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Evaluation of Vocal Tremor

presented by Julie Barkmeier-Kraemer PhD, CCC-SLP

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Disclosure Statement:

Financial — Julie Kraemer receives compensation from MedBridge for the production of this course. There are no other relevant financial relationships. Julie Barkmeier-Kraemer is a Professor at the University of Utah in the Division of Otolaryngology and she is Clinic Director for the Voice Disorders Center in the University of Utah Healthcare System. Non-financial — Julie Kramer is part of the working Group responsible for generating the Instrumental Voice Assessment Protocol supported by the ASHA. Julie Kramer’s research is focused on developing diagnostic methods, tools and treatment approaches for those with vocal tremor.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

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Vocal tremor affects approximately 1/3 of individuals with Essential Tremor, Parkinson Disease, and Spasmodic Dysphonia. To date, the focus of treating these individuals has utilized localized injection of botulinum toxin (Botox(R)) into laryngeal musculature with mixed benefit. Recent work addressing vocal tremor speech science principles determined patterns that enable improved accuracy in identifying and characterizing vocal tremor patterns. Furthermore, speaking strategies were developed to reduce the opportunity of perceiving vocal tremor during speaking for those with mild to moderately severe vocal tremor. However, critical to the success of speech treatment for vocal tremor is a thorough evaluation including auditory-perceptual, acoustic, and laryngeal-pharyngeal imaging methods. The focus of this course is to summarize the background and principles behind clinical evaluation of vocal tremor for effective treatment planning.

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…

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Chapters & Learning Objectives

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1. What is Vocal Tremor?

Understanding the characteristics of tremor, in general, and how the physiology of tremor manifests in vocal tremor is critical to clinical evaluation and treatment. This chapter will also define tremor, vocal tremor, and their classifications.

2. Principles Behind the Evaluation of Vocal Tremor: Overview and Auditory-Perceptual Evaluation

This chapter summarizes the research and scientific/clinical principles behind recommended procedures for evaluating vocal tremor using auditory-perceptual methods.

3. Principles Behind an Acoustic Evaluation of Vocal Tremor

This chapter summarizes the research and scientific/clinical principles behind recommended procedures for evaluating vocal tremor using acoustic methods. Clinical evaluations of fundamental frequency, sound pressure level, and formants one and two will be presented along with measuring articulation rate during connected speech samples.

4. Principles Behind the Evaluation of Vocal Tremor: Laryngeal-Pharyngeal Imaging

This chapter summarizes the research and scientific/clinical principles behind recommended procedures for evaluating vocal tremor using laryngeal-pharyngeal imaging. Analysis of speech tasks during observation of the upper airway and its limitations will be presented.

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