quiz 8

Question 1

6 steps of cognitive motor learning

Answer 1

• recognizing the difference
• willingness to change
• setting goals
• talking therapeutically
  -learning to listen, evaluate, self-correct
  -add cognitive/lingusitic load

Question 2

step 1: recognizing the difference

Answer 2

• patient must recognize how their current voice is different from what they used to or want to do
• will not participate if they don’t see a difference
• idea behind recalibration

Question 3

step 2: willingness to change

Answer 3

• internal force for motivation
• will make little to no progress if they do not want to change

Question 4

step 3: setting goals

Answer 4

• targets to understand what the patient wants to get out of therapy
• further drives motivation
• improves carryover and generalization
• best practice, best care for patients

Question 5

step 4: talking therapeutically

Answer 5

• when in therapy space, employing all techniques at all times
• utilizing every moment with the patient to practice skills

Question 6

step 5: learning to listen, evaluate, and self-correct

Answer 6

• make sure patient is able to hear difference between old voice/new voice in their own production
• if patient is able to self correct, therapy is not over - must add load

Question 7

step 6: add cognitive/linguistic load

Answer 7

• not every environment is warm, open, welcoming with compassionate listener
• have to add challenge to improve generalization

Question 8

vocal health and hygeine

Answer 8

• minimize phonotraumatic voice use
• hydration, either systemic or superficial
• avoid inhaled irritants
• warm-up, cool down, rest voice
• be mindful of acid reflux triggers
• manage post-nasal drip
• exercise
• eat well
• get adequate sleep

Question 9

goals of SOVT exercises

Answer 9

• achieve optimal laryngeal posture
• improve impedance match at level of vocal folds
• coordinate respiratory and phonatory systems
• reduce muscle tension
• reduce or increase vocal effort

Question 10

types of SOVT excercises

Answer 10

• straw phonation in water
• straw phonation
• lip or tongue trills
• humming

Question 11

heirarchy of SOVT

Answer 11

• airflow only
• add one comfortable pitch
• low to high
• high to low
• sirens
• bonus: add a melody

Question 12

goals of RVT

Answer 12

• improve oral resonance
• coordinate all three subsystems equally
• reduce vocal effort or pressure in throat
• establish healthy vocal production
• finding a “forward focus”

Question 13

hierarchy of RVT

Answer 13

• basic training - /m/, /n/, /z/, /v/
• chanted with CVC combos - meem, moom
• words - moon, movie, marshmellow
• phrases - marvelous movie, mom and dad
• sentences - my arm is numb
• paragraphs
• functional phrases
• conversation

Question 14

goals of flow phonation

Answer 14

• reduce hyperfunction
• decrease breath holding
• improve respiratory/phonatory coordination
• establish efficient voice production

Question 15

basic training gesture of flow phonation

Answer 15

• with biofeedback of a tissue or hand
• airflow release - /hu/
• add voice
• transfer to other sounds, words, phrases

Question 16

goals of yawn sigh

Answer 16

• facilitate easier phonation
• reduce laryngeal muscle tension
• yawn expands pharynx, lowers larynx into more neutral position
• sigh should be more relaxed with less tension

Question 17

goals of CTT

Answer 17

• improve oral resonance
• coordinate respiration, phonation, and resonance
• establish target voice production in context immediately - extremely unique - put into conversation immediately!!!

Question 18

basis of CTT

Answer 18

• uses cue of “clear speech”
• over-exaggerated articulation
• clear, crisp consonants

Question 19

six components of CTT

Answer 19

• clear crisp speech
• rapport building
• auditory/kinesthetic awareness
• negative practice and labeling
• embedded basic training gesture, either flow phonation or RVT
  -prosody, pauses, and projection

Question 20

goals of laryngeal massage

Answer 20

• reduce muscle tension
• reduce vocal effort and strain
• establish and/or restore balance to voice production

Question 21

areas for laryngeal massage

Answer 21

• thyrohyoid space
• thyrohyoid circle up
• thyrohyoid circle down
• floor of mouth/tongue
• sides of neck - SCM
• jaw slides

Question 22

goals of PhoRTE

Answer 22

• improve glottic closure
• strengthen laryngeal musculature
• improve overall intelligbility
• does have a risk of phonotrauma

Question 23

hierarchy of PhoRTE

Answer 23

• say “ah” in exuberant voice, as long as u can without strain, 10x
• pitch glides, low to high and back down in exuberant voice without strain, 10x
• say 10 functional phrases in high and loud
• say 10 functional phrases in low and loud
• speak in exuberant voice for 30 seconds to 2 minutes

Question 24

LSVT LOUD

Answer 24

• improve vocal effort to normal amount
• improve intelligibility and loudness
• global cue of “GET LOUD”
• 60min sessions, 4x/week, for 4 weeks, with 10-15min homework 1x/day

Question 25

Speak OUT!

Answer 25

- for hypokinetic dysarthria, decreased vocal effort, PD - aims to increase vocal effort without phonotrauma/vocal hyperfunction - 40-45min sessions, 3x/week for 4 weeks

Question 26

hierarchy of VFEs

Answer 26

- warm up: sustain note for as long as you can without strain 2x - stretching exercise: low to high 2x - contracting exercise: high to low 2x - adductory power exercise: 5 note scale

Question 27

goals of vocal function exercises - VFEs

Answer 27

- developed as a type of physical therapy for voice - strengthen the system - balance airflow to laryngeal muscle effort - balance resonance - renew F0 flexibility

Question 28

structure and timing of voice therapy

Answer 28

- usually short tarm: 4-8 weeks - learning phase - practice phase - generalization phase - self efficacy - maintenance