Clinical Rationale for Assessment and Treatment of Voice Disorders: Discussion of Cases

The goal of this workshop is to interact with the audience through the presentation and discussion of voice samples, clinical acoustic data, self-assessment protocols and laryngeal images. Voice exercises will be presented and trained with volunteers, in order to verify the immediate impact of certain techniques. Cases from two different etiologies of voice problems, behavioral and organic, will be didactically introduced to highlight some points. Vocal behavior can be defined as the set of vocal reactions in response to interpersonal relationships in the environment in which the individual lives. The role of the vocal behavior as the origin of the voice problem may represent a real challenge for voice therapy and many strategies, including coaching questions, will be explored with the participants. Changing vocal habits and behaviors are important focuses for the treatment of this category of voice problems as well as improving self-regulation, an executive function of the prefrontal cortex. On the other hand, scar cases are organic anatomical challenges but there is a rational on proposing a specific, intensive and structured program for rehabilitation. The choices among many philosophical orientations, from a symptomatic to different holistic approaches will be considered. A multiplicity of techniques, specific programs and customized treatments can be used depending on the case. Some cultural preferences and the clinician academic background may play a role at this selection. Regular or intensively administered treatment is an interesting choice, depending on the case. In this workshop, the non-linear process of vocal rehabilitation, based on the patient assessment will be addressed according to two main basic options of intervention: to act on specific aspects, such as pitch, loudness, resonance, vocal quality, or to alter the 3 subsystems of respiration, phonation and resonance altogether, considering the subsystems’ solidarity. The focus of this presentation is to reinforce that the main goal for recovering the voice is to improve the communication as a tool for interpersonal relationship.