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Voice matters! Q&A with Dr. Diane Bless, voice researcher and NIDCD grantee
Dr. Diane Bless (photo courtesy of Caleb Payne, Harmony Home Photography)
Diane Bless is professor emeritus of surgery and communicative disorders at the University of Wisconsin-Madison. The focus of her teaching, research, and clinical endeavors over the four decades of her career has been on vocal fold functioning, particularly as it relates to assessment and treatment. Dr. Bless has a special interest in singers and others who use their voices for a living.
Most recently her NIDCD-supported research has moved us closer to successful treatments for vocal fold scar, a condition that is difficult to treat and causes significant communicative impairment and reduced quality of life. In recognition of her extensive contributions to the field of voice, Dr. Bless has received numerous prestigious awards, as well as an endowed chair in otolaryngology established in her name at the University of Wisconsin-Madison.
We thought World Voice Day offered an opportunity to ask Dr. Bless to share her insights about the changes she has seen in vocal disorder treatment over the course of her career.
What are some of the biggest changes you’ve seen over the course of your career in how voice disorders are treated, especially among people who use their voices for a living?
When I first started working with individuals with voice disorders, patients were seen by both otolaryngologists and speech-language pathologists (SLPs), although not usually together and often without much communication between the two. Now there are Voice Care Teams. These teams often include SLPs, laryngologists, singing teachers and voice coaches, psychologists, life coaches, neurologists, and gastroenterologists and can be found at most major medical centers across the country.
Forty years ago, we did not have the tools available to us today. No one could have predicted that new voice treatments would be evolving from information gained from bioengineering, material sciences, genetics, immunology, neurosciences, epidemiology, cell and molecular biology, drug delivery techniques, robotic surgery, telemedicine, or animal and computer models.
In the past, speech pathologists often had limited training in how to treat adults with voice disorders, particularly professional voice users. Now, many SLPs specialize in working with individuals with voice disorders. They work closely with singing teachers and voice coaches and often have had voice training themselves. It is now well recognized that singers, actors, and other professional voice users are vocal athletes; they have special demands placed upon their voices. The Voice Care Team helps them achieve whatever is necessary to meet their vocal needs.
How have the training needs for new researchers changed?
Training for SLPs getting their doctorates forty years ago emphasized broad exposure to the field of communication sciences and disorders, with coursework focused on speech, language, science, and statistics. Most graduates went immediately into academic positions without considering additional postdoctoral training.
Subsequently, it became apparent that this training was insufficient. It was clear that it was necessary to provide training that was interdisciplinary and encompassed clinical aspects. Now trainees need to know not only about the basics of anatomy, physiology, laryngeal surgery, behavioral management, and statistics, but they also need to be able to understand the biology and physiology of the laryngeal system.
How important is it for clinicians to have an understanding of basic science and for basic scientists to have some knowledge of clinical research?
The relationship between basic science studies and clinical work has always been important but has not always been recognized in curriculum development and degree programs. In today’s scientific world, it is critical for that crossover to take place. Without this common ground, it is nearly impossible to be a successful researcher. The convergence of knowledge of clinical and basic science is necessary if we are to successfully prepare future researchers for productive collaborations that can take laboratory discoveries into clinical trials.
You’ve spent many years helping people who sing for a living keep their voices healthy, or repairing their voices when they are damaged. Why is singing such an important means of human expression?
I suspect if you asked five different people in the field, you would get five different answers. From my perspective, all vocalization is an important means of human expression, whether it’s talking, laughing, crying or singing. Nevertheless, singing, whether in the shower or on the stage, is clearly special. It has been described as what separates humans from other species. Singing can bring joy, it can be spiritual, it can be sorrowful, it can express shared protests or jubilation, it can cause laughter and tears, and it can link people to each other, to memories, to their own feelings, and to other worlds.
Why singing is such an important means of human expression is one of many things we don’t know about voice. As we learn more about such things as the specific patterns of brain activity that distinguish sung words from spoken words, and why and how singing can be used as a therapeutic agent, we may be able to answer that question.