COSD 615 Voice Science and Disorders COSD-615:001 Voice Science and Disorders Prerequisite: Graduate Standing or Permission of Instructor Credit Hours: 4 (8:30 a.m. – 10:10 a.m. MWF; WH-227) Summer III (May 15th – July 14th) Instructor: Raymond N. Linville, Ph.D., CCC-SLP Professor, Communication Sciences & Disorders Associate Dean, Waldron College of Health & Human Services Office: Room 341 Waldron Hall Telephone: 540-831-7600 (Office of the WCHHS Dean) e-mail address: rlinvill@radford.edu FAX: 540-831-7604 (Office of the WCHHS Dean) Conference Hours: Monday 10:10 a.m. – 11:00 a.m. Tuesday 9:00 a.m. – 10:00 a.m. Friday 11:00 a.m. – 12:00 p.m. Others times by appointment. Confirm all times in advance as unavoidable changes may occur. Catalog Entry COSD 615. Voice Science and Disorders. (4) Four hours lecture. Advanced study of voice science including motor control, phonation, respiration, resonance, perception, laryngeal anatomy-physiology, and current methods for prevention, assessment and intervention of voice disorders in children and adults. Detailed Description of Content of Course The principles and concepts presented in this course represent the major topics for the study of normal and pathological voice production. The course will be conducted to emphasize the scientific, diagnostic, and treatment strategies required of a practicing speechlanguage pathologist. The instructional methods used will include lecture-discussion, audiovisual examples, laboratory exercises, group projects, and small-group discussions. Additionally, some lectures and assigned readings will be Podcast for subsequent review (see attachment). 1. 2. Self-directed review of laryngeal neuroanatomy and neurophysiology Developmental aspects of laryngeal aging from neonatal-to-geriatric 2 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Laryngeal histology Speech acoustics Aeromechanics and aerodynamics Speech motor control Behavioral aspects of phonation Basic instrumentation and circuit theory Assessment techniques Laryngeal surgery Clinical management: Child, adolescent, adult, and geriatric Difficult to diagnose/treat patients Care of the professional voice Professional affairs Cultural aspects Course Requirements 1. Attendance and Participation – This course requires an extensive amount of reading, study, and subsequent discussion. Students are required to attend each class and to come prepared to discuss the assigned readings. You are also encouraged to form study groups. Emergencies and circumstances beyond the student’s control will be handled in accordance with the Radford University Student Handbook. 2. Recommended Readings - There are many excellent resources available in this area. Students should also consistently review relevant journals for information. a. Titze, I (1994). Principles of Voice Production. Englewood Cliffs, NJ: Prentice-Hall. ISBN 0-13-717893-X. An excellent text by the current leader in vocology. b. Baer, T., Sasaki, C., & Harris, K. (Eds.). (1987). Laryngeal Function in Phonation and Respiration. San Diego: Little, Brown and Company. ISBN 0-316-348287. An advanced overview from the vocal fold physiology series. c. Fawcus, M. (Ed.) (1992). Voice Disorders and Their Management. Second Edition. San Diego: Singular Publishing Group, Inc. ISBN 1-879105-578. A European perspective. d. Andrews, M. (1999). Manual of Voice Treatment: Pediatric Through Geriatricst. 2nd Ed. San Diego: Singular Publishing Group, Inc. ISBN 156593-998-0. Although presented in an outline format, this is an excellent text for practicing clinicians. Nearly a third of the text is appendices devoted to clinical materials and techniques. Buy this book when you begin practicing! 3 e. Lass, N. (Ed.). (1996). Principles of Experimental Phonetics. New York: Mosby. ISBN 0-8016-7975-3. An excellent and popular text for advanced speech science. 3. Required Textbook a. Colton, R., Casper, J. & Leonard, R. (2006). Understanding Voice Problems: A Physiological Perspective for Diagnosis and Treatment. 3rd Ed. Philadelphia: Lippincott Williams & Wilkins. ISBN 0-7817-4239-0. Do not purchase an earlier edition. See these sites for ordering. Costs range from approximately $48 (used) to $73 (new) – shop wisely. http://www.amazon.com/gp/product/0781742390/qid=1137182191/sr=11/ref=sr_1_1/002-6740233-7316859?s=books&v=glance&n=283155; http://www.walmart.com/catalog/product.do?product_id=4083088 Also available from the campus bookstore. If you purchase a used copy, make certain that it includes the companion DVD which will be used this semester. Supplemental Readings – Additional readings will be provided during the semester. These will include more recent publications and professional presentations. 