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Look how far we have come!

An article by Dr Malcolm Baxter.

When I trained in ENT in the mid-1970s, laryngology was somewhat in the doldrums and not regarded as a subspecialty, which is surprising given its great importance in Victorian times with contributions from outstanding laryngologists in Europe, the UK and the USA.

Certainly, laryngeal malignancy was to the forefront, and in general, in Melbourne, laryngeal carcinoma was treated by radiotherapy and salvage laryngectomy although primary partial laryngectomy was increasingly used in some centres.

The options for benign laryngeal disorders were somewhat more limited.  We were almost unaware of the seminal work of Hirano.  Microlaryngoscopy was done for biopsy and removal of laryngeal lesions, although the instruments were fairly gross, which made it sometimes difficult to produce good results.  There was one C02 laser in Melbourne for laryngeal work during my training, and this was at the Royal Children’s Hospital, used for laryngeal papillomatosis which was then considered to be a paediatric disease largely.  The occasional adult patient with the disease could be treated there by special dispensation.

Concerning other benign lesions, a popular operation at the time was so-called “vocal cord stripping”, a procedure which sounds as bad as its name and produced expected results.  Although various procedures on the external larynx such as the Woodman procedure were described, these were seldom done. We used Teflon injections  for the paralysed vocal cord, an excellent solution for those people with a malignant cause who was not expected to live more than six months but unfortunately this was sometimes carried over in some cases to people who did not have a malignant cause for their paralysis, often with unfortunate  late results such as local laryngeal granulomata and even Teflon spreading to distant organs.

My interest in laryngology was stimulated by one patient I remember who had a so-called vocal cord stripping and on review in the outpatients on indirect laryngoscopy had beautiful looking vocal cords which moved and apposed beautifully without a sign of any lesion but unfortunately with an absolutely dreadful voice.  Of course, the vocal cord stripping ignored the principles of preserving the lamina propria, but without videostroboscopy, I was unable to appreciate the vibration of the vocal cords (or rather the probable total lack of vibration!).

Examination in ENT, including the larynx, throughout most of my training, was still using the frontal mirror, beloved of American cartoonists, using a reflecting lamp which shone from behind the patient on to the surgeon’s head-worn mirror back to the patient. The larynx was examined by indirect laryngoscopy; a technique described first by the singing teacher Garcia in 1862 and which still gave a good visualisation of the larynx in those people whose gag reflex did not completely preclude it but not allowing assessment of connected speech or vibration.

Our speech pathology colleagues usually attended Outpatients but were somewhat frustrated by not being able to visualise the cords and having to rely on our description.  Ros Frank, a leading speech pathologist at the Royal Melbourne Hospital, had acquired an attachment which fitted on the surgeon’s frontal mirror and by standing behind the patient looking at the examining surgeon, you could see a reflected image of what the surgeon saw with his mirror – a sort of doubly indirect laryngoscopy!  Slightly later the frontal mirror was superseded by the Vorroscope now widely used in Australia by ENT specialists.  One further refinement was the use of a half-silvered mirror which was attached to the Vorroscope, which allowed some vision to an external observer.

Even after I did my post-fellowship work overseas, flexible endoscopes were only just making an appearance, although by the end of the ’80s most ENT specialists had converted to using this instrument which obviated the need for indirect mirror laryngoscopy and also thankfully the more difficult technique of mirror nasopharyngoscopy to visualise the nasopharynx.

The general management pattern in the pre-flexible laryngoscope era was that the patient who presented with dysphonia would have an indirect laryngoscopy and if they could not tolerate this or cords not visualised adequately, they would have to be booked for a microlaryngoscopy under a general anaesthetic.  The flexible laryngoscope, besides giving better vision, also greatly reduced the number of GA’s which needed to be given.

