Individualized Patient Vocal Priorities for Tailored Therapy Purpose The purposes of this study are to introduce the concept of vocal priorities based on acoustic correlates, to develop an instrument to determine these vocal priorities, and to analyze the pattern of vocal priorities in patients with voice disorders. Method Questions probing the importance of 5 vocal ... Research Article
Research Article  |   December 10, 2018
Individualized Patient Vocal Priorities for Tailored Therapy
 
Author Affiliations & Notes
  • Ingo R. Titze
    National Center for Voice and Speech, University of Utah, Salt Lake City
    Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
  • Tobias Riede
    Department of Physiology, Midwestern University, Glendale, AZ
  • Anil Palaparthi
    National Center for Voice and Speech, University of Utah, Salt Lake City
  • Linda S. Hynan
    Departments of Clinical Sciences and Psychiatry, University of Texas Southwestern Medical Center, Dallas
  • Amy Hamilton
    Clinical Center for Voice Care, Department of Otolaryngology–Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas
  • Laura Toles
    Clinical Center for Voice Care, Department of Otolaryngology–Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas
    MGH Institute of Health Professions, Center for Laryngeal Surgery and Voice Rehabilitation, Boston, MA
  • Ted Mau
    Clinical Center for Voice Care, Department of Otolaryngology–Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Ingo R. Titze: ingo.titze@utah.edu
  • Editor-in-Chief: Julie Liss
    Editor-in-Chief: Julie Liss×
  • Editor: Jack Jiang
    Editor: Jack Jiang×
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Hearing & Speech Perception / Acoustics / Research Issues, Methods & Evidence-Based Practice / Speech, Voice & Prosody / Speech / Research Articles
Research Article   |   December 10, 2018
Individualized Patient Vocal Priorities for Tailored Therapy
Journal of Speech, Language, and Hearing Research, December 2018, Vol. 61, 2884-2894. doi:10.1044/2018_JSLHR-S-18-0109
History: Received March 27, 2018 , Revised June 19, 2018 , Accepted July 23, 2018
 
Journal of Speech, Language, and Hearing Research, December 2018, Vol. 61, 2884-2894. doi:10.1044/2018_JSLHR-S-18-0109
History: Received March 27, 2018; Revised June 19, 2018; Accepted July 23, 2018

Purpose The purposes of this study are to introduce the concept of vocal priorities based on acoustic correlates, to develop an instrument to determine these vocal priorities, and to analyze the pattern of vocal priorities in patients with voice disorders.

Method Questions probing the importance of 5 vocal attributes (vocal clarity, loudness, mean speaking pitch, pitch range, vocal endurance) were generated from consensus conference involving speech-language pathologists, laryngologists, and voice scientists, as well as patient feedback. The responses to the preliminary items from 213 subjects were subjected to exploratory factor analysis, which confirmed 4 of the predefined domains. The final instrument consisted of a 16-item Vocal Priority Questionnaire probing the relative importance of clarity, loudness, mean speaking pitch, and pitch range.

Results The Vocal Priority Questionnaire had high reliability (Cronbach's α = .824) and good construct validity. A majority of the cohort (61%) ranked vocal clarity as their highest vocal priority, and 20%, 12%, and 7% ranked loudness, mean speaking pitch, and pitch range, respectively, as their highest priority. The frequencies of the highest ranked priorities did not differ by voice diagnosis or by sex. Considerable individual variation in vocal priorities existed within these large trends.

Conclusions A patient's vocal priorities can be identified and taken into consideration in planning behavioral or surgical intervention for a voice disorder. Inclusion of vocal priorities in treatment planning empowers the patient in shared decision making, helps the clinician tailor treatment, and may also improve therapy compliance.

Acknowledgments
This work was supported by National Institute on Deafness and Other Communication Disorders Grant R01 DC014538-01A1 (PI: Ted Mau). The authors thank Lesley Childs for assistance with data collection and Jeremy Mau for assistance with data entry. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Deafness and Other Communication Disorders or the National Institutes of Health.
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