Voice Diagnostics Non-Instrumental Flashcards
What is the purpose of voice eval interview?
Where is it obtained from?
- To get the content/case history information
- To observe the client’s voice, speech, demeanor
- Describe how the overall impact is as a listener, how hard for us and potentially others to hear
2 sets of data we are keeping track of: information from their history and observations from the interview
Obtained from: patient, spouce, chartm paper-pencil questionnaires
What information are you looking for in an interview?
- biographical (name, age, DOB, address, occupation, etc)
- health history: past/present, meds, surgery
- problem description
- voice use status
- psych status
- perceptual impact of voice situation
What kinds of samples might you use to judge observations off of?
- conversational voice (during interview)
- monologues (gives you a chance to hear without being distracted by conversation)
- reading (same as above but easier for patient)
What observations are you making during interview?
What tools can you use to make your observations?
- product (using CAPE-V)
- quality
- pitch
- loudness
- process (eyes, ears, touch)
- respiratory behavior (depth, rate, duraction, effort)
- muscualar tension (chest, neck, jaw, face)
- perception of effort
- facial expression (suggestive of effort (cognitive or physical) or pain/discomfort)
- posture (chin pulled back, neck twisted, etc)
- **check what you see happening to the process as they cahnge in pitch, loudness
- overall impact on you as the listening (CAPE-V)
- severity of the problem (CAPE-V)
- acceptability of the voice
- functional interference (impact on intelligibility, increased distractability, increased cognitive/processing load on the listener)
- listener comfort in hearing the voice
What are elements of quality that you should look for?
- type (rough, breathy, strain)
- severity (visual analog)
- consistency (% time)
What are some of the elements of pitch that you should look for when observing?
- too high-low
- uncontrolled
- for each of the above rate/judge severity of the deficit and consistency
What are some of the elements of loudness that you should look for in an observation?
- too loud/soft
- uncontrolled
- for each of the above rate/judge severity og the deficit and consistency
What are some examples of specific speech/voice samples you can elecit for an observation and why would you use them?
- sustained vowel: demonstrate they can produce enough subglottal air pressure to sustain, see if there is diplophonia, tremor, or phonation breaks, go into glottal fry or have a hard onset
- interrupted vowel: see if they can do hard medial compression /a-a-a/ to be tbried devoicing (laryngeal diodokokinesis), adbuct in the middle of phonating wiht /ha-ha-ha/ (if concerned PCA is paralyzed)
- count from 80-81: hard glottal onset
- breath holding: can ADDuct VFs completely
- softest phonation possible
- etc
What are some vegetative-emotional phonation tasks you could have a client do and why would you use them?
- laugh, cry, sigh, cough, throat clear
- observe swallow
Do them to:
- contrast with speaking voice (poss psych)
- can tell you something about potenital abilities/limitations of larynx/phonatory systems
What is the purpose of assessing laryngeal maximums?
- to tell us what they are capable of doing
- see how well they can manipulate voice and follow directions
What tasks can you do to assess laryngeal maximums?
- pitch range
- loudness range
- MPT
- s/z ratio
- respiration: observe patterns of inhale/exhale
- counting 1-200
Why should you test for stimulability?
- help identify potential tx strategies to try
- help determine if better/normal voice is possible
- evaluate compliance with instructions/therapy regimen
- eval ability to follow instructions
- assess degree of awareness and control they have over their body