Once the patient’s vocal cords were seen, they were usually divided into those which had an observable lesion which were usually booked for biopsy or other surgery or those which did not, in which case they disappeared behind the door marked Speech Pathologist (or possibly in those days, Speech Therapist) never to be seen again.  There was a generally unspoken assumption that if a person had dysphonia with nothing observable on the larynx, then it was obviously something “in the mind” and who better to deal with this than the speech therapist/pathologist!

Stroboscopy of the larynx had been experimented with previously in several centres overseas but nowhere in Australia at that stage to my knowledge.  I do remember reading about this technique before I qualified and thinking it would be something that I would be interested in, but I forgot about it with the pressure of going overseas for post-fellowship work.

On return to Australia, I entered general ENT practice with a special interested in Otology and in the mid-1980’s I asked Laurie Ryan if I could join him at the Royal Victorian Eye & Ear Hospital as a visiting consultant which I duly did.  I was a little lost for a role at that stage and decided that acoustic neuroma surgery was probably not for me, but Laurie suggested,  knowing that I was interested in singers and music, that I consider setting up a voice clinic at the hospital, a suggestion for which I am always grateful.

A short time before, the hospital had bought an early model laryngeal video stroboscope, the Danish Bruel and Kjaer system, a behemoth of a machine on which one could occasionally see pictures of the vocal cords.

Together, I started the Royal Victorian Eye & Ear Hospital Voice Clinic with  Jenni Oates, speech pathologist and we developed a technique of seeing voice patients that presented to us in a joint consultation model which allowed each of us to contribute our own particular special skill sets towards the diagnosis and management.  Mercifully the Bruel and Kjaer system was replaced with a new Kay video stroboscope which was updated once or twice and remained the instrument of choice.  The Kay system, later Kay Pentax, was the standard workhorse for video stroboscopy for many years both in the public system and our private clinic, although in later years in our private rooms we converted to the Xion.

We started the Eye and Ear Voice Clinic around 1989 and in 1991 we recruited Andrew Hughes, Neurologist, and started a laryngeal Botox service which ran very successfully for several years until Andrew left around 2008 closely followed by me.  Unfortunately, this meant that the hospital lost the Botox service although the Voice Clinic was taken up by others, and Jenni continued.  Despite this, Andrew, I and Jenni continued to work closely together as Andrew now had a wide experience with Botox injections and although we now no longer worked in the same location, we still maintained close contact and referred patients between ourselves.

Approximately 25 years ago, Jenni and I joined with Neil Vallance (ENT) and Debbie Phyland (Speech Pathologist), to form the Melbourne Voice Analysis Centre, a private Voice Clinic which had so many locations over the years we probably should have used a caravan.

Again, we had the same model of using a joint ENT and speech pathology assessment, and we insisted on this pattern if a person wished to see us for an assessment.  Some patients wondered why they should see a speech pathologist when they wanted a diagnosis or vice versa why they should see an ENT surgeon when they were told they needed therapy, but we have always insisted that the model was the best for optimal diagnosis and therapy.

The Melbourne Voice Analysis Centre has continued over the years.  We have recruited several other speech pathologists working for Debbie over the years, and Paul Paddle and Charlie Giddings (ENT) have recently joined as laryngologists.  We have seen and treated a wide variety of pathologies, benign and malignant.  Patients who require an operation have been treated either at a private hospital or by Monash Medical Centre ENT Unit, which both Neil and I were involved with.  Over the years, we have taken part in research, therapy and attended international workshops and conferences and made contact with international laryngologists and speech pathologists.

About six years ago we were instrumental in the formation of the Laryngology Society of Australasia, which provides a forum for research and clinical focus for all professionals that are interested in the larynx and voice, particularly laryngologists, other ENT specialists, speech pathologists and voice scientists.  Laryngology has now happily reached the stage where some registrars, here and interstate have gone away and done laryngology Fellowships in the US and brought their skills back. Laryngology is firmly established here, as overseas, as a subspecialty and one which engages the interest of many trainees

Over the years I consider there have been many important advances such as better imaging and documentation due to progress in video stroboscopy, better operative results due to respect for the physical principles of the structure and function of the vocal cord and the advent of finer delicate laryngeal instruments. I had a special interest in the paralysed vocal cord, and we have used a variety of techniques both by injection laryngoplasty and external thyroplasty to correct this problem.  I myself mainly used autologous fat for injections as I was comfortable with it and felt I achieved better results but there are now excellent newer synthetics on the market.  Similarly, the laser is becoming increasingly important in its various manifestations and another particular interest has been the treatment of adult laryngeal papillomatosis for which we have used various techniques including laser, micro debridement and Cidofovir injection in an attempt to control this dreadful disease.

