Published on October 11, 2016
Pleased to post an interview with Tanya Eadie, PhD., CCC-SLP.
TVF: Where do you currently work and do your research? What is your main patient population?
TE: I’m a professor in the Department of Speech and Hearing Sciences at the University of Washington in Seattle. My research isn’t really driven by one patient population - it’s based more on methodology.
I am interested in measuring clinical outcomes in voice, and have focused a large part of my career on auditory-perceptual evaluation and how these measures may or may not relate to what our patients report.
TVF: Where did you complete your education/training in voice?
TE: I completed my Master’s of Science in Communicative Sciences and Disorders (Speech-Language Pathology) at the University of Western Ontario in London, Ontario, Canada in 1999. I then went on to do my PhD in Rehabilitation Sciences at the same university with Dr. Philip Doyle as my mentor. While I was completing my PhD, I was fortunate to work part-time as a speech-language pathologist at a local hospital. As part of my PhD training, I also had the great opportunity to visit some great centers: the MGH Voice Center with Dr. Robert Hillman and his team, as well as Cancer Care Manitoba with Candace Myers. So many people were gracious with their time along the way and so many people have influenced me and the questions I ask every day.
TVF: What motivated you to dedicate yourself to the field of voice sciences?
TE: Music has always been part of my life. When I was a teenager, I had the opportunity to participate in an elite girls choir. We toured Europe more than once and won international competitions. I also played several instruments, including the violin and trumpet. In university, however, I studied biology and neurosciences. When I found speech-language pathology, voice sciences seemed to me the perfect mix of both “art” and “science” and really reflected who I was and my interests.
TVF: What comes to your mind as one of the most pressing issues in contemporary voice disorders?
TE: I know this isn’t strictly a “voice” issue (in fact, it extends to speech and swallowing), but right now, for me, one of the most pressing concerns relates to the HPV epidemic and the escalating rise of oropharyngeal cancers associated with HPV. This is a whole new demographic of individuals (younger, high education, mostly male) who are affected by this disease. Fortunately, the medical prognosis is usually good, but it also means that people are going to live longer with the consequences of treatment, which can affect all aspects of their lives.
TVF: Do you have research interests?
TE: My primary interest relates to clinical outcomes in voice disorders as well as head and neck cancer. I have really embraced the approach taken by the World Health Organization framework in measuring all aspects of a person’s function associated with a health condition; this framework, also endorsed by our professional association, mandates that we not only assess a voice impairment, but that we also consider how a voice disorder affects a person in their everyday lives. My interest started with auditory perceptual evaluation of voice - how we as clinicians measure voice quality, and identifying some of the ways we might improve the reliability and validity of these tools. More recently, I have been pairing these clinical evaluations with patient-reported tools. As you might guess, a clinician’s perceptions about a patient’s voice quality and its severity are often not related to a patient’s perceptions. Our team (including Drs. Kathy Yorkston and Carolyn Baylor) has been involved in developing and validating a patient-reported tool, called the Communicative Participation Item Bank, that measures communication in everyday settings. While this might sound easy, it has been a labor of love and has taken us about 10 years to get to a point where we have a tool that is applicable across a wide number of populations. Specifically, I am now using this instrument to measure the impact of head and neck cancer on communication outcomes, which is an area that has been underserved.
TVF: How do you hope your research will be applied in the clinical field?
TE: My research is directly applicable to clinical practice many ways. First, I have been involved in helping to identify ways to train clinicians to improve their reliability of using auditory-perceptual tools in voice. My work in listener perception of voice has some direct public education implications in understanding how an unfamiliar communication partner might negatively react to speakers with all types of voice disorders. Finally, our patient-reported tool, the Communicative Participation Item Bank, is now available as a 10-item short form that may be used to measure the impact of a health condition or communication disorder on a person’s participation in everyday settings. The tool can be used as part of an initial assessment, or it can be used as a sensitive and meaningful outcome measure to document the effectiveness of our therapy approaches. This is really important in this era of evidence based medicine.
TVF: How can one bridge the gap between basic science and clinical application?
