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Speech and Language Therapy Endoscopy – a survey
Report by Suzanne Slade, Clinical Led Speech and Language Therapist on behalf of the Nottingham Voice Disorders Team, Nottingham University Hospitals Trust
Speech and language therapists across the UK are increasingly using laryngeal endoscopy as part of voice therapy.
This is the finding of a survey recently carried out by the Nottingham Voice Disorders team. A postal survey was sent to 111 speech and language therapists around the UK. The response was excellent with replies received from 108 therapists. 53% of therapists who responded to the survey use laryngeal endoscopy. Of those therapists who do not yet use laryngeal endoscopy, 62% would like to acquire the skills to do so.
Laryngeal endoscopy is the examination of the larynx using either a flexible fibre optic trans-nasal endoscope or rigid trans-oral endoscope. Traditionally this has been carried out by the ENT specialist/ laryngologist for the purpose of diagnosis and it still is. Now however, in many centres, it is also being used during the course of voice therapy. It provides visual feedback for patients helping them to identify poor vocal technique and giving biofeedback during therapy techniques. The therapist can also check the health of the larynx during the course of therapy and quickly return the patient to the laryngologist if necessary.
The survey shows that many therapists are continuing to learn and develop their skills in laryngeal examination. The Royal College of Speech and Language Therapists published guidelines in 2004 for speech and language therapists using laryngeal endoscopy with voice disordered patients. This sets professional standards of training and levels of competence which must be achieved to ensure patient safety. In the survey therapists were asked to self rate their level of competence on a linear scale. 31% rated themselves as fully competent with the remainder still working under close supervision from a competent colleague, usually a consultant laryngologist.
There is emerging evidence of the benefits of speech therapy endoscopy. In some centres voice disorders teams are now able to offer more clinics for example, speech therapy led clinics for professional voice users. Also a study by Rattenbury and Carding published in 2004 found that voice therapy using laryngeal endoscopy is more efficient than traditional therapy, reducing overall intervention time by 2 hours.
As part of the NHS modernisation plan health professionals are encouraged to take on new skills and to step out of their traditional professional boundaries. This survey appears to show that voice therapists in the UK are stepping up to this challenge. Speech and language therapists are taking on new skills to enable them to work more efficiently in the rehabilitation of the voice.
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