Voice Final: Voice Evaluation_LMenchini Flashcards
team approach:
otolaryngologist: ENT speech pathologist: you neurologist: ex: fasiculations gastroenterologist: ex: reflux/ difficulties psychologist: ex: puberphonia pulmonologist: respiratory problems
voice evaluation: important considerations
- combination of measurements: not one measurement gives the info needed to make a diagnosis (ex:pitch/woman is low. only 1 measurement)
- many measures open to multiple interpretations and misinterpretations: the more info the more right the diagnosis
- limited access to various measures (software/devices: cup and water)
- evaluation does not end w/ first visit (you don’t have all info in one visit - continues thru multiple visits)
evaluation steps:
Step 1. Before appointment
-review case history client/parent provided when scheduling the appt.
Step 2. During the appointment:
Hearing screening -> Voice examination -> Oral examination -> Trial treatment (see if anything improves voice) -> Recommnd. and prognosis -> if client as not been evaluated by ENT, recommend an ENT consultation
Step 3. After appointment
-report writing
case history: guidelines during interview
- Assume responsibility for the conduct of the interview
- Avoid control and rigidity that inhibits and intimidates the patient
- Keep the interview in focus
- Maintain flexibility
- Remain sensitive to the patient’s feelings expressed both verbally and nonverbally
- Do not permit expression of subjective, personal feelings
- Remain open and accepting of the patient even if hostile and uncooperative
- Speak in language tailored to the individual patient. Language that they can understand and that is neither insulting to intelligence or patronizing.
What defines content of case history?
obtain relevant background information in order to facilitate diagnosis of voice disorders and to determine possible underlying causes
case history: content
- description of problem and cause (what they think)
- onset of duration of problem
- variability of problem (morning vs. night/ good days vs. bad)
- description of vocal use
- additional case hx (health, vocational, recreational, social, psychological)
- quality of life
- previous treatment (how long, successful, prev. records if allowed)
what is quality of life?
A content criterion in a case history form:
- Voice Handicap Index
- Voice-Related Quality of LIfe
- Voice Symptoms Scale
What can you use the Voice Handicap Index for?
(quality of life: case history content)
use the information as your baseline data (see where they made improvements)
SLP: Voice Diagnosis?
(Voice Examination)
- Perceptual (your ear)
- Acoustic (microphone)
- Aerodynamic (mask)
- Physiologic (EGG)
Briefly describe types of measurements to obtain in the categories of voice diagnosis by SLPS.
- Per: breathiness, harshness, hoarseness, s-s, tremor, pitch and loudness (subj)
- Acou: jitter, shimmer (recorded), F0, intensity (obj)
- Aero: Psg/CmH20
- Phys: electroglottography
voice diagnosis: perceptual measurements
- often first noticeable sign of vocal dysfunction
- critical listening, observation, and description
- subjective measurements
- hoarseness, harshness, breathiness, s-s
- high pitch, low pitch, monopitch
- monoloudness, loudness variations
voice diagnosis: perceptual measurements
what do you use to help you obtain these measurements?
- Boone Voice Program for Children: ask child, teacher, parent what the problem is. Know what problem is and where (environ) it happens. Help from multiple sources
- Consensus Auditory Perceptual Evaluation of Voice (CAPE-V)
CAPE-V stands for
Consensus Auditory Perceptual Evaluation of Voice (measurement in perceptual diagnosis)
ENT: Medical Diagnosis
- Visual
