CSD 538 01: Management of Phonatory Disorders

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CSD 538 - Management of Phonatory Disorders

2023 Spring Syllabus, Section 01, CRN 5889

Course Information

You are responsible for knowing this material, so please read carefully. Any changes will be announced in a Blackboard Announcement. You will be responsible for any changes. Your continued enrollment in this course is your implicit agreement to abide by the requirements of this class.

3 credits

Times and Location

W 5:30pm-8pm in Columbia Hall 1360

Instructor Information

Nicole Kiel, MS, CCC/SLP

Email: nicole.kiel@und.edu

Office: CSD

2023 Spring Office Hours:
On campus M/W. I am always available by appointment via Zoom.

Office Phone: 701-740-9359

About the Professor

20 years medical SLP (acute, rehab, ENT, HNC)
Dysphagia Specialist
Owner / Endoscopist DakMn Dysphagia Diagnostics
Associate Professor for Voice, Motor Speech and Dysphagia.  Clinic Supervisor for adult therapy. 

Course Description

A study of the diagnosis and management of functional and organic voice disorders in children and adults.

Diagnosis and treatment of voice disorders in adults and children. Emphasis is placed on understanding the underlying physiology as the basis for understanding normal phonation, vocal problems, and intervention techniques. Numerous behavioral techniques and their scientific reasoning are discussed. The course discusses vocal pathologies, the mechanics for vocal function for normal and abnormal conditions, evaluation of vocal function (by instrument, by eye, and by ear), history taking, special populations, and management of voice disorders. Evidence-based practices are discussed, but research in intervention of voice is slow to evolve. Highly effective and physiologically reasonable practices that help clients and patients are well known, understandable, and can be learned.

There are three major parts in this course.

  1. Normal Phonation and Vocal Pathology
  2. Diagnostics and Instrumental Evaluation of Voice
  3. Assessment and Intervention (includes Professional Voice)

Voice therapy requires the clinician to be proficient in controlling her or his body for voice and speech production at different levels, and thus it behooves the student of this course to pay close attention to all exercises performed in class, for these provide insight and skills for direct interaction with clients.

Course content, topics, and practices relative to knowledge and skills adhere to the ASHA “Special Interest Division 3, Voice and Voice Disorders” suggested graduate curriculum guidelines, and exceeds the guidelines relative to practice in behavioral modification techniques, the heart of the voice clinic. The objective is not to create polished voice clinicians but informed and newly skilled entry level practitioners in voice diagnostics and therapy. There will always be some discomfort with your first real voice clients, but this course establishes strong concepts and orientations that are meaningful guides for you.

Learning Outcomes

Upon the successful completion of the student is expected to have demonstrated knowledge of:

