15 - Voice Therapy Flashcards
How is voice therapy a very individual process?
7
Different etiologic factors
Background history
Certain voice demands
Medical complexities
Occupational and social issues
Motivation
Patient SKILL!
What is the goal of voice therapy?
2
Restoring best voice possible (focus on functional outcomes)
Re-educating patient most effective and efficient use of voice (eliminate voice disorder/pathology)
What are five things to remember when doing voice therapy?
Clinician needs sufficient information to plan and institute treatment program
Each program should be specifically designed for patient
Patient should understand therapeutic process
Patient shares responsibility for progress
Use a multidisciplinary approach
What are three examples of typical long term goals?
3
Patient will demonstrate functional voice quality for age and gender in spontaneous speech.
Client will decrease vocal fatigue from 90% presence to 10% presence in structured speech tasks
The client will identify no more than 2 instances of vocal fatigue in a 2 week period of typical voice use tasks.
What are five things we may need to teach and explain to the client?
(5)
Laryngeal status
Normal anatomy of VT (vocal tract)
Causative factors
Management plan (To not be here next year, this is what I’m going to have to do)
Explanations should be based on emotional status, educational/intellectual level of patient
What is an indirect therapy method?
Vocal Hygiene
What is a direct therapy method?
Therapy methods improving laryngeal function
What are the 7 typical voice therapy protocols?
Vocal wellness
Respiratory training
Relaxation training
Phonatory retraining
Medical coordination
Singing training
Referrals as appropriate
What are three vocal wellness protocols?
3
Vocal hygiene
Phonotrauma – ID and Eliminate
Vocal Inventory (Take an inventory of how patient uses their voice and how much)
What are three respiratory training protocols?
3
LAB (lower abdominal breathing)
Use of breath in phrases/sentences
Expiratory Muscle Training (Two types)
What are four relaxation training protocols?
4
Whole Body Relaxation
Stress Reduction etc.
LAB (Very relaxing to the larynx; 1,2, and 3 of program)
Laryngeal Massage
What are six phonatory retraining protocols?
6
Easy Voice
Challenge principles (adduction exercises, increase tension)
Rate, intonation
Vocal Function Exercises
Valsalva Maneuver
Resonant Voice Therapy (Mask Focus)
What are two singing training protocols?
2
Referral to or coordination with Singing Teacher
Give advice about singing
What are three conditions that might require medical coordination?
(3)
Reflux
Allergies
Asthma
Who might we make referrals to?
2
Psychology
Neurology
Etc
What is the ultimate goal of voice therapy?
2
Design a series of tasks/exercises to increase phonation efficiency (easier and more effective phonation)
Move from sound -> syllables -> words -> sentences -> conversations on a day-to-day basis
What four things happen when voice therapy session begin?
Describe
Measure motivation for therapy
Discuss a timeline
Home practice materials.
What makes up the describe phase of voice therapy?
4
Normal anatomy and physiology
Etiologic factors
Correlate etiology and vocal symptoms
Impact on vocal fold function
What are reasons to end therapy?
4
Resolution of the vocal pathology
Patient satisfaction with voice outcome
Clinician satisfaction with voice outcome
Other issues – reimbursement, travel, health
What are the therapy approaches?
7
Voice Rest (and Modified Voice Rest)
Vocal Wellness (Hygiene)
Symptomatic Voice Therapy
Psychogenic Voice Therapy
Physiologic Voice Therapy
Eclectic Therapy
Combined Modality
What makes up the psychogenic therapy approach?
2
Idenifying vocal habits due to emotional, occupational, or social stresses (Serious cases, should be referred for a psychiatric evaluation)
Helping patient remediate the emotional disturbances associated with the onset or maintenance of the condition
What makes up the physiologic voice therapy?
Direct exercises used to activate the laryngeal muscle and other subsystems (respiratory and supraglottal)
What are examples of physiologic voice therapy?
4
Vocal Function Exercises
Lessac-Madsen Resonant Voice Therapy
Lee Silverman Voice Treatment
Inspiratory and expiratory muscle strength training (Changes the physiology)
What is Voice Rest?
Not using voice
