For this discussion topic, you are the speech-language pathologist, and this is your client. Please read the SOAP (subjective symptoms, objective tests, assessment review, diagnosis and plan) presented below and answer the discussion questions (following SOAP notes):
Subjective symptoms: client presents with a weak, breathy voice; client also recently diagnosed with rheumatoid arthritis
Objective tests: cursory laryngoscopic view, laryngograph, computerized speech analysis programs to provide objective measures of vocal quality
Assessment review: oral and laryngeal structures appear normal but have limited movement during phonation; laryngograph shows limited muscle movement on the right side of the neck and near-normal muscle movement on the left side of the neck; computer analysis of vocal quality shows low-amplitude intensity of voice with breathy aspiration of consonants
Diagnosis and plan: ankylosis of the arytenoid cartilage; work to strengthen vocal output and minimize breathiness
Please answer these discussion questions:
(a) What is ankylosis? Why would the arytenoid cartilage be affected by this disorder?
(b) Why would this client have a weak, breathy voice? (Hint: What is the function of the arytenoid cartilages?)
(c) How could this client’s vocal intensity be improved?
You may use your textbook and outside, peer-reviewed journals (e.g., ASHA journals) for additional information.
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