Multiple Perspectives on the Barriers to Identification and Management of Pediatric Voice Disorders

2017 ◽  
Vol 2 (3) ◽  
pp. 49-56
Author(s):  
Jana Childes ◽  
Alissa Acker ◽  
Dana Collins

Pediatric voice disorders are typically a low-incidence population in the average caseload of clinicians working within school and general clinic settings. This occurs despite evidence of a fairly high prevalence of childhood voice disorders and the multiple impacts the voice disorder may have on a child's social development, the perception of the child by others, and the child's academic success. There are multiple barriers that affect the identification of children with abnormal vocal qualities and their access to services. These include: the reliance on school personnel, the ability of parents and caretakers to identify abnormal vocal qualities and signs of misuse, the access to specialized medical services for appropriate diagnosis, and treatment planning and issues related to the Speech-Language Pathologists' perception of their skills and competence regarding voice management for pediatric populations. These barriers and possible solutions to them are discussed with perspectives from the school, clinic and university settings.

2019 ◽  
Vol 19 (1) ◽  
pp. 38-44
Author(s):  
M Mikolajcikova ◽  
V Ferencikova ◽  
K Fiolkova ◽  
V Sokolikova ◽  
Z Matuskova ◽  
...  

Abstract Introduction: Voice disorders primarily affect workers in professions with increased voice demands, such as teaching personnel in educational system, singers, lecturers, actors or managers. Severe voice disorders often require a permanent change of work position. Methods: Retrospective analysis of a set of patients with occupational voice disorders who were hospitalized at the Clinic of Occupational Medicine and Toxicology, Martin University Hospital (COMaT, MUH) in the years of 2000–2017. Comparison of the data obtained with the National Centre of Medical Information (NCMI) data on the occurrence of occupational voice disorders throughout the Slovak Republic (SR). Comparison with the retrospective analysis of reported occupational voice disorders in the years of 1967-1996. Case report of a patient with an occupational voice disorder. Results: We point to a long-term low incidence of occupational voice disorders. In the years of 2000-2017, 24 cases of occupational voice disorders were reported in Slovakia, of which 20 cases were reported under item 42-1 and 4 cases under item 42-2 in the List of Occupational Diseases. Through the COMaT, MUH 11 cases of occupational voice disorders were reported during these years, of which 9 cases were listed under item 42-1 and 2 cases under item 42-2. From 1967 to 1996 there were 52 occupational voice disorders reported in Slovakia, of which 45 were under item 42-1 and 7 under item 42-2. Conclusions: As there is a tendency to underestimate the voice difficulties among teaching staff, it is necessary to provide better information about the possible consequences, prevention, and treatment of these diseases. All of this should be in the competency of occupational health services.


2015 ◽  
Vol 4 (1) ◽  
pp. 42-47
Author(s):  
Humaira Hussain

Professionals working in the field of voice disorders have come to recognize the variability of vocal qualities in different populations. While voice disorders can be of organic, neurogenic, or functional etiology, concomitant disorders often directly impact the vocal features. Such a disorder is Tourette’s Syndrome which is an impairment characterized by motor and vocal tics. This study examined the prevalence of voice disorders in individuals with Tourette’s Syndrome. Research was conducted over the duration of two years with clientele aged 15;2 to 26;5. Participants were receiving continuous treatment from a team of neurologist and psychologist at private clinics situated around a suburban area. Two case studies consisting of 1-2 individuals were also closely examined to further distinguish the types of voice disorders present given the severity of motor and vocal tics. Instrumental and perceptual analysis was obtained to accurately diagnose the voice disorder. Given the sample of participants, presence of spasmodic dysphonia and falsetto were noted. Results of this study indicates a strong presence of dysphonia in individuals with Tourette’s Syndrome, particularly spasmodic dysphonia and falsetto. Additionally, dysphonic vocal qualities were irrelevant to the existence of vocal tics. Further research with this population is mandated to determine assessment and treatment strategies


2007 ◽  
Vol 10 (4) ◽  
pp. 625-636 ◽  
Author(s):  
Renata Jardim ◽  
Sandhi Maria Barreto ◽  
Ada Ávila Assunção

Several studies have shown a high prevalence of voice disorders among teachers. However, it is difficult to establish comparisons among the results found given the great variability among criteria and symptoms used to define the presence of vocal alteration, in addition to the variations in the composition of the populations studied (age, gender, origin, working schedule, profession, among others). This study aims to discuss the need for a standard definition of functional voice disorder and possible implications of the lack of such a standard definition on estimating the prevalence of functional voice disorders among teachers. A systematic bibliographic review on voice disorders in teachers was carried out as of 1990 in the Medline, Scielo, Ovid, Pubmed and Lilacs databases. Of the 3,186 citations, 15 fulfilled the inclusion criteria to discuss prevalence of vocal disorder in teachers. Nine articles defined vocal disorder based solely on the presence of vocal symptoms, which varied in relation to type, number, frequency, and reference period. Hoarseness and vocal tiredness were mentioned in all studies that evaluated vocal symptoms. Only three studies reported prevalence based on professional examination. Prevalence rates varied according to reference period and frequency of symptoms. The results ratified the importance of standardizing the case definition of voice disorder in order to better study and understand its occurrence and to compare prevalence obtained from different populations and along time in the same population. Standardized definitions should include laryngeal alterations observed in later phases of voice disorder as well as signs and symptoms present in phases previous to organic alterations, when they are potentially reversible.


