Published on July 10, 2016
Pleased to introduce Denise Stats-Caldwell, Speech-Language Pathologist/Voice specialist. She is a dedicated educator. Please credit The Voice Forum when you share our content. #fellowshipofthelarynx
TVF: Where do you currently practice/teach?
DS: Arizona State University Speech & Hearing Clinic; Valley ENT in Mesa, AZ.
TVF: Where did you complete your education/training in voice?
DS: Western Washington University, videolaryngostroboscopy at Vanderbilt.
TVF: What motivated you to dedicate yourself to the field of voice?
DS: I developed muscle tension dysphonia (MTD) during my clinical fellowship year as a speech-language pathologist (SLP). It only flared with voice patients (the patient type I felt least skilled in assisting). I had to apply voice therapy to myself which provided me with skills and experience to support my patients.
TVF: What comes to your mind as one of the most pressing issues in contemporary voice disorders?
DS: I see the need for better availability of services for the community of individuals who are transgender.
TVF: Which vocal myth would you like to dispel?
DS: I don't like the idea that a school-based SLP who refers a child with dysphonia to a physician obligates the school district to pay for the doctor's visit. This idea is rampant and I feel confident it interferes with appropriate referrals. The school district does not have to pay for a child to go to the doctor to get evaluated for pink eye. Why should the school district pay for a dysphonia evaluation when the purpose of the evaluation is to ensure that the dysphonia is not a symptom of a serious underlying health condition?
TVF: Your most memorable voice case?
DS: I have three memorable voice cases. In the first case, a patient who experienced vocal improvement within the context of our sessions but no skill maintenance outside of therapy had a complete return of functional voicing after she moved out of the house she shared with an abusive partner. That was early on in my career and really highlighted the psychosocial variables that factor in to voice. She had great voicing within our sessions because it was a safe place.
The second case was a patient with MTD with some favorable response to laryngeal massage but I was not able to fade the laryngeal massage even when I paired it with resonant voice and other methods. She was a horse lover and I finally told her, "do you know the expression 'give a horse its head,' you're holding the reins too tight and need to loosen up." She had an immediate return to normal voicing and said her voice felt great. I could hardly believe it but somehow that analogy (sorry Kittie Verdolini-Abbott!) helped her understand the target. She maintained her voice thereafter.
The last case was a case where the patient had rapidly declining speech, voice, swallowing and gait. She was referred to me by her PCP but was not referred to neurology or other practitioners. She was referred to neurology after I called her PCP (I was alarmed by the rapid decline in function). The neurologist thought she had ALS but discontinued her use of Reglan just to be safe. She had a complete return of function once she discontinued the medication, which had caused the known potential side effect of Parkinsonian symptoms. This case always serves as a reminder to me to leave no stone unturned.
TVF: As a voice pathologist/educator, what keeps you on your toes?
DS: Vocal fry keeps me on my toes. It is prevalent with graduate student clinicians in SLP. It undermines their professional persona, interferes with their ability to provide an appropriate vocal model and puts them at risk for developing their own voice disorder.
TVF: What advice would you like to give to the general populace about voice care? How about to the professional voice users?
DS: The best advice I could give to the general populace is to work on becoming better listeners and to allow silence for reflection. This advice has many benefits beyond just benefiting the voice through a reduction in vocal load.
TVF: What sparks “joy” for you as a person?
DS: Blue skies and the infectious laughter of my children. Every year my New Year's resolution is to laugh more.