UAB speech pathologists at The Kirklin Clinic, with William Boswell in the top row, second from left. This and other images courtesy William Boswell.May is National Speech-Language-Hearing Month, which makes this a great time to learn more about communication disorders and the skilled teams that treat them here at UAB.
The Reporter spoke with William Boswell, a speech pathologist-voice therapist in the Department of Otolaryngology and the UAB Voice Center.
There are roughly a dozen specialists in the Division of Speech and Hearing in the Department of Otolaryngology, along with more than two dozen speech pathologists and audiologists who work at Spain Rehabilitation Center and in acute care, Boswell says.
Here are some other things that set UAB apart.
1. There is a lot going on
“Often people think about the profession of speech pathology as only working with children on articulation issues — that is, children who can’t say the ‘r’ sound,” Boswell said. “That is something we do as a profession, but there is so much more out there that we treat.”
Speech pathologists in the Department of Otolaryngology evaluate and treat adults with disorders of the voice and upper airway, such as muscle tension dysphonia or chronic cough; they treat speech and communication issues post-radiation for cancer treatment and post-surgery; they treat swallowing disorders across the spectrum of diagnoses and disease processes; and they help patients with issues related to facial nerves in the Facial Nerve Clinic (see below).
“And our audiologists perform comprehensive audiological testing, including air, bone and speech testing along with tympanometry, hearing aid evaluations as well as cochlear implant activations,” Boswell said.
“In the Spain Rehab Center and in UAB Hospital, speech pathologists evaluate and treat persons with swallowing, language and cognitive impairments,” he added. “We also have a team of speech pathologists that address feeding and swallowing disorders in the neonatal population. Our audiology team performs newborn hearing screenings and adult hearing evaluations.”
2. Patient numbers are rising for several reasons
The COVID-19 pandemic brought patients suffering from chronic cough as well as voice injuries caused by prolonged intubation, Boswell says.
“We have seen an increase in oropharyngeal cancers, fueled partially by the increase in cancers associated with the human papillomavirus, or HPV,” Boswell said. “These cancers and the treatments for them can result in a range of speech and swallowing issues that our team specializes in treating.”
But the biggest trend on the horizon is the aging population. “We anticipate seeing more patients with aging voice concerns in the coming years,” Boswell said. “They may benefit from the therapeutic and/or surgical treatments we offer at the Voice Center.”
3. The UAB Voice Center is a rare gem
The UAB Voice Center is the only such center in Alabama and one of the few truly interprofessional centers in the United States. Patients are seen by a laryngologist — an ear, nose and throat physician with sub-specialty training — and a voice and upper-airway specialized speech-language pathologist at most visits. “We also have an advanced practice provider who specializes in voice care,” Boswell said.
The Voice Clinic’s co-directors, Blake Simpson, M.D., and Edie Hapner, Ph.D., are internationally recognized for their work in developing new treatments. Simpson pioneered the superior laryngeal nerve block procedure for intractable chronic cough, which has been adopted worldwide. Hapner is the co-developer of a voice therapy, known as Phonation Resistance Training Exercises, or PhoRTE, “that improves vocal loudness and reduces vocal effort in response to the changes in the voice most people experience due to aging,” according to the UAB Voice Center’s website.
The Voice Center treats a number of performing artists. It is a specialty that came naturally to Boswell, a singer-songwriter who performs as a solo act with his acoustic guitar — something “along the lines of James Taylor,” he said — and is part of a drums-guitar-piano trio that spans a range of genres and decades, from Sam Cooke and Elvis classics to modern tunes by the likes of Amos Lee and John Mayer. Boswell’s mother is a speech pathologist. “Being a singer, she thought I might be interested in the voice rehab specialty, so I looked into it and decided to pursue it,” he said. Boswell is not the only vocalist at the Voice Center; Sarah Hoch and current fellow Jacob Wright are also professional vocalists with operatic and musical theater backgrounds who have sought a second career in speech pathology and voice rehab.
Speech pathologists in general cover a wide range of conditions related to communication and swallowing across the life spectrum, Boswell says, and while there are generalists, “a large number do tend to specialize in specific areas, just as physicians do,” he noted.
4. How do you keep your voice in good shape? Use it.
“The voice is a muscle,” Boswell said. “So the ‘use it or lose it’ cliche applies. As we age, our muscles get weaker, but they especially get weaker if we don’t use them. We encourage those in their later years to stay vocally active — talk, socialize, sing and generally use their voices.” Outside of the aging voice, if you experience hoarseness that lasts for more than a few days, an evaluation may be warranted, Boswell says.
5. UAB offers elite care for facial nerve conditions, too
UAB also is home to the interprofessional Facial Nerve Clinic, the only such program in Alabama and one of the first in the Southeast. A wide range of conditions affects facial nerve function, including Bell’s palsy, Ramsay Hunt syndrome and other infectious diseases; facial and head trauma, including surgical or radiation damage; cancers and tumors; and paralysis/tremors of unknown origin. The clinic treats cosmetic issues as well as the functional issues that occur with these disorders, including facial expressions, speech and swallowing.
To make an appointment, visit https://www.uabmedicine.org/make-an-appointment/ or call (205) 934-9999 or (800) 822-8816.
