Evaluation of Voice Flashcards
Evaluation of voice
Assessment: Process of Collecting Relevant Data
Evaluation: Appraisal of the Implications
Diagnosis: Clinician to make Decisions about whether the Voice Problem exists and to Differentiate it from other, similar problems
Screening for voice disorders
Actual prevalence of voice disorders in children is difficult to determine
Average: 5% of any given school-based clinician’s caseload
Other individuals identify majority of voice disordered children: teacher, nurse, or family member
Screening tools
Quick Screen for Voice (Lee): Checklist for observations (10 minutes)
- Spontaneous Conversation
- Picture Description
- Imitated Sentences
- Recited Passages
- Counting
- Other Natural Samples of Voice & Speech
Boone Voice Program for Children
Role of SLP & Physician
ASHA Preferred Practice Pattern for Profession of SLP:
Physician preferably in a discipline appropriate to the presenting compliant, must examine all patients/clients with voice disorders.
Physician’s examination may occur BEFORE or AFTER the voice evaluation by the clinician.
Medical Evaluation of Voice Disorders
History Questionnaire administered by Clinicians
Comprehensive Physical Examination by MD: to confirm or rule out medical conditions
Laryngologists need to consult with specialists such as Neurologists, Pulmonologists, Endocrinologists, Psychiatrists, Internists,
Gastroenterologists, Physiatrists, and other specialists
Otolaryngologist
Mirror Laryngoscopy: small laryngeal mirror is placed at back of patient’s mouth & light is shone on the mirror from the physician’s headset. When the Mirror is angled properly then a reflected view of the hypopharynx is achieved.
Laryngeal Endoscopy: Rigid Fiberoptic Scope is placed in the mouth & has a prism at the end of the scope at 70 or 90 degree angle. An inverted V position of the vocal folds is viewed.
Flexible Fiberoptic Scope is passed through one of the nasal passages.
Testing - Auditory and visual status
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Case History
Establish Rapport
Elicit patient’s motivational level to make & adhere to behavioral changes, other treatment modalities which did not work for the patient, & support system for the patient
Description of Problem & Cause:
patient, family, spouse, teacher perception may vary.
Discrepancy in “what the doctor said” is a result of patient’s reluctance to accept & cope with the real problem.
Onset & Duration of Problem:
sudden onset or gradual, acute verses long standing history
Variability:
Laryngopharyngeal reflux, Voice use, environmental irritants
Vocal Demands:
abuse, misuse, & overuse
Additional Case History & Behavioral Observation:
Voice Therapy verses Psychotherapy for interpersonal adjustments
Auditory-Perceptual Rating
is more common than stroboscopy, acoustic, aerodynamic, & electroglottographic assessments
CAPE-V:
drafted following the Consensus Conference on Auditory Perceptual Evaluation of Voice, Univer. of Pittsburgh 6/2002
Sponsored by ASHA Special Interest Division 3 (Voice & Voice Disorders)
6 Aspects of Voice: Overall Severity, Roughness, Breathiness, Strain, Pitch, & Loudness. Also includes 2 unlabeled scales for other significant features, i.e. tremor.
Place a mark on the 100 mm horizontal line
