Voice Therapy Concepts and Techniques
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Voice Therapy Concepts and Techniques

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Questions and Answers

What does it mean for a transgender person to 'pass'?

  • They are acknowledged as transgender by others.
  • They are perceived as their gender identity. (correct)
  • They do not conform to their gender identity.
  • They advocate for others in the transgender community.

    • What are pronouns used for?

  • To promote misunderstanding.
  • To create a sense of discomfort.
  • To validate a person's gender identity. (correct)
  • To confuse individuals regarding gender.

    • Using incorrect pronouns intentionally is considered a transphobic act.

    True

    What should you do if you accidentally use the wrong pronouns for someone?

    <p>Pause, briefly apologize, correct yourself, and continue.</p> Signup and view all the answers

    The ______ is an interactive tool to evaluate cultural competence.

    <p>self-assessment</p> Signup and view all the answers

    What are some characteristics of feminine voice attributes?

    <p>Higher pitch, forward resonance, breathy quality, precise articulation, and longer flowing sentences.</p> Signup and view all the answers

    Which of the following is NOT a characteristic of feminine intonation?

    <p>Sharp peaks in pitch.</p> Signup and view all the answers

    Empathetic reactions and more polite speech are common traits of feminine communication.

    <p>True</p> Signup and view all the answers

    Match the following resources to their descriptions:

    <p>The Genderbread Person = A visual guide to understanding gender and identity Transsexual Voice Questionnaire (TVQMtF) = Self-assessment questionnaire for trans-women regarding voice</p> Signup and view all the answers

    What assessment tools are mentioned for vocal fold efficiency?

    <p>VHI, CAPEV GRAVIS scale, max phonation time, s/z ratio.</p> Signup and view all the answers

    What is the definition of 'spindle' in the context of vocal folds?

    <p>Anterior and posterior portions of the vocal folds are closed, but a large gap remains in the middle.</p> Signup and view all the answers

    What does incomplete closure of the vocal folds mean?

    <p>Vocal folds don’t touch.</p> Signup and view all the answers

    What is 'amplitude of vibration' in the context of vocal folds?

    <p>It refers to how far the vocal folds move laterally from midline during phonation.</p> Signup and view all the answers

    Higher fundamental frequency (F0) leads to increased excursion of vocal fold movement.

    <p>False</p> Signup and view all the answers

    A mucosal wave refers to the 'ripple-like' movement of the mucosa over the body of the vocal folds.

    <p>True</p> Signup and view all the answers

    What is assessed during normal pitch and loudness in relation to the mucosal wave?

    <p>Higher F0 leads to decreased wave and greater intensity leads to increased wave.</p> Signup and view all the answers

    What is the significance of 'vertical level approximation' in vocal folds?

    <p>It indicates whether the vocal folds meet on the same vertical plane.</p> Signup and view all the answers

    Which of the following is NOT a phase symmetry condition?

    <p>Complete Closure</p> Signup and view all the answers

    What type of evaluations can be done for voice assessment?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of the Voice Handicap Index (VHI)?

    <p>It addresses the influence of a voice problem on the patient's life.</p> Signup and view all the answers

    What reading level is recommended for health-related materials?

    <p>Fifth or sixth-grade reading level.</p> Signup and view all the answers

    What complaint could indicate odynophonia?

    <p>Pain with phonation.</p> Signup and view all the answers

    Which of the following can affect voice production?

    <p>Structural issues</p> Signup and view all the answers

    All transgender people undergo gender confirmation surgery.

    <p>False</p> Signup and view all the answers

    Dehydration can deteriorate voice quality in the long term.

    <p>False</p> Signup and view all the answers

    What are the auditory-perceptual features of presbyphonia?

    <p>Tremor, hoarseness, breathiness, voice breaks, decreased loudness, slower speaking rate.</p> Signup and view all the answers

    Which of the following is a treatment approach for presbyphonia?

    <p>All of the above</p> Signup and view all the answers

    What is reflux?

    <p>When stomach contents flow back up into the esophagus.</p> Signup and view all the answers

    Match the following voice evaluation tools with their descriptions:

    <p>Voice Handicap Index (VHI) = Self-questionnaire addressing the voice problem's impact on life. CAPE-V = Consensus Auditory Perceptual Evaluation-Voice. GRBAS Scale = Grade, Roughness, Breathiness, Asthenia, Strain assessment.</p> Signup and view all the answers

    Vocal therapy exercises are often based on _____ and acting voice techniques.

