Psychological considerations in the attainment of esophageal speech

Abstract

In view of the increasing incidence and decreasing mortality due to larynx cancer, the constant 2: 1 ratio of esophageal speakers to nonspeakers among laryngectomees, and the widespread argeement that psychological factors are prime considerations in esophageal speech attainment, the investigation was designed to delineate certain psychological, physical, and sociological variables which might relate to attainment of alaryngeal speech. Ninety-four male laryngectomees responded to the Tennessee Self-concept Scale, the IPAT Anxiety Scale Questionnaire, and a standardized personal interview including a voice recording. Five variables (self-concept, bodyconcept, anxiety level, age at surgery, and defensive distortion of self-concept responses) were found to be significant in differentiating groups of nonesophageal, below-average, average, and above-average esophageal speakers. A significant difference in self-concept and body-concept appeared between the two high and the two low speaker groups. The below-average speakers were more anxious than were the average speakers or the above-average speakers. The above-average speakers were younger in age at surgery than were the subjects in the other three groups. The higher self-concept and body-concept scores of the better speakers may have been a function of a defense mechanism, as indicated by their defensive distortion scores which were higher than those of the below-average group. It was found that the variables of selfconcept, body-concept, and anxiety were ahout three times more influential than those of age at surgery and defensive distortion in identifying groups of speakers. The conclusions warranted were that necessary psychological counseling and immediate postoperative use of an artificial larynx before the institution of esophageal speech therapy would help raise the ratio of esophageal to nonesophageal speakers.

The spouse as facilitator for esophageal speech: A research perspective

“…Those factors that have been associated with the failure to develop esophageal speech include depression, loss of self-esteem and feelings of inferiority, and secondary gains associated with the mute state [Bisi, Conley, 19721. Lack of motivation has been repeatedly indicated in the literature [Smith, 1966;Bisi, Conley, 1965;1974;King, 1968;Nahum and Golden, 19631 as a factor of utmost importance in determining the postoperative course and rehabilitation of the patient in regard to the reestablishment of communication patterns. These factors and the concomitant passivity and dependency on others suggest the presence of the threat of isolation of these patients.…”

Prognostic indicators of esophageal speech

“…However, little research attention has been directed t o this question. Di Bartolo (1971), in a study of 96 laryngectomees, found that self-concept and body-concept were significantly higher for the better speakers and for the successful users of artificial larynges than for for the poorer esophageal speakers. Scores on the P A T Anxiety Scale were significantly higher for the poorer speakers.…”