Voice Evaluation Flashcards
purpose of the voice evaluation
the voice evaluation is implemented to allow the therapist to make several determinations regarding the patient’s voice
3 most important determinations to arrive from the evaluation
- detailed description of the patient’s voice characteristics and how they vary over time
- determination of how severe the patient’s voice disorder is
- determination as to whether the patient would benefit from a program of voice therapy
complete description of the patient’s voice
it is better to use descriptive terms regarding the patient’s voice, rather than simply attaching a label to a disorder
you want to describe 3 things about the patient’s voice
- what the patient does well
- what they do poorly
- what they are unable to do
the description of the patient’s voice should include a hypothesis regarding…
possible etiologies of the vocal pathology or dysfunction
severity rating
based on the information you collect during the voice evaluation, you should be able to make a judgement regarding the severity of an individual’s voice disorder
___ ___ ___ are useful and may provide the best method for making judgments about severity
numerical rating scales
___ ___ of ___ are also potentially useful, although they tend to be general and less meaningful than a formal scale
subjective descriptions, severity
numerical rating scales often provide the clinician with the opportunity to make
several simultaneous severity evaluations concerning various aspects of the patient’s voice
when using numerical rating scales, these number of units are an indication of…
which end of the scale represents normal should be specified
determining candidacy for voice therapy
following the evaluation, the therapist should be able to make a diagnosis of the patient’s dysphonia, as well as formulate a statement regarding the patient’s potential to benefit appreciably from a course of voice therappy
the prognosis for improved voice is generally best for patients who…
report a more acute onset
those that seek help sooner often recognize the voice immediate impact their voice disorder has on daily activities…
they are generally well motivated and usually quite anxious to be rid of the restrictions imposed by the dysphonia
prognosis is poorer for patients who…
report a long-term, chronic dysphonia
often long-term dysphonia patients have had time to…
adapt to the gradual changes in their voice and are relatively undisturbed by the dysphonia
patients with long-term dysphonia may not seek assistance on the own but more often do so on…
the recommendation/insistence of a physician, spouse, or friend
if you are uncertain as to the prognosis for improvement or the benefits of therapy
the recommendation of a trial period of therapy is acceptable
a recommendation for a period of trial therapy should always include a…
length of time
therapeutic protocol
there are no standards regarding the exact procedures which should be followed during a voice evaluation
the current approach of choice is typically…
a perceptual evaluation confirmed by instrumental tests and outside consultations
instrumental tests are ordered dependent on…
availability of laboratory facilities and equipment, clinician training/experience/preference, and the type of presenting problem
a good/complete/ideal protocol for a voice evaluation would be as follows
- analysis of ENT report and other medical information
- case history
- observation of patient’s behavior
- hearing assessment
- oral motor assessment/laryngeal palpation
- articulation/intelligibility
- evaluation of pitch/frequency (perceptual and instrumental)
- analysis of quality/wave complexity (perceptual and instrumental)
- judgment of air wastage/measurement of airflow rate/respiration
- use of other/relevant/pertinent physiological measures (EGG, EMG)
- videoendoscopy
- presentation of appropriate clinical facilitation techniques/trial therapy
you want to be sure to obtain an…
audio and/or videotape sample of the patient’s voice during evaluation
the collection of a case history is a…
critical element of any voice evaluation
your responsibilities during the interview process include
- assuming responsibility for the conduct of the interview
- avoid control and rigidity that inhibits or intimidates the patient
- keep the interview in focus
- remain sensitive to the patient’s feelings expressed both verbally and nonverbally
- not expressing subjective, personal feelings
- remain open and accepting of the patient even when the patient is hostile or uncooperative
it is generally a good idea to start with…
a few minutes of information conversation to put the client at ease and then transition to a facilitative role in which the patient does most of the talking
the informal period allows you to do 2 things
- establish a relaxed environment which places the patient at ease and established some degree of familiarity
- begin making some observations about the communicative abilities, perceptual quality of the voice, and their behaviors
this informal period allows you the opportunity to evaluate the…
more general aspects of the patient’s communication skills, which is especially important as the voice disorder may be a symptom of other underlying problems
expected patient behavior
the patient should be able to function in a reasonably comfortable manner in a conversational setting, with the conversation flowing smoothly with only limited signs of discomfort on the part of the patient
inappropriate patient behavior
patients who struggle with the social aspects of conversation may exhibit:
- failure to maintain normal eye contact
- frequent postural adjustments
- rigidity of facial expression
failure to maintain normal eye contact
