1. Development of an Electronic Documentation System for Voice Therapy
A New Teaching and Clinical Research Tool
Elizabeth Heller Murray, Katherine Girouard, Meredith Cler, Cara Stepp

2. Disclosures
Financial: This work was supported by grant DC from the National Institute on Deafness and Other Communication Disorders (NIDCD). Cara E. Stepp is an assistant professor at Boston University. Elizabeth S. Heller Murray, Katherine L. Girouard, and Meredith J. Cler have no relevant financial interests to disclose.
Nonfinancial: Elizabeth S. Heller Murray, Katherine Girouard, Meredith J. Cler, and Cara E. Stepp are the developers of the VoiceTx application.
Heller Murray, E. S., Girouard, K. L., Cler, M. J., & Stepp, C. E. (2016). Development of an Electronic Documentation System for Voice Therapy: A New Teaching and Clinical Research Tool. Perspectives of the ASHA Special Interest Groups, 1(3),

3. Motivation
Research frequently focuses on the outcomes of voice therapy
Often don’t know the elements that go into the therapy sessions
Research: difficult to repeat or expand on a study
Clinical: difficult to understand what aspects of voice therapy contributed to outcomes

4. Aim of Current Project
Develop a flexible and easy-to-use documentation system
Documents all aspects of therapy
Compiles all the information in one central location
Provides enough detail to use as a teaching tool
Allow the clinician to document everything they do, without putting any limitations on their clinical care

5. Development and Suggested Use
Structure developed from research articles, textbooks, and knowledge of clinical practice
Amended terminology
A Taxonomy of Voice Therapy (Van Stan, et al., 2015)
All definitions of terms provided in application
Suggested use
Teaching tool
Clinical research
Noted limitation in integrating into expert clinical practice

6. Structure of Documentation System
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11. Indirect Intervention
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12. Indirect Intervention
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18. Structure of Documentation System
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20. Direct Intervention
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22. Direct Intervention
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24. Direct Intervention
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34. (8/10)

38. Teaching Tool: Student Competencies
Checklist of assessing graduate student competencies in voice disorders (Teten et al., 2013)
Plans and implements a treatment program to address the individual needs of the patient and communication styles of family members based on the results of a comprehensive assessment and patient and/or family consultation
Assists patient with developing and adhering to a plan for managing vocal hygiene
Displays flexibility in selecting appropriate facilitating voice techniques when assessing the patient’s stimulability for improved voice quality at the time of the initial evaluation and during ongoing treatment
Writes evaluation, therapy, and referral reports that adequately explain the nature of the patient’s voice disorder and treatment for the patient and the family

39. Teaching Tool: Student Competencies
Planning and implementing a treatment program
Student can document the choices of an expert clinician to began to understand a training program
Development of goals
Document goals based on voice evaluation
Expert clinician can put in goals as a model
All decisions moving through therapy are documented, allowing concrete points for feedback
Vocal Hygiene: Vocal hygiene hierarchy (Stemple et al., 2000)
Identify the behavior
Describe the effects
Define specific occurrences
Plan for modifying behavior

40. Teaching Tool: Student Competencies
Flexibility in selecting appropriate therapy techniques
Structure allows for guidance on selecting therapy technique: cannot select a tool in isolation
Provides way to document success to assist with decision making
Writing reports
Documentation of tasks and data regarding success are saved
Summary printed at the end of each session

41. Clinical Research
Large dataset of information compiled in one location
Everything is linked to a patient and goal
Download entire database in SQL
For example, allows examination of:
Effectiveness of interventions for certain presentations
Trends in a large sample
Relationship between success in different interventions
Sql = structured query language: used to communicate with a database

42. Summary and Future Directions
New tool for teaching and clinical research
Allow all aspects of voice therapy to be documented
Future directions
Expanding beyond voice
Continuing to improve usability
Make application publically available (soon!)
Interested in testing Voicetx?

43. Speech, Language, & Hearing Sciences
Acknowledgements:
Stepp Lab, Boston University:
Speech, Language, & Hearing Sciences
Grace O’Donnell
Jessica Silfen
Jordan Piel
Edie Hapner
Brienne Ruel
Jackie Gartner-Schmidt
Ali Lewandowski
Jarrad Van Stan
Robert Hillman
Elizabeth Gavett
Adrianna Shembel
Biomedical Engineering
Computational Neuroscience

44. References
Heller Murray, E. S., Girouard, K. L., Cler, M. J., & Stepp, C. E. (2016). Development of an Electronic Documentation System for Voice Therapy: A New Teaching and Clinical Research Tool. Perspectives of the ASHA Special Interest Groups, 1(3),
Stemple, J. C., Glaze, L. E., & Gerdeman, B. K. (2000). Clinical voice pathology: Theory and management (3rd ed.). San Diego, CA: Cengage Learning.
Teten, A. F., DeVeney, S. L., & Friehe, M. J. (2013). Checklist for assessing graduate student competencies in voice disorders. Perspectives on Voice and Voice Disorders, 23, 95–100.
Van Stan, J. H., Roy, N., Awan, S., Stemple, J., & Hillman, R. E. (2015). A taxonomy of voice therapy. American Journal of Speech-Language Pathology, 24, 101–125.