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26 Cards in this Set
- Front
- Back
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what are the categories for management-voice therapy for special voice problems?
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particular populations
respiratory-based problems laryngeal cancer |
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list particular population for special voice problems
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the aging voice
deaf and hard of hearing pediatric professional voice users transgender |
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list respiratory-based problems
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airway obstructions
asthma emphysema faulty breath control PVFM tracheostomy |
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list laryngeal cancers for special voice problems
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medical intervention
laryngectomy counseling and communication options |
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what are specific areas that affect the quality of life for the elderly
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voice related effort and discomfort
increased anxiety and frustration need to repeat oneself |
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define presbyphonia
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often used to describe the clinical condition of elderly patients of gradual weakening of the voice
inability to project the voice over background noise and hoarse voice quality |
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what the most common cause of hoarseness in elderly patients?
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1. benign vocal fold lesions (polyps)
2. malignant lesions 3. vocal fold paralysis 4. functional dysphonia |
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what was the 1st comprehensive study reporting age related changes in speech breathing
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hoit and hixon, 1987
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what were the major findings of hoit and hixon
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- elderly males demonstrated larger rib cage volume initiations, larger lung volume excursions, and larger lung volume expenditure per syllable than younger men
- compared to younger women, elderly females demonstrated larger rib cage excursions, increased frequency of inhalation, increased air expenditure, larger lung volume |
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how does speaking fundamental frequency change from young adulthood into old age?
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men: SFF lowers from young adulthood into middle age, then drop slightly though old age
women: SFF remain fairly constant into middle age, then drop slightly through old age |
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what are some conclusions that have been developed from research literature on a relationship between the elderly speaker and listener's perception
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1. young adult listeners are capable of discriminating between younger and older adult voices with high degree of accuracy
2. young adults can distinguish minor different in ages of older speakers (ie. distinguishing between 60, 70, and 80 year olds) 3. young adults have a better chance to estimate within 5 years of the speakers age 4. listeners are able to estimate an older speaker's weight and height as well as looking at photos 5. listeners perceive older speakers more negatively than younger speakers |
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what are specific acoustic characteristics that have been identified in elderly men and women
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tremor
hoarseness breathiness voice breaks decreased loudness slower speaking rate change in habitual pitch |
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what approaches are useful in improving the voice of an older person
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good vocal hygiene
improving respiratory efficiency auditory feedback visual feedback focus glottal fry masking |
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what are voice characteristics of deaf or profoundly heard of hearing
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elevated fundamental frequency
downward formant shifts varied pitch and loudness changes resonance variations |
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what is a useful voice training device by SLP for deaf and hard of hearing
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cue arrows
- points in the desired direction of pitch change |
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what can a slp focus on when working with a deaf or hard of hearing client?
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eliminating hypernasality
altering tongue position to a forward position develop an awareness of what it feels like to use the lips, the tongue against the alveolar, etc... |
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what does the term professional voice apply to?
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people whose primary occupation competence is shaped by their voices
actor singer teacher salesperson minister telemarketer politician broadcaster |
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what are obstacles SLP experience in work with the professional voice
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the relative "performance innocence" of the teacher or clinician
- client uses the voice beyond the normal limits associated with heavy voice use the lack of a meaningful shared language between the performer and the clinician - ie. different ways of breathing for performing |
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in transgender client, what do SLPs concentrate on?
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use the gender speech voice scale for 10 different behaviors
- elevating voice pitch and increasing pitch variability and intonation - prolong vowels and to take intra-phrase pauses (MtF0 - fast rate is encourages for (FtM) |
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what are basic contributing causes of airway obstruction
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structural and lesion mass airflow interference
abnormal laryngeal movement interference |
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define paradoxical vocal fold movement
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a nonorganic disorder of the upper airway with both true and false vocal fold exhibiting paradoxical function of closure on inspiration, expiration or a combination of both
ie. vocal fold closed when they should be open for breathing |
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what are possible etiologies for PVFM
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psychogenic (conversation reaction)
visceral (irritation from laryngopharyngeal reflux and/or upper airway sensitivity) neurological (laryngeal dystonia) |
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what is a tracheostomy
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external opening into the trachea
used when an individual experiences respiratory difficulties due to an obstruction of the upper airway or requires mechanical ventilation to maintain adequate respiration |
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where does laryngeal caner normally occur at?
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one or a combination of:
supraglottis subglottis glottis |
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what are the 3 general communication options for someone who had a laryngectomy?
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1. esophageal speech
- air is inhaled into the pharyngoesophageal (PE) segment and then expelled, setting the tissue of the PE into vibration (voice source) 2. electrolarynx - introduces sound for voice through an instrument externally placed against the throat or oral structures or inserted into the mouth 3. tracheoesophageal voice restoration surgery - an opening is made through the posterior wall of the trachea, extending through the anterior wall of the esophagus. a prosthesis is inserted into the puncture causing surrounding tissues to vibrate |
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what are the candidacy requirements for successful TE speech
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1. must have adequate pulmonary support to shut air from the lungs and trachea to the esphagus
2. patient must possess the necessary cognitive and sensorimotor skills to occlude the stoma for speech and to remove and clean the prosthesis 3. patient must have a PE segment that vibrates adequately to generate a sound source for speech |
