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PEDIATRIC VOICE CASE HISTORY FORM Name: Date of Birth: Address: Age: Referred by: Contact person and relationship: Phone: (h) (w) Primary Language Family physician: Phone: Grade: School: Reason for
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How to fill out pediatric voice case history

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How to fill out pediatric voice case history:

01
Start by gathering basic information about the child, including their name, age, and contact information.
02
Ask about any relevant medical history, such as previous surgeries, allergies, or chronic conditions.
03
Inquire about any medications the child is currently taking, as certain medications can impact the voice.
04
Ask about any voice or speech concerns the child or their parents may have, such as hoarseness, vocal fatigue, or difficulty producing certain sounds.
05
Discuss any previous voice therapy or intervention the child may have undergone.
06
Explore the child's vocal habits and behaviors, such as excessive throat clearing or coughing.
07
Inquire about the child's home environment, including exposure to second-hand smoke or environmental allergens.
08
Discuss any social or emotional factors that may be influencing the child's voice, such as bullying or anxiety.
09
Assess the child's academic performance and communication skills to understand the impact of their voice on daily activities.
10
Finally, document any other relevant information, such as family history of voice disorders or any recent changes in the child's voice.

Who needs pediatric voice case history:

01
Speech-language pathologists who specialize in pediatric voice disorders.
02
Otolaryngologists or ENT physicians who treat voice concerns in children.
03
Pediatricians who want to evaluate and monitor a child's voice development and health.
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Pediatric voice case history is a comprehensive record that collects relevant information about a child's vocal health, including their medical, developmental, and social history as it pertains to their voice and communication.
Typically, a licensed speech-language pathologist or an audiologist who is assessing the child's vocal health is required to file the pediatric voice case history.
To fill out pediatric voice case history, gather all pertinent information from the child's caregivers, including details about the child's voice use, any medical conditions, previous interventions, and psychosocial factors influencing voice health.
The purpose of pediatric voice case history is to provide a baseline for understanding the child's vocal difficulties, to guide assessment and treatment planning, and to monitor changes in the child's voice over time.
The information that must be reported includes the child's age, medical history, voice symptoms, duration of voice issues, family history of voice disorders, environmental factors, and any previous treatments related to voice or speech.
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