Voice Therapy Methods for Dysphonia

Overseen By Amanda Gillespie, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Emory University

Disqualifiers: Voice therapy, Surgery, Hearing, Pregnancy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

Duration: 4 weeks

120 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests various methods of voice therapy to assess their effectiveness for individuals with voice problems. It targets those with muscle tension dysphonia (a voice issue from muscle strain) or benign vocal fold lesions (non-cancerous growths on the vocal cords). Participants will engage in different therapy approaches, including Deconstructing Voice Therapy, and monitor their progress over a year. Ideal candidates are non-smokers with these conditions, who have not recently undergone voice therapy or surgery, and are willing to attend sessions and use a smartphone for practice. As an unphased trial, this study allows participants to explore innovative therapy methods and contribute to advancing voice treatment options.

Do I have to stop taking my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that these voice therapy methods are safe for treating dysphonia?

Research has shown that both Non-Hierarchical and Hierarchical Conversation Training Therapies (CTT) are generally well-tolerated by individuals with voice issues such as muscle tension dysphonia and vocal fold lesions. Studies on these therapies have not reported any serious side effects, indicating safety for most individuals.

In past studies, patients who underwent these therapies reported improvements in voice quality without major negative effects. Specifically, they experienced better overall voice quality and less strain. This suggests that these therapies are likely safe and could be a good option for those considering participation in a clinical trial for voice problems. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Voice Therapy Methods for Dysphonia trial because it explores innovative approaches to voice therapy that differ from traditional methods like vocal exercises and surgery. This trial investigates two methods: Non-Hierarchical Conversation Training Therapy (CTT) and Hierarchical Conversation Training Therapy (CTT-H). These techniques emphasize conversation-based training, which could offer a more practical and engaging way for patients to improve their vocal function. By focusing on real-world communication, these therapies aim to enhance voice quality and patient outcomes more naturally and effectively than current standard treatments.

What evidence suggests that this trial's treatments could be effective for dysphonia?

This trial will compare two methods of Conversation Training Therapy (CTT) for individuals with muscle tension dysphonia (MTD) or non-cancerous vocal cord issues. Studies have shown that CTT can improve scores on the Voice Handicap Index–10, which measures the impact of voice problems on daily life. One arm of this trial will use Non-Hierarchical Conversation Training Therapy (CTT), employing natural conversation as the main treatment to help patients use their voices more effectively in everyday situations. Another arm will use Hierarchical Conversation Training Therapy (CTT-H), which organizes conversation tasks to enhance voice outcomes. Both methods rely on motor learning theory, which aids skill acquisition through natural practice. Early findings suggest these therapies might boost confidence and reduce restrictions for those with voice problems. ^{1 6 7 8 9}

Who Is on the Research Team?

Amanda Gillespie, PhD

Principal Investigator

Emory University

Are You a Good Fit for This Trial?

This trial is for individuals with voice problems diagnosed as non-phonotraumatic vocal hyperfunction (primary muscle tension dysphonia) or phonotraumatic vocal hyperfunction (benign vocal fold lesions). Specific eligibility criteria are not provided, but typically include age, health status, and the severity of the condition.

Inclusion Criteria

Non-smoking

Stimulable and appropriate for behavioral voice intervention as determined by a voice-specialized speech-language pathologist and laryngologist

Willingness to attend all therapeutic interventions and follow-up sessions

Exclusion Criteria

Not stimulable or inappropriate for behavioral voice intervention as determined by a voice-specialized speech-language pathologist and laryngologist

Abnormal hearing ability (despite appropriate amplification)

Pregnant women

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either Non-Hierarchical Conversation Training Therapy (CTT) or Hierarchical Conversation Training Therapy (CTT-H) over a 4-week period

4 weeks

Weekly sessions

Follow-up

Participants are monitored for voice outcomes and adherence to therapy at multiple intervals post-treatment

12 months

Assessments at 3, 6, and 12 months post-treatment

What Are the Treatments Tested in This Trial?

Interventions

• Deconstructing Voice Therapy

Trial Overview The study compares two methods of voice therapy: a hierarchical method and a non-hierarchical method. It aims to see which one improves communication outcomes over a year by looking at how clear speech affects voice quality and patient satisfaction.

How Is the Trial Designed?

Group I: Non-Hierarchical Conversation Training Therapy (CTT) Experimental Treatment 1 Intervention

Group II: Hierarchical Conversation Training Therapy (CTT-H) Experimental Treatment 1 Intervention

Who Is Running the Clinical Trial?

Emory University

Lead Sponsor

Trials

1,735

Recruited

2,605,000+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7203518/

Efficacy of Conversation Training Therapy for Patients With ... A prospective study of CTT treatment outcomes in adults with dysphonia due to primary muscle tension dysphonia or benign vocal fold lesions

2. clinicaltrials.gov clinicaltrials.gov/study/NCT07176988

Deconstructing Voice Therapy: Towards Enhanced ... This research study aims to evaluate the effect of treatment delivery method on voice outcomes over 12 months in people with a primary ...

3. pubs.asha.org pubs.asha.org/doi/abs/10.1044/2019_JSLHR-S-19-0136

Efficacy of Conversation Training Therapy for Patients With ... A prospective study of CTT treatment outcomes in adults with dysphonia due to primary muscle tension dysphonia or benign vocal fold lesions compared to age, ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0892199715001368

The Development of Conversation Training Therapy CTT is a new therapy approach based on motor learning theory, which exclusively uses patient-driven conversational narrative as the sole therapeutic stimuli.

5. eric.ed.gov eric.ed.gov/?id=EJ1236773

EJ1236773 - Efficacy of Conversation Training Therapy for ... The purpose of this investigation was to determine the efficacy of CTT compared to standard-of-care voice therapy approaches for the treatment of patients with ...

6. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/31619107/

Efficacy of Conversation Training Therapy for Patients With ... A prospective study of CTT treatment outcomes in adults with dysphonia due to primary muscle tension dysphonia or benign vocal fold lesions

7. 2024.sci-hub.se 2024.sci-hub.se/8573/e7fba7180afa7ed9c30a88a2b0306841/gartner-schmidt2021.pdf

Conversation Training Therapy: Let's Talk It Through This article introduces a novel approach to voice therapy called conversation training therapy (CTT). CTT is the first voice therapy.

8. thieme-connect.com thieme-connect.com/products/ejournals/abstract/10.1055/s-0040-1722751?device=desktop&innerWidth=412&offsetWidth=412

Conversation Training Therapy: Let's Talk It Through Abstract. This article introduces a novel approach to voice therapy called conversation training therapy (CTT).

9. withpower.com withpower.com/trial/phase-dysphonia-8-2025-bec7b

Voice Therapy Methods for Dysphonia Participants receive either Non-Hierarchical Conversation Training Therapy (CTT) or Hierarchical Conversation Training Therapy (CTT-H) over a 4-week period.