Speech-Language Pathology Streamlined

Procter is part of a group that includes Maurice Goodwin and Stephen D’Amico—both also speech-pathologists for Houston Methodist—who all have professional singing backgrounds and treat voice disorders as speech-language pathologists. “We all have an intimate understanding of the voice in an artistic and in a scientific way,” said D’Amico. “I got into this field after studying music and performing professionally for years,” Goodwin said. "I grew up in a musical family, and, from a young age, was ‘obsessed’ with learning how the voice works. I was lucky enough to attend a conference in 2013 where, for the first time, I met speech pathologists, physicians, voice teachers, voice scientists and other specialists who had similar interests. I knew from that moment on where I wanted to go with my career.” Procter added, “I wanted to be a nurse or a singer and this is a perfect synergy. I get to use my passion for science and research to help rehabilitate voices and vocal folds and have an interpersonal connection with patients which pairs with my singing and performing artist background.”

The care model ideally allows the whole team to collaborate more closely with the voice-specialized laryngologists, ENTs who specialize in the larynx, on the patient’s first visit. Patients undergo a comprehensive assessment to evaluate what may be causing the change in voice. The physician and speech-pathology team, along with the patient, create a plan of care centered on the patient’s individual goal(s) and their quality of life. “One of the greatest assets we have here is the team model,” Goodwin said. “Our goal as a team is to work together, effectively and efficiently, to help the people who seek out our care.” “We prioritize our plan of action within the realistic boundaries of what the anatomy is,” Procter noted. “We provide behavioral interventions, techniques and exercises to help an individual understand how their body works to produce voice. Part of the diagnosis is ‘why’ and ‘how’ they’re using their body and voice that we can potentially manipulate a change to create new or more sustainable patterns to help them through this time,” D’Amico said. “It’s never just one thing when it comes to managing the voice. It can be a lot of different concerns. Each person is a different case,” he adds.

Voice therapy is an option for many patients to manage and hopefully improve their symptoms through a behavioral approach, and it’s an option that comes with an education component. “The recurring theme with my patients is that, despite there being some abnormality to their vocal system, they are able to be introduced to tools and ways of making their voice in a different way where the end result is they produce a voice that feels and sounds easier, clearer and smoother and more like them,” D’Amico said. “They have these perfectly imperfect vocal folds and are making sounds and using their voices in a way that, just because they have it, does not mean they are completely handicapped because of it. They learn how to work with their body and their system where the result is they achieve a voice that is close to normal,” he emphasized. “My goal for helping patients,” Goodwin said, “is a balance between education and functional improvement. I want to help patients make sense of what is going on and plan to achieve their functional communication and enjoyment goals.” Just knowing something is, in fact, going on with your voice is one of the most affirming experiences of the visit, the specialists said. “We’re building exercise physiology for the future,” Procter said, adding there are plans to include outpatient swallowing therapy and evaluation services and continue deep partnerships with the Center for the Performing Arts Medicine. “Every voice matters. Everyone should be able to participate in their daily activities without their vocal cords getting in the way,” said Procter.