Phonetograms as a tool in the voice clinic: changes across voice therapy for patients with vocal fatigue.

This study discusses phonetogram recordings as a tool in the voice clinic. It reports experiences during recordings and changes in measures across voice therapy for women with vocal fatigue. Phonetogram data are discussed along with subglottal pressure measurements and subjective evaluations of voice function and quality. Assessments were made pre-, mid-, and post behaviorally based voice therapy. Maximum voice range profile (VRPmax), subglottal pressure, patient's and speech and language pathologist's (SLP) ratings of voice function and quality, and voice handicap index (VHI). Patients and SLPs often agreed in direction of voice change across therapy. Subglottal pressure did not change systematically across therapy. VHI had decreased and VRPmax increased after therapy, although not to normal values. Increased VRPmax for individuals was mainly due to extended capacity in the low intensities; high intensities did not change noticeably. Changes tended to occur after the mid-therapy session, suggesting that the therapy should not be shortened. The results and experiences from the assessments are discussed in terms of the use of phonetograms as a tool in the voice clinic and for voice therapy outcome evaluation.