4. Goals and Objectives of the Course At the successful completion of this course students will be able to: Understand the neuroanatomy and pathophysiology of vocalization. Recognize basic terminology. Understand the general physics of sound and fluid mechanics. Describe histological factors related to vocal dysfunction. Understand pressure-flow and acoustic relationships. Describe the accepted theories of voice production. Explain (in both professional and lay terms) how vocal pitch and intensity are varied during speech and singing. Conduct a general voice examination. List pertinent surgeries and related medical procedures. Correlate behavioral aspects with other aspects of communication. Describe the standard assessment protocols. Classify voice disorders in terms of objective and perceptual rating scales. Describe treatment techniques. Recognize cultural aspects of voice production. Describe instrumentation used to assess vocalizations. 4 Understand care for the professional voice. List voice prevention strategies. Relate scientific principles of phonation to disordered categories. Understand laboratory and clinical safety precautions. Apply speech science concepts. Assessment Measures Student achievement will be assessed to determine attainment of the course objectives and to identify areas for improvement. A variety of measures will be included such as attendance, assigned projects, positive contributions towards scholarly discussions, and formal examinations following each subsection. There will be a total of 100 percentage points. 1. Tests – objective/subjective (e.g., multiple choice, T/F, short answer, etc.) a. Test #1 - 10% of the final course grade, self-paced neuroanatomy; students will have three opportunities to take the test; the final grade will be the highest score or a student may submit a score after the first or second test if it is greater than 85. A copy of the test is attached. b. Test #2 - 30% of the final course grade, science, acoustics, and phonation c. Test #3 - 40% of the final course grade, intervention, and assessment; contains extensive readings (get a head start!). 2. Student Project – Each student will conduct an independent project which will count as 20% of the final course grade. The project will involve a detailed interview including a voice history, perceptual voice comparison and analysis. See attached project description for more information and due date. 3. Attendance a. For each absence without an acceptable written excuse one (1) point will be automatically deducted from the student’s final course grade. b. Students may take one (1) excused absence for the observance of important events (e.g., religious holiday or personal day) without penalty although she or he will still be responsible for the materials covered during their absences. The Instructor must approve in advance or it will be recorded as an unexcused absence (see 3.a.). 4. Participation – Portions of the course will include student participation. This will be in the form of class discussions, group projects, and the sharing of information from other resources. A maximum of ten (10) additional points will be awarded for consistent (i.e., every class) and thoughtful contributions. 5 Grading Scale The following scale will be used in determining final grades. No "curves" will be applied and final scores (e.g., 89.9) will not be "rounded up." 100-90.0% or A: outstanding achievement; available only for the highest accomplishment; goes beyond requirements; demonstrates breath & depth; exhibits critical thought processes; professional in presentation & appearance; shows considerable & consistent efforts; imaginative; creative; unique 89.9-80.0% or B: praiseworthy performance; definitely above average; well organized & complete; effectively & clearly presented; demonstrates clear understanding; applies what has been learned; thoughtful & supported with ideas; detailed & well organized 79.9-70.0% or C: average; awarded for satisfactory performance; meets general requirements; includes basic information but lacks details & superior examples; lacks originality & above average organization; routine & unimaginative presentation 69.9-60.0% or D: missing evidence; “sloppy” & poorly organized; demonstrates only surface understanding; less than minimal effort; poorly written & documented; uninteresting presentation; no application or clear understanding 59.9-0% or F: failing; no evidence or submitted after deadline; indicative of a need for remedial intervention Other Course Information Honor Code – By accepting admission to Radford University, each student makes a commitment to understand, support, and abide by the University Honor Code without compromise or exception. Violations of academic integrity will not be tolerated. This class will be conducted in strict observation of the Honor Code. Refer to your copy of the Student Handbook for details. Please be especially alert to acts of plagiarism, which can be easily detected with the use of electronic scanning and readily available software. The Pledge to Uphold the Honor Code can be found at