Semester of Graduation

May 2021


Master of Arts (MA)


Communication Sciences and Disorders

Document Type



Voice therapy is evidence-based, behavioral intervention that can reduce functional and organic voice disorders. Despite its proven effectiveness, non-adherence to voice therapy is still an issue. Research shows that an estimated 65% of patients who initiate voice therapy drop out before reaching therapeutic goals. Voice therapy outcomes are largely dependent on patients’ adherence to treatment regimens, but there is limited information concerning factors that may be associated with voice therapy adherence and therapeutic outcomes for patients who successfully complete voice therapy.

The purpose of this study was to investigate which demographic factors could be associated with higher adherence rates to voice therapy and whether adherent patients reported greater positive change in vocal quality than non-adherent patients. The study consisted of a retrospective chart review of 287 patients diagnosed with various voice disorders who attended voice therapy at the outpatient Our Lady of The Lake Voice Center in Baton Rouge, Louisiana. Using a Microsoft Excel spreadsheet, the following demographic information was collected for this study: race/ethnicity, age, gender, and vocal pathology. Vocal pathologies and disorders observed were vocal fold atrophy, benign lesions, chronic laryngitis, vocal fold edema, vocal fold leukoplakia, muscle tension dysphonia (MTD), vocal cord dysfunction (VCD), sulcus vocalis/vocal fold scarring, and vocal fold paralysis.

The following information was also collected: discharge status (whether the subject was discharged from therapy by the SLP or discontinued therapy without a recommendation for discharge) and pre- and post-therapy Voice Handicap Index (VHI, Jacobson et al.1997) responses to determine the clinical significance of subject-perceived improvement in voice quality upon successfully completing voice therapy.

Results indicated an overall adherence rate of 33.8% and a non-adherence rate of 66.2%. These results are consistent with literature published in other behavior change fields that examine adherence rates to behavioral therapies. Demographic factors associated with higher adherence rates occurred among subjects who were white, female, and older (65+ years in age). Non-white subjects, however, reported higher rates of clinically significant improvement in voice quality after completing voice therapy.

Committee Chair

Kunduk, Melda