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Research Article|Articles in Press

A Human-Centered Design Approach to SOVTE Straw Phonation Instruction

Published:February 25, 2023DOI:https://doi.org/10.1016/j.jvoice.2023.01.023

      Summary

      Objectives

      Extensive research has demonstrated that straw/tube phonation exercises produce positive effects on the voice quality of the user. The purpose of this study was to explore pedagogical practices employed by a range of voice professionals when using SOVTEs by applying human-centered design approaches to examine workflow and communication between teachers and students.

      Method/Design

      The researchers conducted a series of five participatory role-playing workshop activities at a multi-disciplinary vocology conference that included speech-language pathologists, voice scientists, physicians, singing teachers, acting voice teachers, choral directors, and singers. Volunteers were asked to assume the role of teaching or learning straw phonation exercises. The other participants from each workshop were asked to provide written and verbal feedback regarding the teacher/student dynamics and what they found most important and relevant in terms of best practices for SOVTEs. Expert evaluators subsequently provided similar feedback based on video recordings of the workshops.

      Results

      While there was variability noted in teaching techniques and results, common themes emerged in the analysis. Successful and unsuccessful student and teacher techniques were identified by the workshop participants. Through the video analysis, the research team identified themes in instructional teaching, experiential learning, and straw articulation and mechanics.

      Conclusions

      The benefits of straw/tube phonation exercises on voice quality have been well-established and are clear. As we continue to refine best practices in SOVTEs and, in particular, straw phonation, involvement of experts in HCD as part of multidisciplinary teams may lead to the eventual design of SOVTE tools that provide greater precision, consistency, and effectiveness both in clinical and pedagogical settings, and aid in the differentiation of SOVTE approaches within the taxonomy of vocal habilitation and rehabilitation techniques.

      Key Words

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      References

        • Fourie K
        • Richardson M
        • van der Linde J
        • et al.
        The reported incidence and nature of voice disorders in the private healthcare context of gauteng.
        J Voice. 2017; 31: 774.e23-774.e28https://doi.org/10.1016/j.jvoice.2017.02.013
        • Bhattacharyya N.
        The prevalence of voice problems among adults in the United States.
        Laryngoscope. 2014; 124: 2359-2362https://doi.org/10.1002/lary.24740
        • Cohen SM
        • Kim J
        • Roy N
        • et al.
        Direct health care costs of laryngeal diseases and disorders.
        Laryngoscope. 2012; 122: 1582-1588https://doi.org/10.1002/lary.23189
        • Payten CL
        • Nguyen DD
        • Novakovic D
        • et al.
        Telehealth voice assessment by speech language pathologists during a global pandemic using principles of a primary contact model: an observational cohort study protocol.
        BMJ Open. 2022; 12e052518https://doi.org/10.1136/bmjopen-2021-052518
        • Desjardins M
        • Halstead L
        • Cooke M
        • et al.
        A systematic review of voice therapy: what “effectiveness” really implies.
        J Voice. 2017; 31: 392.e13-392.e32https://doi.org/10.1016/j.jvoice.2016.10.002
        • Dijkers MP
        • Ferraro MK
        • Hart T
        • et al.
        Toward a rehabilitation treatment taxonomy: summary of work in progress.
        Phys Ther. 2014; 94: 319https://doi.org/10.2522/ptj.20140009
        • Van Stan JH
        • Roy N
        • Awan S
        • et al.
        A taxonomy of voice therapy.
        American J Speech-Lang Pathol. 2015; 24: 101-125
        • Van Stan JH
        • Whyte J
        • Duffy JR
        • et al.
        Voice therapy according to the rehabilitation treatment specification system: expert consensus ingredients and targets.
        Am J Speech Lang Pathol. 2021; 30: 2169-2201https://doi.org/10.1044/2021_AJSLP-21-00076
        • Guzman M
        • Bertucci T
        • Pacheco C
        • et al.
        Effectiveness of a physiologic voice therapy program based on different semioccluded vocal tract exercises in subjects with behavioral dysphonia: A randomized controlled trial.
        J Commun Disord. 2020; 87106023https://doi.org/10.1016/j.jcomdis.2020.106023
      1. Abbott KV. National Center for Voice and Speech’s Guide to Vocology. Iowa City, IA: National Center for Voice and Speech; 1998.

        • Nasser K
        The Accent Method of Voice Therapy. Singular Publishing Group, San Diego, CA1995
        • Stemple J
        • Hapner E
        Voice Therapy: Clinical Case Studies. 5th ed. Plural Publishing, Inc, San Diego, CA2019
      2. Apfelbach CS, Guzmán M. Acoustic, Aerodynamic, Morphometric, and Perceptual Changes During and After Semi-Occluded Vocal Tract Exercise: An Integrative Review. Journal of voice. 2021:1-2,20. doi:https://doi.org/10.1016/j.jvoice.2021.09.031

