Assessment of Voice Disorders
Aging affects the whole body system and changes that may cause neurologic deficits and tremor or alter pulmonary capacity or breath support, could also be affecting an older individual's voice and be indicative of an underlying medical condition. Thus, a correct diagnosis of any voice problems in the older client is the first step in any voice treatment (Goodman, 2008). Treatment recommendations should not be made until a medical report has been obtained (Boone, McFarlane, Von Berg, & Zraick, 2013). The American Speech-Language Hearing Association (ASHA) Preferred Practice Patterns for the Profession of Speech-Language Pathology reports that "All patients/clients with voice disorders are examined by a physician, preferably in a discipline appropriate to the presenting complaint (ASHA, 2004). A detailed medical history, consisting of environmental factors (e.g., tobacco smoke) and medications that can affect the voice, an examination of the larynx to look at the vocal cords and to determine the degree of glottal incompetence is very important (Goodman, 2008)
Voice production is a function that involves the coordination and integration of the movements of various structures. Voicing requires the involvement of the cognitive, neurologic, phonatory, respiratory and digestive systems with no single system devoted to it. It is influenced by the health of the mind, body, emotions, and the external environment. It is perceived differently by different listeners. Thus, voice production is a dynamic experience that can be described and analyzed in a variety of ways. Each assessment method provides distinct information (Andrews, 1995).