Academic Journal
Rehabilitation Treatment Specification System: Reliability and Dosage of Common Ingredients in Standard-of-Care Therapy for Vocal Hyperfunction.
| Τίτλος: | Rehabilitation Treatment Specification System: Reliability and Dosage of Common Ingredients in Standard-of-Care Therapy for Vocal Hyperfunction. |
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| Συγγραφείς: | Wolfberg J; Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston.; MGH Institute of Health Professions, Boston, MA., Ward M; Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston.; MGH Institute of Health Professions, Boston, MA., Raymond C; Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston.; MGH Institute of Health Professions, Boston, MA., Whyte J; Jefferson Moss Rehabilitation Research Institute, Elkins Park, PA., Tolejano CJ; University of Wisconsin-Madison., Petty B; Emory University, Atlanta, GA., Muise J; Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston.; MGH Institute of Health Professions, Boston, MA., Gherson S; New York University, NY., Doyle P; University of Connecticut School of Medicine, Farmington., Vallila-Rohter S; MGH Institute of Health Professions, Boston, MA., Hillman RE; Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston.; MGH Institute of Health Professions, Boston, MA.; Harvard Medical School, Boston, MA., Van Stan JH; Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston.; MGH Institute of Health Professions, Boston, MA.; Harvard Medical School, Boston, MA. |
| Πηγή: | American journal of speech-language pathology [Am J Speech Lang Pathol] 2026 Sep 08; Vol. 35 (5), pp. 2035-2053. Date of Electronic Publication: 2026 Jun 29. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: American Speech-Language-Hearing Association Country of Publication: United States NLM ID: 9114726 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1558-9110 (Electronic) Linking ISSN: 10580360 NLM ISO Abbreviation: Am J Speech Lang Pathol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Rockville Md : American Speech-Language-Hearing Association |
| Ιατρικοί όροι (MeSH): | Voice Disorders*/rehabilitation , Voice Disorders*/diagnosis , Voice Disorders*/physiopathology , Speech-Language Pathology*/standards , Speech-Language Pathology*/methods , Voice Training* , Voice Quality*, Humans ; Reproducibility of Results ; Observer Variation ; Video Recording ; Female ; Male ; Middle Aged ; Treatment Outcome ; Speech Production Measurement ; Adult ; Volition |
| Περίληψη: | Purpose: The Rehabilitation Treatment Specification System (RTSS) is a theory-driven framework for identifying the active ingredients of rehabilitation treatments and was used to create standard labels in voice therapy (RTSS-Voice). The RTSS and RTSS-Voice have high validity, but reliability has not been tested. This study evaluated if RTSS-Voice ingredients can be reliably coded in standard-of-care voice therapy videos and used to identify commonalities and differences in ingredient dosage across five expert voice clinicians from different institutions. Method: Five speech-language pathologists from different institutions videotaped one voice therapy session for 36 patients with vocal hyperfunction. Two trained graduate students coded sessions using four RTSS-Voice ingredients: (a) opportunities to practice voicing, (b) feedback, (c) volition ingredients, and (d) vocal hygiene information. Twelve sessions were double coded for interrater reliability. Results: Practice voicing codes achieved strong to almost perfect reliability (κs: .80-.95), while informational codes achieved moderate-to-strong reliability (κs: .61-.87). All clinicians spent more time on volition ingredients (14-34 min/52.4%-65.7% of the session) compared to practice voicing (3-8 min/6.3%-23.3% of the session) and feedback (3-11 min/10.8%-19.1% of the session). For practice voicing, clinicians incorporated modified airflow and resonance into over 70% of their practice and spent more time in nonspeech and structured speech compared to spontaneous speech practice. Clinicians differed in delivering volitional information and feedback directly versus indirectly. Conclusions: Multiple RTSS-Voice ingredients were reliable across raters, indicating that, with appropriate training, these are readily observable clinician actions that can aid in the study of dosage in voice therapy. The RTSS and RTSS-Voice also identified commonalities and differences in ingredient usage across multiple expert clinicians. Future work could use the RTSS and RTSS-Voice to investigate relationships between variations in therapy ingredients and individual patient outcomes. Supplemental Material: https://doi.org/10.23641/asha.32785938. |
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| Grant Information: | R01 DC020247 United States DC NIDCD NIH HHS; R21 DC016124 United States DC NIDCD NIH HHS |
| Entry Date(s): | Date Created: 20260629 Date Completed: 20260908 Latest Revision: 20260917 |
| Update Code: | 20260917 |
| PubMed Central ID: | PMC13576691 |
| DOI: | 10.1044/2026_AJSLP-25-00455 |
| PMID: | 42372713 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1558-9110 |
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| DOI: | 10.1044/2026_AJSLP-25-00455 |