Voice-Specialized Speech-Language Pathologist's Criteria for Discharge from Voice Therapy

Abstract

Objective: No standard protocol exists to determine when a patient is ready and able to be discharged from voice therapy. The aim of the present study was to determine what factors speech-language pathologists (SLPs) deem most important when discharging a patient from voice therapy. A second aim was to determine if responses differed based on years of voice experience.

Methods: Step 1: Seven voice-specialized SLPs generated a list of items thought to be relevant to voice therapy discharge. Step 2: Fifty voice-specialized SLPs rated each item on the list in terms of importance in determining discharge from voice therapy.

Results: Step 1: Four themes emerged-outcome measures, laryngeal appearance, SLP perceptions, and patient factors-as important items when determining discharge from voice therapy. Step 2: The top five most important criteria for discharge readiness were that the patient had to be able to (1) independently use a better voice (transfer), (2) function with his or her new voice production in activities of daily living (transfer), (3) differentiate between good and bad voice, (4) take responsibility for voice, and (5) sound better from baseline. Novice and experienced clinicians agreed between 94% and 97% concerning what was deemed "very important."

Conclusions: SLPs agree that a patient's ability to use voice techniques in conversation and real-life situations outside of the therapy room are the most important determinants for voice therapy discharge.

Keywords: Attrition; Discharge; Patient satisfaction; Survey; Voice therapy.