VINCE LARA: This is Vince Lara at the College of Applied Health Sciences at the University of Illinois. Today, I spend a few minutes with Keiko Ishikawa of the Speech and Hearing Science department to discuss her research on voice disorders and helping people with dysphonia communicate better. My first question, did you always want to teach?

KEIKO ISHIKAWA: Well, this kind of came with my choice of job. And I always taught. I started out, actually, as a voice teacher. I went to a music school and before I went into speech pathology. And I was a voice teacher for many different individuals back then. So it was not classroom teaching, but that's how I started out as a teacher. And as you go through the PhD training, it just came with the job, and I discovered I really love teaching, and I find it very rewarding.

VINCE LARA: Now, was that in the States that you were teaching? Where were you teaching?

KEIKO ISHIKAWA: Yes, back in New Jersey.

VINCE LARA: Oh, OK. Got you. And so what kind of voice teaching were you doing? Like for singing?

KEIKO ISHIKAWA: Yes.

VINCE LARA: Oh, interesting.

KEIKO ISHIKAWA: So I have two master's degrees. And one is in speech pathology. And another one is master's in music in voice performance and pedagogy. And so that was classical singing. I sang myself and then taught opera singers-to-be.

VINCE LARA: You know, I often ask faculty what inspires their research. So what inspired you to do what you do?

KEIKO ISHIKAWA: OK, so as a clinician, I worked in Mass Eye and Ear Infirmary in Boston. And I was a voice specialist there. And coming from a music background, I was all about, OK, let's make people's voice cleaner and prettier and you know, just get what they're wanting. So that's what we do.

But then I realized that people who come to my room said, Keiko, I don't care how I sound. I just need to talk. That's when kind of, oh, people are not really here for getting pretty voices. I mean, there are individuals who are also after that. But the majority of my patients were looking for the way to enhance their communicative ability. And I just had no way to measure that aspect of their disability.

So these people are chronically hoarse, struggling to talk in noisy places which, today's environment, everywhere is pretty noisy, like restaurants, classrooms, bus stops. We are exposed by noise all the time. So these individuals are struggling to get through their day, because they cannot be heard and understood in these daily environments.

So now, as a clinician, I had no way of measuring their struggles, which is a problem for clinical outcome measurement. And so I don't know how effective what I'm doing, and how much of a struggle these individuals are facing every day. That inspired me to look into the intelligibility problem in dysphonia population.

VINCE LARA: Now, you spoke about how your research focuses on voice disorders affecting speech intelligibility. So what are some of the challenges of people who have voice dysphonia, which is basically, you have hoarse all the time--

KEIKO ISHIKAWA: Hoarseness.

VINCE LARA: Yes.

KEIKO ISHIKAWA: So hoarseness obviously makes you sound like not yourself. And people may ask, like, are you sick, or can you speak up more. And then also, for children, there's some data saying that teachers perceive these children to be different from other healthy children. So just because of their voice, they are somewhat stigmatized. And that is something to think about as well.

VINCE LARA: Do they associate it with a learning disability?

KEIKO ISHIKAWA: Not necessarily.

VINCE LARA: OK. Now, the way we communicate today, meaning email and text, does that make it slightly easier for people who have chronic hoarseness to communicate?

KEIKO ISHIKAWA: That is one of the means, of course. They can use that. I actually recommend that clinically when they are unable to use their voice, to use text, email, whatever that doesn't use voice. However, that doesn't really resolve the problem of daily things that they need to do.

So everybody needs to go to restaurants for enjoyment, as well as the job that you need to do this for your occupational reasons. And if you can't do that, you have a, say, breakfast meeting with your customer, that is a problem.

VINCE LARA: Absolutely. Now, what led you to the University of Illinois?

KEIKO ISHIKAWA: Well, University of Illinois is a research-oriented university. This is a very research-intensive university. I was always wanting to come to this type of institution while I was getting my PhD. Just happened to have an opening, and it was very, very attractive in terms of collaboration with the computer science and engineering. Some of those things that helped me advance my science in my lab. So I chose this place thinking that this is the best environment that I could progress in my research program.

VINCE LARA: So are you working on something that you're particularly excited about coming up?

KEIKO ISHIKAWA: Oh, many different things.

VINCE LARA: OK. Anything in particular you wanted to discuss?

KEIKO ISHIKAWA: Sure. Well, so one of the things we do here is to automate speech evaluation. So for example, as I said, people with dysphonia have a problem in noisy places. And this is very, very difficult to judge in a clinical setting, because clinical setting is quiet. You're usually with the patient without the noise in the background. So for us, it would be really good to have some sort of software that measures these challenges. And to do so, we have to have some acoustic-based software. And we are in process of developing that in collaboration with other labs.

So one of our activities that has become very fruitful was to open a free voice-screening clinic. And this was supported by provost faculty retreat grant, as well as the CITL, Center of Innovation, Teaching, and Learning.

VINCE LARA: Right.

KEIKO ISHIKAWA: And this funding allowed us to, again, open the free voice clinic at the Speech and Hearing Science building, where we welcome anybody who is concerned about voice who just want to have a wellness visit to check what their vocal folds look like.

VINCE LARA: So anyone can come in?

KEIKO ISHIKAWA: Anyone can come in. And we do this every Friday.

VINCE LARA: Oh, that's great.

KEIKO ISHIKAWA: And so our students in our department also get to learn from this clinic. They get to interview the participants, as well as to watch me perform endoscopy and learn about anatomy and physiology and pathology of the voice disorders. So this has become a really good activity. And we were overwhelmed by the number of interested parties across the campus. And we realized that, well, we are thinking voice is important for teachers and also vocal performers. But what we didn't really realize that yes, every faculty member teach and talk and present. And so everybody was interested in voice problems. So we are now fully booked until February.

VINCE LARA: Wow.

KEIKO ISHIKAWA: Yes, so we are very fortunate to be given this grant.

VINCE LARA: My thanks to Dr. Ishikawa. This has been A Few Minutes With.