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Speech Treatment for Vocal Tremor

presented by Julie Barkmeier-Kraemer PhD

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Vocal tremor affects approximately 1/3 of individuals with essential tremor, Parkinson's disease, and spasmodic dysphonia. To date, the focus of treating these individuals has utilized localized injection of botulinum toxin (Botox®) into laryngeal musculature with mixed benefits. Recent work addressing vocal tremor speech science principles identified patterns that enable improved accuracy in identifying and characterizing vocal tremor patterns. Further, speaking strategies were developed to reduce the opportunity of perceiving vocal tremor during speaking for those with mild to moderately severe vocal tremor. The focus of this course is to summarize the background and principles behind clinical treatment of vocal tremor.

Meet Your Instructor

  • Julie Barkmeier-Kraemer PhD, CCC-SLP

    Julie Barkmeier-Kraemer, PhD, CCC-SLP is a speech-language pathologist and professor in the Division of Otolaryngology, Clinic Director for the Voice Disorders Center, and Adjunct Faculty to the Communication Sciences and Disorders program at the University of Utah. Dr. Barkmeier-Kraemer received her M.A. and Ph.D. degrees from the Department of Speech Pathology and Audiology at the University of Iowa and completed postdoctoral work in the area of neurolaryngology with Dr. Christy Ludlow at the National Institutes of Health. Prior to joining the faculty at the University of Utah, Dr. Barkmeier-Kraemer served in the Department of Speech, Language, and Hearing Sciences faculty at the University of Arizona (1997-2011), after which she joined the Neuroscience Graduate Group as well as the Voice-Speech-Swallowing Center team in the Department of Otolaryngology at UC, Davis (2011-2014). She has served on several ASHA committees, including as a past coordinator for ASHA’s SIG 3: Voice and Voice Disorders, during which time she contributed to the development of the Consensus Assessment Protocol for Evaluation of Voice (CAPE-V) and the Classification Manual for Voice Disorders. She co-chaired the ASHA Annual Research Symposium on Neural Regeneration in 2009, served as ASHA’s representative to the AAOHNS Guidelines on Improving Voice Outcomes after Thyroid Surgery and the American Academy of Neurology’s working group for the development of the Essential Tremor Quality Measurement Set, and served on ASHA’s working group for the development of the Core Instrumental Voice Assessment Protocol completed in 2015. She has published numerous book chapters, one workbook, and several publications in scientific and educational journals related to her clinical and research interests in the neural controls of the larynx for respiration, voicing, and swallowing functions. In 2011, she was awarded Fellow of the American Speech-Language-Hearing Association in recognition of her contributions to the profession.

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Chapters & Learning Objectives

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  1. Introduction to Speech Treatment for Vocal Tremor

    1. Introduction to Speech Treatment for Vocal Tremor

    The purpose of this chapter will be to summarize the key components of the voice evaluation with vocal tremor that are important in determining candidacy and optimal methods for treatment planning the includes speech treatment.

  2. Principles of Speech Treatment for Vocal Tremor

    2. Principles of Speech Treatment for Vocal Tremor

    The purpose of this chapter will be to highlight the key strategies for reducing the perception of vocal tremor during speech treatment.

  3. Voice Evaluation with Vocal Tremor

    3. Voice Evaluation with Vocal Tremor

    The purpose of this chapter will be to highlight the key strategies for reducing the perception of vocal tremor during speech treatment case demonstrations. Participants will identify and describe the key principles regarding vocal tremor, identify and describe therapeutic methods used to achieve speech treatment objectives, and compare and contrast approaches used with individuals that have co-occurring spasmodic dysphonia.