    <p>singing</p> Signup and view all the answers

    Match the following types of phonation exercises with their descriptions:

    <p>Straw phonation = Narrows/lengthens the vocal tract increasing air pressure above the vocal folds. Lip trills = Provides sensation of elevated pressure within the oral cavity and reduces effort in phonation. Inhalation phonation = Phonation on inhalation aiming to match exhalation voice. Chewing = Exaggerated chewing that aids in voice production and can be combined with open-mouth approaches.</p> Signup and view all the answers

    What are the basic goals of resonant voice therapy?

    <p>To improve ease, quality, and efficiency of phonation, and decrease strain and effort of phonation.</p> Signup and view all the answers

    The Lee Silverman Voice Treatment (LSVT) is aimed at making phonation softer.

    <p>False</p> Signup and view all the answers

    What is the role of a speech-language pathologist (SLP) for a patient undergoing a laryngectomy?

    <p>To provide pre-op education, involve family in counseling, and discuss functional communication options.</p> Signup and view all the answers

    Which of the following statements about artificial larynx is true?

    <p>It produces mechanical sound introduced into the vocal tract.</p> Signup and view all the answers

    Paradoxical vocal fold motion involves the _____ of the vocal folds during inhalation.

    <p>adduction</p> Signup and view all the answers

    Indirect laryngoscopy requires direct visualization of the vocal folds.

    <p>True</p> Signup and view all the answers

    What is one advantage of tracheoesophageal speech?

    <p>Natural phrasing and acoustically more typical speech.</p> Signup and view all the answers

    Study Notes

    Issues Affecting Voice Production

    • Voice issues can stem from structural or behavioral causes, or a combination of both.
    • Lifestyle modifications include reflux management and vocal health/hygiene practices.

    Hydration and Dehydration

    • Systemic hydration refers to fluid intake; surface hydration includes steam inhalation and humidifiers.
    • Dehydration can increase subglottic pressure and negatively impact vocal quality in the short term.
    • Dehydration raises the risk of phonotrauma and hampers recovery from existing vocal injuries.

    Reflux Management

    • Reflux occurs when stomach contents flow back into the esophagus and can be managed through medication or lifestyle changes.
    • Common reflux triggers include fatty foods, spices, citrus, and habits like smoking or high stress.
    • Strategies to manage reflux include dietary changes and lifestyle adjustments like elevating the bed.

    Vocal Trauma and Habits

    • Vocal trauma can result from habitual or work-related behaviors.
    • Identifying potentially harmful vocal habits is crucial; strategies should promote lifestyle modifications.
    • Handouts for patients should emphasize positive language and be easy to understand.

    Voice Therapy Goals

    • Improve coordination of respiration, phonation, and resonance for better voice production.
    • Enhance ease, quality, and awareness of vocal sensations linked with new phonation patterns.
    • Applicable to various disorders with hyper- and hypo-functional vocal patterns.

    Semi-Occluded Vocal Tract (SOVT)

    • SOVT exercises narrow the vocal tract to produce a resonant voice, maximizing interaction between sound source and filter.
    • Such exercises reduce tension, increase efficiency, and can improve vocal quality.
    • Activities include straw phonation, lip trills, humming, and using voiced fricatives.

    Resonant Voice Therapy

    • Focuses on improving ease, quality, and efficiency of phonation, along with reducing strain.
    • Sensations of buzzing in the oral cavity encourage vocal health and minimize injury exacerbation.
    • Lessac-Madsen Resonant Voice Therapy (LMRVT) and Vocal Function Exercises aim to strengthen laryngeal function.

    Additional Voice Therapy Techniques

    • LaxVox utilizes straw phonation with water; the Accent method incorporates rhythmic exercises for airflow and vocal fold coordination.
    • Twang voice technique narrows the vocal tract for increased efficiency and reduced effort in phonation.

    Flow Phonation Techniques

    • Stretch and Flow therapy addresses functional dysphonia and excessive tension while focusing on airflow coordination.
    • Techniques like Yawn-Sigh facilitate phonation while monitoring airflow through biofeedback methods.
    • Other exercises include Confidential voice, Open-Mouth techniques, and Chant talk for smoother vocal delivery.

    Exercises for Vocal Tension Reduction

    • Tongue protrusion and glottal fry are used to reduce laryngeal tension and promote relaxed vocal fold function.
    • Inhalation phonation can be beneficial for establishing phonation in cases of functional aphonia.

    Strength and High-Effort Exercises

    • Vocal Function Exercises and semi-occluded techniques support physical aspects of voice production.
    • High phonatory effort exercises, like Lee Silverman Voice Treatment (LSVT), target patients with Parkinson’s and related disorders.

