SPHY303 - Voice Disorders Across the Lifespan

Year

Credit points

Campus offering

Prerequisites

SPHY205 Motor Speech Disorders (Acquired) AND SPHY207 Speech Pathology Practice 2B

Unit rationale, description and aim

Voice disorders impact communication and reduce the person’s ability to communicate and participate within their community. In order to address the communication needs of people with voice disorders, speech pathologists need to be able to understand the range of voice disorders, reach the correct diagnosis and provide appropriate intervention to enable participation of individuals within their communities. Consequently, voice is a designated Range of Practice Area (RoPA) in which speech pathology students are expected to demonstrate competency in order to meet professional Entry Level requirements.

In this unit, students will develop an understanding of evidence-based approaches to the assessment and management of voice disorders. Students will review underlying anatomy, physiology and neurology with reference to vocal function. Skills in the perception and analysis of normal versus disordered voice will be developed as a basis for management. Consideration will be given to the functional impairments and activity limitations resulting from voice disorders and how these may impact on an individual and their quality of life. Students will learn to apply voice therapy techniques to the treatment of voice disorders as well as health promotion strategies for those at risk for of vocal damage.

This unit provides a theoretical base, and opportunities to apply knowledge in practical activities, to ensure successful preparation for future professional practice in the Range of Practice Area of voice disorders. The overall aim of this unit is for students to become competent in assessment, intervention and support so as to enable individual participation and enhance quality of life for a diverse range of individuals with voice disorders.  

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Demonstrate knowledge of voice disorders through describing origins/causes, salient features and prognosis; describe and demonstrate appropriate methods to evaluate voice (GA4, GA5)

LO2 -Analyse and interpret assessment information to accurately diagnose voice disorders (GA4,GA5,GA8, GA9)

LO3 - Formulate and justify person -centred, culturally-responsive and evidence-based management plans for individuals with voice disorders, guided by relevant frameworks of practice (including ICF and EBP )(GA1, GA4, GA5, GA8, GA9)

LO4 - Demonstrate technical skills required to deliver a voice therapy intervention/s and manage within session contingencies (GA4, GA5, GA8, GA9)

Graduate attributes

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA8 - locate, organise, analyse, synthesise and evaluate information 

GA9 - demonstrate effective communication in oral and written English language and visual media 

Content

Topics will include:

Background to voice disorders   

• Contexts of clinical practice 
• Working within the multidisciplinary team
• Understanding the International Classification of Functioning Disability and Health (ICF) when applied to in the assessment and management of voice disorders across the lifespan

The normal and disordered voice

• Application of anatomy, physiology and neurology to the production of voice across the lifespan 
• Understanding the acoustics of voice production
• Understanding vocal dysfunction across the lifespan 
• Congenital voice disorders, vocal cord pathology, common medical conditions, functional voice disorders, neurological voice disorders, the aging voice

Assessment of the voice

• Understanding the referral information
• Taking a case history for different voice disordered populations 
• Developing perceptual rating skills and undertaking a perceptual voice evaluation
• Conducting a non-instrumental voice assessment
• Developing skills in undertaking an acoustic and aerodynamic voice assessment 
• Analysing the results of voice assessment tasks and interpreting them against normative data
• Understanding the medical assessment and results
• Integration of assessment findings and evidence to support the management of voice disorders across the lifespan 

Management of voice disorders: an evidence-based perspective 

• Speech Pathology Management of Voice Disorders
• Evidence-based approaches to vocal care 
• Developing skills in voice therapy techniques
• Selecting vocal techniques for specific voice disorders
• Understanding the complexities of voice management: compliance, motivation, education and counselling 
• Measuring the outcome of intervention 
• Medical and Surgical Management of Voice Disorders 
• Management of common medical conditions underlying voice disorders.
• Surgical management of voice disorders

Specific populations

• Working with professional voice users 
• Prevention of voice disorders – promoting healthy voice use in at-risk populations
• Paediatric voice disorders and their management 
• Complex voice conditions (puberphonia, transgender voice, mutism)
• Head and Neck Cancer and Laryngectomy 

Learning and teaching strategy and rationale

This unit involves 150 hours of focused learning. Teaching and learning strategies include lectures, skills classes (tutorials), and critical thinking activities. Students will be expected to take responsibility for their learning and to participate actively within group activities. A blended learning approach has been chosen for this unit as it combines modes of learning that enable the integration of the best aspects of face-to-face, group work and online activities.

 Lectures will occur prior to weekly face-to-face skills classes to enable students to prepare adequately for face to face skills classes. In this way, students are familiar with important concepts and can explore and consolidate these in a more applied way within class/tutorial time.

Emphasis will be placed on consolidating key, fundamental concepts and exploring application to practice through discussion, discipline specific case studies and peer simulation. Learning activities will involve mostly small group work and whole class activities with a focus on inquiry based learning.

Skills classes will focus on the practice of clinical skills and reasoning required to treat voice disorders. Successful participation in skills class activities are dependent on student preparation; therefore it is expected that the lecture materials, pre-reading and any prescribed tasks will be completed prior to skills classes. 

Assessment strategy and rationale

The assessment tasks for this unit are designed to demonstrate achievement of each learning outcome, and in turn to develop entry level professional competencies essential to the Speech Pathology Profession (CBOS, 2011). Assessments are varied, and include case-based formats requiring students to respond in professional written and oral communication contexts, and a series of quizzes.

The hurdle task requires students to undertake perceptual ratings of voice disorders using a clinical assessment tool (GRBAS). They are expected to demonstrate entry level skills (ie within 1 rating of consensus rating). This task reflects an authentic clinical activity and enables a whole-of-cohort evaluation of their skills in assessing voice disorders.

Assessment 1 (Quizzes)) will assess students’ acquisition of theoretical content relating to all learning outcomes.

Assessment 2 is a case study that will enable students to apply their knowledge to the assessment, diagnosis and intervention planning relating to a client’s condition (LO1, LO2 and LO3). This assessment combines analysis, synthesis and application of knowledge in a case based-clinical context and allows students to make a connection between theory and clinical practice.

Assessment 3 is a simulation which will provide students with the opportunity to discuss and demonstrate their intervention planning  (LO2) and to technical skills required for intervention (LO4) .The assessment tasks for this unit are designed to meet the unit learning outcomes and to develop graduate attributes consistent with ACU assessment requirements

Overview of assessments

In order to successfully complete this unit, students must submit and make a credible attempt at all assessment tasks and are required to:

- obtain a cumulative mark that is equal to or greater than 50% of the possible marks available; AND

- pass the ungraded hurdle task

Representative texts and references

Aronson, A., & Bless, D. (2009). Clinical voice disorders. Thieme Medical Publishers. Colton, R. H., Casper, J. K. & Leonard, R. (2011). Understanding voice problems: A

physiological perspective for diagnosis and treatment (4th ed ed.). Williams and Wilkins

Carding P (2000). Evaluating Voice Therapy: measuring the effectiveness of treatment. Whurr Publishing

Hartnick, C. & Boseley, M. (2010). Clinical management of children’s voice disorders. Plural Publishing.

Mathieson, L. (2013). Greene and Mathieson’s the voice and its disorders (6th ed.). Whurr

Rubin, J., Sataloff, R., & Korovin, G. (Eds.). (2006). Diagnosis and treatment of voice disorders (3rd ed.). Plural Publishing.

Sataloff, R. (2005). Professional voice: The science and art of clinical care (3rd ed.). Plural Publishing.