http://www.radford.edu/~dosweb/pledge.htm and tips for avoiding honor code violations may be reviewed at http://www.radford.edu/~dos-web/honortips.htm. Please give special attention to violations involving plagiarism (a very serious offense which is reviewed at http://www.coloradocollege.edu/dept/PY/Plag.html). Tests will be objective-subjective and follow a format designed to familiarize students with the Praxis I comprehensive examinations. Information will come primarily from the lectures and assigned readings. Students can anticipate a mix of the information being derived from class notes and the readings. This syllabus outlines a tentative course schedule, assignments, and grading. However, each aspect is subject to change as may be required during the semester. 6 Per the Buckley Amendment (Freedom of Information Act), no identifying information such as social security numbers, initials or other easily identifiable information may be used in the posting of student grades. Therefore, each student will be assigned a unique score code which will be used to convey test results. Maintaining confidentiality of his/her score code is each student’s responsibility. Students with Disabilities and/or Special Needs: If you are seeking classroom accommodations under the Americans With Disabilities Act, you are required to register with the Disability Resource Office (DRO). To receive academic accommodations for this class, please obtain the proper DRO forms and meet with me no later than the second week of the semester. Any student experiencing difficulty managing stress is encouraged to contact the Radford University Center for Counseling and Student Development. Laboratory Guidelines – The class will meet in the Speech Science Laboratory (room # 237). This 219 sq. ft. facility is designed primarily for investigative activities. It also serves as an instructional/clinical resource. As a laboratory, there are specific rules and regulations regarding its operation that all users must be aware. A notebook describing relevant procedures is provided in lab. Failure to follow lab procedures will result in restricted usage. Due to class size, demonstrations will be conducted in shifts to better facilitate viewing. Instructor’s Expectations – I expect participation and preparation. I also expect each student to make a genuine effort to learn the material. Students must conduct themselves in a professional manner at all times and to adhere to the Honor Code as a Radford University student and as an advanced student in the Department of Communication Sciences and Disorders. Each student is also expected to meet regularly with the Instructor for academic assistance and/or discussions. Class Courtesies (aka rules) - “No brainers,” but just for the record and because past students have complained). Power cell phones off upon entering the class. Do not come to class late as an automatic point deduction will be incurred – same as an unexcused absence. Do not bring food to class. Beverages are permissible. Children and/or guests may not accompany you to class without prior permission. Maintain patient confidentiality. Do not conduct private conversations during class. Do not engage in unrelated behaviors (e.g., sleeping, eating, etc.). Independent recording of lectures is not permitted without the Instructor’s permission. Informative & Helpful Web Sites - These will be beneficial to the course and future work as a professional health-care provider, patient educator, researcher, etc. Web sites are interactive in the electronic version of this syllabus. Many more sites exist – find some and share them with the class! 7 http://www.mcf.org/mcf/grant/writing.htm - How to write small grants. http://www.alahns.org/ - American Laryngological Association. http://www.entnet.org/ - American Academy of Otolaryngology – Head and Neck Surgery. http://www.nidcd.nih.gov/order/index.asp - Free publications from NIDCD. http://cnet.shs.arizona.edu/ - National Center for Neurogenic Communication Disorders. http://www.dysphonia.org/ - National Spasmodic Dysphonia Association. http://www.aro.org/ - The Association for Research in Otolaryngology. http://www.ncvs.org/ - National Center for Voice and Speech. http://www.voiceacademy.org:8080/vaweb/voiceacademy.html - Voice Academy (for teachers). http://www.csbsju.edu/VoiceCare/ - The Voice Care Network. http://www.vasta.org/ - The Voice and Speech Trainers Association, Inc. http://www.acdaonline.org/ - American Choral Directors Association. http://www.choralresearch.org/ - International Journal of Research in Choral Singing. http://www.mtna.org/flash.html - Music Teachers National. http://www.nats.org/ - The National Association of Teachers of Singing, Inc. http://asa.aip.org/ - Acoustical Society of America. http://www.resna.org/ - Rehabilitation Engineering & Assistive Technology Society of North America. http://www.entusa.com/larynx_videos.htm - Laryngeal