Current Practices in the Assessment of Voice: A Comparison of Providers Across Different Clinical Settings.

Abstract

Objective: To investigate the current assessment practices of speech-language pathologists (SLPs) in the United States working with adult clients with voice disorders with regard to the frequency, utility, and confidence in the use of five elements of a comprehensive voice evaluation, as well as training, access to instrumentation, and the use of published scales.

Methods: An online survey was distributed to SLPs who currently see adults with dysphonia as part of their caseload. Clinicians in a voice-focused setting were compared to those who worked in a general medical setting.

Results: Nearly all of the 86 participants reported using published validated scales for patient self-assessment and auditory-perceptual ratings. Most respondents had received training in auditory-perceptual voice assessment, acoustic assessment, and videostroboscopy, but a minority reported training in aerodynamic assessment. The majority of SLPs had access to acoustic equipment but a minority had access to the instrumentation for videostroboscopic or aerodynamic assessment. Auditory-perceptual voice evaluation was the procedure most commonly performed and most highly rated for diagnostic utility. Postgraduate training and access to instrumentation were associated with significantly higher frequency of use and confidence with all three instrumental assessment methods. SLPs in voice-focused settings were significantly more likely to have received training in videostroboscopy and perform or interpret it. SLPs in voice-focused settings were also significantly more likely to have access to equipment for all three instrumental techniques and reported significantly higher confidence in their use. Both groups rated the utility of the different components of a voice evaluation similarly and there were no significant differences between the groups in the use of validated patient questionnaires or auditory-perceptual scales.

Conclusions: Most clinicians in our survey reported following practice guidelines when performing comprehensive voice evaluations across settings, despite barriers of training and access to instrumentation.