title: Development of a speech treatment program for a client with essential vocal tremor.
abstract: Vocal tremor is characterized by involuntary rhythmic modulations of pitch and loudness and is best perceived during sustained phonation of vowels. It is most often present in individuals affected by neurogenic disorders such as Parkinson's disease, amyotrophic lateral sclerosis, spinal muscular dystrophy, spasmodic dysphonia, and essential tremor. Vocal tremor does not appear to be responsive to systemic pharmaceutical management but may benefit from injection of botulinum toxin (i.e., Botox) into affected musculature. However, many individuals do not tolerate the potential side effects of severe breathiness and difficulty swallowing associated with Botox injections. In this article, we summarize the speech evaluation and treatment methods successfully used with an individual with essential vocal tremor. Methods used for characterizing the individual's vocal tremor patterns and the ensuing rationale for behavioral intervention is provided. The outcomes of this case example motivated consideration of speech treatment as a beneficial strategy for some individuals with vocal tremor.
authors.affiliation: Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, AZ 85721, USA. jbark@u.arizona.edu
authors.forename: Julie
authors.initials: J
authors.lastname: Barkmeier-Kraemer
authors.forename: Andrea
authors.initials: A
authors.lastname: Lato
authors.forename: Kay
authors.initials: K
authors.lastname: Wiley
mesh_terms: D001184:Articulation Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D020329:Essential Tremor / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010699:Phonation; D013060:Speech; D013061:Speech Acoustics; D013062:Speech Articulation Tests; D013067:Speech Perception; D013070:Speech Therapy; D049489:Stroboscopy; D014743:Videotape Recording; D014831:Voice; D014832:Voice Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*