Final: Behavioral Treatment Options Flashcards
Vocal Hygeine:
Goal?
Who needs it?
What all is involved in a good vocal hygeine program?
Goal?
- to identify, eliminate, modify causative or maintaining factors
Who needs it?
- Most people
What all is involved in a good vocal hygeine program?
- Can be techniques to limit use of voice, avoid use of loud, effortful voice, maintian good general health habits, or limit laryngeal/lung irritants
Examples of ways to reduce use of voice:
- limit non-essential talking/singing
- use of non-vocal signals to get attention
- use of more gestural, visual aids in lectures
Examples of ways to avoid use of loud, effortful voice
- limit background noise
- move closer
- use amplification
- avoid loud laughing
Examples of ways to maintain good general health habits:
- adequate sleep/rest
- balanced/nutritious diet
- exercise
- minimize stress
Examples of way to limit laryngeal/lung irritants
- increase hydration
- limit throat clearing/coughing
- avoid alcohol/caffeine
- avoid airborne irritants
- avoid meds that affect hydration, blood thinning
- limit talking in presence of cold/allergies
What’s an important thing to do when creating a vocal hygiene program for a client?
Prioritize for them the order of importance. Too much informaiton and they may feel overwhelmed.
Is a vocal hygeine program a treatment of the disorder?
No, it’s a treatment of the behaviors that have led to the disorder
How does behavioral treatment differ from other treatment you may see in our field?
- initial training/education in a short period of time
- out on their own for a short period of time with a spaced follow up
- booster therapy sessions when they forget
What’s the key to success in behavioral therapy?
Client motivation
There is a lot of work they need to do outside of therapy that they need to be aware of beforehand.
When is it necessary to try to alter the person’s attitude of their voice?
- Rectify/recalibrate impression of severity: some may think it’s worse than it is (parents hypersensitie pt) or don’t think it’s bad enough (PD)
- Tolerance/impact: desensitize speaker/listener to impact reations
When do you need to trigger normal or “best” voice?
- False vocal fold phonation
- Psychogenic dysphonias
- Those with strange voicing patterns (too high pitch, loudness, effort
What ways can you trigger normal or best voice?
Passively:
If they can do it, does it mean it’s psychogenic?
Vegetative Phonation
- laugh, throat clearing, etc
- shows that there is some phonation
- Not necessarily psychogenic, could be VF paralysis
What ways can you trigger normal or best voice?
Actively
- Ask if they can change it “Do you have an “other” voice?”
- if you hear a better voice at some point, ask if they can reproduce it
- Trigger true VF phonation on
- inhalation
- falsetto
- glottal fry voice
- Reposture/rebalance larynx
- Laryngeal manipulation
- alter head position
What order should you try when getting client to move from a triggered phonation to normal voice production?
- first: trigger (show them they can do it)
- sustained vowel
- voiced syllables (because with –v syllables they have to Abduct
- fully voiced phrases
- sentences
- conversations
Eliminating voicing as a treatment strategy:
When to use total rest vs modified rest:
Total rest:
- Open lesions that need to heal
- Can’t produce voice w/o substantial effort (break the voice pattern)
- help client realize the frequency of the behavior
Modified rest:
- to reduce edema
- counterbalance heavy use
- entails: limit conversation time, exclusively use primarily 1-on-1 conversations, limit background noise, avoid singing/whispering/lifting/pushing
