Vocal Effort in Clinical Settings of North and South American Countries: Characterization From Argentinian, Chilean, Colombian, and the United States Clinician's Reports.

Background: In voice clinics, vocal effort is a prevalent complaint, with around 25% of clinicians citing it as the primary issue.

Aim: This study had two objectives. First, it sought to establish the prevalence of vocal effort, both as the primary and the only symptom, among patients receiving treatment from clinicians specializing in voice disorders in various countries across South and North America. Second, this study aimed to distinguish key factors, including country of clinical practice, clinicians' experience, and the instruments employed to assess effort, associated with the identification of vocal effort.

Methods: This cross-sectional study surveyed speech-language pathologists (SLPs) from North and South America on vocal effort in patients. The survey covered SLP demographics, caseload composition, patient challenges, and measures of vocal effort that were used. Statistical analysis assessed relationships between SLP demographics, caseload, and vocal effort factors.

Results and conclusion: The results suggest significant geographical variations in SLPs' experiences with vocal effort. Colombian clinicians report significantly fewer voice cases and a lower proportion of vocal effort in their caseload, while Argentinian clinicians were more likely to report vocal effort in their voice cases. Years of experience were identified as a significant predictor of a higher likelihood of a voice-dominant caseload and higher rates of vocal effort among patients. Interestingly, using the Vocal Fatigue Index during the assessments increased the likelihood of reporting vocal effort in the clinicians' caseload. These findings suggest a potential association between experience, outcome measure selection, and vocal effort caseload. These lead to suggestions that opportunities for additional voice disorder training beyond that which SLPs find in school are valuable.