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See detailVoice use among music theory teachers: A voice dosimetry and self-assessment study
Schiller, Isabel ULiege; Morsomme, Dominique ULiege; Remacle, Angélique ULiege

in Journal of Voice (in press)

Objectives: (1) To investigate music theory teachers’ professional and extra-professional vocal loading and background noise exposure, (2) to determine the correlation between vocal loading and background ... [more ▼]

Objectives: (1) To investigate music theory teachers’ professional and extra-professional vocal loading and background noise exposure, (2) to determine the correlation between vocal loading and background noise, and (3) to determine the correlation between vocal loading and self-evaluation data. Methods: Using voice dosimetry, 13 music theory teachers were monitored for one workweek. Parameters analysed were voice SPL, F0, phonation time, vocal loading index (VLI) and noise SPL. Spearman’s correlation was used to correlate vocal loading parameters (voice SPL, F0 and phonation time) and noise SPL. Each day, subjects self-assessed their voice using visual analogue scales. VLI and self-evaluation data were correlated using Spearman’s correlation. Results: Vocal loading parameters and noise SPL were significantly higher in the professional than in the extra-professional environment. Voice SPL, phonation time and females’ F0 correlated positively with noise SPL. VLI correlated with self-assessed voice quality, vocal fatigue and amount of singing and speaking voice produced. Conclusions: Teaching music theory is a profession with high vocal demands. More background noise is associated with increased vocal loading and may indirectly increase the risk for voice disorders. Correlations between VLI and self-assessments suggest that these teachers are well-aware of their vocal demands and feel their effect on voice quality and vocal fatigue. Visual analogue scales seem to represent a useful tool for subjective vocal loading assessment and associated symptoms in these professional voice users. [less ▲]

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See detailLa voix dans tous ses états. Couleurs vocales: entre voix parlée et voix chantée
Morsomme, Dominique ULiege; Gaspar, Martine

Conference given outside the academic context (2017)

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See detailEvidence-Based Practice Applied To Voice Therapy
Morsomme, Dominique ULiege

Conference (2017, August 30)

Voice therapy supports dysphonic patients. To rehabilitate the dysphonic patient, each voice therapist uses different exercises. These exercises are mostly described in books, which offer a step-by-step ... [more ▼]

Voice therapy supports dysphonic patients. To rehabilitate the dysphonic patient, each voice therapist uses different exercises. These exercises are mostly described in books, which offer a step-by-step acquisition model of the required vocal motor gesture and propose techniques of voice rehabilitation. However, the same technique can cover different therapeutic aspects. Van Stan et al. (2015) recently suggested a taxonomy to clarify therapeutic programs, detail their content and classify them according to their direct intervention category (auditory, vocal function, somatosensory, musculo-skeletal, and respiratory). Sensitize the patient to vocal hygiene, teach the basics of respiratory support, adjust the subglottal pressure, encourage vocal placement in the resonators, replace the wrong motor gesture with another healthier, controlling glottal attacks are the rehabilitation principles basics for voice disorders. All exercises are generally based on raising awareness of both inadequate and adequate vocal gesture by increasing proprioception. The final goal is that the patient gradually regains control over his vocal gesture. To ensure the best treatment to the patient, our approach must rely on the evidence based practice (EBP) principles. The questions we must ask ourselves as clinician are: Which voice techniques, for which patients, with which diagnoses, in what environments, with what effectiveness? This workshop attempts answering the question: how can a voice therapist implement EBP in his clinical practice in order to ensure the best treatment to his patient? To illustrate the process, I opted for a therapeutic approach that has been questioned: manual therapy adapted to voice therapy. I will address the notion of therapeutic efficiency of the manual therapy in the light of the scientific literature, knowing that level 1A or 1B studies on the classification of evidence levels are rare in the field of vocology (Benninger, 2011). To end the workshop, I will present short video sequences of voice therapy with three patients and their therapist who have kindly accepted to be filmed during their sessions. These sequences illustrate how manual therapy is implemented in the treatment of these patients who suffer from presbyphonia, muscle tension dysphonia and nodules respectively. [less ▲]

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See detailVoice use among music theory teachers
Schiller, Isabel ULiege; Morsomme, Dominique ULiege; Sfez, Lou et al

Conference (2017, August 30)

In Belgium, there is a particular group of music teachers referred to as music theory teachers. Working at music schools, they convey theoretical knowledge and practical musical skills to groups of ... [more ▼]