  1. Identifies normal voice production by describing quality, pitch, loudness, and resonance (III-B, III-C).
  2. Develops preventative strategies for maintenance of vocal wellness and hygiene (III-D, IV-G 1a).
  3. Obtains a comprehensive case history by documenting information about psychological, psychosocial, developmental, occupational, medical, pharmacological, behavioral, and cultural variables that may influence voice production (III-D, IV-G 1b).
  4. Performs auditory-perceptual evaluations of voice quality using parameters of roughness, breathiness, strain, pitch, loudness, and overall severity of the voice (III-D, IV-G 1c, IV-G 1d, IV-G 1e).
  5. Considers environmental variables (e.g., emotional reactions, social pressures) that may impact the severity of the voice disorder (III-D, IV-G 1d, IV-G 1e).
  6. Utilizes available and appropriate Non instrumental and/or instrumental diagnostic tools (e.g., physiological, acoustic, aerodynamic, and auditory-perceptual) to assess voice (III-D, IV-G 1c).
  7. Differentiates etiologies of voice disorders (i.e., organic, functional, neurogenic) to make appropriate referrals and/or treatment decisions (IV-G 1b, IV-G 1e, IV-G 1g).
  8. Identifies and describes anatomical and physiological sources of hyper- or hypofunction as they relate to voice disorders (III-C, III-D).
  9. Attends to the needs, cultural values, gender roles, and linguistic backgrounds of the client and relevant family members when performing assessments and/or interventions for voice disorders (III-C, IV-G 2e, IV-G 3a, IV-G 3c.).
  10. Considers the development of voice disorders in a broader context that includes the potential presence of concomitant communication disorders such as motor speech and/or swallowing disorders (III-D, IV-G 3b).
  11.  Integrates developmental vocal milestones and expected changes throughout the lifespan during the assessment of voice disorders (III-B).
  12. Displays flexibility in selecting appropriate facilitating voice techniques when assessing the client’s stimulability for improved vocal quality at the time of the initial evaluation and during ongoing treatment (IV-G 1c, IV-G 1d, IV-G 2c, IV-G 2e).
  13. Plans and implements a treatment program to address the individual needs of the client and communication styles of family members based on the results of comprehensive assessment and client and/or family consultation (IV-G 2a, IV-G 2b, IV-G 3a)
  14. Clearly and effectively conveys information to clients and/or their family members regarding a variety of therapeutic choices and their evidence base (III-F, IV-G 2a, IVG 3a, IV-G 3c)
  15. Demonstrates various therapeutic strategies for facilitating the restoration of normal balance between respiration, phonation, and resonance to achieve balanced voice production (IV-G 2c).
  16. Considers implementation of several different procedures to facilitate maintenance and generalization of vocal improvements achieved in the clinical setting (IV-G 2c).
  17. Recognizes procedures for implementing use of speaking valves with tracheostomized patients (III-C, III-D, IV-G 2c).
  18.  Identifies and demonstrates various modalities of communication for alaryngeal speakers (III-D, IV-G 2a, IV-G 2c).
  19. Demonstrates knowledge of tracheoesophageal voice prosthesis management, hygiene, and placement procedures (III-D)
  20. Assists clients with developing and adhering to a plan for managing vocal hygiene (III-D, IV-G 2a, IV-G 2c, IV-G 2e).
  21. Uses appropriate counseling skills to adequately attend to client and family feelings, attitudes, and coping strategies (IV-G 3a, IV-G 3c).
  22. Demonstrates understanding of the roles of various professionals of the multidisciplinary voice team and makes appropriate referrals to other professionals as needed (IV-G 1g, IV-G 2g, IV-G 3b).
  23. Writes evaluation, therapy, and referral reports that adequately explain the nature of the client’s voice disorder and treatment for the client and family (IV-B, IV-G 1f, IV-G 2f ).
  24. Communicates ethical and professional issues inherent in providing services to individuals with voice disorders (III-E, III-G, III-H, IV-G 3d).
  25. Recognizes the potential handicapping nature of the voice disorder and educates the client and/or relevant family members accordingly (IV-G 2a, IV-G 2b, IV-G 3a).

Course Materials

Stemple, J. C., Roy, N., & Klaben, B. K. (2020). Clinical voice pathology: Theory and management, 6th ed. Plural Publishing. ISBN 1635500281

MEDBRIDGE subscription is mandatory.  You will sign up for a calendar year to utilize for Phonatory Disorders, Motor Speech Disorders and Dysphagia courses.  Anna Dumas (CSD Administrative Assistant) will assist with our group registration.  The cost is $50.00 for the year / per person.

Simucase: you will already have a student subscription prior to this course.

Technical Requirements/Assistance

Whether you’re taking courses in the classroom or online, it’s important to have the right technology and equipment.  Visit the UND Technical Requirements webpage for more information. Students are expected to use their official UND email in the course. For technical assistance, please contact UND Technical Support at 701.777.2222. Visit the University Information Technologies (UIT) website for their hours, help documents and other resources.

Minimum Technical Skills Needed

In order to succeed in this course, at a minimum, you should be able to:

  • Navigate in and use basic Blackboard functions
  • Download and open electronic documents
  • Create, save, and upload/attach electronic documents
  • Send, receive, and manage email

Course Logistics

Access and Log in Information

This course was developed and will be facilitated utilizing Blackboard. To get started with the course, please go to: http://blackboard.UND.edu and log in with your NDUS.Identifier, Username and Password. If you do not know your NDUS Identifier or have forgotten your password, please visit Your NDUS Account page on the UIT website.

Course Overview

Weekly agenda posted on Blackboard under syllabus tab
Exam Schedule
Videos, readings, additional tasks under Resources tab
Chapter power points under Content tab

Resources

Many services are available to UND students such as writing assistance from the UND Writing Center, free online tutoring, and more. Visit the Student Resources page for more information. Students also have access to the UND Student Resource Site via Blackboard. It is recommended that you become familiar with the tools and tutorials within the site to better equip you in navigating the course.

