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Swallowing and Voice > Voice assessment > Flashcards

Voice assessment Flashcards

1
Q

Steps of assessment/differential diagnosis of voice disorders (6)

A
  1. Interview/case history
  2. Examination of medical records
  3. Examination of laryngeal structures and their function
  4. Rating of perceptual characteristics
  5. Measurement of acoustic, aerodynamic, vibratory and muscle action events
  6. Treatment probing - trialling different therapy techniques to discover receptiveness
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2
Q

What to find out in case history? (3)

A
  • Impact of voice disorder on client
  • Development of problem (onset/course/severity)
  • Patient history (voice use, vocational, social, recreational, psychological)
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3
Q

Means of auditory-perceptual voice assessment

A
  • Rating scales
  • Use of anchors
  • Terminology
  • Standardisation
  • CAPE-V
  • GRBAS
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4
Q

Diagnostic probing of voice (4)

A
  • Production of reflexive sounds: cough, laugh, throat clear, to give an idea of vocalisation of non-speech
  • Altering pitch: phonation range, use clinician modelling, people may be self-conscious
  • Sustained prolonged phonation: /ah/, observe control of phonation and respiration
  • Altering loudness: quiet, loud, incremental, phonation with effortful glottal closure/increased muscle tension
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5
Q

Non-instrumental assessment of voice (6)

A
  • Maximum phonation time
  • s/z ratio
  • GRBAS
  • CAPE-V
  • Perceptual descriptions
  • QOL scales
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6
Q

What is maximum phonation time?

A
  • Check respiratory function
  • Check glottal efficiency
  • Check laryngeal control
  • Repeat 3 times
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7
Q

What is s/z ratio?

A
  • Differentiate between laryngeal efficiency and respiratory support
  • Reduced vibratory efficiency should yield air wastage
  • ‘Healthy’ person should get same result for each /s/ and /z/
  • Repeat at least 2 time
  • May not be very reliable as it is a ratio
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8
Q

What is GRBAS?

A

GRADE (hoarseness), ROUGHNESS (irregularity of VF vibe/amplitude/frequency), BREATHINESS (air leakage), ASTHENIA (weakness), STRAIN hyperfunction
- Rating each feature on a scale of 0-3
- Inter-rate agreement higher with this 4-point scale than visual analogue scale

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9
Q

What is CAPE-V?

A
  • Rating perceptual characteristics on 0-100 scale
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10
Q

What are the perceptual characteristics of voice? (10)

A
  1. Loudness
  2. Quality
  3. Breathy
  4. Strained
  5. Rough
  6. Glottal fry
  7. Falsetto
  8. Phonation breaks
  9. Voice arrests
  10. Diplophonia
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11
Q

What are some QOL scales for voice? (6)

A
  • Voice Handicap Index (VHI)
  • Voice Handicap Index Partner (VHI-P)
  • Voice Handicap Index-10 (VHI-10)
    VHI = psychosocial consequences of voice disorders
  • Paediatric Voice-Related Quality of Life (PVRQOL)
  • Voice Activity and Participation Profile (VAPP)
  • V-RQOL
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12
Q

Recommended voice assessment protocol (9)

A
  1. Patient history
  2. Presenting problems - case history
  3. OPE
  4. Perception - diagnostic probing
  5. Videostroboscopy
  6. Acoustics
  7. Aerodynamics/efficiency
  8. Subjective rating by patient
  9. Voice related QOL
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13
Q

Key questions to ask regarding acoustic voice analysis (4)

A
  1. What is the purpose of voice samples? - listener judgement, language sampling, acoustic features
  2. Where are the recordings taking place? - clinic, home, in the field
  3. What is the budget? - individual devices or tested conducted centrally using one set
  4. What is the level of expertise of the use? - BYO device or complex multi-component setup
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14
Q

Data capture options for acoustic analysis (4)

A
  1. Desktop: MAC, PC
  2. Mobile: iOS, Android
  3. Online: web-based
  4. Passive: in the home
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15
Q

Instrumental assessment of voice (5)

A
  • Aerodynamic measurement
  • Measuring VF movements
  • Muscle activity measurements
  • OPE
  • Acoustic analysis
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16
Q

What is aerodynamic measurement?

A
  • MPT 3 times, choose longest
  • Spirometer to measure vital capactiy
  • Measure peak airflow during vibratory cycle, steady airflow
  • Measure subglottal air pressure, high readings can suggest excessive lung pressure or inefficient valving of VF, excessive variation can suggest poor motor control
  • Tools = aerophone II, phonatory aerodynamic system
17
Q

Measurement of VF movement

A
  • Observing vibratory behaviours, shape, regularity of glottal opening, mucosal wave
  • Tools = electroglottography, high speech laryngoscopy, stroboscopy, videokymography
18
Q

Muscle activity measurements of voice

A
  • Tools = electromyography
  • Observation of muscle movements or activation
19
Q

Observable physical signs of voice

A
  • Tissue changes
  • Anatomical structures
  • Laryngeal position/elevation
  • Appearance
  • Tools = laryngoscope, mirror exam, flexible nasendoscopy
20
Q

OPE for voice

A
  • Infection control
  • Symmetry
  • Tone
  • Posture

Swallowing and Voice (11 decks)

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