In Belgium, there is a particular group of music teachers referred to as music theory teachers. Working at music schools, they convey theoretical knowledge and practical musical skills to groups of individuals who learn music during their free-time. Even though music theory teachers use both speaking and singing voice intensively at work, little is known about their voice use profiles. This study investigated the vocal loading among French-speaking music theory teachers. Objectives were (1) to describe their professional and extra-professional vocal loading, (2) to determine the relationship between vocal loading and background noise level and (3) to investigate whether objectively measured vocal loading is reflected in music theory teachers’ auto-evaluation of their voice. Using voice dosimetry, 13 music theory teachers were monitored for one workweek. Parameters analysed were F0, voice sound pressure level (SPL), phonation time, vocal loading index (VLI) and background noise SPL. At the end of each monitoring day, subjects self-assessed their voice use by means of visual analogue scales. Results revealed (1) significantly higher vocal loading in the professional context than in the extra-professional context, (2) significant positive correlations between background noise level and the parameters F0, voice SPL and phonation time and (3) significant correlations between the VLI and auto-evaluation data (e.g. voice quality and vocal fatigue). These results highlight that teaching music theory is a profession with high vocal demands. At work, music theory teachers are exposed to high background noise, which seems to influence their voice use and may potentially contribute to the development of voice problems among this population. Visual analogue scales provide a promising tool to subjectively investigate vocal loading among music theory teachers. [less ▲]

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See detailVoice use among music theory teachers
Schiller, Isabel ULiege; Morsomme, Dominique ULiege; Sfez, Lou et al

Conference (2017, August)

In Belgium, there is a particular group of music teachers referred to as music theory teachers. Working at music schools, they convey theoretical knowledge and practical musical skills to groups of ... [more ▼]

In Belgium, there is a particular group of music teachers referred to as music theory teachers. Working at music schools, they convey theoretical knowledge and practical musical skills to groups of individuals who learn music during their free-time. Even though music theory teachers use both speaking and singing voice intensively at work, little is known about their voice use profiles. This study investigated the vocal loading among French-speaking music theory teachers. Objectives were (1) to describe their professional and extra-professional vocal loading, (2) to determine the relationship between vocal loading and background noise level and (3) to investigate whether objectively measured vocal loading is reflected in music theory teachers’ auto-evaluation of their voice. Using voice dosimetry, 13 music theory teachers were monitored for one workweek. Parameters analysed were F0, voice sound pressure level (SPL), phonation time, vocal loading index (VLI) and background noise SPL. At the end of each monitoring day, subjects self-assessed their voice use by means of visual analogue scales. Results revealed (1) significantly higher vocal loading in the professional context than in the extra-professional context, (2) significant positive correlations between background noise level and the parameters F0, voice SPL and phonation time and (3) significant correlations between the VLI and auto-evaluation data (e.g. voice quality and vocal fatigue). These results highlight that teaching music theory is a profession with high vocal demands. At work, music theory teachers are exposed to high background noise, which seems to influence their voice use and may potentially contribute to the development of voice problems among this population. Visual analogue scales provide a promising tool to subjectively investigate vocal loading among music theory teachers. [less ▲]

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See detailL’usage vocal des professeurs de formation musicale
Remacle, Angélique ULiege; Schiller, Isabel ULiege; Sfez, Lou et al

Conference (2017, June 29)

Introduction : En Belgique, les professeurs de formation musicale, ou professeurs de solfège, dispensent une éducation à la musique par un enseignement du langage musical. Plus précisément, ils enseignent ... [more ▼]

