Effect of Two Isolated Vocal-facilitating Techniques Chant Talk and Pitch Inflections on the Phonation of Female Speech-language Pathology Students: A Pilot Study

The comparison between vocal facilitating techniques, manual circumlaryngeal therapy, and combined voice therapy in teachers with muscle tension dysphonia: a randomized clinical trial

PURPOSE

Although voice therapy (VT) has been known effective in muscle tension dysphonia (MTD), it is not obviously clear which VT approach is more effective. This study aimed to compare the effectiveness of Vocal Facilitating Techniques (VFTs), Manual Circumlaryngeal Therapy (MCT), and combined VT in teachers with MTD.

METHODS

This study was a double-blind parallel randomized clinical trial. Thirty elementary female teachers with MTD were divided into three treatment groups including VFTs; MCT, and combined VT. In addition, vocal hygiene was presented to all groups. All participants received 10 individual 45-min sessions of VT twice a week. The effectiveness was assessed using Vocal Tract Discomfort (VTD) scale and Dysphonia Severity Index (DSI) before and after treatment and improvement measurement was calculated. The participants and data analyzer were blinded to the type of VT.

RESULTS

All groups showed significantly better results on the subscales of VTD scale and DSI score after VT (p ≤ 0.001; η2 ≥ 0.90). There was a significant difference between the three groups on the results of VTD scale and DSI score (p ≤ 0.05). The improvement measurement on the VTD severity subscale and DSI score following the combined VT was the greatest compared with other groups (η2 = 0.99 and 0.98, respectively). The significant interactive effect of treatment and time was observed on the VTD severity subscale and DSI score (p < 0.05; η2 ≥ 0.56).

CONCLUSIONS

This study showed that the VFTs, MCT, and combined VT were effective for MTD teachers, and the combined VT is the most effective one. It seems the combination of different approaches is recommended for the VT of MTD patients.

Voice Quality of Choir Singers and the Effect of a Performance on the Voice

BACKGROUND

The voice use of choir singers is understudied despite the imbalance of high vocal demands versus low vocal education, and consequently increased risk for voice problems. Also, there is a lack of information on the effects of a performance on choristers' voices. Available studies included performances of at least one hour. To date, no studies investigated the effects of a choir performance with a duration resembling vocal warm-ups.

PURPOSE

The first purpose of this study was to determine the voice quality, capacities, symptoms and voice-related quality of life of choir singers. Secondly, the effect of a short choir performance, resembling warm-up duration (15 minutes), on the choristers' voices was investigated.

METHODS

A randomized controlled trial was used. Thirty adult choir singers (25 women, 5 men; mean age: 32 years) were assigned randomly to an experimental group or a control group. Participants in the experimental group sung in choir for 15 minutes immediately after their pre voice assessment, whereas the control group was instructed to have standard voice use (one-on-one conversation with the investigator, no singing) across that time span. A second voice assessment was repeated afterwards.

RESULTS

The choir singers showed excellent voice quality and capacities with mean scores on the Dysphonia Severity Index and Acoustic Voice Quality Index of 7.5 and 2.0, respectively. Auditory-perceptually, the mean grade score was 5/100 corresponding with a normal to mildly deviant voice quality. Patient-reported outcome measures showed mean deviant scores, indicating a considerable singing voice handicap. The choir singers seem vulnerable for stress with a high occurrence rate of 76.7% (23/30). Compared with the control group, the Dysphonia Severity Index significantly improved, whereas the self-perceived presence of vocal fatigue and complaints increased after 15 minutes of choir singing. Fundamental frequency increased in both groups, being more outspoken in the experimental group.

CONCLUSIONS

Choir singers show excellent voice quality and capacities, that further improve after a short choir performance of 15 minutes. Vocal fatigue and complaints, on the other hand, already increased after that short time span. Realizing that vocal load is much higher in real-life rehearsals, competitions and performances, choristers deserve and need a qualitative voice training and a strict follow-up. Future research should focus on effective vocal warm-up and cool-down programs for this population.

Student perceptions of factors that influence clinical competency in voice

PURPOSE

This study aimed to explore factors, perceived by students themselves, that help or hinder development of competency in voice.

METHOD

Focus group interviews were conducted with a convenience sample of 14 speech pathology students (93% female, mean age 22 years). Interviews were transcribed verbatim and analysed using template analysis.

RESULT

Students' perceptions of influencing factors were grouped into two major themes: (1) personal factors, and (2) educational factors. A key finding was that many participants perceived a student's own voice to be a major factor impacting their development and attainment of clinical competency in voice, and that mindsets towards the (un)changeability of students' own voices varied across participants. Students with a performance background were considered to be at an advantage in terms of performing vocal tasks and suitability to work with specific populations. Key facilitatory educational factors included access to and experience of demonstrations (face-to-face and video), additional training workshops, peer learning, and simulation.

CONCLUSION

This study identified a number of personal and educational factors that students perceive to impact the development of competency in voice. Consideration of these holistic factors may assist speech-language pathology educators to deliver optimally effective voice-related curricula.

Phonogenic Voice Problems among Speech-Language Pathologists in Synchronous Telepractice: An Overview and Recommendations

Many speech-language pathologists (SLPs) recently adopted a live, synchronous online distribution of clinical services due to physical distancing measures aimed at bringing the coronavirus disease 2019 (COVID-19) outbreak under control. Few SLPs had received training in telepractice to prepare them for changes from an in-person service delivery model to synchronous telepractice. The new telepractice environment may alter vocal behaviors and communication interactions in such a way that negatively impacts voice production. Thus, delivering synchronous online clinical services may require that SLPs adopt novel prevention strategies for avoiding phonogenic voice problems. Guided by two complementary injury frameworks, the Haddon Matrix and the Haddon Countermeasures, this article provides an overview of potential factors associated with phonogenic voice problems among SLPs in telepractice and proposes possible prevention strategies to maintain optimal vocal health and function with synchronous modes of online clinical practice.

Effect of two isolated vocal facilitating techniques glottal fry and yawn-sigh on the phonation of female speech-language pathology students: A pilot study

OBJECTIVE

The purpose of this study was to determine the effect of two isolated vocal facilitating techniques, glottal fry and yawn-sigh, on the phonation of vocally healthy female speech-language pathology (SLP) students.

STUDY DESIGN

A multigroup pretest-posttest design was used.

METHODS

A group of thirty-six healthy female SLP students with a mean age of 18.1 years were assigned into three groups: a glottal fry group (practicing the facilitating technique glottal fry across 18 weeks, n=12), a yawn-sigh group (practicing the facilitating technique yawn-sigh across 18 weeks, n=12) and a control group (receiving no facilitating techniques, n=12). To compare vocal measures before and after this training period, an identical objective voice assessment protocol (maximum performance task, acoustic analysis, voice range profile and Dysphonia Severity Index) was performed in the three groups. Groups were compared over time using linear mixed models. Within-group effects of time were determined using post hoc pairwise comparisons.

RESULTS

Glottal fry resulted in a significant decrease in lowest and highest intensity. Yawn-sigh resulted in a significant increase in fundamental frequency, a significant decrease in shimmer and noise-to-harmonic ratio, and a significant increase in highest intensity.

CONCLUSIONS

Yawn-sigh may have a positive effect on the phonation of female vocally healthy future SLPs, whereas results are less supportive for using glottal fry in training this population's voice.