Chapter 7: Voice Management (Hygienic Voice Therapy)

Question 1

What are 4 components of vocal hygiene counseling?

Answer 1

1) identifying the abusive behaviors
2) describing the physiologic effects of those behaviors on the voice production mechanisms
3) defining the specific occurrences
4) modifying or eliminating the behavior

Question 2

What are 6 typical voice abuses/misuses?

Answer 2

1) shouting
2) loud talking
3) screaming
4) vocal noises
5) coughing
6) throat clearing

Question 3

What is the typical presentation of chronic cough syndrome? (3)

Answer 3

1) pt has coughed for months or years
2) all medical testing has proven to be negative
3) no medications are causing the cough

Question 4

Laryngeal hypersensitivity caused by the cough in chronic cough syndrome causes coughing during what 3 situations:

Answer 4

1) forced inhalation
2) normal drainage
3) humidity changes

Question 5

What are 2 cough substitutions that can be used for individuals with chronic cough syndrome?

Answer 5

1) forceful swallow

2) hydration (cold/hot water can trigger the cough sometimes)

Question 6

A traditional hygiene approach for children will include charting what 3 potential inappropriate behaviors?

Answer 6

1) shouting
2) loud talking
3) vocal noises

Question 7

What are 6 additional diagnostic questions for children in hygienic therapy?

Answer 7

1) how does the child shout?
2) why does the child shout?
3) Does non-play shouting occur?
4) does the child make vocal noises?
5) has the laryngeal pathology created a physiologic imbalance?
6) does habitual throat clearing occur?

Question 8

How does the child shout? (4)

Answer 8

• some children shout more than others
• children are differentially susceptible
• some vocal mechanisms are not as resilient
• some children may should in a more balanced and supported manner

Question 9

How do you teach a child to shout appropriately? (2: what and why?)

Answer 9

1) use a low pitch (reduce adductory impact)

2) use adequate breath support and an extreme froward focus (reduce laryngeal tension)

Question 9

How do you teach a child to shout appropriately? (2: what and why?)

Answer 9

1) use a low pitch (reduce adductory impact)

2) use adequate breath support and an extreme froward focus (reduce laryngeal tension)

Question 10

Why is it important to note why a child shouts? (2)

Answer 10

1) explore the psychodynamics of the shouting behavior
2) modify psychosocial aspects of behavior (may require modification of family interactions, interpersonal strategies, etc.)

Question 11

How can you address non-play shouting behaviors of a child with the family? (3)

Answer 11

1) don’t respond when child calls from another room
2) don’t shout for the child from another room
3) attempt to control sibling arguments/shouting

Question 12

What are vocal noises a child may make and how should they be addressed?

Answer 12

• lots of play (cars, sirens, guns, animals, etc)

- try to stop or substitute non-vocalized mouth sounds, typically happens naturally with maturation

Question 13

How can we address a child’s habitual throat clearing?

Answer 13

1) behavior modification with forceful swallow

2) lightly adducted vocal folds

Question 14

What is the summary of a vocal hygiene plan?

• 1/4
• 1
• 2
• 1/4

Answer 14

1) identify the phonotrauma (shouting, loud talking, vocal noises, throat clearing)
2) describe the effects (use pictures, diagrams, drawing, video, etc)
3) define specific occurrences and psychodynamics
4) modify the behaviors (teach how to shout, modify/eliminate vocal noises, eliminate non-play shouting, eliminate throat clearing)