Introduction : En Belgique, les professeurs de formation musicale, ou professeurs de solfège, dispensent une éducation à la musique par un enseignement du langage musical. Plus précisément, ils enseignent l’apprentissage de la rythmique, de la lecture et de l’écriture de partitions, la pratique du chant, le développement de l’oreille musicale, ou encore la constitution d’un répertoire de référence. Ces enseignements sont dispensés dans des académies de musique ou des conservatoires. En tant que professionnels de la voix, ces professeurs font partie des travailleurs les plus à risque de consulter un phoniatre pour leur voix (1). Cependant, leur usage vocal reste peu décrit. Cette étude a pour objectif 1) de mesurer la charge vocale de professeurs de formation musicale en contexte professionnel et extra-professionnel, 2) de décrire l’influence du bruit ambiant sur leur voix et 3) d’identifier l’impact de la charge vocale sur leur qualité et leur fatigue vocale. Méthode : 13 professeurs de formation musicale (9 femmes, 4 hommes) ont été enregistrés pendant une semaine complète à l’aide d’un dosimètre vocal (VoxLog) porté du lever au coucher. Le dosimètre mesure la durée de phonation et la fréquence vocale (F0) avec un accéléromètre, ainsi que l’intensité de la voix et du bruit ambiant avec un microphone positionné au niveau du cou. L’analyse du signal est réalisée avec le logiciel VoxLog Discovery. Ce logiciel calcule notamment le nombre d’oscillations des plis vocaux par jour. A la fin de chaque journée, les professeurs ont auto-évalué leur qualité et leur fatigue vocale à l’aide d’échelles visuelles analogiques. Résultats : Les paramètres vocaux et le bruit ambiant sont significativement plus élevés en contexte professionnel qu’extra-professionnel (p<.001). L’élévation du bruit ambiant est accompagnée d’une élévation de l’intensité vocale pour les 13 professeurs (r=.61, p<.001), ainsi que d’une augmentation de F0 pour les femmes (r=.41, p=.002) mais non pour les hommes (r=.39, p=.055). Enfin, le bruit ambiant élevé est associé à une augmentation de la durée de phonation (r=.05, p<.001). L’augmentation du nombre d’oscillations journalier des plis vocaux est associée à une augmentation de la fatigue (r=0.438, p<.001) et à une diminution de la qualité vocale (r=-0.538, p<.001). Conclusion : De façon similaire aux professeurs d’école (2), les paramètres vocaux ainsi que le bruit ambiant sont significativement plus élevés en contexte professionnel. Sur leur lieu de travail, les professeurs d’éducation musicale sont confrontés à un bruit ambiant dépassant la limite recommandée par l’OMS (3). En accord avec l’effet Lombard, ce bruit élevé est associé à une augmentation de l’intensité vocale. Chez les femmes, une voix plus aigüe est observée en environnement bruyant. Comme dans l’étude de Ternström, Södersten et Bohman (4), un bruit ambiant élevé est associé à une durée de phonation plus importante, potentiellement dû à une prolongation des segments voisés par souci d’intelligibilité. En conclusion, les professeurs de formation musicale utilisent leur voix de manière intensive dans le cadre de leur travail, alternant voix parlée et voix chantée. Les corrélations entre le nombre d’oscillations journalier et les auto-évaluations montrent que la quantité de voix utilisée a un impact sur le ressenti des participants. De plus, l’élévation du bruit est corrélée à une augmentation des paramètres de charge vocale. Bibliographie 1. Remacle, A., Petitfils, C., Lejeune, L., Finck, C., & Morsomme, D. (2015, April 10). What is the professional profile of patients in phoniatrics? Oral communication presented at the 4th International Occupational Voice Symposium, London, UK. 2. Remacle, A., Morsomme, D., & Finck, C. (2014). Comparison of vocal loading parameters in kindergarten and elementary school teachers. Journal of Speech, Language, and Hearing Research, 57, 406-415. 3. Inserm. (2006). La voix : Ses troubles chez les enseignants (Expertise collective). Paris : Institut National de la Santé et de la Recherche médicale. 4. Ternström, S., Södersten, M., & Bohman, M. (2002). Correlation of simulated environmental noise as a tool for measuring vocal performance during noise exposure. Journal of Voice, 16(2), 195-206. [less ▲]

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See detailVoice dosimetry in music theory teachers
Schiller, Isabel ULiege; Morsomme, Dominique ULiege; Sfez, Lou et al

Conference (2017, March 28)

BACKGROUND: In Belgium, music theory teachers teach theoretical aspects of rhythm, singing and other music-related skills (such as pitch accuracy or singing in harmony) outside the regular school setting ... [more ▼]

BACKGROUND: In Belgium, music theory teachers teach theoretical aspects of rhythm, singing and other music-related skills (such as pitch accuracy or singing in harmony) outside the regular school setting. To date, their voice use and how it may be affected by background noise have hardly been studied. OBJECTIVES: 1) to determine the relationship between music theory teachers’ vocal loading and background noise and 2) to examine if the daily number of vocal fold vibration cycles (vocal loading index, VLI) is reflected in the teachers’ auto-evaluation of their voice. METHODS: A VoxLog voice dosimeter (Sonvox) was used to monitor 13 music theory teachers for one 6-day workweek from the early morning until late evening. Parameters analysed were fundamental frequency (F0, Hz), voice sound pressure level (SPL, dB), time dose (%), noise SPL (dB), and VLI. At the end of each monitoring day, subjects evaluated their voice quality, vocal fatigue, and amount of speaking and singing voice used by means of a visual analogue scale. RESULTS: Statistical analysis revealed positive correlations between noise SPL and F0, voice SPL and time dose. Correlations were also found between VLI and auto-evaluation data: a rise in VLI accompanied a decrease in self-perceived voice quality, an increase in vocal fatigue and an increase in the perceived amount of singing and speaking voice used. CONCLUSION: Three conclusions were drawn from the results. Firstly, vocal loading measured in music theory teachers is connected to the background noise level. Secondly, a great number of vibration cycles is associated with a self-reported increase in vocal fatigue and a lower general voice quality at the end of the day. Finally, correlations between the number of vibration cycles and the self-reported amount of voice use suggest that visual analogue scales are a reliable method to evaluate daily voice use. [less ▲]

