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You can tell the difference between male and female post-pubescent voices because ____.
there is a differentiation in the make up of the vocal folds.
When your voice is worse at the beginning of the day than the end, it is a sign of ____.
Primary identification of laryngeal pathology is the responsibility of _____.
For ethical and legal protection you should refer all patients to ___ prior to _____.
An evaluation is not complete until medical diagnosis from ____ has been made.
There are some cases where any delay in medical examination could _____.
potentially be life threatening
Rigid fiberoptic oral endoscopy (RFOE) is performed with _____.
a rigid tube inserted into the oral or pharyngeal cavity
What are the advantages and disadvantages of rigid fiberoptic oral endoscopy (RFOE)?
- Advantages: high illumination, wide field of view and excellent image reproduction
- Disadvantages: interference with normal speech production and minor patient discomfort.
Flexible fiberoptic nasendoscopy (FFN) is performed with ____.
a flexible nasendoscope inserted through the nasal passage
What are some advantages and disadvantages of flexible fiberoptic nasoendoscopy (FFN)?
- Advantages: Excellent image of the vocal folds and velopharyngeal structures during voicing, conversation, or singing and potential for image recording and instant replay.
- Disadvantages: Equipment expense and possible patient discomfort.
Define vocal abuse.
Normal vocal behaviors used in excess, leading to vocal fold injury (excessive loudness or cough)
Define vocal misuse.
Abnormal vocal behaviors that cause stress or injury to the vocal folds (excess tension while speaking).
Define vocal overuse.
Normal voice behavior that takes its toll with time (teacher of 40 years).
Descriptions of vocal use (Daily use/misuse/abuse) Daily charting
- It's important to determine how the patient uses the voice in most life situations
- The voice you see in the clinic room may not be anything like what they produces in outside situations
- You can ask patient to demonstrate their voice in each relevant speaking situation but use observation (if possible), charting and audio recording will provide more reliable results
What are some causes of variability in the problem?
Hydration, allergies, reflux
What are some additional considerations for variables in a patient's problem?
Surgery history, head or neck trauma, swallowing difficulties, hiatal hernia, sudden weight loss, professional siging (use of birth control pills), use of illegal drugs, medications, open mouth vs. nasal breather, whispering
The clinician needs to determine if there are any _____ factors that may be contributing to voice.
Should we wait to enroll a child in stuttering therapy?
- Therapy won't hurt
- Stuttering therapy results in an overall positive effect
- No one treatment approach for stuttering demonstrates significantly greater effects over another treatment approach
- Reassure parent we don't have to observe motoric behavior of stuttering in order to determine child is in need of therapy
Name some Preschool Treatments of Stuttering: Parent and Clinician
- Model use of fluency facilitative techniques
- Demonstrate appropriate reactions to speech disfluencies
- Promote appropriate interaction styles
- Provide parent education about stuttering
- Desensitize parents to stuttering
- Facilitate child's development of positive communication image
- Monitor transfer outside of clinic environment
Name some goals for the child in preschool treatment of stuttering.
- To learn appropriate interaction styles
- to learn different ways of talking and the related consequences
- to learn appropriate reactions to speech disfluencies
- to learn about their feelings related to speech and stuttering
- to develop positive communication attitudes
Goals for stuttering treatment in school age children
- Education - speech production and stuttering
- Development of Positive Communication Image
Name three strategies for stuttering modification.
- Preparatory set
Stuttering modification modifies the _____ and fluency shaping has more to do with shaping ______.
- stuttering moment
- overall fluency