Qualitative Analysis of Speech-Language Pathologists' Voice Evaluation Practices and Perspectives

PURPOSE: The purpose of this qualitative study was to examine the structure of voice evaluations and gather clinicians' opinions on the barriers to and benefits of using acoustic measures in these evaluations. A secondary goal was to investigate how clinicians assess strain and vocal effort. METHOD: Fifteen voice-specialized speech-language pathologists from voice centers around the United States were interviewed to query their current voice evaluation practice patterns and opinions on acoustic measures. They were also asked how they evaluate strain and vocal effort. Thematic analysis was performed by two researchers based on the recorded interviews. RESULTS: Differences among practitioners were found in almost every component of the evaluation. Four themes related to barriers to and benefits of implementing acoustic measures in a voice evaluation were identified: Collecting and analyzing acoustic measures (a) take time, (b) do not inform therapy patterns, (c) allow for the most accurate comparison, and (d) supplement patient-centered care. Three themes emerged related to evaluating vocal effort and strain: Clinicians (a) lack consensus on objective measures of strain, (b) use more than just auditory perception to evaluate strain, and (c) assess vocal effort in different ways. CONCLUSIONS: Although some speech-language pathologists view acoustic assessment as the gold standard for guiding therapeutic decisions, others believe it may not be strictly necessary for delivering effective voice therapy. Variations in the assessment of strain and vocal effort across voice clinics suggest a need for additional research in this area. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.29391725.