Components of A Voice Evaluation
Components of A Voice Evaluation
Components of A Voice Evaluation
s? Report this in the patients own words. Medical History o Any medical diagnoses o Surgeries o Trauma o Medications o History of reflux Frequency of GERD, management, Rx dosage Symptoms include sour taste, halitosis, heartburn Ask about vocal hygiene o How much water do you drink each day? o Smoke o Recreational drugs? o Caffeine? o Alcohol? o Occupation (if not above or below) Ask about vocal behaviors o Occupation o Talk a lot? o Hours/day speaking? o Coach? o Teacher? o Kids on sports team? o Singer? Practice how much per day? o Customer service? o Bartender? (Working in noisy environment, so you talk louder) o Whispering? o Throat clearing? Ask about Environment o Industrial o Chemicals o Factory or plant o Drug manufacturer o Second hand smoke o Pollution o Allergens o Temperature changes How is this affecting your life (social/employment, etc) After the case history is taken: Audio-perceptual examination (listen to them talk) o Make judgments o Protocol to go through o Things like hoarseness, pitch, breathiness, nasality (hyper or hypo), glottal attacks, amplitude (loudness): All these things fall into one of THREE categories: Intensity, Quality, Frequency Here, were beginning to hone in on where the disorder is. o Watch their breathingwhere is it coming from? Thoracic breathing, clavicular, or diaphragmatic?
Look at posture Take measurements, such as: Maximum Phonation Timemeasure of respiration S/Z Ratio---measure of the coordination between respiration and phonation Oral Mechanism Exam Standards, and may include Phrase breath groups Diadochokinetic rate o o Instrumental Analysis Types of samples o Sustained vowel phonation o Connected speech o Reading o Pitch glides (sometimes people do well in isolated vowels, but have range issues) Now we have a general idea of what the issue may be. So now you can: Discuss vocal hygiene Therapeutic probes---techniques to measure stimulability Might check-off on a protocol Determine level of functioning (disability, etc.) Finally: Write report Make appropriate referrals Acoustic analysis measure Parent/client education--be sure to call in addition to sending the report. To summarizethe parts of the evaluation are: Case history Audio-perceptual Exam Oral Mechanism Exam Instrumental Analysis Talking with client post-evaluation Follow-through