TE: My research is really clinically applicable, so I have less of this problem than some researchers do, although it’s always a challenge to implement in real world settings. However, I believe it all comes down to collaboration - we really need to listen to our patients and to our colleagues about what is really important so that we continue to ask meaningful questions.
TVF: In your opinion, what poses the greatest challenge in care of voice disorders?
TE: This answer transcends voice disorders, but I think it’s adherence to treatment. Behavioral changes are really hard to make and involve so many psychological factors as well as other environmental barriers. There is no “one size fits all” in making a therapy successful. I believe that we have a lot to learn from other professions that ask individuals to make any type of behavioral change - whether it is smoking cessation, weight loss, or in our case, asking people to perform swallowing exercises throughout head and neck cancer treatment, changing the amount of voice use or intensity of our voices, or performing vocal function exercises.
TVF: Which vocal myth would you like to dispel?
TE: I’m not going to stick with traditional voice in this case, but I’ll go to one of my areas of research, which involves head and neck cancer. There was a landmark study about 25 years ago that showed equal survival rates in those with advanced laryngeal cancer when they were treated either with chemoradiation (a larynx sparing treatment) or total laryngectomy. The conclusion from that study was that given equivocal results in survival, then the better treatment was chemoradiation, since this meant that the person would not lose their larynx and have a tracheostoma (breathing hole created at base of neck). The myth I’d like to dispel is that preservation of the larynx equals function. Indeed, it does NOT mean that, and taking it one step further, function does not equal quality of life. There are many functional and psychosocial considerations that need to be made in these cases.
TVF: Do you have a vocal pet peeve and why?
TE: It’s more of a speech-related pet peeve, but it’s the linguistic phenomenon known as uptalk (when a person sounds like they are asking a question, rather than making a statement). As a female professor and researcher, this was something that I realized I did when I started my career. It really doesn’t make you sound very confident or knowledgeable when you use this speech pattern, and I made the decision to change it. As a professor who works mostly with younger, female students, I believe we need to change this pattern so that we can put our best foot forward in our professional and social lives.
TVF: As a voice pathologist/educator/researcher, what keeps you on your toes?
TE: Definitely, my students. I am constantly learning new things from them, especially in learning new technologies.
TVF: What do you think the next steps are in growing the field of laryngology/Vocology/voice rehabilitation?
TE: Wow - there are lots of exciting next steps, especially in the development and use of technology for new assessment tools (imaging), ways to perform therapy (telehealth) and ways to promote generalization to everyday using smartphone apps and virtual therapists. We just need the research to tell us how to best implement these tools and for whom these methods are appropriate. I think it will help us in making our services more evidence-based, stream-lined, and effective.
TVF: The “voice” community is a very tight knit group of medical professionals, pedagogues, scientists, and vocal performers of many genres. What can we learn from each other?
TE: We are all better when we work together as a team. Speaking as a scientist, it’s an “interaction” effect, and not a main effect (in this case 1 + 1 + 1 + 1 = 25, and not 4). We need to continue to work in teams and not in our silos so that our patients get the best possible care and so that we ask meaningful scientific questions. I am so lucky to have a huge group of these colleagues around the country and in the Pacific Northwest specifically. We have an extremely active northwest chapter of the voice foundation, led by Dr. Albert Merati, and I am continually learning from my colleagues at the University of Washington and University of Washington Medical Center.
TVF: Who are your favorite singers?
TE: I know this is funny coming from Seattle, but Dave Matthews has always been one of my favorites, even before I lived here. I love the musicality of the band, and especially his live albums and concerts. He puts so much of himself into his songs and his performance. I’ve also always been a huge Ella Fitzgerald fan - talk about a pure voice and brilliant ways of improvising. And being a former trumpet player, I really enjoy the joyfulness of Louis Armstrong even if his voice quality is something we discuss in our voice class.
TVF: What sparks “joy” for you as a person?
TE: In my professional life, it’s seeing my students learn and grow, and move onto their careers and make huge contributions to the world. It just makes me so proud. In my personal life, it’s really my family and the experiences we share together.