A focus of course both in public and private has been the so-called “professional voice user”, a concept I have never been entirely comfortable with as I believe that a person’s voice is important to them irrespective of occupation. Whilst recognising that singers and actors are totally dependent on their voice people such as teachers and call centre workers are economically dependent on it as well.  We have seen a wide variety of people from all walks of life including singers at all stages of their profession.  Apart from those reliant on it for their living, there are of course the students and aspiring singers but also a large variety of people who sing for the love of it and for whom dysphonia is a significant handicap in that it is often such as major interest in their life.

Of course, laryngeal disease may manifest as airway problems also which I became increasingly interested in. One unexpected consequence of this was suddenly becoming an apparent magnet for Chronic Cough referrals, often from Respiratory Physicians. Thankfully I fell back on the earlier principle of sending them to the Speech Pathologist but many came back leaving us trialling things like Gabapentin with variable results.

A few years ago, Professor Phil Bardin at Monash Lung and Sleep Department, Monash Medical Centre formed a Laryngeal Clinic because of their interest in vocal cord dysfunction as it impacted on respiratory conditions and its relationship with difficult to control asthma.  Although this was a source of some turf war mutterings, it is, in fact, logical that the Respiratory Physician should be equally interested in this condition of vocal cord dysfunction or VCD, now increasingly becoming known as ILO (Inducible Laryngeal Obstruction).

Phil and I ultimately joined together to form a Multidisciplinary Team and clinic to tackle this problem at Monash.  Debbie Phyland joined us as a speech pathologist plus Ken Lau as a radiologist with Laurie Ruane, respiratory scientist and we conduct outpatient clinics and injecting session for laryngeal Botox as well. Our treatment protocol involves “Laryngeal Retraining” (Speech Pathologist again!) in the first instance and those not responding may be offered laryngeal botox or other modalities. We have now seen over 80 patients with some encouraging results and have published our results.

I no longer operate apart from squirting the odd amount of Botox into the vocal cords and do not see many voice patients these days.  I have, however, become increasingly interested in patients with VCD /ILO.  These are generally fairly sick patients, and I believe our clinic is helping them greatly although whether it is the therapies we offer or the psychological support we give, I am not entirely sure.  Watch this space as this is a work in progress!

If you had told me at the beginning of my career that I would at the end be managing chronic cough and asthmatics and working with Respiratory Physicians, I would have thought you were mad, or possibly changed specialities.

In summary, it is gratifying looking back over the last 40 odd years to see what has happened to laryngology in this country. It is now definitely at the point where it is recognised as being a separate sub-speciality of Otolaryngology, and this must be for the good of our practice and our patients.

“Unless stated otherwise, this article represents only the views of the author and not the views of the AVA”

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National Voice Meeting 2018 – Presenter Series #2

The Australian Voice Association

By Cecilia Pemberton

I am very much looking forward to returning to Adelaide to present at the 2018 Australian Voice Association’s National Voice Meeting: Voice on! The Road to Recovery.

It is interesting to reflect how far the AVA has come, since the Inaugural Voice Symposium was held in Adelaide in May 1991 at the Queen Elizabeth Hospital. I was on the organising committee for that symposium along with Alison Russell, Jan Baker, David Close and Alison Bagnall.

