Czechoslovakia

Olga Dlouhá, Prague

The history of Czechoslovak phoniatrics began in 1922, when at the Czech Clinic for Oral, Nasal and Laryngeal Disorders headed by professor Kutwirt, an out-patient department was established for speech and voice disorders and defective hearing. It was headed by Dr. Miloslav Seeman, who had studied under the founder of European phoniatrics, professor Hermann Gutzmann senior.
Prof. M. Seeman, founder of Czechoslovak phoniatrics played a major part in the development of that field of medicine, at least Europe-wide. He, who in his view of disorders in inter-personal communication was far ahead of his time, succeeded in founding the first independent phoniatric hospital ward in Europe (1957), which together with the out-patient department gained the status of phoniatric clinic in October 1967. Based on its example, further such clinics were founded later at various European teaching hospitals. Professor Seeman was one of the founders of phoniatrics on the European scale. He is the author of the recognised theory of the extra-pyramidal origin of stuttering and evolved a system of comprehensive treatment of that disorder. Also, he was the author of the aspiration method of oesophageal voice education, of Czech speech audiometry and other methods.
He promoted inter-disciplinary collaboration, particularly with neurology, represented at that time by professor K. Henner, the founder of Czech neurology as an autonomous field.
Seeman helped to organise the International Association for Logopedics and Phoniatrics – IALP and its journal Folia Phoniatrica. Seeman´s monograph Speech Disorders in Children was published in several languages, the German version appeared in three editions. In Czechoslovakia, phoniatrics originated as a further specialisation on the basis of otorhinolaryngology. Thanks to Seeman´s work, the Phoniatric Clinic, of which he was the first Head, became a centre of modern curative and preventive treatment, as well as a centre of research and pre-graduate and graduate teaching.
The history of Czechoslovak (Czech) phoniatrics is closely linked to the history of the Phoniatric Clinic. The founding of the Clinic is inseperably linked with the names of professor Miloslav Seeman, professor Karel Sedlacek and associate-professor Eva Sedlackova. In the 60´s dr. Sedlackova published a number of reports dealing with problems of the neuro-vegetative system in patients with a stutter. Langova discussed EEG findings in stuttering patients, Novak published his findings on the influence of delayed acoustic feedback. A major advance presented the electro-physiological studies of Lastovka, investigating the sensorimotoric feedback system in fluency disorders. The scientific papers of the Prague phoniatric school were always highly appreciated, for her work on the acoustic composition of the neonate voice and its development ass.prof. Sedlackova received the Gold Award (1967). Dr. Sedlackova was a founding member of the Union of European Phoniatricians – UEP in 1971. All this led to the fact that in Europe the Phoniatric clinic of the General Faculty Hospital and the First Medical Faculty of Charles University is described as the Seeman´s Phoniatric School of Prague. In the 60´s, practically all renowned phoniatricians in the socialist countries and many physicians from Western countries were trained by professor Seeman and associate professor Sedlackova. In the Czech Republic, dr. Sedlackova was the first to introduce into the study of delayed speech development linguistic and phonological methods and created the basis for diagnosing professional voice disorders, using the latest technique of spectral voice analysis.
Curative and preventive care and research of a high standard has not confined to the Phoniatric Clinic and its Phoniatric laboratory. The pupils of professor Seeman and later also of associate professor Sedlackova gradually established phoniatric divisions at other ORL-clinics and departments in Czechoslovakia. During the last 40 years, roughly 100 phoniatricians were trained, most of them are nowadays running their own surgeries. However, the teaching hospitals retained their phoniatric departments, which roughly correspond to the former regional clinics. Out of the contemporary number of 85 phoniatricians working there, only one third do so full-time in the field of phoniatrics. Their work remains focussed on treating patients with speech, voice and hearing disorders, and particularly on paedaudiology.
Great attention is paid to persons using their voice professionally and to children with disorders in speech development, to patients with stutter to aphasics and patients with impaired hearing, especially children.
The clinic always formed the centre of activities in the field of phoniatrics, domestically as well as internationally. This accounts for the organisation of the world congresses in Prague – the Congress of the IALP (International Association of Logopedics and Phoniatrics) in 1930 (president prof. Miloslav Seeman, M.D., PhD..) and in 1989 (president prof. Alexej Novak, M.D., PhD.).
Three times the congress of the UEP was held in Prague, the last in 1993. Professor Seeman was Honorary President of the Union for life, ass.prof. Sedlackova was president of the Union of European Phoniatricians in 1972-1973, professor Novak (recently Head of the Phoniatric Clinic), was board member of the IALP during the term of 1986-1992 and member of the UEP general secretary in 1982-1993. In the years 1992-1998, associate professor Frantisek Sram was a member of the IALP Board. He too was originally on the staff of the Phoniatric Clinic, now heads a private phoniatric centre.
Since the year 1945, the Czech Otorhinolaryngology Society had a phoniatric committee, which in 1968 was transformed into the Phoniatric Section of the Czech ORL Society. Since 1970 this Section holds its own annual congresses called Phoniatric Work Days, since 1977 they bear the name of Eva Sedlackova.

At present, the Phoniatric Clinic in Prague (headed by prof. Milan Lastovka, M.D., PhD.) the only in-patient facility in Czech Republic, provides the entire range of diagnostics and treatment on a state-of-the-art level. It has at its disposal diagnostic and curative equipment such as is not available elsewhere in the Czech Republic, it is standard in industrialised Europe. Treatment is provided to hospitalised and out-patients and at the auditory centre – the Clinic is a graduate-training centre for phoniatricians working in public and private health facilities all over the Czech Republic.
The Clinic´s research work is reflected by a number of projects funded by grants, on subjects such as fluency disorders (dr. Cerny, prof. Lastovka), mathematical modelling of vocal folds (dr. Vohradnik), problems of central processing of speech signals in developmental speech disorders (dr. Dlouha), auditory screening of neonates at risk (dr. Dlouha, dr. Jedlicka, dr. Cerny, dr. Puchmajer), EMG monitoring of paresis of the larynx (prof. Lastovka), utilising the neuron networks in assessing dysphony (ing. Vokral). Thus the Phoniatric Clinic carries forward the tradition of the founders of Czechoslovak phoniatrics, professor Seeman and associate professor Sedlackova, in the activities of the contemporary second generation of their pupils.