videos & self tests. http://sprojects.mmi.mcgill.ca/larynx/Default.htm - Class notes from McGill. http://www.medicinenet.com/larynx_cancer/article.htm - Laryngeal cancer. http://www.medicine.uiowa.edu/otolaryngology/cases/index1.htm - Case presentations of voice surgery including video files. http://www.bartleby.com/107/236.html - Gray’s anatomy. http://www.entusa.com/voice_box_cancer.htm - Cancer & smoking. http://www.merck.com/mrkshared/mmanual/section7/chapter88/88a.jsp Merck Manual entry. http://www.emedicine.com/ent/topic324.htm - Laryngeal development and congenital malformations. http://www.med.umich.edu/lrc/coursepages/M1/anatomy/html/atlas/atlas_in dex.html - Neuroanatomical images. http://www.hopkinsmedicine.org/voice/ - The Johns Hopkins University entry. http://mywebpages.comcast.net/wnor/lesson11.htm - Anatomical pictures. http://www.gbmc.org/voice/anatomyphysiologyofthelarynx.cfm - M. Dance Center for rehabilitation. http://www.ling.yale.edu:16080/ling120/Larynx_film_festival/ - Excellent mucosal wave images. http://voicecenter.upmc.com/OfficeVisit.htm - University of Pittsburgh entry. http://www.emedicine.com/ent/topic685.htm - Flexible endoscopy review. http://www.aafp.org/afp/980600ap/rosen.html - On hoarseness. http://www1.wfubmc.edu/voice and http://www.wfubmc.edu/slp3d/voiceindex.html - Wake Forest University entries including surgery. http://www.vh.org/ - The University of Iowa’s Virtual Hospital. 8 Tentative* Course Schedule CLASS MEETING 1 APPROX. DATE May 15th READING ASSIGNMENT(S) TOPIC & ACTIVITIES Syllabus Chapter 13, pp. 399-409 Chapter 11, pp. 373-386 2 May 17th On Being a Scientist www.nap.edu/readingroom/ books/obas/index.html Course Objectives, Scientific Method, Neuroanatomy, PodCasting Information, Anatomy self review Science, ethics, methodology & societal values 3 May 19th None Basic electronics 4 May 22nd Electrical Safety Safety Issues & Universal Precautions www.cdc.gov/niosh/pdfs/02-123.pdf Skim Section 2, pp. 6-11 & Section 3, pp. 12-17 Also skim: www.radford.edu/~fac-man/Safety/; http://www.niehs.nih.gov/odhsb/ biosafe/univers.htm; 5 May 24th Chapter 2, pp. 21-29 Basic Acoustics 6 May 26th www.phys.unsw.edu.au/ Speech Acoustics PHYSICS_!/SPEECH_HELIUM/ speech.html; Last day to drop. May 29th Memorial Day Continue readings Remember our Vets! This class will not meet. 7 May 31st Chapter 14, pp. 410-419 Theories of Speech Acoustics 8 June 2nd None EMG, Fluid Mechanics & Speech Aerodynamics 9 9 June 5th None A/D Conversion, Fourier Analyses, Linear Prediction, Cepstral Analysis & Inverse Filtering 8 June 7th Lab Exercise CLS Demonstrations 9 June 9th Chapter 3, pp. 64-75 Theories of Phonation 10 June 12th None Exam #2 -----------------------------------------------------------------------------------------------------11 June 14th Chapter 4, pp. 76-99 Phonotrauma 12 June 16th Chapter 4, pp. 100-117 Phonotrauma 13 June 19th Chapter 8, pp. 235-288 Instrumentation 14 June 21st Chapter 8, pp. 235-288 Instrumentation 15 June 23rd Chapter 2, pp. 12-21; pp. 29-36 Assessment & Differential Diagnosis 16 June 26th Chapter 2, pp, 36-63 Assessment & Differential Diagnosis 17 June 28th Chapter 8, pp. 224-235 Last day to withdraw with a Grade of “W” Voice History 18 July 3rd Chapter 10, pp. 321-350 Vocal Rehabilitation 19 July 5th Chapter 10, pp. 351-372 Vocal Rehabilitation 20 July 7th Chapter 7, pp. 200-214 Pediatric Disorders 21 July 10th Chapter 7, pp. 214-223 Geriatric Disorders 22 July 12th Chapter 9, pp. 289-320 Surgical & Medical Management ------------------------------------------------------------------------------------------------------23 July 14th TBA Exam #3 * The lecture schedule may vary. As such topics and test dates (with exception of Test #3) are unconfirmed. Students should therefore not make travel arrangements or other plans based upon the tentative schedule. 10 COSD:615 – Voice Science & Disorders Test 1: Laryngeal and Velopharynegal Neuroanatomy # __________ (score code) Attempt Number: __________ (out of 3) Instructions: You have three (3) opportunities to take this test. The highest score will be used or the student may elect to use any single score 85 or greater. For example, a student who does well on the first attempt may decide to use that score and not make two additional attempts to increase the score. Print your answers on the test using small case letters. The same test will be used for each administration. The test(s) must be taken during office hours and without notes. Part One: Listing – List the following items as instructed. A. List four (4) velopharyngeal muscles and supply corresponding information. Muscle Name Innervation Primary Function 1. 2. 3. 4. B. List ten (10) extrinsic laryngeal muscles and supply corresponding information. Muscle Name 1. 2. 3. 4. 5. 6. 7. Innervation Primary Function 11 8. 9. 10. C. List five (5) intrinsic laryngeal muscles and supply corresponding information. 