The Keynote speaker was Dr Robert Bastian, then Professor of Otolaryngology at Loyola University School of Medicine, Washington. He is the Founder and President of the Bastian Voice Institute. Professor Bastian’s interests in the field of laryngology encompassed both voice and swallowing with a special interest in the needs of professional voice users. What a wonderful choice of speaker he was, so generous in his knowledge and time. He had an infectious enthusiasm for the idea of collaboration of all the professionals interested in voice.

As a committee we were impecunious, but Professor Bastian generously agreed to present with no remuneration. We were indeed very fortunate. He was so encouraging of our endeavours not only for the symposium but also to build an association to foster collaboration.  We did of course have some anxious moments, especially as we were spending money we didn’t actually have and weren’t sure anyone would attend! We were soon rewarded when registration opened, the response was overwhelming. We quickly broke even and had soon made a profit.  200 delegates attended that inaugural symposium; speech pathologists, ENTs, teachers of singing and voice coaches.

The success of the symposium was the impetus for the formation of the AVA. By the end of 1991, Alison Russell, Jan Baker and I had established the AVA with a charter to foster collaboration between all voice professionals in the education, research and care of voice users.

The financial success of the inaugural symposium meant that, from then on, seeding funds were available for future AVA organising committees.

So it is, many successful symposia later, that the current AVA committee have put together a very exciting, diverse programme which will encompass care and rehabilitation of the singing and spoken voice in both the adult and paediatric fields.

We are so fortunate to have Leda Scearce as the keynote speaker. I recently watched an interview that Liz Johnson Schafer did of Leda as part of “Interviews on Voice Matters”. Leda talks about her background as a professional singer before retraining as a speech pathologist and also her philosophy for the rehabilitation of the singing voice. I highly recommend watching the video https//you.be/0bpwU-Fjr50 .

I also saw a webinar of Leda presenting as part of the 2018 Performance Voice Conference at The University of Utah, Voice Disorders Centre. Leda ran a very successful master class. It was so interesting to see her at work with some young singers. I’m sure she will be a treat to have at the 2018 AVA National Voice Meeting.

Also on the programme this year is Nicole Free. For those of you who don’t know Nicole, check out her 3-minute thesis: https://youtu.be/3ebmlZbJgcQ. She is now through to the Asia Pacific finals.

I look forward to seeing you in Adelaide.

Also on the programme this year is Nicole Free. For those of you who don’t know Nicole, check out her 3-minute thesis: https://youtu.be/3ebmlZbJgcQ. She is now through to the Asia Pacific finals.

Cecilia Pemberton is a speech pathologist in her private practice, Voice Care

Australia and at the Voice Assessment Centre at St Vincent’s Clinic, Sydney. In 1991, she co-founded the Australian Voice Association after the Inaugural Australian Voice Symposium in Adelaide.
Her research has covered the normative data for endoscopic examination of the larynx, changes in speaking fundamental frequency in women’s voice with age and intergenerational and most recently the effectiveness of prevention and early intervention programmes for voice problems in teachers. Cecilia is co-author of Voice Care for Teachers DVD.

In 2009 she was awarded Fellowship by Speech Pathology Australia for her contribution to the profession. Her voice care programme for teachers with the Catholic Education Diocese of Wollongong has been a finalist in both the NSW Safe Work Awards (2009) and the Australian Human Resources Institute, Martin Seligman Award for Health and Wellbeing (2015). In 2014 she won the British Voice Association Van Lawrence Prize for her paper “Efficiently and Cost Effectively Managing Teachers’ Voice Problems”.

To register for the AVA National Voice Meeting and AGM 2018 click here:

“Unless stated otherwise, this article represents only the views of the author and not the views of the AVA”

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World Voice Day Interview with Meagan Rudd

Meagan Rudd

Spreading The Music with Key Word Sign.

Since its inception in 2014, the Nordoff-Robbins Key Word Sign Choir, under the guidance of Meagan Rudd, has become a regular feature at a variety of events throughout Sydney. The AVA had the opportunity sit down with Meagan on the lead up to their upcoming World Voice Day performance to learn more about the choir.