Course Requirements/Expectations

  1. The student will review the syllabus and course schedule posted in Blackboard.
  2. The student will access and follow all course instructions found in the weekly area of the Blackboard course.
  3. The student will participate in any lecture or discussion sessions on campus or online as provided and as part of this course.
  4. The student will complete and submit assignments, exams, quizzes, etc. by the dated noted and in the manner described in Blackboard and on the course schedule. We will use Central Standard Time for due dates and times.
  5. The student will participate fully and in a timely manner to get the benefit of learning from instructor and/or peers.

Communication

Email Professor Kiel
Phone: 701-740-0359

Announcements

Announcements will be posted in Blackboard on a regular basis. Be sure to check the class announcements regularly as they will contain important information about class assignments and other class matters.

Email

You are encouraged to post your questions about the course in the FAQs discussion board forum in the Blackboard site or raise them in class if held synchronously or on campus. The Blackboard discussion board is an open forum in which you and your classmates are encouraged to answer each other’s questions. But, if you need to contact me directly, check the Faculty tab in Blackboard or the syllabus for my contact information. I will respond back to you within 48 hours during the week.

Course Etiquette

When participating in class (online or in person) it is important to interact with your peers in an appropriate manner. Always use professional language (no netspeak) in your postings and emails. Please be respectful of your classmates at all times even if you disagree with their ideas.

Assessment Summary

Assignment Points
3 Exams, 100 points each 300
Simucase

20
Vocal Hygiene Reflection Paper

10
Voice Therapy:  Partnered videos of therapy techniques

30
Larynx model

Pass/Fail
Total

360

Grading Scale

100% to 90% A

89.99% to 80% B

79.99% to 70% C

69.99% to 60% D

59.99% to 0% F

Appendix

By satisfactorily completing the evaluations of this course, the student will meet the following ASHA CFCC and/or CAA standards:

Standard Learning Activities Evaluation Criteria
Standard IV-B The applicant must have demonstrated Knowledge of basic human communication and swallowing processes, including the appropriate biological, neurological, acoustic, psychological, developmental and linguistic and cultural bases. The applicant must have demonstrated the ability to integrate information pertaining to normal and abnormal human development across the life span Lectures, Readings, Exams, PBLs Instructor grading
Standard IV-C The applicant must have demonstrated knowledge of communication and swallowing disorders and differences, including the appropriate etiologies, characteristics, anatomical/physiological, developmental, and linguistic and cultural correlates in the following areas: cognitive aspects of communication (attention, memory, sequencing, problem-solving, executive functioning)

Lectures, Readings, Exams, PBLs, Simucase

Instructor grading
Standard IV-D For each of the areas specified in Standard IV-C, the applicant must have demonstrated current knowledge of the principles and methods of prevention, assessment, and intervention for people with communication and swallowing disorders, including consideration of anatomical/physiological, psychological, developmental and linguistic and cultural correlates.

Lectures, Readings, Exams, PBLs

Instructor grading

Course Policies

Assignment Policy

Due dates for each assignment or activity will be posted in Blackboard.

Late Work

All assignments must be submitted by the due dates posted in the course. The acceptance of late assignments is at the discretion of the instructor, if you contact the instructor before the due date and ask for an extension. All requirements for this course must be completed during the course dates. A 10% reduction in grade will be deducted per day the assignment is late. 

Instructor Responsibilities and Feedback

  • The instructor will provide feedback on all assignments and group activities by Wednesday of the following week.
  • The instructor will be available within 48 hours from request to answer questions, provide feedback, and offer advice.  I will email the class when I am traveling and not able to respond in a timely manner. 
     

Class Participation

Students are required to login regularly to the online class site. Students are also required to participate in all class activities such as discussion board, blogs, and wikis Students are expected to attend on campus or synchronous classes, etc.

Incompletes

It is expected that students will complete all requirements for a course during the time frame of the course. For reasons beyond a student’s control, and upon request by the student or on behalf of the student, an incomplete grade may be assigned by the instructor when there is reasonable certainty the student will successfully complete the course without retaking it. The mark “I,” Incomplete, will be assigned only to the student who has been in attendance and has done satisfactory work up to a time within four weeks of the close of the semester, including the examination period, and whose work is incomplete for reasons satisfactory to his or her instructor. More information regarding UND’s Incomplete policy can be found on The Grading System webpage.

