CSD493 voice prep assessment (edit!)

Interprofessional Practice (IPP) for voice : 4 job field

1. Speech pathologist

2. PA / NP

3. Layngologist

4. Voice teacher / vocal coach

Self-report questionnaire types (Give 5)

1. Voice Handicap Index (VHI - 10)

2. Vocal Fatigue Index (VFI)

3. OMNI - Vocal Effort Scale (OMNI-VES)

4. Dyspnea Index (DI)

5. Cough severity Index (CSI)

VHI assess what?

Voice handicap index / voice quality of life

VHI-10 abnormal criteria

>11

OMNI-VES abnormal criteria

>3

DI abnormal criteria

>10

CSI score abnormal criteria

>3

What does OMNI-VES assess

How much effort do you perceive when trying to talk

GRBAS short for

Grade / Roughness / Breathiness / Asthenia / Strain

Grade

overall degree of dysphonia

Roughness

irregularity of the vibration of VF

Breathiness

degree of air escaping between VF

Asthenia

degree of weakness in the voice

Strain

extent to which hyperfunctional use of phonation is heard

GRBAS scoring scale

0(normal) - 3 (severe)

GRBAS limitation

limited range for rating with 4 point scale rating

CAPE-V tasks (3)

1. sustained vowel production on /a/ & /i/

2. 6 specific sentences with different phonetic context

3. Natural speech

Quality to be assessed for CAPE-V

Overall severity / Roughness / Breathiness / Strain / Pitch / Loudness

Cape-V scoring scale

0 (normal) ~ 100 (severe) / Consistent - Inconsistent

Acoustic Assessment equipment

CSL (Computerized Speech Lab) / Praat / Mic / Audio-interface / Sound level meter

Acoustic assessment - what they measure

Sustained vowel 3-5 sec

CPP vowel (Cepstral peak prominence)

Acoustic assessment - what they measure

Standard reading passage

CPP speech / Average vocal freq (Hz) / Vocal freq SD (Hz) / Habitual vocal SPL (dB)

Loudness range (glide on /a/)

Max vocal SPL / Min vocal SPL

Pitch glide on vowel /a/ or /i/

Max vocal freq / Min vocal freqCP

CPP short for what? What does it measure?

Cepstral peak prominence

It is a measure of noise present in vocal signal

More noise = lower CPP

Aerodynamic Assessment equipment

PAS / Spirometer

Aerodynamic Assessment - task and what does it measure

“Take a deep breath then blow out all your air into the mask”

vital capacity

Aerodynamic Assessment - task and what does it measure
/pi/*5 at normal and increased loudness

Average subglottal air pressure

Aerodynamic Assessment - task and what does it measure
Voicing (sustained /a/ phonation)

Mean/Peak airflow and max phonation time(MPT)

Phonation quotient equation

VC / MPT

Limit of aerodynamic data

1. It cannot differentiate between pathologies (can’t exactly tell what they have)

2. Is it the disorder or their vocal capability

How is the acoustic / aerodynamic data helpful

1. Baseline data & recording of initial concerns

2. Provides objective data for support

3. used for biofeedback in therapy

   1. Provides clean recording of patient’s voice

Laryngeal palpation cite (5)

1. Thyrohyoid space

2. Suprahyoid

3. Submental

4. Masseter

5. SCM (sternocleidomastoid)

Transoral exam - pro

1. Detailed, high, res image

2. Quick

3. Less invasive

   1. x need anesthesia maybe

Transoral / Rigid exam - Con

1. Can trigger gag reflex for some

2. Less natural VF position (chin up)

3. X see supraglottic structures

Transnasal / Fluid - Pro

1. Can view during connected speech

2. Broader view of vocal tract & supraglottic region

Transnasal / Fluid - Con

1. Darker image

2. Limited by velum movement / swallow

3. Sometimes difficult to get stable image (bc it is hard to tolerate)

Laryngoscopy for observing…

1. Gross movement

2. Anatomy

3. Glottis

4. Secretion

5. Pyriform sinus, Valleculae

Stroboscopy - observe what?

VF during phonation

Supraglottic hyperfunction

Concentric / Lateral / A&P compression

Obstructing / Partially / Completely obstructing VF