[PDF] Resource Manual for Commissioning and Planning Services for SLCN - Voice

Source:
Royal College of Speech and Language Therapists - RCSLT
Publisher:
Royal College of Speech and Language Therapists
Publication date:
06 February 2012

Abstract

1. Speech and language therapists have a unique role in identifying and analysing the specific nature of the vocal dysfunction. They contribute to differential diagnosis and facilitate the identification of appropriate management strategies. 2. Speech and language therapists working with dysphonic patients are members of a specialist multidisciplinary team and should be commissioned as part of such. 3. Direct speech and language therapy treatment of a person with the voice disorder is most frequently conducted in a one-to-one situation whereas most educational programmes aimed at preventing voice disorders or their relapse are conducted in groups 4. SLT intervention in dysphonia maximises a patient’s benefit from other treatments e.g. surgery and medication, thus improving overall efficiency of the episode of care. 5. A large percentage of dysphonic patients are rendered unable to work by their symptom. SLT is key to restoring their vocal health and enabling both their return to work and prevention of future relapse. 6. Speech and language therapists may incorporate instrumental assessment and treatment with biofeedback devices as an integral part of their management of the person with the voice disorder. 7. Speech and language therapists have a key role in identifying vocal risk (particularly in those who are heavy voice users e.g. teachers, call centre workers) and in educating in methods of preventing vocal abuse. 8. Difficulties with social communication are a predominant feature in those with a vocal disorder. This can reduce access to recreation, education, employment, social integration, including forming relationships and expressing personality. It has a major impact upon the quality of life. 9. The use of voice amplifiers for those who are heavily dependent on using their voice in their work have been found to be effective in preventing dysphonia or relapse. 10. Speech and language therapy management involving both direct and indirect approaches is advocated. 11. There is evidence that persons having a voice disorder treated by a speech and language therapist particularly for paradoxical vocal fold dysfunction have a better outcome than those not treated in this manner 12. The level of input required does not have a simple linear relationship to the severity of the symptom; e.g. a patient with a severely abnormal speaking voice may only require one session of SLT input, whereas a patient with an apparently normal speaking voice may require six sessions.