7. PROJECT SUMMARY/ABSTRACT
Due to the COVID-19 pandemic, telepractice has grown rapidly. To date, synchronous telepractice (i.e.,
in real-time videoconferencing) has been the focus of most research with asynchronous telepractice (i.e.
information stored and accessed later) being used minimally only to record synchronous encounters.
Descriptions of voice therapy concepts are minimally available in the literature with no standard reporting
framework and no clinical efficacy or effectiveness data. Thus, the proposed study will address these barriers.
First, an asynchronous method will be developed that will impact both in-person and telepractice services by
offering repeated learning opportunities in the client’s environment. The method includes ecological momentary
intervention (EMI) through a daily voice therapy practice app, server, and web portal that is flexible in its
programming to meet the needs of the client, offers performance feedback, and charts results over time.
Second, voice therapy concepts will be tested improving our knowledge about such concepts that facilitate
successful client-centered outcomes for both prevention and treatment of voice problems. The participants in
the study will be teachers who have a high prevalence of voice problems, impact the healthcare system when
treatment is needed, and negatively affect students’ learning abilities in the classroom when communicating
with a voice problem. Third, the Rehabilitation Treatment Specification System (RTSS) framework will be used
to describe the voice therapy concepts. The concepts include: training multiple voices to meet all the clients’
vocal needs, defining voice qualities by the anatomy and physiology of the voice production system,
generalizing voice targets into hierarchical speech tasks, and using “new” vs “other/old” voice to help the client
become their own clinician. Vocally healthy student teachers and professional teachers with voice complaints
will be randomized into one of four voice therapy conditions delivered via telepractice. Both groups of teachers
are needed to assess the concepts for prevention and treatment. Condition 2, which fully represents the
proposed voice therapy concepts, will be superior to the other three conditions, which do not fully represent the
concepts, by demonstrating a greater decrease in client-reported primary outcome measures of the Voice
Handicap Index-10 and factor 1 and 2 of the Vocal Fatigue Index. Secondary outcomes of acoustic measures,
Borg Category Ratio-10 scales for vocal and mental effort, and voice therapy satisfaction surveys will also be
investigated. The results will be useful at a practical level by advancing asynchronous telepractice and by
improving efficacy of voice therapy concepts. In addition, the results will lay the groundwork for future studies
involving development of EMI platforms in other areas of speech-language pathology and testing additional
voice therapy concepts that facilitate successful client-centered outcomes.