1. 2. 3. 4. 5. Part 2: Draw and label – Illustrate the following and identify the list structures by drawing appropr1ate arrows between labels and structures. A. Draw the thyroid cartilage and label the following: sup. cornu, inf. cornu, lamina, oblique line, thyroid notch, and thyroid angle. B. Draw the cricoid cartilage and label the following: lamina, cricoid arch, crioarytenoid facet, and criothyroid facet. 12 C. Draw the hyoid bone and label the following: corpus, lesser cornu, greater cornu, and Triticial cartilages. D. Draw an artyenoid cartilage and label the following: vocal process, muscular process, apex, base, and corniculate cartilage. E. Draw a cross-section of one human vocal fold and label the following layers: mucosal, lamina propria (including superficial, intermediate & deep layers), and vocalis (thyroarytenoid) muscle. End of Test 13 COSD-615: Voice Science and Disorders Independent Student Project Description Project Goals: This project is designed to assist students in conducting a detailed interview with an adult relative (e.g., ideally a natural mother or father) that also enables the student to compare his/her vocal patterns with those of an immediate family member. The general format will be similar to that of an oral history, except it will focus upon the family member’s vocal history. All information will be treated as confidential (don’t even need to mention his/her name) and will be shared only with the Instructor. The individual will also need to sign a brief statement at the end of the written transcript attesting to their permission for the Instructor to access the information (see below). General Format: Each student will conduct a one-hour, live interview with an adult “blood relative.” A written transcript and tape (or CD) recording will be submitted on Friday, June 9, 2006. Late submissions will receive an automatic ten-point deduction. Introduction of relative and general history (e.g., relation to student, age, gender, vocal history, etc.). Individual’s self description of his/her voice – encourage them to talk about it as opposed to simply saying, “I think it’s OK.” Plan this section before you actually do it! Vocal history – ask questions designed to probe the individual’s memory of past events (e.g., voices changes at puberty, past problems with his/her voice, humorous stories of mistaken identity, singing, personal accounts of how their voice has help or hindered their experiences, etc.) Comparison of voice between you and the individual – each of you read a one-to-two sentence passage and then listen to them together; then talk about the similarities and differences with the individual. Recollection of the student’s voice – ask the individual to describe your voice (e.g., Can you remember what my cries sounded like as an infant? When did you first think I sounded like an adult?” “When you hear my voice over the phone, what does it make you think of? Was I a good singer as a youth?”) Grading: The project will be assessed in the following manner. 1. 2. 3. 4. Was it submitted on time and as instructed? (5%) Did the interview follow the General Format? (10%) Did the student include creative questions designed to meet the project goals? (40%) Was the comparison of the individual’s voice and that of the student comprehensive and reflective of course topics? (40%) 5. Did the student include other aspects beyond the general requirements illustrative of significant planning, design, and implementation? (5%) Consent: I, _________________________ hereby grant permission to _________________________ and (family member’s signature) (student’s signature) Dr. Raymond Linville to use the recorded information as part of a class assignment. I also understand that no part of this information will be shared with others and that all information will be treated as confidential. _____________________________ (date) 14 Attendance Sheet for ______________________ Please enter your written signature. 1. _____________________________ 21. _____________________________ 2. _____________________________ 22. _____________________________ 3. _____________________________ 23. _____________________________ 4. _____________________________ 24. _____________________________ 5. _____________________________ 25. _____________________________ 6. _____________________________ 26. _____________________________ 7. _____________________________ 27. _____________________________ 8. _____________________________ 28. _____________________________ 9. _____________________________ 29. _____________________________ 10. _____________________________ 30. _____________________________ 11. _____________________________ 31. _____________________________ 12. _____________________________ 32. _____________________________ 13. _____________________________ 33. _____________________________ 14. _____________________________ 34. _____________________________ 