated statistically significant agreement. Sensitivity, specificity, and predictive values for the diagnosis of LD by the raters were overall strong. CONCLUSIONS: Findings demonstrate that non-Spanish speaking SLPs with expertise in the assessment and treatment of LD can reliably identify the presence of LD using Spanish language stimuli in Spanish-speaking individuals. This study supports the use of newly developed Spanish language phonemically loaded voiced and voiceless sentences by English speaking clinicians as an effective tool for identifying LD in Spanish speakers, perhaps mitigating diagnostic delays experienced by patients with LD.