Can you tell us a bit more about how and why the Key Word Sign Choir began?

I’ve always been fascinated by all forms of sign communication and have studied them for many years. I work in Special Education in a high school setting, so many of the students have used or been exposed to Key Word Sign as a means of communication since early intervention. For me, the idea of forming a Key Word Sign choir began as a way to enhance the students’ communication skills by increasing their “sign” vocabulary in a fun way. From the outset the students loved it, I loved it and their sign vocabulary improved noticeably.

How long has the Key Word Sign Choir been up and running for?

After offering Key Word Sign choir as an extra-curricular activity for many years at school, a parent of a graduating student who particularly loved Sign Choir asked me if I knew of any similar choirs her daughter could join in the community. After some research I wasn’t able to find anything I could refer her to, so the idea of forming a Key Word Sign choir for young adults in the community started to take shape. As I’d been associated with Nordoff-Robbins Music Therapy Australia for many years, the inception of their Community Music Program was the perfect opportunity to pitch the idea of including a sign choir in the program and in 2014 it became a reality and has been going strong ever since.

How has the relationship between Key Word Sign within music and popular culture developed over the years?

The concept of using Key Word signs to perform song lyrics is not a new one but has mainly been confined to preschool & early intervention settings using songs suitable for preschoolers. What I wanted to offer was the opportunity for young adults to learn to sign the lyrics of songs that were age appropriate for them. We currently have a repertoire of more than 80 songs by artists such as Katy Perry, Pink, Sheppard, One Direction, Ed Sheeran, Miley Cyrus & Bruno Mars as well as some classics by ABBA, the Beatles & Queen, (& songs from nearly every Disney musical ever made). The songs we choose to learn are very much driven by the choir members themselves.

Are there any other choirs like this around Australia and the world?

There are quite a few choirs in Australia & around the world using the sign language of the Deaf community of their country (AUSLAN is the language of the Australian Deaf community). Some schools & preschools teach individual songs in Key Word Sign but I don’t know of any other Key Word Sign choirs in Sydney or NSW that are open to people of any age or ability.

Can you share any favourite moments or memories of your time with the Key Word Sign Choir?

Being part of the Key Word Sign choir gives these young adults the opportunity to showcase their unique skills by performing at mainstream events which otherwise might not be available to them. My favourite moments are watching them blossom when they perform and seeing them bask in the audiences’ applause. It never fails to bring a smile to my face (and a tear to my eye). Among the choir’s most memorable moments are performances at various events with well known Australian artists Melinda Schneider & David Taylor. The choir had the privilege of being on stage with them, signing the song with the artist as they sang.

How did you get involved with World Voice Day and where and when can we catch the Key Word Sign Choir performing?

The choir first became involved with World Voice Day in 2015 through our affiliation with Nordoff-Robbins music therapy Australia, who is one of the sponsors of the annual event. The choir also performs regularly at a variety of other events throughout the year such as eisteddfods, festivals, fairs, Carols nights & events celebrating International Day for People with Disabilities.

What inspires you to continue working with the Key Word Sign Choir?

My inspiration to continue working with the Key Word Sign choir is, quite simply, the joy the choir members give me every time we meet. They’re enthusiastic, talented, funny, cheeky and great to be around. It’s my favourite time of the week and seeing each choir members’ confidence and self-esteem grow never fails to make my day.

Thanks to Meagan and each of the members of the Key Word Sign Choir for their time and sharing their talent with Australia.

The Nordoff-Robbins Key Word Sign Choir is performing at the World Voice Day event in Penrith, “Voices in the Valley”, at the Joan Sutherland Performing Art Centre on Saturday 7th April 2018 7:30 pm. Tickets can be purchased here: http://thejoan.com.au/whats-on/voices-valley-world-voice-day-2018/

“Unless stated otherwise, this article represents only the views of the author and not the views of the AVA”

 

 

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World Voice Day Interview with Louise Bale

Louise Bale

In the lead up to this year’s World Voice Day, the Australian Voice Association sat down with Louise Bale to find out what is in store for 2018 and how her own journey with dysphonia has influenced her life.

