24. The goal of voice therapy, regardless of etiology, is to help patients achieve their best voice possible.

4. Your patient is a 56 year old male professional voice user referred for behavioral voice therapy by his ENT.  The patient has been diagnosed with vocal nodules and is eager to begin therapy.  His social history is significant for 4-6 cups of coffee per day, 3-4 cups of water per day, non-smoking (no history of smoking).  Other relevant medical history includes reflux (well-managed).  b). The patient identifies hoarseness as his most bothersome symptom, but is also troubled by the reduction in his pitch range.  What two symptomatic voice therapy techniques would you use for this patient given these complaints? (2 points)

5. Penetration occurs when material enters the airway and passes below the vocal folds.

20. Family intervention is an essential part of the management of pediatric voice disorders.

2. Convert:

Video Case 2. A 59 year old male (RL) who carries a medical diagnosis of multiple system atrophy-cerebellar (MSA-C) presents to your outpatient clinic for progressive changes to speech and swallowing function. More specifically, he reports “slurred” speech and a “raspy/breathy” vocal quality. He notes that listeners frequently have difficulty understanding him, especially on the telephone. He and his wife note occasional coughing/choking during meals. d) Based on the MBS, please select any of the following signs/symptoms of dysphagia that you observe. (2 points) Oral Phase (Word Bank):                                                                                ” Pre-swallow spill (Specify to the: valleculae or pyriform)               ” Delayed initiation of bolus transit                                              ”  ” Difficulty with bolus formation                                                    ”  ” Slow oral transit                                                                               ” Fast oral transit                                             ” Oral residue

7. Convert:

Video Case 2. A 59 year old male (RL) who carries a medical diagnosis of multiple system atrophy-cerebellar (MSA-C) presents to your outpatient clinic for progressive changes to speech and swallowing function. More specifically, he reports “slurred” speech and a “raspy/breathy” vocal quality. He notes that listeners frequently have difficulty understanding him, especially on the telephone. He and his wife note occasional coughing/choking during meals. a). Motor Speech Evaluation: Perceptual speech evaluation is rated on a 0-7 point scale, with 0 indicating normal function and 7 indicating profound dysfunction. Please rate each subsystem and characteristic that you hear (6 points). Respiratory mechanism is involved with a severity rating of: Maximum phonation duration:      Maximum loudness:                Normal           Adequate          Inadequate                                      Loudness in conversation:      Normal           Adequate          Inadequate Laryngeal mechanism is involved with a severity rating of: Vocal quality:      Normal                Hoarse              Breathy (continuous)                               Breathy (transient)           Strained-strangled           Harsh              Rough Pitch range:         Normal            Adequate          InadequateVocal tremor:      Yes                      No Velopharyngeal mechanism is involved with a severity rating of:                               Resonance:          Normal            Hypernasal            HyponasalNasal emission:        Yes                        No                                                                                  Nasal assimilation:   Yes                        No Orofacial mechanism is involved with a severity rating of:                                    Conversation:           Precise               Imprecise                                                        Diadochokinesis:     Precise               Imprecise Rate is involved with a severity rating of:                                                                                            Speed:            Normal              Fast                  Slow                                                                        Pace:              Consistent        VariableDDK rate:      Normal             Fast                     Slow Prosody is involved with a severity rating of:                                                                    Intonation in conversation:           Normal            Variable            Monotonous                  Stress in conversation:                  Normal            Equal and excess                                                                                                                      Reduced stress               Excess loudness variation Fluency is involved with a severity rating of: Neurogenic stuttering:     Yes             No Palilalia:                             Yes              No Naturalness is involved with a severity rating of (0-7): Intelligibility in connected speech is:

10. Cerebellar dysfunction is most commonly associated with ataxic dysarthria.

21. You receive a consult to perform speech, swallowing, and cognitive-linguistic evaluations for a 66 year-old male who is believed to have a Parkinsonian disorder. His medical history is also significant for GERD. The patient and his wife report significant decline of his speech function with listeners frequently asking him to repeat himself because of reduced loudness and consonant imprecision. He also acknowledges coughing/choking with thin liquids at home approximately once per meal. a) What tasks/evaluative techniques would you use to evaluate this patient? (1 point)