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See detailComment optimaliser sa voix dans le cadre de l'enseignement?
Morsomme, Dominique ULiege; Remacle, Angélique ULiege

Scientific conference (2017, March 07)

Detailed reference viewed: 38 (1 ULiège)
See detailQuand la voix s'enraye. Application de l'EBP à la rééducation vocale.
Morsomme, Dominique ULiege

Scientific conference (2017, February 10)

La rééducation orthophonique des troubles de la voix est un vaste sujet. Mon intention n’est pas de vous exposer des séries d’exercices consacrées à la coordination pneumo-phonique, à la qualité de ... [more ▼]

La rééducation orthophonique des troubles de la voix est un vaste sujet. Mon intention n’est pas de vous exposer des séries d’exercices consacrées à la coordination pneumo-phonique, à la qualité de l’accolement cordal, au placement de la voix dans les résonateurs ou encore à la posture. De nombreux ouvrages orthophoniques expliquent ces pratiques et peuvent aisément enrichir vos connaissances sur le sujet. Après une brève introduction, j’ai choisi de vous présenter une démarche thérapeutique concrète qui repose sur une pratique basée sur les preuves (Evidence Based Practice, EBP). Autrement dit, comment un thérapeute de la voix peut-il implémenter dans sa pratique les bases de l’EBP afin d’assurer le meilleur traitement à son patient. Aussi, pour illustrer mon propos, j’ai opté pour une technique très discutée : la thérapie manuelle. Nous débattrons donc de l’efficacité thérapeutique sachant que les études de niveau 1A ou 1B sur le classement des niveaux de preuves sont rares dans le domaine de la vocologie. Ensuite, je ferai entendre une série de voix pré et post traitements. Cette étape, je l’espère, vous réconciliera avec le concept d’efficacité parfois si compliqué à démontrer. Je clôturerai la séance par une capsule vidéo illustrant des morceaux choisis de la thérapie vocale de trois patientes. Ces patientes et leur thérapeute, Catherine Jansen, ont aimablement accepté de livrer leur voix face caméra. [less ▲]

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See detailLa voix dans tous ses états.
Morsomme, Dominique ULiege

Conference given outside the academic context (2017)

La voix occupe une place prépondérante dans notre vie. Elle fait partie de notre identité. Sur un simple « allo », nous identifions aisément son propriétaire, plus encore nous sommes capables de détecter ... [more ▼]

La voix occupe une place prépondérante dans notre vie. Elle fait partie de notre identité. Sur un simple « allo », nous identifions aisément son propriétaire, plus encore nous sommes capables de détecter son humeur. Si elle s’enraye, elle perturbe non seulement notre capacité à communiquer, mais elle influence également la perception que l’auditeur a de nous. Elle fait l’objet de recherche au carrefour de domaines aussi variés que la médecine, la psychologie, la logopédie et la pédagogie. Nous débuterons cette conférence par voyager dans le monde de la voix via différents échantillons vocaux provenant des 4 coins du monde. Cette expérience auditive nous permettra de prendre conscience des nombreuses capacités de notre système vocale. Ensuite, nous tâcherons de comprendre son fonctionnement et ses caractéristiques. Nous discuterons des professionnels de la voix, ceux que vous croisez tous les jours, les enseignants, les orateurs, les présentateurs. Nous parlerons de la charge vocale et de ce qu’implique un métier à voix. Le concept de dysphonie, trouble de la voix parlée, sera abordé et nous verrons comment la médecine et la logopédie peuvent répondre aux plaintes de patients dysphoniques. Nous terminerons cet exposé par des extraits de films de rééducation afin que vous compreniez mieux en quoi consiste une rééducation vocale. Nous espérons ainsi rendre à la voix la place qu’elle mérite dans notre système social et humain. [less ▲]

