Interview with Dr. Abby Hemmerich of University of Wisconsin Eau Claire

Note: You should consult with your doctor or speech pathologist for recommendations on treatment. The views and opinions expressed in this article are those of Abby Hemmerich and do not necessarily reflect the official policy or position of SpeechPathologyMastersPrograms.com

How did you become interested in researching voice disorders?

I had my first experience with a person with a voice disorder in my graduate program. I loved how it incorporated both very scientific information with a bit of art in getting a good voice quality. After that, I sought out experiences with voice in my clinical experiences, externships, and later in my first job. I became the “voice person” at the outpatient clinic where I was working. I loved seeing the progress these individuals could make. I’m not going to lie, I also liked working with people who were neurotypical and adults. As I moved into my doctoral program, I knew I had to keep working in the area of voice. There are just so many unanswered questions in all areas of our field, but in voice I felt I could make some contributions to our knowledge.

How has our knowledge of effective voice disorder treatments changed over time?

I think the biggest two aspects are 1) our understanding of how the vocal mechanism works and 2) use of technology.

Over the past few decades, the understanding of vocal fold vibration and how the larynx fits within the greater context of sound production has significantly deepened. Having the ability to view the vibration using newer technology has allowed researchers to not only understand the mechanism better, but also design new therapies for treating disorders. We still use many behavioral techniques, but now that is more appropriately guided by physiology so the therapy is better targeted and can be more effective. Related to technology, the applications and tools available now are providing more and more options for both assessment and intervention. My biggest interest is in intervention, and seeing how use of technology can support practice and generalization of skills is rapidly expanding. A number of researchers have been working on ways to provide therapy via the internet, as well as using things like cell phone apps to aid patients in utilizing/practicing the skills they have learned. The potential impact on patient care is immense and exciting.

What are some of the challenges of treating patients who have voice disorders?

One of my biggest challenges has always been carryover or generalization. My patients often can achieve a great voice in the clinic, but then struggle to practice that at home. Using technology is an exciting new method for assisting with that transition.

How can video self-modeling improve outcomes for those with voice disorders?

Video self-modeling is a tool where individuals can view themselves performing a target behavior successfully. There are two types in use clinically – the first type requires video-editing by the clinician, so the patient only views successful performance of the behavior. The second type includes the entire sample, so the patient sees both the positive and negative aspects within their attempt at the behavior.

For individuals with voice disorder, we’ve done preliminary research on the first type, with the edited videos. The individuals in our study did not show major perceptual or objective voice changes, but did note improvement in their compliance with treatment activities at home as well as improved confidence in their ability to perform those activities. This has big implications for assisting with that transition from clinic to home.

Are there potential challenges for SLPs who are using video self-modeling as a tool for the first time? How can SLPs easily integrate this therapy into their practice?

Video self-modeling is relatively easy. Many practitioners are likely already using it in clinical practice, if they’re asking their patients to review video (or audio) of themselves during the session. Implementing that in a home program simply requires the technology, which can be the patient’s own cell phone. The SLP would need to record a video of the patient performing the desired voice task and edit it to eliminate extraneous talking and/or incorrect productions. That process of editing can be a bit daunting if a person has never attempted it before. However, video editing software is fairly accessible and easy to use; to create the videos, it’s simply clipping out the unwanted segments.

You coordinate the online SLP program at University of Wisconsin Eau Claire. What are the advantages of the online program?

The online program at UW-Eau Claire is designed as a part-time program. The benefits are numerous. The students are able to move through the program at a slower pace, so they can continue working some and managing family life. The academic courses are offered mostly online, so they have the flexibility to work on coursework when their schedule permits. I say mostly online, as we do require a few visits to campus, during which we accomplish hands-on work that cannot be completed online, such as practicing stroboscopy or using an audiometer. Other benefits of the online program here at UWEC are that the courses are the same and the instructors are the same, as our traditional on-campus, full-time program. The students are getting the same rigorous graduate program, just offered through a different modality. The students develop the same connectedness with each other and with the instructors. Perhaps the biggest benefit of the online program is that it allows students to stay where they are and complete their graduate work. We have a number of students who are tied to a particular geographic region, where there may not be a graduate program available within driving distance. We’re filling that need of providing graduate education to those who live more remotely, those who have to move every year, or those who simply are unable to move due to family or work obligations.

How are the classes structured for the online program?

Students complete approximately two academic courses per semester. These are offered through our learning management system, which currently is Desire2Learn (D2L). Students receive access at the beginning of the semester and have the same type of syllabus and course calendar as in a traditional course. They get their textbooks and complete readings, they watch videos created by the course instructor for the lectures, and participate in discussions on a discussion board to allow for student-student and student-instructor interactions. Assignments are submitted through D2L and include both written, audio, and video types of work. Occasionally, instructors will offer or require video chat sessions for further discussion of content or testing purposes.

What is your advice for future SLP graduate students?

Future SLP graduate students should focus on the ultimate goal, being an SLP. We are always looking for students who really are here to learn how to be a great SLP. To us, that means grades and test scores may not really tell the whole story because a great SLP also has the people skills to make the important connections. Once in a graduate program, I always encourage our students to stop worrying so much about the grades and to focus on the learning. With our field, things are constantly changing, so our students need to not only learn the content we’re teaching, but also learn how to learn so that they can continue to do so after graduation.

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