Principle Set #2 : The “what” of voice training and therapy : Perceptual-motor learning

1. Principle Set #2:The “what” of voice training and therapy: Perceptual-motor learning Kittie Verdolini Abbott, PhD, CCC-SLP; 2011 Communication Science and Disorders School of Health and Rehabilitation Sciences

4. Whatto train in voice therapy The best answer depends on learner needs and goals “Idealized” focus was Barely ad/abducted VFs Semi-occluded vocal tract Clinician may elect to address other issues as well, depending on clinician and patient Posture Breathing Larynx Jaw Tongue Neck adjustments Etc. Where we left off

5. “Please abduct your vocal folds by 0.6-0.7 mm, at the vocal processes.” “Please utilize a narrowed epilarynx while you’re at it.” cheezburger.com cheezburger.com But “how” to train???

6. Teacher of singing and early speech-language pathologist “The big gulf.” My history with the question

7. The “how” of training How do people acquire new physical behaviors? Especially relevant for behaviors in miniscule structures not available to vision. Prompted Ph.D. studies (cognitive science – motor learning) Interest evoked

8. Mechanisms involved in acquiring new motor patterns (and overriding old ones) Definition of motor learning Cognitive mechanisms in motor learning Law of practice Structuring practice Implications for voice training This talk

9. Motor Learning “A set of processes associated with practice or experience leading to relatively permanent changes in the capability for movement.” (Schmidt & Lee, 1999) Intro: Definitions

10. Seen shortly in discussion of “laws of practice” Things we do in the clinic to improve immediate performance may mess up learning seen in the long term Things we do in the clinic that mess up immediate performance may enhance learning seen in the long term Intro: Implications

11. Key concept is that motor learning = perceptual-motor learning Seen for example in studies of neurological substrates in motor learning Intro: Of interest

12. Summary from Cabeza & Nyberg, 2000 (p. 30); regions of activation

13. One fruitful model for has to do with distinction between “declarative” versus “procedural” learning Definitions Declarative learning:  Memory for specific events and general facts about the world; seen by verbal reports (“introspection”) Procedural learning:  Memory for processes or procedures; seen by performance changes following practice or exposure (not verbal reports or insight) E.g. Squire, 1986 Model of motor learning

14. Model of motor learning • Evidence of distinction: • Declarative learning impaired in amnesia (damage to hippocampus and amygdala) • Procedural learning spared in amnesia (does not depend on hippocampus and amygdala) • E.g. Milner, 1962

15. Implication: “Book learning” and “motor learning” depend on different neuroanatomical substrates Declarative memory depends on hippocampus and amygdala Procedural memory does not depend on hippocampus and amygdala Model of motor learning

16. Further implication: Motor learning can and does occur without conscious memory of prior training—i.e. without conscious support of what has been learned What are further cognitive characteristics of the system that learns motor things? Note: Notions of an entirely “clean distinction” between declarative and procedural learning has been challenged; for simplification we will set those aside today and consider characteristics of the “procedural” system which is certainly involved in motor learning. Model of motor learning

17. Declarative learning Conscious Associational Intentional Flexible Slow serial processing Phylogenetically and ontogenetically new Vanishing, unstable Attention-dependent Repetition-dependent Procedural learning Non-conscious Sensory/perceptual Incidental Stereotypic Fast parallel proc-g Phylogenetically and ontogenetically old Stable over time Attention-dependent Repetition-dependent (massive, for habit formation) Note: Data largely from verbal “priming” studies Review by Verdolini (1997) Model of motor learning

18. Attention • Attention: • Attention to mechanics: Harms both performance and learning (e.g. ski simulator; Wulf & Weigelt, 1997; image Wulf et al., 1997; image from Lee, 2002) • Instructions around mechanics: Harm motor performance and learning, even if metaphorical (“pretend you are…x”) (e.g. tracking task, Verdolini-Marston & Balota, 1994; voice task, Verdolini et al., in preparation)

19. Does attention to mechanics harm learning because they direct attention to an internal (versus external) locus? Data on internal versus external locus of attention: Attention to force of feet on platform (internal focus), as opposed to force of feet on wheels below platform (external focus) decreased performance and learning (ski simulator; Wulf, Höß, and Prinz, 1998) Attention to swing of arm (internal focus), as opposed to swing of club (external focus) decreased performance and learning (accuracy in golf task; Wulf, Lauterbach, & Toole, 1999) Attention, cont’d

20. Is the benefit of an external locus of attention really due to the external locus, or because an external locus is often focused on movements’ effects? Data on movements’ effects: Is external locus of attention better because you’re not paying attention to the mechanics, or because you are paying attention to movements’ effects? Addressed in tennis study: attention to events antecedent to swing (approaching ball) produced poorer performance and learning than attention to movements’ effects (arc of ball as it left raquet; Wulf, McNevin, Fuchs, Ritter, & Toole, 2000) Attention

21. Current conclusions: Attention to gestures’ effects may be vastly better for both performance and motor learning, as compared to attention to mechanics. What are implications for voice training models? Attention