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See detailDescription of patients consulting the voice clinic regarding gender, age, occupational status, and diagnosis
Remacle, Angélique ULiege; Petitfils, Cloé; FINCK, Camille ULiege et al

in European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) (2017), 274(3), 1567-1576

Purpose. To describe the gender, age, occupational status and diagnosis of dysphonic patients. Method. We retrospectively analyzed the medical records of 1079 patients examined at the Voice clinic of the ... [more ▼]

Purpose. To describe the gender, age, occupational status and diagnosis of dysphonic patients. Method. We retrospectively analyzed the medical records of 1079 patients examined at the Voice clinic of the University hospital of Liège in French-speaking Belgium. Results. Overall, seven out of 10 patients who attended the voice clinic for dysphonia were females. The patients’ ages ranged from 4 to 93 (mean=43.5). Females predominantly consulted at the age of 54 and males at the age of 9. Regarding the occupational status, workers represented more than half of our patients (53%), while 11.2% were unemployed, 15.4% were students, and 19.9% were retired. Regarding the diagnoses of the 1079 patients, nodules were the most common pathologies (n=182, 16.9% of the patients), prevailing in females (n=142, 18.8% of the females), encountered in 16.8% of the workers and 42.8% of the students consulting the voice clinic. Following nodules, laryngeal mobility disorders were diagnosed in 16.4% of the patients (n=177), mainly females (n=115), and was the most frequent diagnosis in retirees (n=75, 34.9%). Conclusions. The majority of the patients consulting the voice clinic for dysphonia were adult females, in their workforce, diagnosed with vocal nodules. The identification of the patients’ characteristics and diagnoses is important to develop treatments and prevention of dysphonia, estimate their costs, and allow comparisons across referral centers. [less ▲]

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See detailFaire de sa voix, son alliée.
Morsomme, Dominique ULiege; Remacle, Angélique

Conference given outside the academic context (2017)

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See detailL’apport du biofeedback dans le traitement des troubles de la voix
Remacle, Angélique ULiege; Boughabi, Loubna; Morsomme, Dominique ULiege

in Joyeux, Nathaly; Topouzkhanian, Sylvia (Eds.) Actes des XVIèmes Rencontres internationales d’orthophonie: Orthophonie et technologies innovantes (2016, December)

It has recently become possible to monitor patients’ voices outside the speech therapist’s office with a portable, easy-to-use tool: the voice dosimeter. This tool measures voice frequency and sound ... [more ▼]

It has recently become possible to monitor patients’ voices outside the speech therapist’s office with a portable, easy-to-use tool: the voice dosimeter. This tool measures voice frequency and sound pressure level, as well as the duration of phonation, during a full day of regular activities. In addition to voice accumulation in an ecological context, the dosimeter used in this study (VoxLog, Sonvox) gives patients feedback on their voice use. In practice, the clinician configures the device so that it provides a vibratory signal in real time when the patient speaks above or below a predetermined frequency or sound pressure threshold. The feedback is intended to make patients aware of inappropriate vocal behavior and encourage them to change it. In this case study, we used biofeedback with the aim of reducing sound pressure level for a teacher suffering from vocal fold nodules. Our goal was to determine whether vibrotactile biofeedback applied in an ecological context for three consecutive weeks could reduce excess sound pressure. The feedback was activated every time the teacher spoke too loudly; its purpose was to help her avoid vocal abuse and (re)learn healthy vocal behaviors. This preliminary study generated encouraging results regarding the use of biofeedback in voice treatment. Nevertheless, it is important to investigate how this tool can best be implemented for patient management in speech language pathology. In addition, the method should be validated with randomized studies using a larger sample. [less ▲]

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See detailLong-Term Results of 18 Fat Injections in Unilateral Vocal Fold Paralysis
PAGANO, Rémi ULiege; Morsomme, Dominique ULiege; CAMBY, Séverine ULiege et al

in Journal of Voice (2016)

Summary: Objective. The purposes of this study were to assess the long-term efficacy of medialization laryngo- plasty via injection of autologous fat in patients with unilateral laryngeal paralysis, and ... [more ▼]

