Voice Evaluation

Question 1

purpose of the voice evaluation

Answer 1

the voice evaluation is implemented to allow the therapist to make several determinations regarding the patient’s voice

Question 2

3 most important determinations to arrive from the evaluation

Answer 2

1. detailed description of the patient’s voice characteristics and how they vary over time
2. determination of how severe the patient’s voice disorder is
3. determination as to whether the patient would benefit from a program of voice therapy

Question 3

complete description of the patient’s voice

Answer 3

it is better to use descriptive terms regarding the patient’s voice, rather than simply attaching a label to a disorder

Question 4

you want to describe 3 things about the patient’s voice

Answer 4

1. what the patient does well
2. what they do poorly
3. what they are unable to do

Question 5

the description of the patient’s voice should include a hypothesis regarding…

Answer 5

possible etiologies of the vocal pathology or dysfunction

Question 6

severity rating

Answer 6

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

Question 7

___ ___ ___ are useful and may provide the best method for making judgments about severity

Answer 7

numerical rating scales

Question 8

___ ___ of ___ are also potentially useful, although they tend to be general and less meaningful than a formal scale

Answer 8

subjective descriptions, severity

Question 9

numerical rating scales often provide the clinician with the opportunity to make

Answer 9

several simultaneous severity evaluations concerning various aspects of the patient’s voice

Question 10

when using numerical rating scales, these number of units are an indication of…

Answer 10

which end of the scale represents normal should be specified

Question 11

determining candidacy for voice therapy

Answer 11

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

Question 12

the prognosis for improved voice is generally best for patients who…

Answer 12

report a more acute onset

Question 13

those that seek help sooner often recognize the voice immediate impact their voice disorder has on daily activities…

Answer 13

they are generally well motivated and usually quite anxious to be rid of the restrictions imposed by the dysphonia

Question 14

prognosis is poorer for patients who…

Answer 14

report a long-term, chronic dysphonia

Question 15

often long-term dysphonia patients have had time to…

Answer 15

adapt to the gradual changes in their voice and are relatively undisturbed by the dysphonia

Question 16

patients with long-term dysphonia may not seek assistance on the own but more often do so on…

Answer 16

the recommendation/insistence of a physician, spouse, or friend

Question 17

if you are uncertain as to the prognosis for improvement or the benefits of therapy

Answer 17

the recommendation of a trial period of therapy is acceptable

Question 18

a recommendation for a period of trial therapy should always include a…

Answer 18

length of time

Question 19

therapeutic protocol

Answer 19

there are no standards regarding the exact procedures which should be followed during a voice evaluation

Question 20

the current approach of choice is typically…

Answer 20

a perceptual evaluation confirmed by instrumental tests and outside consultations

Question 21

instrumental tests are ordered dependent on…

Answer 21

availability of laboratory facilities and equipment, clinician training/experience/preference, and the type of presenting problem

Question 22

a good/complete/ideal protocol for a voice evaluation would be as follows

Answer 22

• 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

Question 23

you want to be sure to obtain an…

Answer 23

audio and/or videotape sample of the patient’s voice during evaluation

Question 24

the collection of a case history is a…

Answer 24

critical element of any voice evaluation

Question 25

your responsibilities during the interview process include

Answer 25

- 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

Question 26

it is generally a good idea to start with...

Answer 26

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

Question 27

the informal period allows you to do 2 things

Answer 27

1. establish a relaxed environment which places the patient at ease and established some degree of familiarity 2. begin making some observations about the communicative abilities, perceptual quality of the voice, and their behaviors

Question 28

this informal period allows you the opportunity to evaluate the...

Answer 28

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

Question 29

expected patient behavior

Answer 29

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

Question 30

inappropriate patient behavior

Answer 30

patients who struggle with the social aspects of conversation may exhibit: - failure to maintain normal eye contact - frequent postural adjustments - rigidity of facial expression

Question 31

failure to maintain normal eye contact