How and why did World Voice Day start?

WVD began in Brazil in 1999. It was the brainchild of a group of scientists who believed the voice was an amazing, yet under-recognised aspect of the human existence…and that it needed and deserved a day of recognition.

Since it’s inception, WVD has expanded well beyond the scientific community, to become a global celebration of the role our voices play in every aspect of daily life.

What is your role with World Voice Day and what got you interested in the event?

I have been the National Coordinator of WVD in Australia since 2013.

In my ‘real’ world, I work as a Health Promotion professional. While most aspects of health and wellbeing fascinate me – I had never really given much thought to the voice, until I lost mine.  In 2006 I developed a neurological voice disorder called spasmodic dysphonia, and life as I knew it has never been the same.

When I first became aware of WVD I embraced the idea of getting involved and raising awareness of the voice and celebrating its uniqueness, magic and beauty.

Over the years the event’s focus has broadened to include voice care initiatives for teachers, performers and the general population; voice screening clinics for vocal performers, professional development events for voice health practitioners and vocal variety concerts. Since the establishment of the Australian Dysphonia Network in 2016, the various concerts have also been used to draw closer attention to dysphonia and raise funds for research.

Can you tell us a little bit about your journey with spasmodic dysphonia (SD)?

It’s been a very strange experience.  Like so many others, my story began as a mysterious hiccup in an otherwise fairly unremarkable period of my life…that was twelve years ago.

After noticing some voice breaks and feeling like my voice was letting me down, I made a quick trip to see an Ear Nose and Throat Doctor, who ruled out anything like nodules.  It was then off to the speech pathologist to look for bad habits / poor vocal technique.  But, after a few months of correcting the minor technical problems came the crunch, “you have spasmodic dysphonia”.

I was happy to have a diagnosis and thought “OK – Let’s just fix it and get on with life”. But, as we all know, nothing is ever simple.

The ‘gold standard treatment’ is Botox injections into the muscles that control the vocal folds. But I resisted Botox for about a year, trying all things alternate instead. You know the stuff, hypnotherapy, nutritional medicine, acupuncture, massage, mindfulness, kinesiology. etc etc etc. I FELT fantastic, but my voice remained an issue.

After about a year, I finally ‘succumbed’ to Botox and found my voice. A slightly different voice, but smooth, sultry and without spasms, I was in heaven…initially.

Since then the results of Botox have been mixed for me. It’s been a rollercoaster while my brain has adapted, adapted and adapted again (almost saying… ‘bring it on… I will NOT be silenced’). We’ve stopped the Botox, pumped up the vocal folds, restarted the Botox, retrained my brain, and I’ve even been to vocal boot camp.

My diagnosis has changed…from adductor SD to abductor SD…to “is this really SD?” and then back to abductor SD…I started to wonder ‘what’s in a name?’ (Funny really, after having been so keen to have one back at the beginning.)

What led you to seek treatment?

At first, I noticed that my voice was dropping out, kind of like a bad mobile phone signal really. Bits were missing, and it felt like my voice was tripping over itself in otherwise easy and robust conversations. Of course, I imagined that it was all in my head until people started to complain about the “poor mobile reception” (when I was on a landline – now that was a hint).

I had been asked to be MC at a 2-day conference, and needed to do something fast – the rest (and the conference) as they say…”is history”

Has it influenced your day-to-day life and professional life?

Absolutely! I was born to talk, and for many years I had been the public face of my workplace in Health Promotion. The conference facilitator, the presenter and the media spokesperson for all things sex, drugs…. interesting and fun.

BUT that all changed.

I became withdrawn and felt that I was no longer useful. My ability to speak up at meetings, contribute to decision-making discussions, join in lunchtime conversations with the team or even answer phones…had gone. I felt like people thought I was unintelligent because I couldn’t speak up and contribute opinions…I wanted to quit.  But I am fortunate to have a very supportive Director and team who were willing to accommodate whatever I needed.

