Confidential voice - the secret revealed
Date
2014-11-05
Authors
Serrão, Bianca Joelene
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Rationale:
Evidence
based
practice
proposes
an
ethical
method
of
addressing
longstanding
questions
about
clinical
practice
in
communication
disorders.
The
existing
knowledge
base
available
on
clinical
interventions
is
frequently
incomplete,
potentially
incorrect
and
biased
according
to
Dodd
(2007).
Confidential
Voice
Therapy
technique
is
a
technique
that
was
introduced
by
Colton
and
Casper
in
1990
and
has
been
used
to
treat
a
myriad
of
voice
disorders
since
its
inception.
A
small
number
of
studies
have
been
done
to
evaluate
this
treatment’s
efficacy.
It
has
been
proven
effective
at
a
physiological
level
and
patients
have
perceived
it
to
be
beneficial.
However
the
founders
themselves
have
stated
that
this
technique
it
is
not
effective
for
all
patients
it
was
employed
on.
However
they
failed
to
state
why
this
is
so.
Aims:
The
current
study
looked
at
how
the
confidential
voice
technique
changes
the
voices
of
patients
with
hyperfunctional
voice
disorders
physiologically,
acoustically
and
in
terms
of
air
flow,
as
well
as
patients’
perceptions
of
the
technique
and
its
effect
on
their
voices.
Method:
A
quasi-‐experimental
design,
single
group
pre-‐test
post-‐test
design
was
employed.
A
sample
of
twelve
individuals
with
hyperfunctional
voice
disorders
were
examined
using
a
flexible
fiberoptic
examination,
acoustic
analysis,
aerodynamic
measures,
a
self-‐constructed
questionnaire
and
stroboscopic
examination
prior
to
employing
confidential
voice
technique
and
again
during
the
use
of
confidential
voice
technique.
The
results
of
the
acoustic
analysis
and
aerodynamic
measures
were
analysed
using
paired
t-‐tests
while
the
questionnaire
and
SERF
results
were
analysed
descriptively.
Results:
The
overaching
result
of
this
study
was
that
the
confidential
voice
technique
did
not
have
a
significant
effect
on
the
voices
of
individuals
with
hyperfunctional
voice
disorders.
There
were
exceptions
to
this,
as
five
out
of
thirty-‐two
parameters
were
significant
in
terms
of
acoustic
analysis
(i.e.
Average
Fundamental
Frequency,
Mean
Fundamental
Frequency,
Average
Pitch
Period,
Relative
Average
Pertubation
and
Smoothed
Pitch
Perturbation
Quotient)
and
half
of
the
aerodynamic
measures
used
were
significant
(i.e.
Maximum
SPL,
Maximum
Pitch,
Pitch
Range,
Phonation
Time
and
Peak
Inspiratory
Airflow).
Stroboscopic
evaluations
revealed
changes
in
glottal
closure,
mucosal
wave
and
amplitude,
supraglottic
activity
and
phase
closure.
In
terms
of
the
participants
perceptions,
the
majority
were
able
to
identify
the
need
for
the
technique
however
felt
that
it
required
a
significant
amount
of
concentration
and
limited
them
in
their
daily
lives.
Conclusions:
Despite
the
lack
of
statistical
significance
the
results
of
this
study
have
provided
information
that
should
inform
practice
and
result
in
more
successful
treatment
of
patients
as
the
clinician
should
now
be
able
to
estimate
the
potential
effectiveness
of
the
technique
for
a
specific
patient
with
a
hyperfunctional
voice
disorder.
It
is
envisioned
that
the
present
study
provided
objective
information
on
the
question
of
how
and
why
confidential
voice
technique
works
in
the
treatment
of
hyperfunctional
voice
disorders
as
well
how
patients
perceive
the
technique
which
has
implications
for
therapeutic
adherance.
Keywords:
Voice
therapy;
Hyperfunctional
Voice
Disorders;
Confidential
Voice;
Evidence-‐based
practice
Description
The
Discipline
of
Speech
Pathology
and
Audiology
School
of
Human
and
Community
Development
Faculty
of
Humanities
University
of
the
Witwatersrand
In
fulfillment
of
the
requirements
For
the
degree
M.A.
Speech
Therapy
(by
Research)