Summary: Objective. The purposes of this study were to assess the long-term efficacy of medialization laryngo- plasty via injection of autologous fat in patients with unilateral laryngeal paralysis, and to discuss the results based on the volume of fat injected and the size of the initial glottic gap. Study design. This was a retrospective study with clinical reevaluation of 18 patients treated for unilateral laryn- geal paralysis at Liège University Hospital between April 1, 2011, and December 1, 2014. Method. The voice examination included subjective scales (GRBAS and the Voice Handicap Index), a report on acous- tic and aerodynamic voice parameters, and laryngostroboscopic assessment of glottic closure and mucosal wave (T0: preoperative; T1: immediate postoperative; T2: >1 year). Results. The median follow-up duration was 19 months. We observed a significant improvement in maximum pho- nation time; mean flow rate; jitter; the Voice Handicap Index; the G, R, B, and A subscales of the GRBAS-I; and glottic closure at T1. These parameters remained stable over time, without any significant difference except for shimmer and glottic closure between T1 and T2. Regardless of the volume of fat injected and the magnitude of the initial glottic gap, we did not see any significant difference from one assessment time to another. Conclusion. Medialization laryngoplasty by means of the injection of autologous fat is a safe, effective surgical tech- nique for patients with unilateral laryngeal paralysis regardless of the size of the initial glottic gap. The results are maintained longer than 1 year, and no evidence of significant resorption of the fat was found in our study over a period of 12–58 months. The volume of fat injected does not seem to affect the functional results. Key Words: Glottic insufficiency–Glottic closure–Glottic gap–Laryngeal paralysis–Vocal fold paralysis–Laryngoplasty– Autologous fat–Fat injection. [less ▲]

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See detailFéminiser la voix
Morsomme, Dominique ULiege; Remacle, Angélique ULiege

in De la voix parlée au chant: Bilans, rééducations, pathologies de la voix parlée et chantée (2016)

Dans ce chapitre, nous présentons la voix du point de vue du genre. En effet, l’Unité Logopédie de la Voix (www.logopedie-voix.be) s’intéresse entre autres à la féminisation vocale chez les personnes ... [more ▼]

Dans ce chapitre, nous présentons la voix du point de vue du genre. En effet, l’Unité Logopédie de la Voix (www.logopedie-voix.be) s’intéresse entre autres à la féminisation vocale chez les personnes transidentitaires, en processus de changement de genre. Ces personnes ne s’identifiant pas au sexe et au genre qui leur ont été attribués à la naissance, elles éprouvent un désir profond de vivre comme une personne du sexe opposé à leur sexe biologique. Lors du processus de transition où ont lieu les transformations nécessaires au changement de genre, l'orthophonie a pour but d’améliorer la cohérence entre l’apparence de la personne et sa voix. Ainsi, notre recherche se focalise sur ce qui distingue la voix féminine de la voix masculine. Nous visons à développer des stratégies de féminisation vocale, portant sur des paramètres tels que la fréquence fondamentale de la voix, les formants, les contours intonatifs, le débit de parole, le rythme, ou encore le vocabulaire choisi. Féminiser une voix, c’est chercher à comprendre ce qui permet d’en identifier le genre, mais également participer à la construction de l’identité de la personne à part entière. [less ▲]

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See detailLe repos vocal : Pourquoi, comment, et dans quelles circonstances ?
Remacle, Angélique ULiege; Morsomme, Dominique ULiege

in De la voix parlée au chant: Bilans, rééducations, pathologies de la voix parlée et chantée (2016)

Régulièrement recommandé à des fins préventives ou curatives, le repos vocal favorise la récupération dans différentes circonstances. Bon nombre de phonochirurgiens l’incluent dans les soins ... [more ▼]

Régulièrement recommandé à des fins préventives ou curatives, le repos vocal favorise la récupération dans différentes circonstances. Bon nombre de phonochirurgiens l’incluent dans les soins postopératoires, avant une éventuelle prise en charge orthophonique. Le repos vocal permet également de résorber une simple fatigue ressentie suite à un usage intensif ou inhabituel de la voix, ou peut faire l’objet d’une indication thérapeutique dans le cadre de lésions consécutives aux phonotraumatismes. Compte tenu du manque de données scientifiques et de la diversité des pratiques sur le sujet, il n’est pas toujours aisé de donner des indications claires aux patients, souvent réticents à l’idée de ne pas pouvoir utiliser leur voix pendant une durée prolongée. Basé sur des recherches récentes et sur des expériences cliniques, ce chapitre permet de mieux comprendre l’intérêt du repos vocal et suggère des lignes de conduites quant à la manière de l’organiser [less ▲]

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See detailRééducation orthophonique des troubles de la voix
Morsomme, Dominique ULiege

Scientific conference (2016, September 29)

