Lecture 1 - 9/3

Question 1

Voice Disorder Objectives (5)

Answer 1

to develop awareness of your voice
to develop physiological empathy
to develop a working knowledge of vocal physiology
to develop critical observation skills
to appreciate patient centered treatment

Question 2

Modified Jaw Release Exercise

Answer 2

purpose- to realize the jaw to the neutral rest position

creates space between the top and bottom teeth= freeway space

Question 3

8 mantras for a new clinician

Answer 3

1 it is impossible to remember and implement everything you have learned in your coursework
2 your skills will improve with more experience
3 listen to your patients
4 every patient is unique
5 remember you empathize differently with patients vs your family
6 you can not persuade anyone of anything
7 techniques or models don’t work for everyone
8 it’s okay to say I don’t know

Question 4

How do I use theory to solve clinical problems?

Answer 4

Hypothesis based treatment
Anatomy and Physiology
Motor learning theory
risk to vocal health

Question 5

How do I answer my patient’s questions?

Answer 5

Good knowledge base
-cultural humility
-patient centered therapy
- self efficacy
-transtheoretical model
- motivated interviewing
-procedures
practical experience

Question 6

Hypothesis Testing

Answer 6

Hypothesis: A simple declarative statement that incorporates cause and effect and can be tested
Based on behavior: not judgment/assumption
Critical Reasoning:Observe voice, take history, incorporate patient’s perspective

Question 7

Goal of Rehabilitation:

Answer 7

To Facilitate Change (help patient change behaviors that compromise voice production).
Do this with a Plan of individualized management strategy based their specific needs and particular symptoms.

Question 8

Develop Hypotheses Based On Knowledge Of…

Answer 8

1. Normal Anatomy and Physiology
2. Anatomical Changes
3. Manner of Phonation
4. Symptoms

Question 9

Test Hypotheses by…

AKA: Voice Rehabilitation

Answer 9

1. Engage in Therapeutic Behaviors
2. Observe Results
3. Ask about sensations in Head, neck, thorax
   If results support hypothesis = accept
   If results do not support = modify or reject

Question 10

Manners of Observable Phonation

Answer 10

• High Effort Levels
• Effortful Phonation (Abrupt Onset)
• Extraneous Muscle activity in head, neck, thorax

Question 11

Observable assessment of freedom of movement in Vocal Tract

Answer 11

• Stiffness in the jaw
• Stiffness in tongue base
• Excessive elevation of hyoid and larynx