        • Dargin TC
        • Searl J.
        Semi-occluded vocal tract exercises: aerodynamic and electroglottographic measurements in singers.
        J Voice. 2015; 29: 155-164https://doi.org/10.1016/j.jvoice.2014.05.009
        • Castillo-Allendes A
        • Cantor-Cutiva LC
        • Hunter EJ
        Acoustic Effects of Vocal Warm-Up: A 7-Week Longitudinal Case Study.
        Journal of voice. 2021; : 1-7https://doi.org/10.1016/j.jvoice.2021.09.030
        • Titze IR
        • Palaparthi A
        • Cox K
        • et al.
        Vocalization with semi-occluded airways is favorable for optimizing sound production.
        PLoS Comput Biol. 2021; 17e1008744https://doi.org/10.1371/journal.pcbi.1008744
        • Dargin TC
        • DeLaunay A
        • Searl J.
        Semioccluded vocal tract exercises: changes in laryngeal and pharyngeal activity during stroboscopy.
        J Voice. 2016; 30: 377.e1-377.e9https://doi.org/10.1016/j.jvoice.2015.05.006
        • Manternach JN
        • Clark C
        • Daugherty JF.
        Effects of a straw phonation protocol on acoustic measures of an SATB chorus singing two contrasting renaissance works.
        J Voice. 2017; 31: 514.e5-514.e10https://doi.org/10.1016/j.jvoice.2016.12.008
        • Gillespie AI
        • Fanucchi A
        • Gartner-Schmidt J
        • et al.
        Phonation with a variably occluded facemask: effects of task duration.
        J Voice. 2022; 36: 183-193https://doi.org/10.1016/j.jvoice.2020.05.011
        • Meerschman I
        • Van Lierde K
        • Peeters K
        • et al.
        Short-term effect of two semi-occluded vocal tract training programs on the vocal quality of future occupational voice users: "resonant voice training using nasal consonants" versus "straw phonation".
        J Speech Lang Hear Res: JSLHR. 2017; 60: 2519https://doi.org/10.1044/2017_JSLHR-S-17-0017
        • Maxfield L
        • Titze I
        • Hunter E
        • et al.
        Intraoral pressures produced by thirteen semi-occluded vocal tract gestures.
        Logoped Phoniatr Vocol. 2015; 40: 86-92https://doi.org/10.3109/14015439.2014.913074
        • Andrade PA
        • Wood G
        • Ratcliffe P
        • et al.
        Electroglottographic study of seven semi-occluded exercises: laxvox, straw, lip-trill, tongue-trill, humming, hand-over-mouth, and tongue-trill combined with hand-over-mouth.
        J Voice. 2014; 28: 589-595https://doi.org/10.1016/j.jvoice.2013.11.004
        • Yamasaki R
        • Murano EZ
        • Gebrim E
        • et al.
        Vocal tract adjustments of dysphonic and non-dysphonic women pre- and post-flexible resonance tube in water exercise: a quantitative MRI study.
        J Voice. 2017; 31: 442-454https://doi.org/10.1016/j.jvoice.2016.10.015
        • Titze IR.
        Voice training and therapy with a semi-occluded vocal tract: rationale and scientific underpinnings.
        J Speech Lang Hear Res. 2006; 49: 448-459https://doi.org/10.1044/1092-4388(2006/035
        • Gaskill CS
        • Quinney DM.
        The effect of resonance tubes on glottal contact quotient with and without task instruction: a comparison of trained and untrained voices.
        J Voice. 2012; 26: e79-e93https://doi.org/10.1016/j.jvoice.2011.03.003
        • Croake DJ
        • Andreatta RD
        • Stemple JC.
        Immediate effects of the vocal function exercises semi-occluded mouth posture on glottal airflow parameters: a preliminary study.
        J Voice. 2016; 31 (.e9-245.e14): 245https://doi.org/10.1016/j.jvoice.2016.08.009
        • Göttgens I
        • Oertelt-Prigione S
        The Application of Human-Centered Design Approaches in Health Research and Innovation: A Narrative Review of Current Practices.
        JMIR mHealth and uHealth. 2021; 9e28102https://doi.org/10.2196/28102
        • Melles M
        • Albayrak A
        • Goossens RHM.
        Innovating health care: Key characteristics of human-centered design.
        Int J Qual Health Care. 2021; 33: 37-44https://doi.org/10.1093/intqhc/mzaa127
        • Roper A
        • Skeat J.
        Innovation through participatory design: Collaborative qualitative methods in the development of speech-language pathology technology.
        Int J Speech Lang Pathol. 2022; (ahead-of-print(ahead-of-print)): 1-6https://doi.org/10.1080/17549507.2022.2050943
      3. Hudson L, Amponsah C, Bampoe JO, et al. Co-designing digital tools to enhance speech and language therapy training in Ghana.

        • Kim ES
        • Laird L
        • Wilson C
        • et al.
        Implementation and effects of an information technology–based intervention to support speech and language therapy among stroke patients with aphasia: protocol for a virtual randomized controlled trial.
        JMIR Res Protoc. 2021; 10: e30621https://doi.org/10.2196/30621
        • Behrman A.
        Facilitating behavioral change in voice therapy: the relevance of motivational interviewing.
        Am J Speech Lang Pathol. 2006; 15: 215-225https://doi.org/10.1044/1058-0360(2006/020
      4. Maxfield L. Improve your students’ learning by improving your feedback. J Singing. 2013;69:471–478. https://search.proquest.com/docview/1321134110. Accessed October 11, 2022

      5. Maxfield L. Incorporating motivation into your model of motor learning. J Singing. 2019;75:583–587. https://search.proquest.com/docview/2227795652. Accessed October 11, 2022

        • Lee TD
        • Schmidt RA
        Motor Learning and Performance: from Principles to Application. 6th Edition. Human Kinetics, Champaign, IL2019