I saw a psychologist to help me grieve the life I had lost and to regain a sense of self-worth. Since then I have been able to change the way I do my work – carve out new ways of doing old tasks, and also take on some new and exciting roles using social media and web-based technology – I have a unique role in the same workplace and have again found my passion for the work I do.

At home, there are many daily challenges too. A simple thing like going out to dinner is problematic because restaurants and bars are such noisy places. Talking to friends or my husband in the car is extremely hard work. TV or any background noise just creates a wall between others and me in the room BUT…thank goodness for text messaging because the telephone is IMPOSSIBLE for most of us who live with dysphonia.

One of my biggest losses is the ability for natural and spontaneous conversation…the stuff of easy relationships, where conversations just flow.

What are some of your favourite World Voice Day memories from years gone by?

From the outset, I was keen to ensure that the focus was not ONLY on professional/performing voice users but that EVERYBODY’S voice was seen as valued and important. As a result, our annual concerts have seen acclaimed celebrities sharing the stage with members of the community from all walks of life.

Without a doubt, the sentimental favourites have been: the Sydney Street Choir; an inspiring group of homeless and disadvantaged people from our community who embrace the pure joy of singing…the Nordoff Robbins Children’s Signing Choir who express their own unique voice through key-word sign language…and the Newcastle Stroke Choir who demonstrate such determination and tenacity while they celebrate the ability to perform and be heard.

In 2017 the Australian Dysphonia Network team joined forces with a similar organization in the United States to host a 6-day long online symposium which focused on all aspects of dysphonia management. It was an enormous feat bringing together over 3,500 people across the globe; something we hope will become a bi-annual event into the future.

None of the activities or events of the past 5 years would have been possible without the amazing generosity of people who share a passion for giving a voice to EVERYONE. I have also been enormously grateful for the ongoing trust and financial support from the Australian Voice Association, both as an organization and the individuals who represent the AVA.

How is World Voice Day different this year and what are some of the upcoming events you are most excited about?

This year we have decided to extend the opportunity to get involved by expanding from a single day of celebration to an entire month of raising awareness and events.

April this year will become Voice Awareness Month – with the tagline “Value your Voice – Love your Larynx – Be alert for changes”. This will allow people in clinical settings like hospitals and private practices to get involved by utilizing promotional material, organizing events, offering screening clinics, and taking advantage of local internal/external media opportunities…or just getting the platform to TALK about the importance of voice with colleagues and clients.

A master class “Care of the Performing Voice” will be held for tutors, teachers and senior students of the Conservatorium of Performing Arts – Penrith.  This is a first and signifies the beginning of a partnership with the Joan Sutherland Performing Arts Centre which we hope will continue to grow.

We will have the support of celebrity ambassadors: singer/songwriter Melinda Schneider, comedian Anthony Ackroyd, and country music artist Drew McAllister. These amazing people have loaned their voices to our cause and will perform at 2 fundraising events on behalf of dysphonia research.

What would be your advice to someone wanting to get involved this year and/or put on an event for World Voice Day?

Don’t be scared – have fun, be creative and do what feels good. It does not need to be huge to make a difference and raise awareness. Remember (almost) everyone has a voice so it makes it easy to talk about!

If appropriate, you can consider using your event/activity as a charity fundraising opportunity. The Australian Dysphonia Network is currently fundraising for a number of exciting voice initiatives. For further details on how to donate you can find us here.

Feel free to also email me with details of your event, or for ideas at loubale@gmail.com

Where can we find information on events?

Thanks so much to Louise Bale for her time and dedication.

“Unless stated otherwise, this article represents only the views of the author and not the views of the AVA”

Lou Bale is the National World Voice Day Coordinator, President of the Australian Dysphonia Network and is recognised by her work and contribution to the field of Health Promotion with NSW Health for the past 28 years.