NIH-Funded Pitt Research Study to Evaluate New Voice Therapy Technique

A voice therapy program that was refined by experts at the UPMC Voice Center and successfully piloted on a small group of patients with voice disorders, will be reaching more patients due to a $300,000 National Institutes of Health (NIH) grant recently awarded to the University of Pittsburgh School of Medicine. McGowan Institute for Regenerative Medicine affiliated faculty member Clark Rosen, MD, Director of the University of Pittsburgh Voice Center and Professor of Otolaryngology in the School of Medicine, is a co-investigator on the 3-year grant (R03 DC015305) awarded by the National Institute on Deafness and other Communication Disorders.

The new voice therapy approach, Conversation Training Therapy (CTT), concentrates on voice training in spontaneous, conversational speech for patients with voice impairment.

“With this approach, we focus on patients becoming aware and efficient in conversation, instead of in voice exercises. Results from our initial trial showed that patients met their voice therapy goals in just three sessions, substantially below the number of sessions typically required in traditional voice therapy programs, which can take up to 12 or even 24 sessions. Patients also reported that they noticed marked improvement in their voice impairment,” said lead researcher Amanda Gillespie, PhD, assistant professor, Department of Otolaryngology, Pitt School of Medicine, and director of Clinical Research, UPMC Voice Center.

Treatment aimed at modifying behaviors that cause or contribute to voice disorders is the standard of care for many people experiencing voice issues. Although voice therapy is effective at treating voice disorders, substantial limitations exist with traditional treatment models. These limitations cause a protracted length of time in required treatment, as well as drop out and voice problem relapse rates approaching 70 percent, which contribute to the high costs associated with treating voice disorders.

CTT was developed by a team of expert voice-specialized speech-language pathologists at voice centers around the U.S. The goal of this study is to determine the effectiveness of CTT in the rehabilitation of patients with two common voice disorders—benign vocal fold lesions and muscle tension dysphonia. Once that is determined, the long term goal is to conduct multi-center trials comparing CTT to traditional voice therapy programs in people with voice disorders.

Pitt’s research study is the first to look at a voice therapy program based in theories of motor learning and neuroplasticity, developed with input from patients with voice disorders and expert, clinical speech-language pathologists.

“Results of the current research have the potential to dramatically change how voice therapy is delivered, including the necessary time spent in treatment, resulting in a potential savings of health care funds and improved quality of life for people with voice disorders,” said Jackie L. Gartner-Schmidt, PhD, co-investigator on the study, co-director of the UPMC Voice Center, and director of Speech-Language Pathology-Voice Division, Pitt School of Medicine.

Researchers will recruit 60 participants to undergo 4 weeks of treatment with a CTT-trained voice therapist. Each will be evaluated prior to starting CTT, before each treatment session, and at 1-week and 3-month intervals after the last CTT session. Outcome measures will include participant-perceived voice handicap, acoustic, aerodynamic, and audio-perceptual voice analyses, and will be compared to matched past patients who previously underwent traditional voice therapy. Participants are compensated for their time.