Special Considerations in Evaluating Professional Singers
Speech-language pathologists (SLPs) who specialize in the area of voice disorders have routine evaluations for the typical voice patient; however, when working with professional singers, there are a multitude of factors to be considered outside of the routine evaluation. This population has a different set of expectations for their voice which aren’t typical for the average person. Patient centered care should be at the forefront of clinical decision making as every performer is unique. Therefore, the SLP should be familiar with the demands of different musical genres. For example, music theatre has different styles including lyrical singing and “belting,” which is a more powerful sound that imitates speech-like inflections but in a higher than normal range for the singer’s speaking voice. When done incorrectly, belting can be extremely harmful for the vocal folds which can be detrimental to people who use their voices professionally. However, no significant impacts will likely be seen with the typical voice user, so don’t worry about telling your patient that they can’t “rock out” to their favorite songs in the shower!
As with any new patient, obtaining an in-depth history is extremely important. Finding out information about their typical lifestyle habits and environmental factors (including hydration, diet, exercise regimens, and participation in phonotraumatic habits like smoking, excessive throat clearing, whispering or screaming, etc.) is important to better understand the patient and his/her lifestyle. While asking questions such as these can provide valuable information, asking patients what they think/feel and having them describe their problem is essential to helping them feel heard while also building rapport.
A detailed case history is important for every patient; however, additional factors are important to consider when specifically working with this population. Singers are often expected to perform with added challenges, such as unnatural posturing when holding an instrument or performing choreography and performing in costumes or props that may affect range of movement, posture, balance, or muscle tension of the primary accessory muscles and other respiratory muscles. Environmental barriers such as fog machines, dust, loud background noise, or poor amplification/acoustics may also heighten vocal burden or irritation. Even when challenges arise, singers may be unable to cancel a performance or lessen vocal use due to potential loss of revenue as their salaries may be dependent on performances and additional events like meet and greet sessions.
While there are many similarities between your typical voice patient and professional singers, there are also several important distinctions when obtaining an in-depth case history and being able to complete a proper evaluation. This isn’t a comprehensive guide to assessing professional singers, rather the goal of this discussion is to bring general awareness to the different considerations which exist when working with this population during initial evaluations. While treatment and rehabilitation services for this population should only be provided by highly specialized SLPs who have plenty of experience and comprehensive knowledge of the best evidence based practices, it’s important that all SLPs have a general understanding of the different populations that they may encounter within their practice.
Rubin, Adam D., and Juliana Codino. “The Art of Caring for the Professional Singer.” Otolaryngologic Clinics of North America, vol. 52, no. 4, 2019, pp. 769–778., doi:10.1016/j.otc.2019.03.019.