La rééducation orthophonique des troubles de la voix est un vaste sujet. Mon intention n’est pas de vous exposer des séries d’exercices consacrées à la coordination pneumo-phonique, à la qualité de ... [more ▼]

La rééducation orthophonique des troubles de la voix est un vaste sujet. Mon intention n’est pas de vous exposer des séries d’exercices consacrées à la coordination pneumo-phonique, à la qualité de l’accolement cordal, au placement de la voix dans les résonateurs ou encore à la posture. De nombreux ouvrages orthophoniques expliquent ces pratiques et peuvent aisément enrichir vos connaissances sur le sujet. Après une brève introduction, j’ai choisi de vous présenter une démarche thérapeutique concrète qui repose sur une pratique basée sur les preuves (Evidence Based Practice, EBP). Autrement dit, comment un thérapeute de la voix peut-il implémenter dans sa pratique les bases de l’EBP afin d’assurer le meilleur traitement à son patient. Aussi, pour illustrer mon propos, j’ai opté pour une technique très discutée : la thérapie manuelle. Nous débattrons donc de l’efficacité thérapeutique sachant que les études de niveau 1A ou 1B sur le classement des niveaux de preuves sont rares dans le domaine de la vocologie. Ensuite, je ferai entendre une série de voix pré et post traitements. Cette étape, je l’espère, vous réconciliera avec le concept d’efficacité parfois si compliqué à démontrer. Je clôturerai la séance par une capsule vidéo illustrant des morceaux choisis de la thérapie vocale de trois patientes. Ces patientes et leur thérapeute, Catherine Jansen, ont aimablement accepté de livrer leur voix face caméra. Et enfin, si le temps nous le permet, je vous inviterai à pratiquer deux ou trois exercices vus dans la vidéo. [less ▲]

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See detailNormative data on teachers’ voice use in real-life situations
Schiller, Isabel ULiege; Morsomme, Dominique ULiege; Alcoulombre, Anaëlle et al

Conference (2016, August 25)

Background As part of their working routine, teachers use their voice for extended periods of time. To compensate for adverse acoustic conditions and background noise, they are also required to speak at ... [more ▼]

Background As part of their working routine, teachers use their voice for extended periods of time. To compensate for adverse acoustic conditions and background noise, they are also required to speak at high intensities. Since teaching is acknowledged to be vocally demanding, several studies have investigated teachers’ vocal load, that is, the stress inflicted on the larynx during vocalization, which is thought to be influenced by duration, intensity and frequency of phonation. A promising method for analyzing teachers’ phonatory behavior in real-life situations is the use of a portable voice dosimeter that objectively documents vocal parameters. Depending on several factors, those parameters may vary within the teaching profession (Masuda et al., 1993; Morrow and Connor, 2011; Remacle, Morsomme, and Finck, 2014). With the aim of quantifying their vocal parameters and identifying the most at-risk teaching conditions, we have established a large database of French-speaking teachers. Based on this database, this study analyzed vocal loading differences with regard to gender, teaching level, and environment (professional versus extra-professional). Methods Seventy-six French-speaking teachers (15 males and 61 females) were monitored during one workweek using the Ambulatory Phonation Monitor voice dosimeter (KayPENTAX). The subjects included 21 kindergarten, 20 primary and 35 secondary school teachers. All male subjects were in the latter group. The vocal parameters analyzed were phonation time, intensity and fundamental frequency (F0). Results The statistical analysis revealed that, irrespective of gender, phonation time, F0 and intensity level were significantly higher in the professional environment than the extra-professional environment (p<.01). Among female subjects, the F0 of kindergarten teachers was significantly higher than that of primary school teachers, which in turn was higher than that of secondary school teachers (p<.01). The phonation time and intensity were also higher in female kindergarten teachers than other female teachers, but this difference did not reach significance. As expected, regarding gender differences, we found that female secondary school teachers spoke with significantly higher F0 than their male colleagues (p<.001). In the extra-professional setting, they also spoke with a significantly higher intensity (p<.05), but no such effect was found in the professional environment. Conclusion Overall, our subjects showed an increase in vocal loading parameters when they were at work compared to their free time. This confirms the results of earlier studies and demonstrates that teaching is an occupation with remarkably high vocal demands. The analysis of mean frequency showed that lower school levels were associated with higher-pitched voice. It can be assumed that kindergarten teachers adapt to the higher F0 of their young pupils and that their effort to maintain the pupils’ attention results in greater frequency variations. References Masuda, T., Ikeda, Y., Manako, H., & Komiyama, S. (1993). Analysis of vocal abuse: Fluctuations in phonation time and intensity in 4 groups of speakers. Acta Oto-Laryngologica, 113(3), 547–552. Morrow, S. L., & Connor, N. P. (2011). Comparison of voice-use profiles between elementary classroom and music teachers. Journal of Voice, 25(3), 367–372. Remacle, A., Morsomme, D., & Finck, C. (2014). Comparison of vocal loading parameters in kindergarten and elementary school teachers. Journal of Speech, Language, and Hearing Research, 57(2), 406–415. [less ▲]

