The Role of the Speech-Language Pathologist, the Teacher of Singing, and the Speaking Voice Trainer in Voice Habilitation
ASHA Ad Hoc Joint Committee With the National Association of Teachers of Singing and the Voice and Speech Trainers Association
About this Document
This is an official joint technical report of the American Speech-Language-Hearing Association (ASHA), the National Association of Teachers of Singing (NATS), and the Voice and Speech Trainers Association (VASTA). Members of the Ad Hoc Joint Committee With the National Association of Teachers of Singing, and the Voice and Speech Trainers Association responsible for developing this statement were ASHA Special Interest Division 3, Voice and Voice Disorders representatives Mary Sandage (chair), Janet Graves-Wright, Reinhardt Heuer, Katherine Verdolini, and Michelle Ferketic (ex officio). NATS representatives were Jean Westerman Gregg and Ingo Titze. VASTA representatives were Kate DeVore and Bonnie Raphael. Celia Hooper, vice president for professional practices (2003–2005), served as monitoring vice president for ASHA.
Since the founding of the American Speech-Language-Hearing Association (ASHA) in 1925, the founding of the National Association of Teachers of Singing (NATS) in 1944, and the founding of the Voice and Speech Trainers Association (VASTA) in 1986, there has been increasing awareness of (a) the importance of having healthy laryngeal function in all styles of speech and singing and (b) the existence of a connection between optimal vocal usage in speech and optimal vocal usage in singing. The fundamental mechanism for healthy phonation is essentially the same for both singing and speaking. Therefore, it is recognized by ASHA, NATS, and VASTA that the etiology of a voice disorder may be related to either improper singing or to improper speaking technique.
Historically, rehabilitation of the speaking voice related to disorders of laryngeal maturation and function has been the province of qualified speech-language pathologists, with special attention given to the prevention and remediation of voice disorders to restore and maintain normal voice function. Development of the voice to its maximum function for use in singing has been the province of teachers of singing, with attention given to the development of full pitch and dynamic range, artistic quality, and vocal endurance of the singing voice. Similarly, the development of basically normal speaking voices to their maximum potential for use in performance, public address, and teaching has been the province of voice and speech trainers, teachers, and coaches, with primary attention given to developing essentially normal voices into instruments capable of optimum resonance, range, clarity, expressiveness, and endurance. This traditional division of labor has resulted in separate, independent work conducted in a serial approach for the vocal training and habilitation/rehabilitation of speakers and singers.
In recent years, there has been increasing awareness within ASHA, NATS, and VASTA that this separatist approach may not be in the best interest of speakers and singers with voice problems or disorders. Rather, all three organizations acknowledge that the most effective path to vocal recovery often will include an integrated approach to optimal voice care and production that addresses both speech and singing tasks. ASHA, NATS, and VASTA therefore collectively affirm the importance of interdisciplinary management of speakers and singers with voice problems and disorders, with the management team ideally consisting of some or all of the following individuals: an otolaryngologist, a speech-language pathologist, and a singing teacher, and/or speaking voice and speech trainer.
ASHA, NATS, and VASTA recognize that there is a variety of possible configurations for such teams: Some ASHA-certified speech-language pathologists may be experienced teachers of singing who are members of NATS and/or qualified voice and speech trainers. Similarly, there may be some otolaryngologists who hold ASHA certification in speech-language pathology or who are members of NATS or VASTA. And there are also a number of voice and speech trainers who are members of ASHA and/or NATS. However, ASHA, NATS, and VASTA recognize that such multiple specialization is rare and that in most cases, the management team will need to consist of at least three individuals.
Although ASHA, NATS, and VASTA recognize the differences in both professional preparation and the primary goals of their respective membership, all three organizations acknowledge the need for broader, interdisciplinary training of speech-language pathologists, teachers of singing, and voice and speech trainers who plan to work with professional voice users. The following general guidelines are recommended:
The preparation of the speech-language pathologist who works with singers, actors, and other professional speakers (e.g., clergy, politicians, teachers, and radio and television announcers) needs to be augmented to include instruction in vocal pedagogy (the art and science of teaching voice) and vocal performance to develop both the singing voice and speaking voice to optimum levels of health, performance, and artistry.
The preparation of the teachers of singing needs to be augmented in a comparable manner to include training in anatomy and physiology, behavioral management of voice problems, development of the speaking voice, and the singing teacher's role in working with the speech-language pathologist and the physician in the medical management of voice disorders.
Similarly, the preparation of voice and speech trainers who work with singers and other professional speakers needs to include instruction in anatomy and physiology, behavioral management of voice problems, singing pedagogy and performance, and the voice and speech trainer's role in working with the speech-language pathologist and the physician in the medical management of voice disorders.
ASHA, NATS, and VASTA mutually affirm that the following areas remain the province of our individual organizations to act upon as desired: (a) the development of more specific training requirements for individual members who elect to work with speakers and singers with voice disorders, (b) the development of criteria for evaluation and subsequent recommendation and/or accreditation of training programs, and (c) the development of criteria for identification and/or certification of individual members who obtain the recommended specialty training.
Furthermore, ASHA, NATS, and VASTA recognize the existence of state licensure laws that govern delivery of services to persons with communication disorders, including voice disorders. All persons who work with speakers and singers with voice disorders are encouraged to become familiar with these laws. ASHA, NATS, and VASTA affirm that it remains the responsibility of the individual practitioner to ensure that his or her work with singers and other professional voice users does not violate the scope of practice defined by the laws in the state(s) where the work is done.
ASHA, NATS, and VASTA encourage their members to cooperate in the development and delivery of interdisciplinary programs and services for singers and other professional voice users with voice disorders.
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