Voice Assessment: The Case History

Voice Assessment : 

Voice Assessment The Case History

Assessment: Aims : 

Assessment: Aims Etiology Diagnosis Prognosis Planning

Primary components of Assessment : 

Primary components of Assessment Chart Review Case History Clinical Evaluation Non-instrumented evaluation Instrumented evaluation Quality of life Indicators Experimental/diagnostic therapy

Case History : 

Case History Voice Symptom History Voice Use History Health History Social/Vocational History Psychosocial History

Voice Symptom History : 

Voice Symptom History What are the current complaints? Common voice symptoms Hoarseness Vocal fatigue Breathy and/or rough voice Reduced phonational range Aphonia or voice loss Pitch breaks/inappropriately high pitch Strain/struggle Tremor Pain and other sensations (e.g. “Globus”) Are there any non-voice, but related symptoms (e.g. speech, swallowing)? Have you seen anyone else for assistance?

Voice Symptom History : 

Voice Symptom History What is the effect of the current voice problem? Workplace Home Recreation Self rating of the problem

Voice Symptom History : 

Voice Symptom History What is time course of the current voice problem? Duration Gradual or sudden onset Chronic vs. episodic Variation over different time scales Moment to moment Daily, weekly & monthly Check for patterns in voice symptoms Past History of voice problems

Voice Use History : 

Voice Use History Establish voice use patterns On the job At home In social settings Look for, Environmental factors (noise, air quality)

Voice Use History : 

Voice Use History If a vocal performer Establish practice/performance schedule Singing range Genre Choral vs. solo Determine level of training Performance environment Recreational vs. serious amateur vs. professional performer

Health/Medical History : 

Health/Medical History Current health problems & past history Specific areas to probe Respiratory problems Gastrointestinal problems Neurological problems Allergies Head and neck trauma, surgery, disease Prescription and OTC drugs Substance use: alcohol, tobacco, drugs, caffeine Exercise/diet considerations

Social/Vocational History : 

Social/Vocational History Personal life Work Status Recreational activities

Psychosocial Interview : 

Psychosocial Interview “The voice is often sensitive to our emotional well being…” Ask about, Stress/emotional problems Chronic or episodic History of counseling

Clinical Evaluation : 

Clinical Evaluation Non-instrumented evaluation Auditory perceptual evaluation of voice Maximal effort tasks Assessment of laryngeal musculoskeletal tension Instrumented evaluation Videolaryngostroboscopy Acoustic evaluation Other selected instruments Quality of life indicators Voice Handicap Index