Pathogens ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 53
Author(s):  
Vivek Khanal ◽  
Harrington Wells ◽  
Akhtar Ali

Field information about viruses infecting crops is fundamental for understanding the severity of the effects they cause in plants. To determine the status of cucurbit viruses, surveys were conducted for three consecutive years (2016–2018) in different agricultural districts of Oklahoma. A total of 1331 leaf samples from >90 fields were randomly collected from both symptomatic and asymptomatic cucurbit plants across 11 counties. All samples were tested with the dot-immunobinding assay (DIBA) against the antisera of 10 known viruses. Samples infected with papaya ringspot virus (PRSV-W), watermelon mosaic virus (WMV), zucchini yellow mosaic virus (ZYMV), and cucurbit aphid-borne-yellows virus (CABYV) were also tested by RT-PCR. Of the 10 viruses, PRSV-W was the most widespread, with an overall prevalence of 59.1%, present in all 11 counties, followed by ZYMV (27.6%), in 10 counties, and WMV (20.7%), in seven counties, while the remaining viruses were present sporadically with low incidence. Approximately 42% of the infected samples were positive, with more than one virus indicating a high proportion of mixed infections. CABYV was detected for the first time in Oklahoma, and the phylogenetic analysis of the first complete genome sequence of a CABYV isolate (BL-4) from the US showed a close relationship with Asian isolates.


2018 ◽  
Vol 128 (3) ◽  
pp. 249-262 ◽  
Author(s):  
Nelson Roy ◽  
Ray M. Merrill ◽  
Jenny Pierce ◽  
Krishna M. Sundar

Objective: Obstructive sleep apnea (OSA) is characterized by frequent interruptions in breathing related to upper airway collapse during sleep and may adversely affect phonatory function. This study aimed to: (1) establish the prevalence, risks, and quality of life burden of voice disorders in OSA and (2) explore the relation between voice disorders and positive airway pressure (PAP) therapy. Study Design: Cross-sectional, descriptive epidemiology study. Methods: Analyses were based on 94 individuals with OSA (53 men, 41 women; mean age = 54.7 ± 12.8 years) who completed a telephone interview. Results: Twenty-eight percent of participants reported having a current voice disorder. Of those with a current voice disorder, 83% had experienced symptoms for at least a year, and 58% had symptoms for at least 4 years. The prevalence of a current voice disorder was greater in women than men (44% vs 15%, P = .0020) but did not vary significantly across different age groups, body mass index (BMI), apnea/hypopnea index (AHI) severity, or medical history. After adjusting for sex, consistent use of PAP therapy (with humidification) was associated with (1) lower occurrence of voice disorders in women (Mantel-Haenszel [MH] χ2 P = .0195), (2) reduced snoring severity accompanied by fewer voice disorders in men (MH χ2 P = .0101), and (3) fewer reports of acid reflux as a possible trigger for voice problems (MH χ2 P = .0226). Patients with OSA who also had a current voice disorder experienced lower overall quality of life compared to those without. Conclusions: Chronic, longstanding voice disorders are common in women with OSA and produce significant adverse effects on quality of life. Nightly PAP use (with humidification) was associated with fewer voice symptoms and reduced severity of snoring and acid reflux as possible contributors. Further research is necessary to better understand the origin of these voice disorders in OSA and their potential response to treatment.


2002 ◽  
Vol 111 (6) ◽  
pp. 537-541 ◽  
Author(s):  
Tzu-Yu Hsiao ◽  
Chia-Ming Liu ◽  
Kai-Nan Lin

The mucus layer on the vocal folds was examined by videostrobolaryngoscopy in patients with laryngeal tension-fatigue syndrome, a chronic functional dysphonia due to vocal abuse and misuse. Besides the findings in previous reports (such as abnormal glottal closure, phase or amplitude asymmetry, and the irregular mucosal wave), the vocal folds during vibration had an uneven mucus surface. The occurrence of an uneven mucus layer on vocal folds was significantly greater in subjects with this voice disorder (83% or 250 of 301 patients in this series) than in those without voice disorders (18.5% or 5 of 27). The increase of mucus viscosity, mucus aggregation, and the formation of rough surfaces on the vocal folds alter the mechanical properties that contribute to vibration of the cover of the vocal folds, and thereby worsen the symptoms of dysphonia in patients with laryngeal tension-fatigue syndrome.