Course Evaluation

Around the middle of the semester, we will complete a formative assessment to see how the course is going. Near the end of the semester, you will be asked to complete an online course evaluation form (SELFI). Your feedback on the course is extremely valuable to me. I read my students’ comments carefully and use them to improve the course the next time I teach it.

  • When the time comes, please let me know which aspects of the course helped you learn—and which aspects might be modified to help future students learn more effectively. 
  • Please note that the course evaluations are anonymous and that I won’t see the results until after the grades for the course are submitted, allowing you to provide honest and constructive feedback. 
  • And if you have feedback to offer before the end of the semester, please let me know.

University of North Dakota Policies & Resources

Academic Integrity

Academic integrity is a serious matter, and any deviations from appropriate behavior will be dealt with strongly. At the discretion of the professor, situations of concern may be dealt with as a scholastic matter or a disciplinary matter.

As a scholastic matter, the professor has the discretion to determine appropriate penalties for the student’s workload or grade, but the situation may be resolved without involving many individuals. An alternative is to treat the situation as a disciplinary matter, which can result in suspension from the University, or have lesser penalties. Be aware that I view this as a very serious matter and will have little tolerance and/or sympathy for questionable practices. A student who attempts to obtain credit for work that is not their own (whether that be on a paper, quiz, homework assignment, exam, etc.) will likely receive a failing grade for that item of work, and at the professor’s discretion, may also receive a failing grade in the course. For more information read the Code of Student Life.

Access and Opportunity, Disability Support, & Medical Services

The University of North Dakota is committed to providing equal access to students with documented disabilities. To ensure access to this class and your program, please contact Disability Services for Students (DSS) to engage in a confidential discussion about accommodations for the classroom and clinical settings. Accommodations are not provided retroactively. Students are encouraged to register with DSS at the start of their program. More information can be obtained by email UND.dss@UND.edu or by phone at 701.777.2664.

COVID-19

UND is committed to maintaining a safe learning environment while providing quality learning experiences for our students. COVID-19’s continued presence within our UND community may necessitate changes in classroom management as the academic year progresses. As such, UND asks students and instructors to be flexible when necessary to promote a safe environment for learning. Please do not attend an in-person class or lab if you are feeling ill, particularly if you are experiencing symptoms of COVID-19, or if you have been directed by health professionals to quarantine or isolate. If you are not able to attend class or lab, please notify your instructor as soon as possible and discuss options for making up any missed work in order to ensure your ability to succeed in the course. If you will have an extended absence due to serious illness or other uncontrollable circumstances, you may request an absence notification through the Office of Student Rights and Responsibilities. Similarly, if your instructor is ill they may need to cancel class or temporarily move your course to online delivery to ensure that you are able to complete the course successfully.  Instructors may require students to wear masks in the classroom or in the laboratory as a preventative measure designed to facilitate uninterrupted classroom engagement and to facilitate health and safety in the classroom.   If your instructor does require masks in class or in a laboratory, you are expected to comply with that request.

UND also strongly encourages all members of the University community, including students, to get vaccinated, seek out testing when needed, and model positive behavior both on- and off-campus to foster a healthy and safe learning environment for all students. Individuals who would like to discuss disability accommodations regarding masks should contact the Disability Services for Students (DSS) office at 701.777.2664 or UND.dss@UND.edu. Individuals who are unable to wear a mask due to a sincerely held religious belief should contact the UND Equal Opportunity and Title IX Office at 701.777.4171 or UND.EO.TitleIX@UND.edu.

Religious Accommodations

UND offers religious accommodations, which are reasonable changes in the academic environment that enable a student to practice or observe a sincerely held religious belief without undue hardship on the University. Examples include time for prayer or the ability to attend religious events or observe a religious holiday. To request an accommodation, complete the student religious accommodation request form. If you have any questions, you may contact the Equal Opportunity & Title IX Office.

Pregnancy Accommodations

Students who need assistance with academic adjustments related to pregnancy or childbirth may contact the Equal Opportunity & Title IX Office or Academic Affairs to learn about your options. Additional information and services may be found at Pregnancy Resources.

