Spasmodic Dysphonia/Muscle Tension Dysphonia Evaluation
Name:
_______________________
Date:
_______________________
SENTENCE PRODUCTION
Stimulus sentences:
Voiced
1. We eat eels every day.
2. Berries are good on bread.
3. We mow our lawn all year.
4. Early one morning a man and a woman were ambling along a one-mile lane running near Rainy
Island Avenue.
5. Count 80-90.
Voiceless
1. The puppy bit the tape.
2. She speaks pleasingly.
3. Harry had a head of hair.
4. He saw half a shape mystically cross fifty or sixty steps in front of his sister Kathy’s house.
5. Count 1-10.
More difficulty with Voiced sentences1:
ADSD
More difficulty with Voiceless sentences2:
ABSD
Equal difficulty with both types of sentence1: Mixed SD or MTD or Laryngeal dystonia
PHONATION
Voice quality (Describe in terms of consistency, severity, and quality and any related observation: pitch
breaks, phonation breaks, hard glottal attack, glottal fry, tremor, monotone…Describe the
conversational voice as completely and concisely as possible.)
on /ah/:
during reading:
during conversation:
Describe intelligibility:
Comments:
Note:
In MTD, may hear consistent strain in speaking, regardless of context.
In ADSD, may hear hard onsets for words beginning with vowels or other voiced sounds.
In ABSD, may hear difficulty initiating words beginning with voiceless sounds.
1
2
Roy et al, 2005
Edgar et al, 2001
LARYNGEAL PALPATION
By report or observation: Excessive tension in the:
Neck
Yes
No
Shoulders
Yes
No
Face
Yes
No
On laryngeal palpation
Pain on palpation:
Laryngeal stiffness:
Laryngeal elevation:
Muscle tension can be associated with both SD and MTD, but is more often part of MTD3.
RESPIRATION
Breath control (Instructions and scoring depends on the norms you are using. “Take a deep breath and
sustain /s/ as long and steady as you can”. Take the best of 3 trials. Norms for males = 25 sec +/- 7
and for females = 21 +/- 6 sec). S/z ratio < 1.4
Sustained s-s-s:
________
Duration (s)
________
________
Sustained z-z-z:
________
________
________
Comments:
Respiratory support may be diminished in MTD4
ARTICULATION
Describe any articulation problems:
IMPRESSIONS
Brief description of the voice:
Likely diagnosis:
ABSD
Mixed SD
Is there concurrent tremor?
Yes
No
Therapy recommendations:
Botox
Behavioral tx
Prognosis:
Excellent
Good
Comments:
3
4
Roy et al, 1996
Altman et al, 2004
ADSD
MTD
Laryngeal dystonia
Other:_________________
Poor
References:
Altman, K. W., Atkinson, C., & Lazarus, C. (2005). Current and emerging concepts in muscle tension
dysphonia: a 30-month review. J Voice, 19(2), 261-267.
Edgar, J. D., Sapienza, C. M., Bidus, K., & Ludlow, C. L. (2001). Acoustic measures of symptoms in
abductor spasmodic dysphonia. J Voice, 15(3), 362-372.
Erickson, M. L. (2003). Effects of voicing and syntactic complexity on sign expression in adductor
spasmodic dysphonia. Am J Speech Lang Pathol, 12(4), 416-424.
Roy, N., Ford, C. N., & Bless, D. M. (1996). Muscle tension dysphonia and spasmodic dysphonia: the
role of manual laryngeal tension reduction in diagnosis and management. Ann Otol Rhinol
Laryngol, 105(11), 851-856.
Roy, N., Gouse, M., Mauszycki, S. C., Merrill, R. M., & Smith, M. E. (2005). Task specificity in adductor
spasmodic dysphonia versus muscle tension dysphonia. Laryngoscope, 115(2), 311-316.
Roy, N., Mauszycki, S. C., Merrill, R. M., Gouse, M., & Smith, M. E. (2007). Toward improved
differential diagnosis of adductor spasmodic dysphonia and muscle tension dysphonia. Folia
Phoniatr Logop, 59(2), 83-90.
Sapienza, C. M., Walton, S., & Murry, T. (2000). Adductor spasmodic dysphonia and muscular tension
dysphonia: acoustic analysis of sustained phonation and reading. J Voice, 14(4), 502-520.