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See detailThe influence of background noise on vocal loading parameters in music theory teachers
Schiller, Isabel ULiege; Morsomme, Dominique ULiege; Sfez, Lou et al

Poster (2016, August 23)

Background: Music theory teachers, who teach rhythm, singing and other music-related skills and topics, depend greatly on a well-functioning voice. Unlike other schoolteachers, who primarily use their ... [more ▼]

Background: Music theory teachers, who teach rhythm, singing and other music-related skills and topics, depend greatly on a well-functioning voice. Unlike other schoolteachers, who primarily use their voice as a pedagogic tool, music theory teachers also use it as an instrument. Furthermore, they often engage in vocally demanding free-time activities requiring a singing voice. To date, few studies have specifically looked at the voice use of music theory teachers. This study aims (1) to measure the background noise level and the amount of vocal loading affecting this specific population, and (2) to describe the influence of background noise on vocal loading parameters. Methods: Thirteen French-speaking music theory teachers (9 females and 4 males) working in a music school were monitored for one workweek, using the VoxLog voice dosimeter (Sonvox). To investigate the professional and extra-professional environments, all subjects wore the dosimeter from early morning until the end of the day. The parameters analysed were background noise level, duration of phonation, sound pressure level (SPL) and fundamental frequency (F0) of voice. Results: Overall, the mean background noise level was 75.2 dB (SD=5.4). We measured higher background noise level at work (mean=78.2 dB, SD=5.8) than in the extra-professional environment (mean=72.2 dB, SD=5.2). As expected, a rise in background noise was accompanied by a significant rise in voice SPL in both males and females (r=.61, p<.001). A significant correlation between background noise and F0 was found in females (r=.41, p=.002), but not in males (r=.39, p=.055). Furthermore, our data exhibit a significant correlation between background noise and duration of phonation (r=.05, p<.001). Conclusion: Our data suggest, that in class, music theory teachers must cope with background noise levels that dramatically exceed the limit of 35 dB recommended by the WHO (Inserm, 2006). High background noise levels lead to an increase in voice SPL, a phenomenon known as the Lombard effect (Inserm, 2006). In female subjects, we also observed a rise in F0 further to high background noise. Like Ternström, Södersten, and Bohman’s (2002) study, our data indicate that high background noise levels increase the duration of phonation. In a noisy environment, subjects seem to prolong the voiced segments of speech to make themselves understood. In other words, high background noise levels result in higher vocal loading. In the long run, this may increase the risk of voice disorders such as hyperfunctional dysphonia or vocal fold pathologies consecutive to repeated microtrauma in music theory teachers. [less ▲]

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See detailFéminiser la voix
Morsomme, Dominique ULiege; Remacle, Angélique ULiege

Scientific conference (2016, April 19)

Notre exposé sur la féminisation se centre principalement sur l’acquisition de patterns féminins dans le cadre d’une prise en charge chez les personnes souffrant de dysphorie de genre. Nous discutons de ... [more ▼]

Notre exposé sur la féminisation se centre principalement sur l’acquisition de patterns féminins dans le cadre d’une prise en charge chez les personnes souffrant de dysphorie de genre. Nous discutons de la voix en tant qu’identité de genre et de l’importance pour certaines personnes d’être perçue comme femme. Féminiser la voix est un défi tant les contraintes anatomo- physiologiques peuvent mener la vie dure à nos techniques de prises en charge. La recherche s’attèle à enrichir nos outils techniques pour une rééducation efficace et satisfaisante. A la lumière de la littérature scientifique, nous faisons le point sur les traitements chirurgicaux et orthophoniques, et proposons une prise en charge en 9 étapes. Celle-ci aborde les points suivants:
 Geste vocal sain, soutien respiratoire, hauteur tonale, résonance, courbes intonatives, contrastes intonatifs, volume, débit, articulation, langage et comportements non verbaux. [less ▲]

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