2020 ◽  
Vol 19 (2) ◽  
pp. 93-99
Author(s):  
A. I. Kryukov ◽  
◽  
S. G. Romanenko ◽  
O. G. Pavlikhin ◽  
E. V. Lesogorova ◽  
...  

The article The article describes in detail the main stages of the diagnosis of voice disorders with an indication of the methods and major errors leading to an incorrect diagnosis. Since in some cases, impaired voice quality is the first and/ or only symptom of concomitant diseases of organs or systems of various etiologies, an expanded diagnostic search is required to make a correct diagnosis. The features of receiving of complaints and medical history from patients with laryngeal diseases, the guidelines for laryngoscopy are described. A description of the laryngoscopic vew is presented, which helps in the diagnosis of the initial stages of Reinke’s edema, hyperplastic laryngitis and early stages of laryngeal cancer. The relationship between the functional and organic pathology of the larynx is very close, it can be difficult to understand the root cause of voice disorder, this leads to incorrect treatment tactics, the progression and relapse of the disease. The causes of laryngeal diseases of an organic and functional nature, the features of the clinical picture and the differential diagnosis of voice disorders are considered. Cases of diagnosis, a clinic of chronic laryngitis, laryngomycosis, and laryngeal cancer are described; the main approaches to the treatment of laryngeal diseases are presented. The article will be useful to otorhinolaryngologists, phoniatricians of outpatient and inpatient care.


2019 ◽  
Vol 22 (1b) ◽  
pp. 2156759X1983444
Author(s):  
Qi Shi ◽  
Jennifer Watkinson

Using an evidence-based framework in a mixed-method study, we examined the needs of English Language Learners (ELLs) in a middle school in the eastern United States and identified strategic intervention approaches to enhance ELL students’ sense of school belonging to promote academic success. We illustrate how describing a problem as part of an evidence-based framework can lead to a targeted intervention for ELLs. When describing the problem, we considered intersectional social identity factors of ELL students. Problem description revealed how ELLs perceived their relationships with teachers, how school personnel viewed ELL student needs, obstacles to meeting ELL student needs, and current solutions. Suggested interventions focus on a culturally responsive bibliotherapy approach.


Cancers ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 132 ◽  
Author(s):  
Pål Møller ◽  
Mev Dominguez-Valentin ◽  
Einar Rødland ◽  
Eivind Hovig

Background: We have previously demonstrated that the Norwegian frequent pathogenic BRCA1 (path_BRCA1) variants are caused by genetic drift and recurrent de-novo mutations. We here examined the penetrance of frequent path_BRCA1 variants in fertile ages as a surrogate marker for fitness. Material and methods: We conducted an observational prospective study of penetrance for cancer in Norwegian female carriers of frequent path_BRCA1 variants, and compared our observed results to penetrance of infrequent path_BRCA1 variants and to average penetrance of path_BRCA1 variants reported by others. Results: The cumulative risk for breast cancer at 45 years in carriers of frequent path_BRCA1 variants was 20% (94% confidence interval 10–30%), compared to 35% (95% confidence interval 22–48%) in carriers of infrequent path_BRCA1 variants (p = 0.02), and to the 35% (confidence interval 32–39%) average for path_BRCA1 carriers reported by others (p = 0.0001). Discussion and conclusion: Carriers of the most frequent Norwegian path_BRCA1 variants had low incidence of cancer in fertile ages, indicating a low selective disadvantage. This, together with the variant locations being hotspots for de novo mutations and subject to genetic drift, as previously described, may have caused their high prevalence today. Besides being of theoretical interest to explain the phenomenon that a few path_BRCA1 variants are frequent, the later onset of breast cancer associated with the most frequent path_BRCA1 variants may be of interest for carriers who have to decide if and when to select prophylactic mastectomy.


1981 ◽  
Vol 46 (4) ◽  
pp. 428-432 ◽  
Author(s):  
David E. Hartman ◽  
Arnold E. Aronson

Case history and voice data for 17 patients who presented with intermittent moments of breathy dysphonia (IBD) in contextual speech were analyzed. From recorded samples of vowel prolongation four variants of phonation were identified. Of 13 patients examined neurologically, 10 (77%) had positive neurologic signs. Psychiatric and physical illnesses were often associated with onset of the voice disorder. Sex ratio of the patients in this study was nearly the same as that for adductor spastic dysphonia. Age at onset was similar to that which has been described for "functional" voice disorders. Different therapies were generally ineffective in alleviating the disorder. Although not conclusive, patients presenting with IBD in connected speech may have an underlying neurologic or psychologic disorders.


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