SLPOtherArchives of physical medicine and rehabilitation2021

Rehabilitation Treatment Specification System: Methodology to Identify and Describe Unique Targets and Ingredients.

Jarrad H Van Stan, John Whyte, Joseph R Duffy and 10 others

PMID 33065124

WHAT IT FOUND

A Delphi consensus process among 10 voice specialists produced standardized categories for voice therapy targets and ingredients.

The resulting framework helps clinicians describe treatments precisely and replicate research protocols, though it currently excludes complex activity-based and cognitive interventions.

Key findings

01Experts used a Delphi process to agree on unique categories for voice therapy targets and ingredients, excluding treatments with theoretically infinite variations.

02The final lists focus on general behaviors and physical functions, such as applying pressure or practicing voicing, rather than specific activities like cooking or singing.

03The methodology distinguishes between direct targets and indirect aims, such as identifying vocal effort as an aim rather than a target.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The system currently excludes treatments targeting specific activities (like singing or cooking) and cognitive/representational changes, which are a large part of real-world therapy. The consensus relies on the perspectives of 10 experts in vocal rehabilitation, which may not generalize to other fields or broader populations. The methodology describes a classification system, not the clinical effectiveness of the treatments themselves.

Declared interests

The study was supported by the National Institutes of Health. The authors declared no conflicts of interest.

The easy way to misread this

Do not interpret this paper as evidence that these specific treatment categories improve patient outcomes. This is a methodology paper establishing a common language for describing therapy, not a clinical trial testing the efficacy of voice rehabilitation.

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