Synchronous use of VoiceEvalU8 involves the client, with the clinician present, completing a log session in real time through videoconferencing, whereas asynchronous use of VoiceEvalU8 implies that the client completes the log sessions on their own with no SLP present. VoiceEvalU8 provides the option to complete an evaluation either in-person or through synchronous and/or asynchronous telepractice. Thus, VoiceEvalU8, a smartphone/tablet app, Health Insurance Portability and Accountability Act (HIPAA)-compliant server, and web portal, was created to assess voice in the client’s environment that is easily accessible to clients and SLPs either in-person or through telepractice (i.e., audiology and speech-language pathology services delivered at a distance), meeting COVID-19 physical distancing recommendations and state-at-home orders.ĭuring the COVID-19 pandemic, televoice evaluations tools were a necessity to continue comprehensive voice evaluations. A solution may involve smartphone application (app) technology. 5, 8, 9 A method is needed to collect acoustic, perceptual, and aerodynamic measures throughout a day of vocal loading that captures a realistic, functional picture of the client’s voice in their environment without requiring an in-person visit. A voice assessment at only before and after voice rehabilitation does not provide an accurate representation of the effects of vocal loading, or vocal use, throughout a day of talking. Typically, only two “snapshots” of the client’s voice are provided (i.e., before and after voice rehabilitation). The in-person voice assessment session may take 1–2 hours to complete, which does not include data analysis and write-up of the report. To capture these measures before the COVID-19 pandemic, SLPs required clients to travel to their office to complete the voice assessment in-person. Aerodynamic measures capture the client’s ability to manage airflow with vocal fold phonation. Perceptual measures provide auditory-perceptual ratings of the client’s voice and the impact the voice problem has on the client’s quality of life. These recording are then analyzed by voice analysis software. 4 Clients are asked to record sustained phonation and speech tasks. 6 Acoustic measures determine vocal amplitude, frequency, and quality of the voice signal. 4– 7 Acoustic, perceptual, and aerodynamic measures are components of a comprehensive voice assessment. 3, 6 SLPs assess clients by collecting a clinical history, acoustic, perceptual (including client reported outcome measures), and aerodynamic measures to determine the function of the vocal mechanism, limitations caused by the impairment, impact of the impairment on quality of life, and stimulability for voice therapy. 5, 6 Otolaryngologists assess clients by collecting a case history, performing a physical examination, and visualizing the larynx using laryngoscopy to determine a diagnosis and the best course of treatment. 4 Individuals who are suspected of having a voice disorder are assessed by a multidisciplinary team that includes an otolaryngologist and a speech-language pathologist (SLP). 2 A voice disorder is defined as “altered voice quality, pitch, loudness, or vocal effort that impairs communication … and/or affects quality of life.” 3,p.3 The etiology of a voice disorder can be organic (i.e., a structural or neurological change that affects the respiratory, laryngeal, or vocal tract mechanisms) or functional (i.e., extensive or improper use of the vocal mechanism). According to the 2012 National Health Interview Survey, voice disorders are the most reported communication impairment 1 with an estimated 1 in 13 adults in the United States having a voice disorder annually.
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