15. _____________________________ 35. _____________________________ 16. _____________________________ 36. _____________________________ 17. _____________________________ 37. _____________________________ 18. _____________________________ 38. _____________________________ 19. _____________________________ 39. _____________________________ 20. _____________________________ 40. _____________________________ 15 Podcasting 101 Many of the materials in this course will be podcast, including the assigned readings. If you’re familiar with podcasting or blogging, then you need read no further. If not, then here’s a brief overview. Podcasting is a world wide-web based system for broadcasting digital audio and video media, typically in the form of the ubiquitous MP3 format (e.g., iTunes). The technique is very simple to learn and more simple to use. With just a computer, you can share information with any of over two billion people! By using a basic set of rules known as RSS (Really Simple Syndication), you can download more information than an average person could read in a lifetime! For a quick “taste” of podcasting, go to Podcast Alley at www.podcastalley.com. Click on one of the featured Podcasts (e.g., http://audio.news.ufl.edu/20060116-UpdateWeekly.mp3) and listen in on what is being presented (I’ll demonstrate this in class). I’ll be recording lectures and reviewing reading assignments this term and posting them to a server from where you can download them for subsequent listening, review, etc. Typically, podcasters speak into a microphone that is connected to a computer using software such as Garage Band or Audacity (download a free version at http://audacity.sourceforge.net/). The quality of the microphone and recording environment greatly influence recording quality. Video files can also be recorded using software such as iMovie (see: http://edweb.sdsu.edu/sciencetg/ie/ or http://www.jessamine.k12.ky.us/jelv/meetstaff/trt/iMovie/), but many of these software programs cost between $50 and $150+. To avoid being “chained” to a computer by way of a microphone, I’ll be making recordings of the lectures with a Sony Digital Voice Recorder that also has the latest Dragon speech-to-text software. If all goes well (50/50 chance of success here and preliminary attempts have been problematic), the lectures will be converted into a text file so that you don’t even take notes! Even still, the lectures will be available in an audio format on the web. Please note, however, that podcasts are not always stored permanently and with each new upload (i.e., lecture) the previous lecture may be erased! I’m working with the University to keep all of the files available, but that may not be possible. Keep you eye out for RU’s iTunes U which will be among the first in the nation! If you own an Apple iPod (way cool) or other MP3 player/recorder, then you can also listen to some lectures without the need of a computer. The fourth and fifth generation iPods have all of the needed options, but please keep you files organized as some of the files will get quite large. I’ll be using a College provided fifth generation video iPod with 60GB of storage capacity. While that sounds like a lot, it fills up fast! You may also come by my office and find a “Do Not Disturb” sign posted on the door. If so, then I’m recording something for class and cannot answer the door. Please don’t knock/bang on the door as it too will be recorded and I’ll have to start over and/or edit the files (i.e., time consuming). Please don’t take this to mean that I’m too busy for you, but only that I’ve begun a recording session that can’t be stopped easily so just wait patiently or send me an e-mail message that you’re chillin’ nearby. It 16 will appear (quietly) on my computer screen and I’ll know that you’re waiting to see me. And if I can’t get to you quickly, then I’ll let you know with a return message at a convenient place to pause. To access the podcast, you’ll need to download a free (and latest) version of iTunes at this website: http://www.apple.com/itunes/download/. The setup procedure will take about 3-5 minutes. After accepting the user’s agreement, the application will open. On the top left of the menu will be an icon for the library of music followed by one for podcasts. The site will hopefully be where you’ll find our class materials (or a RU URL). The actual site name may change depending upon RU policies which are still being developed at this writing. Note: If you’re interested in learning more about podcasting and gaining “hands on” experience assisting me, then come by my office to chat about the project. Finally, this portion of the course is experimental. If it begins to interfere with our discussions, delay our progress (due to technical difficulties), or impose too great a burden upon our efforts to learn the material, then we’ll “ditch it” and I’ll worry about it after our time together.