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Purpose Clinical trials have demonstrated that standardized voice treatment programs are effective for some patients, but identifying the unique individual treatment ingredients specifically responsible for observed improvements remains elusive. To address this problem, the authors used a taxonomy of voice therapy, the Rehabilitation Treatment Specification System (RTSS), and a Delphi process to develop the RTSS-Voice (expert consensus categories of measurable and unique voice treatment ingredients and targets). Method Initial targets and ingredients were derived from a taxonomy of voice therapy. Through six Delphi Rounds, 10 vocal rehabilitation experts rated the measurability and uniqueness of individual treatment targets and ingredients. After each round, revisions (guided by the experts' feedback) were finalized among a primary reader (a voice therapy expert) and two external readers (rehabilitation experts outside the field of voice). Consensus was established when the label and definition of an ingredient or target reached a supramajority threshold (≥ 8 of 10 expert agreement). Results Thirty-five target and 19 ingredient categories were agreed to be measurable, unique, and accurate reflections of the rules and terminology of the RTSS. Operational definitions for each category included differences in the way ingredients are delivered and the way individual targets are modified by those ingredients. Conclusions The consensus labels and operationalized ingredients and targets making up the RTSS-Voice have potential to improve voice therapy research, practice, and education/training. The methods used to develop these lists may be useful for other speech, language, and hearing treatment specifications. Supplemental Material https://doi.org/10.23641/asha.15243357

The pitch-matching abilities of speech-language pathology graduate students were investigated. Subjects ( N =86) attempted to match prerecorded human-voice and pitch-pipe models of the tones C 4 , D 4 , E 4 , G 4 , and B 4 . Mean fundamental frequencies of subject responses were calculated and then converted to semitones. Eighty three percent of the tones were matched within plus or minus one semitone. However, 47% of the subjects were two or more semitones away from the expected tone on two to nine of the ten tones presented. Tones produced in imitation of the human voice were closer to the target than those produced in imitation of the pitch pipe.

In this investigation the coping, adjustment, self-esteem, general well-being, perceived communication abilities, and preferred communication modes of 41 patients with laryngectomies were evaluated. Specifically, we wanted to determine how well patients with laryngectomies adjust to and cope with their cancer, whether differences in coping and adjustment vary as a function either of the type of alaryngeal voice used or the amount of time since the laryngectomy, and whether relationships exist between the speech of patients with laryngectomies and their adjustment. Standardized interview protocols and tests were employed during face-to-face interviews. Results revealed that 73% of the sample showed good adjustment and used predominantly problem-focused and seeking-social-support strategies to cope with their cancer. The 27% who were classified as poor copers also performed poorly on self-esteem and general well-being measures and used more self-blame and avoidance strategies. There were no significant differences among different types of preferred communication modes. Significant differences existed between patients with recent and distant laryngectomies; the latter showed better overall adjustment. The subjects who were well adjusted also tended to view their voice rehabilitation as more beneficial and rated themselves as more easily understood by listeners than did those subjects demonstrating psychological distress and poor adjustment. Implications for advanced voice therapy, the need for counseling and referrals, and the relationship among voice, self-esteem, and therapy are discussed.