“No matter what people tell you, words and ideas can change this world.”
-Robin Williams, Dead Poets Society
I first heard the word habilitation in 2012 at the Summer Vocology Institute in Salt Lake City, UT. It came up in association with the treatment of injured voices and was the topic of much discussion that summer. (It continues to be the topic of much discussion, it turns out.)
Most of us are familiar with rehabilitation as a medical term, but what about habilitation? It carries a different meaning than rehabilitation and, in the opinion of vocology experts, deserves a conversation – both for the sake of voice practitioners and consumers alike.
As defined by the text Vocology,
“habilitation is the process of enabling, equipping for, or capacitating. Voice habilitation is therefore more than repairing a voice, or bringing it back to a normal state. It includes the process of building and strengthening the voice to meet specific needs.” (Titze, Verdolini Abbott, 2012 pg.11)
Rehabilitation vs. Habilitation
Let’s look at habilitation and rehabiltation back to back. Merriam Webster online defines the verb habilitate as:
Habilitate (v) : to make fit or capable
When compared to the verb rehabilitate, the nuance between habilitation and rehabilitation becomes more evident:
Rehabilitate (v) : to restore or bring to a condition of health or useful and constructive activity
As voice professionals, these definitions become useful because they can help define the scope of practice across specialties, and more accurately represent the type and quality of work being done by each as the field of vocology matures. (NCVS, 2013, pg. 5)
We are living in a time where these terms and roles have “historically been inexact, inconsistent, and unclear.” (Scearce, 2016) Fortunately, a relatively new professional organization called the Pan American Vocology Association (PAVA) is codifing these terms.
In 2013, in a Summary Statement for the inaugural symposium of PAVA, language was drafted to address the difference between voice habilitation and rehabilitation:
“The major demarcation drawn was between voice habilitation and voice rehabilitation for the performance voice. It was generally agreed that voice habilitation describes maintenance, building and enhancing vocal skills and knowledge in a healthy performer, and that voice rehabilitation describes restoration of lost vocal function for a performer who has suffered a voice disorder or voice injury.” (NCVS, 2013, as reported by Scearce, 2016, pg. 6)
In voice, rehabilitation describes the process of healing from injury, or returning the voice to a basic, functional level.
Habilitation describes the process of building fitness into a normally functioning voice in order for it to perform more demanding tasks such as athletic singing and high-demand speaking tasks (think oration, acting, and customer service).
In the above quote Titze and Verdolini Abbott say “voice habilitation is therefore more than repairing a voice,” and I interpret this to mean voice habilitation is NOT voice repair, but occurs after repair and involves voice fitness training.
This discussion gets dicey, however, when we want to produce a simple, pat answer about which voice professionals are allowed to enter which domains. Rehabilitation and habilitation may at some future date be more formally defined by licensures and governances.
For now, the leaders in the field of vocology “acknowledge the reality that this is a dynamic and emerging profession in which historical and contemporary approaches are both currently at play. A more clearly delineated pathway will likely arise in the not-too-distant future.” (Scearce, 2016, pg. 7)
Habilitation in Practice
It is important to note that quality voice habilitation “necessitates a thorough understanding of the principles of voice habilitation relative to the mechanics and acoustics of singing.” (Scearce, 2016, pg. 148)
Today it is more common to find speech language pathologists who specialize in voice, and “in some practices, the singing voice rehabilitation specialist is also a licensed, certified speech language pathologist.” (LeBorgne, Rosenberg, 2014) Pairing a “vocal arts professional such as a voice teacher with expertise in vocal health,” and a speech language pathologist who specializes in voice, a patient can build a multidisciplinary team to address both rehabilitation and habilitation issues. (LeBorgne, Rosenberg, 2014)
The key word here is multidisciplinary, and more voice care teams are making professional collaborations part of their fundamental approach to care. (The multidisciplinary voice care team is lauded as important in all of the textbooks referenced in this post.)
Discussions and definitions regarding voice rehabilitation and habilitation are much needed, and I can see the benefit of having them – as I said, for both voice professionals and consumers of voice care.
Funny enough, WordPress doesn’t acknowledge the word habilitation, so it is highlighted as incorrectly spelled as I type this post. (Every. Single. Time.) This confirms, in a small way at least, that the word habilitation deserves more conversation.
LeBorgne, W. D., Rosenberg, M. (2014) The Vocal Athlete. San Diego, CA: Plural.
National Center for Voice and Speech (NCVS). (2013) NCVS Symposium on Specialty Training in Vocal Health Summary Report; April 25-26, 2013, Salt Lake City, UT. Retrieved from http://www.ncvs.org/STVH_Summary_Report_2013.pdf and as reported by Scearce (2016), pg. 6.
Scearce, L. (2016) Manual of Singing Voice Rehabilitation. San Diego, CA: Plural.
Titze, I., Verdolini Abbott, K. (2012) Vocology, The Science and Practice of Voice Habilitation. Salt Lake City, UT: National Center for Voice and Speech.