Notice of Nondiscrimination

It is the policy of the University of North Dakota that no person shall be discriminated against because of race, religion, age, color, gender, disability, national origin, creed, sexual orientation, gender identity, genetic information, marital status, veteran’s status, or political belief or affiliation and the equal opportunity and access to facilities shall be available to all. Concerns regarding Title IX, Title VI, Title VII, ADA, and Section 504 may be addressed to Donna Smith, Assistant Vice President for Equal Opportunity & Title IX and Title IX/ADA Coordinator, 102 Twamley Hall, 701.777.4171, UND.EO.TitleIX@UND.edu or the Office for Civil Rights, U.S. Dept. of Education, 230 S. Dearborn St., 37th Floor, Chicago, IL 60604 or any other federal agency.

Reporting of Discrimination, Harassment, or Sexual Misconduct

If you or a friend has experienced sexual misconduct, such as sexual harassment, sexual assault, domestic violence, dating violence, or stalking, please contact the Equal Opportunity & Title IX Office or UND’s Title IX Coordinator, Donna Smith, for assistance: 701.777.4171; donna.smith@UND.edu; or visit the Title IX webpage. You may also contact the Equal Opportunity & Title IX office if you or a friend has experienced discrimination or harassment based on a protected class, such as race, color, national origin, religion, sex, age, disability, sexual orientation, gender identity, genetic information, pregnancy, marital or parental status, veteran's status, or political belief or affiliation.

Faculty Reporting Obligations Regarding Discrimination, Harassment, or Sexual Misconduct

It is important for students to understand that faculty are required to share with UND’s Title IX Coordinator any incidents of sexual misconduct or of discrimination or harassment based on a protected class that they become aware of, even if those incidents occurred in the past or are disclosed as part of a class assignment. This does not mean an investigation will occur if the student does not want that, but it does allow UND to provide resources to help the student continue to be successful at UND. If you have been impacted by discrimination, harassment, or sexual misconduct, you can find information about confidential support services on the Equal Opportunity & Title IX webpage..

UND Cares Program

How to Seek Help When in Distress

We know that while college is a wonderful time for most students, however, some students may struggle or have issues that arise. You may experience students in distress on campus, in your classroom, in your home, and within residence halls. Distressed students may initially seek assistance from faculty, staff members, their parents, and other students. In addition to the support we can provide to each other, there are also professional support services available to students through the Dean of Students and University Counseling Center. Both staffs are available to consult with you about getting help or providing a friend with the help that he or she may need. For more additional information, please visit the UND Cares Program Webpage.

How to Recognize When a Student is in Distress

The term “distressed” can mean any of the following:

  • Student has significant changes in eating, sleeping, grooming, spending, or other daily activities.
  • Student has cut off or minimized contact with family or friends.
  • Student has significant changes in performance or involvement in academics, sports, extracurricular, or social activities.
  • Student describes problems (missing class, not remembering, destructive behavior) that result from experiences with drinking or drugs.
  • Student is acting withdrawn, volatile, tearful, etc.
  • Student is acting out of character or different than usual.
  • Student is talking explicitly about hopelessness or suicide.
  • Student has difficulty concentrating or difficulty carrying on a normal conversation.
  • Student has excessive dependence on others for company or support.
  • Student reports feeling out of control of one’s emotions, thoughts, or behaviors.

Land Acknowledgement Statement

Today, the University of North Dakota rests on the ancestral lands of the Pembina and Red Lake Bands of Ojibwe and the Dakota Oyate - presently existing as composite parts of the Red Lake, Turtle Mountain, White Earth Bands, and the Dakota Tribes of Minnesota and North Dakota. We acknowledge the people who resided here for generations and recognize that the spirit of the Ojibwe and Oyate people permeate this land. As a university community, we will continue to build upon our relations with the First Nations of the State of North Dakota - the Mandan, Hidatsa, and Arikara Nation, Sisseton-Wahpeton Oyate Nation, Spirit Lake Nation, Standing Rock Sioux Tribe, and Turtle Mountain Band of Chippewa Indians.

Additional Resources

It is my goal to foster an environment of mutual respect in which everyone feels comfortable voicing their opinions, sharing their stories, and learning about potentially heavy or personally relevant material. If, at any point, you feel like the information covered in this class elicits thoughts, feelings, or concerns that you would like to discuss further, don’t hesitate to reach out to me, or the UND Counseling Center (701-777-2127).

Further, if you experience extenuating circumstances, sexual violence, identity-based harm, or any other personal crisis during the semester, don’t hesitate to reach out to me so we can provide academic assistance and help you in this course, and put you in contact with the appropriate resources and services (if needed).