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    12 views29 pages

    Voice Therapy Does Science Support The Art

    Uploaded by

    Liseth Martinez

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    © All Rights Reserved
    Download as PDF or read online from Scribd
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    of 29
    Voice Therapy: Does Science Support the Art? Lisa B. Thomas and Joseph C. Stemple University of Kentucky Lexington, Kentucky ‘Three primary orientations to the treatment of functional voice disorders have emerged in the lit erature. Hygienic approaches focus on the elimination of behaviors considered to be harmful to the vocal mechanism, Symptomatic approaches target the direct modification of aberrant features of pitch, loudness, and quality Finally, physiologic methods approach treatment holistically as they ‘work to retrain and rebalance the subsystems of respiration, phonation, and resonance. With the va- riety of approaches now available, selection of appropriate and effective techniques can be chal- lenging for cinicians-The purposes of this review are to:(1) describe various hygienic, symptomatic, and physiologic approaches to voice treatment, (2) investigate the evidence base behind the thera. peutic approaches, (3) draw conclusions regarding the relative strength of hygienic, symptomatic, and physiologic therapies,and (4) suggest directions for furure study, Introduction ‘Over the years,a number of techniques have emerged for the treatment of functional voice disorders, Some ‘methods have emerged from our sister feld, the vocal arts, others from the scientific study of Voice production, and still others from the modification of basic vegetative functions What is more, ome methods have approached voice treatment holistically by modifying the full speech production system, whereas others have treated via pa: tient education or through the retraining of a specific voice parameter The result has been the emergence of 4 broad, and ever expanding, inventory of voice thera- ‘PY methods. This growth, although exciting, has posed a ‘unique challenge to clinicians.The voice clinician of to- day must not only be knowledgeable of available meth Communicative Disorders Reve ‘Volume 1,Number 1, pp.49-77 Copyright © 2007 Pra Publishing, Ine ‘ods, but he or she must aso appreciate the evidence-base behind each.This can be a daunting task to the clinician ‘who is attempting to stay abreast of developments across the breadth of the field Therefore, the purpose of this re- view is to provide clinicians with an overview of voice therapy methods across a variety of treatment orienta: tions and establish the level of evidence supporting each method. Ta so doing, the review will assist clinicians in preparing appropriate and effective treatment programs {for the individuals whom they serve, Evolution of Research ‘The first attempts to examine the effects of voice therapy methods can be identified as far back as the 9 50 _ COMMUNICATIVE DISORDERS REVIEW.VOL, 1,NO.1 1940s Croeschels, 1943; Feacher & Holinger, 1947). It ‘was not, however,untl the 1970s that consistent calls for ‘outcomes research inthe field were expressed. In 1971, Paul Moore, speech scientist and speech language pa. thologist, considered the voice therapy literature and de- termined that the field of voice therapy sulfered froma Jack sufficient scientific support. Furthermore, he con: cluded that many methods used in voice therapy were chosen, not because of scientific evidence, ut because of clinician preference.As 2 result, Moore proposed that voice therapy remained primarily an art, without suff-

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