    Breathing Techniques

    • Emphasis on low-centered and diaphragmatic breathing for proper vocal support.
    • Vocal training selections should be patient-specific based on individual needs and background.

    Special Populations

    • Paradoxical Vocal Fold Motion (PVFM) characterized by inappropriate adduction during inhalation can mimic asthma symptoms.
    • Treatment for PVFM includes relaxed breathing techniques and voice therapy.

    Laryngectomy Considerations

    • Laryngectomy involves surgical removal of the larynx, requiring a multifaceted approach to communication post-surgery.
    • Communication options for laryngectomees include electro-larynx, tracheoesophageal speech, and esophageal speech techniques.

    Voice Evaluation Techniques

    • Voice evaluations encompass various assessments, including indirect laryngoscopy, acoustic, aerodynamic, and subjective measures.
    • Laryngoscopic observations focus on vocal fold edge, closure patterns, vibration amplitude, and mucosal wave assessments.

    Acoustic and Aerodynamic Analyses

    • Acoustic measurements assess fundamental frequency, intensity variability, and other vocal parameters.
    • Aerodynamic evaluations measure lung volumes, airflow, and laryngeal resistance for comprehensive voice assessments.

    Patient Self-Rating

    • Self-evaluation includes the patient's perception of how dysphonia affects their quality of life, aiding in targeted interventions.

    Voice Assessment Tools

    • Adult Scales: Include Voice Handicap Index (VHI), Voice Symptom Scale (VoiSS), Vocal Tract Discomfort Scale, and more.
    • Pediatric Scales: Pediatric Voice Handicap Index, Children’s Voice Handicap Index-10, and related assessments for parents.
    • Special Populations: Singing VHI for singers, Transsexual Voice Questionnaire, and Transgender Self-Evaluation Questionnaire.

    Voice Handicap Index (VHI)

    • A 30-item self-questionnaire evaluating how voice problems affect life, scored across three subscales: Functional, Emotional, and Physical.
    • Variants include VHI-10 and Singing Voice Handicap Index (SVHI).

    Health Literacy Considerations

    • Average reading level for English-speaking adults in the U.S. is at or below seventh grade.
    • Health materials should target fifth or sixth-grade reading levels for better comprehension.

    Patient Interview Techniques

    • Use open-ended questions to gather comprehensive patient histories about their voice complaints and habits.
    • Assess vocal hygiene, lifestyle factors (e.g., smoking and hydration), and medications that may affect voice quality.

    Vocal Behavioral Assessment

    • Analyze vocal behaviors in different settings (work vs. social).
    • Identify potential vocal abuse (e.g., yelling, excessive throat clearing) and associated stressors.

    Perceptual Evaluation

    • Assess overall severity and qualities of voice, including roughness, breathiness, hoarseness, and strain.
    • Evaluate pitch intensity and breathing patterns.

    Objective Measures

    • GRBAS Scale: Measures Grade, Roughness, Breathiness, Asthenia, and Strain on a 0-3 scale.
    • CAPE-V: Consensus auditory perceptual evaluation focusing on global voice severity, roughness, breathiness, strain, pitch, and loudness.

    Physical Evaluation

    • Involves laryngeal palpation and tension assessment in areas like the jaw, neck, and shoulders.

    Aging Voice and Presbyphonia

    • Presbyphonia results in weak, hoarse voices impacting quality of life in aging populations.
    • Key signs include vocal fold bowing and asymmetry, leading to perceptual features like tremor and decreased loudness.
    • Management may include laryngoplasty, thyroplasty, and voice therapy.

    Transgender Voice Therapy

    • Stages of transition include Pre-discovery, Discovery, Acceptance, and Disclosure, with distinct emotional and social implications.
    • SLP should foster a supportive environment and collaborate with a multidisciplinary team for individualized care.

    Feminine vs. Masculine Voice Characteristics

    • Feminine voice typically features a wider pitch range, forward resonance, and breathier quality.
    • Feminine communication includes more empathetic language and less directness, with fluid body language and expressive gestures.

    Assessment Measures Summary

    • Utilize tools like the VHI, CAPE-V, and s/z ratio to gauge vocal fold efficiency rather than directly diagnosing respiratory issues.
    • Recognize the differences in communication traits among various populations, including post-laryngectomy patients.

    Additional Resources

    • The Genderbread Person: A guide to understanding gender and identity.
    • Transsexual Voice Questionnaire: An assessment tool for trans-women's vocal experiences.

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    Description

    Explore the fundamental principles of voice therapy, including issues affecting voice production, lifestyle modifications for vocal health, and the impacts of hydration and dehydration. This quiz will test your understanding of how structural and behavioral factors intertwine to influence voice performance.

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