Schizophrenia Case Studies

Patient’s Name: Allison A.
Type of Case: Bilateral Vocal Nodules
Age: 7 years of age

Referral: Referred by the client’s ENT Dr. Ambrosia.
Reason for Referral: Client demonstrates an excessive amount of hoarseness in her voice and many occasions of losing her voice secondary to a diagnosis of vocal nodules.
History of the Problem: Appears vocal abnormalities were first noticed when the child was in the first grade and continued into second grade. Teachers observed hoarseness and a loss of voice at variable points throughout the school year. The client was subsequently referred to the school nurse and Speech Language Pathologist who ultimately referred her to an ENT. The ENT found bilateral vocal nodules on the client’s vocal folds.
Medical
Poor hydration
Prognosis: Prognosis is good based on the client’s age and the nodules being of only moderate size and soft appearance. Additionally, vocal pathology is not consistent for all parameters meaning vocal quality can be within normal limits intermittently. Client is motivated to obtain a normal sounding voice. The treatment program for the client’s voice disorders should last approximately 12 to 14
Voice therapy sessions will focus on the client’s use of her voice, stress reduction and various dietary recommendations (Tezcaner, Ozgursoy, Sati Durson, 2009). Research by Tezcaner et. al. (2009) showed that combination of vocal hygiene therapy, change of diet and tension reduction in the vocal mechanism were instrumental in the reduction of vocal nodules for 29 of their 32 participants (Tezcaner et. al., 2009). Based on these findings vocal hygiene counseling will be implemented initially to teach the client about good vocal behaviors (Tezcaner et. al., 2009). It will be necessary that the client eliminate any abusive vocal behaviors, such as hoarseness, which is a contributing factor to vocal nodules (Tezcaner et. al., 2009). Initial diet recommendations will include the reduction of caffeine consumption and water intake needs to be increased to hydrate the client’s vocal folds (Tezcaner et. al., 2009). It is recommended that the client continue to receive outside counseling with her family to help with any possible emotional factors that are affecting her voice (Stemple, Roy, Klaben, 2014). It will be important that stress is limited as much as possible for the client’s vocal health (Tezcaner et. al., 2009). Within therapy the client will work on relaxation techniques to eliminate the client’s tension within her neck (Tezcaner et. al., 2009).