CRITIQUE OF UNSUPPORTED PROCEDURAL DESCRIPTIONS
(also known as Expert Opinion)
C = clinician
MtF = male to female
NA = not applicable
P = patient or participant
pmh = Patricia Hargrove, blog developer
SLP = speech-language pathologist
Source: Babajanians, T. (2019.) Giving voice to gender expression. The ASHA Leader, 24(2), 54-63.
Date: February 3, 2019
Overall Assigned Grade: no assigned grade because there was no supporting data
Level of Evidence: F = Expert Opinion, no supporting evidence for the effectiveness of the intervention although the author may provide secondary evidence supporting components of the intervention.
Take Away: This brief article provided guidance in the treatment of male-to-female (MtF) voice. The author provided a brief overview of intake strategies, assessment, and treatment. In addition, other resources that are available electronically were cited. While the recommended guidelines involved a holistic approach including several aspects of communication, this blog review is only concerned with targets associated with prosody. The author also discussed issues concerned with vocal feminization surgery.
- Was there a review of the literature supporting components of the intervention?No
- Were the specific procedures/components of the intervention tied to the reviewed literature? Not Applicable (NA)
- Was the intervention based on clinically sound clinical procedures? Yes
- Did the author provide a rationale for components of the intervention? Yes
- Description of outcome measures:
∞ Are outcome measures suggested? Yes
∞ The following are outcome measures derived from the article.
- Outcome #1: To produce a forward focused resonance with elevated pitch
- Outcome #2: “Vocal health through a custom vocal hygiene plan and daily practice of vocal function exercises” (p. 57) thereby increasing the pitch range
- Outcome #3: Establishment of “feminine speech pattern” (p. 59)
- Was generalization addressed? Yes. The author assigned regular and intensive homework to clients to facilitate generalization.
- Was maintenance addressed?
SUMMARY OF INTERVENTION
PURPOSE: To describe a strategy for working with MtF transgender voices including intensive practice and communication counseling
POPULATION: Transgender (MtF); Adults
MODALITY TARGETED: production
ELEMENTS/FUNCTIONS OF PROSODY TARGETED: pitch, loudness, duration, and concordance
DOSAGE: 1 to 2 sessions a week for 10 weeks; intensive homework included in the treatment plan
- The author presented a holistic approach to working with MtF transgender clients involving direct intervention, counseling, and targets from multiple aspects of communication (e.g., articulation, prosody, voice/resonance, nonverbal communication.)This summary only focuses on the prosody targets.
- Outcome #1:To produce a forward focused resonance with elevated pitch
– Increase the tactile sensation of producing speech in the front of the mouth
- Practice humming
- Produce of words and phrases that start with /m/.
- Encourage good posture and breathing which to facilitated elevation of
- Outcome #2:“Vocal health through a custom vocal hygiene plan and daily practice of vocal function exercises” (p. 57) thereby increasing the pitch range
– Use of contracting and expanding exercises.
– Consider eliminating smoking and the consumption of dairy to reduce throat clearing
- Outcome #3:Establishment of “feminine speech pattern” (p. 59)
∞ Prosodic targets include
– Increased breathiness
– Decreased loudness
– Easy onsets
– Longer duration of vowels
– Decreased rate of speech.
- The author encourages her clients to complete several tasks as daily homework, such as
– practicing exercises 2 times a day (on arising and before going to bed)