22. Metaphoric imagery (associational processing) widely used in voice training ASHA Division 3 query (2003): 37/500 (ca.) responders; 35/37 use imagery sometimes, often, or extensively (95%) Colton & Casper (1996) VASTA Newsletter (2003) Journal of Singing (2003) Metaphoric images vs perceptual processing

23. Metaphoric images vs perceptual processing • Question • Is metaphoric imagery helpful in physical training in general, and in voice training in particular? • Verdolini-Marston & Balota, 1994; Verdolini et al., in preparation

24. Metaphoric images vs perceptual processing

25. cc/sec Metaphoric images vs perceptual processing • Image of feedback people got in the airflow study

26. Groups Metaphoric imagery (associational processing) No instruction (perceptual processing) Metaphoric images vs perceptual processing

27. Metaphoric images vs perceptual processing • Results

28. Discussion Results similar to those for large hand-eye coordination study (Verdolini-Marston & Balota) Subjects thought metaphors were helpful for learning; they were wrong Perceptual (not associational) processes regulate motor learning Metaphoric images vs perceptual processing

29. Current conclusions: At present there is no empirical evidence that metaphoric images help learning in general physical or voice training; there is evidence that such images harm learning. At present there is evidence that perceptual processing assists learning. Implications for voice training models? Metaphoric images vs perceptual processing

30. How-ever Questions about use of metaphoric images does not extend to the case of “familiar event” (Liao & Masters, 1991; Lam et al., 2009) – and possibly not to “emotional” suggestion. Metaphoric images vs perceptual processing

31. Two types: “Trying” versus “go for it” Generally thought in training that “trying” is bad, but “go for it” is good Intention

32. Theory: “Trying” supports declarative learning (e.g. verbal priming, Schacter & Graf, 1986) and harms procedural performance (e.g. video game playing; Baumeister, 1984). “Go for it” is instead critical to goal accomplishment (e.g. lip closure, Cole & Abbs, 1983). Intention

33. Interesting findings: Golf (Crews, 2001): Looked at pressure experimentally induced Looked at golfers who choked under pressure versus golfers who performed well under pressure Looked at effects of experimentally induced pressure Intention

34. Both “chokers” and “non-chokers” had same increase in anxiety with pressure (e.g. heart rate doubled) However, brain activation patterns were different across “chokers” and “non-chokers”…. Intention

35. Left = non-chokers; right = chokers (top = BL, down = increasing pressure; EEG data; note: figures scanned from article – they don’t seem to match verbal descriptions on the next page—possibly labeled wrong?; I would trust next page)

36. Chokers: left brain doing most of work Non-chokers: same amount of increase in brain activity, but spread evenly across both sides of brain Intention

37. Cognitively, the implication is that the more the right side of the brain stays involved (“creative” and processes target awareness), the better you perform under stress. Translated, this means perceptual imagery (not metaphoric imagery), i.e. target awareness, assists performance(and I’d guess learning). Intention

38. Study in voice (Yiu et al., 2005) 22 adults (F/M), no history of voice problems Received EMG biofeedback from thyrohyoid site bilaterally; did not receive biofeedback from orofacial control site Intention

41. Yiu et al., cont’d All subjects had 11 blocks of spoken reading trials (2 baseline, 5 training, 2 immediate no-feedback test, 2 delayed no-feedback test one wk later) Randomly assigned to either CONCURRENT or TERMINAL feedback conditions Intention

44. Yiu et al., cont’d Results showed no learning for the intended (and attended) laryngeal site Results showed learning for the unintended (and unattended) orofacial site! Intention

45. Current conclusions: Consistent with most pedagogical tradition, “trying” appears harmful to performance (and I’d guess learning). Awareness of goal appears helpful to performance (and I’d guess learning) in some studies; in one voice study even goal does not seem relevant! What does this say about our voice training models? Intention

46. Findings for consciousness follow from the preceding Summary of the preceding Attention to mechanics = bad Attention to gestures’ effects = good Metaphoric (“as if”) images = bad Perceptual (goal-related) “images” = good Trying too hard = bad Intending = good Consciousness

47. Study looking at effect of verbal (declarative) versus experiential (implicit) training approaches for learning to identify “balanced” and “closed” musical phrases Musically naïve subjects M & F, age 13-14 Baseline musical aptitude same in all (Gordon’s AMMA) Altenmueller et al., 1997 Consciousness

48. Three groups Declarative training (verbal training) Procedural training (experiential training) Control group (no training) Behavioral and EEG measures Baseline After 5 wk training One yr following training Consciousness

49. Behavioral results: Immediately after 5 wk of training, both “learning groups” had improved in performance, equivalently; control group did not. One year after training, the “procedural” group performed better than the “declarative” group. Consciousness

50. Consciousness • Brain results: A = declarative learning (pronounced increase over left frontal region; moderate increase over whole left hemisphere after learning) B = procedural learning (pronounced increase over right frontal regions and posterior parietal regions of both hemispheres after learning) C = control group (no change from baseline, or attenuation due to habituation to procedures)