Voice Disorders: Research and Resources When patients are referred for voice treatment, what factors affect their attendance and outcomes? Researchers from the University of Illinois and Rush University used a retrospective study to identify factors that may distinguish patients who attended voice treatment and had positive voice change from those who did not. The ... Research in Brief
Free
Research in Brief  |   November 01, 2010
Voice Disorders: Research and Resources
Author Notes
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Speech, Voice & Prosody / Research in Brief
Research in Brief   |   November 01, 2010
Voice Disorders: Research and Resources
The ASHA Leader, November 2010, Vol. 15, 20-21. doi:10.1044/leader.RIB.15142010.20
The ASHA Leader, November 2010, Vol. 15, 20-21. doi:10.1044/leader.RIB.15142010.20
Successful Voice Treatment Predictors
When patients are referred for voice treatment, what factors affect their attendance and outcomes? Researchers from the University of Illinois and Rush University used a retrospective study to identify factors that may distinguish patients who attended voice treatment and had positive voice change from those who did not. The study included medical records for 100 patients at a major urban, academic medical center. The attendance/outcomes of voice treatment resulted in patient division into five groups—those who were successfully discharged from therapy; attended a few sessions, had voices that improved to normal or near-normal and then stopped attending; attended many sessions with some voice gain; failed to improve despite attending voice treatment; or failed to attend recommended voice treatment. Outcomes for the first three groups (53% of patients) were considered successful; outcomes for the last two groups (47% of patients) were considered unsuccessful.
Patients with successful outcomes were more likely to be female, younger, and employed, and have fewer laryngeal diagnoses and medical problems, a less severe voice disorder, and lower Voice Handicap Index (VHI) scores at the start of treatment. Patients with more complex laryngeal diagnoses, more perceived vocal severity, occupational issues, more health issues, and higher VHI scores at the initial voice evaluation may be at greater risk for failing to attend treatment. The article appears in “Articles in Press” (search on “Bonnie Smith”) of the Journal of Voice.
Public Awareness of Voice Treatment
Most Americans don’t know that treatment for voice problems is available or think the problems will go away on their own, according to a new study from the Duke Voice Care Center. Results of the study help determine why two-thirds of those with voice problems don’t seek medical care.
The study included 789 patients in a primary care network. Nearly 30% had dysphonia at least once; 4.3% had it for more than four weeks. More than half of those with current dysphonia had missed at least one day of work as a result. More than three-quarters of the patients who had dysphonia more than once had never received treatment.
Study patients failed to seek treatment because they didn’t know it was available (30.4%); thought the condition would go away on its own (33.3%); their physician didn’t ask about vocal problems (26.1%); they thought dysphonia was due to aging (14.5%); they were concerned about expense and insurance coverage (7.2%); or they had travel limitations (4.3%). The article appears in the October issue of Laryngoscope.
Voice Use in Teachers
Teachers represent 16% of all occupational voice users (individuals dependent on a high level of vocal endurance and/or voice quality to perform their jobs), but their vocal health problems on the job are well-known. Researchers at the National Center for Voice and Speech (NCVS) at the University of Utah have created a more concise picture of teachers’ vocal demands by comparing their occupational voice use with their non-occupational voice use.
The researchers used the NCVS voice dosimetry databank to calculate voicing percentage per hour as well as average dB SPL and fundamental frequency (F0) for occupational voice use (9 a.m.–3 p.m. weekdays) and non-occupational voice use (4–10 p.m. and weekends) for 57 teachers for two weeks.
Key findings include: occupational voicing percentage per hour is more than twice that of non-occupational voicing; teachers experienced a wide range of occupational voicing percentages per hour (30% ± 11% per hour); average occupational voice was about 1 dB SPL louder than the non-occupational voice and remained constant throughout the day; occupational voice exhibited an increased pitch and trended upward throughout the day; and some gender differences were apparent.
Researchers concluded that data regarding voicing percentages (F0 and dB SPL) provide critical insight into teachers’ vocal health and that because non-occupational voice use is added to an already overloaded voice, it may add key insights into recovery patterns and should be the focus of future studies. The study appears in the August 2010 issue of the Journal of Speech, Language, and Hearing Research.
Vocal Function Exercises for Presbylaryngis
Vocal function exercises may produce significant functional and perceptual improvements in voice for elderly patients with presbylaryngis (aging of the larynx), according to research at the University of Utah Voice Disorders Center.
Researchers examined the effects of vocal function exercises as a primary treatment for the condition, which can adversely affect older adults’ vocal function and quality of life. After six weeks of voice treatment using vocal function exercises, nine patients with presbylaryngis reported significant reductions on Voice Handicap Index scores, phonatory effort levels, and voice disorder severity.
Blinded listeners rated the post-treatment voices as significantly less breathy and strained. However, comparison of pretreatment and post-treatment maximum phonation times, acoustic measures, and laryngeal images did not reveal significant changes. The research appears in the July 2010 issue of Annals of Otology, Rhinology, and Laryngology.
Resources
ASHA’s webpage on voice and voice disorders, although not all-inclusive, includes links to a number of policy documents, special interest divisions, related organizations, and professional development opportunities, including:
ASHA Policies and Reports
  • General guidance (definitions of communication disorders and communication variations, preferred practice patterns for the profession of speech-language pathology)

  • Endoscopy (roles of otolaryngologists and SLPs in strobovideolaryngoscopy; position statement, technical report, and knowledge and skills document on vocal tract visualization and imaging)

  • Tracheoesophageal puncture (roles and responsibilities position statement, technical report, knowledge and skills document)

  • Voice prosthesis (position statement, guidelines, and knowledge and skills document on use of voice prostheses in tracheotomized persons with or without ventilatory dependence)

  • Dysphonia and theuse of voice treatment

  • Voice habilitation and the role of the speech-language pathologist, singing teacher, and speaking voice trainer

General Information
  • ASHA Special Interest Division 3, Voice and Voice Disorders

  • Professional development (CEU) opportunities on voice disorders

  • Laryngeal-based voice disorders treatment efficacy summary

  • Graduate curriculum on voice and voice disorders

  • Consumer resources related to voice disorders

Multicultural Resources
  • Communication development and disorders in multicultural populations

  • Multicultural issues in the treatment of voice disorders

  • Voice and communication therapy for transgender/transsexual clients

Related Organizations
  • National Institute on Deafness and Other Communication Disorders

  • National Spasmodic Dysphonia Association

  • The American Academy of Otolaryngology-Head and Neck Cancer

  • National Center for Voice and SpeechК

  • Greater Baltimore Medical CenterСMilton J. Dance Jr. Head and Neck Center

0 Comments
Submit a Comment
Submit A Comment
Name
Comment Title
Comment


This feature is available to Subscribers Only
Sign In or Create an Account ×
FROM THIS ISSUE
November 2010
Volume 15, Issue 14