Janet Baker

• L.A.C.S.T., M.SC., PHD
• Professor (Associate) at Flinders University

Functional neurological disorder (FND) is a common and disabling disorder, often misunderstood by clinicians. Although viewed sceptically by some, FND is a diagnosis that can be made accurately, based on positive clinical signs, with clinical features that have remained stable for over 100 years. Despite some progress in the last decade, people wit...

As members of a multidisciplinary team of professionals who treat children and adolescents with functional neurological (conversion) disorder (FND), we highlight the pressing need to develop an FND-informed culture of care that takes into account recent advances in our understanding of this group of patients. Stories of clinical encounters in healt...

Communication problems (eg, dysphonia, dysfluency and language and articulation disorders), swallowing disorders (dysphagia and globus), cough and upper airway symptoms, resulting from functional neurological disorder (FND), are commonly encountered by speech and language professionals. However, there are few descriptions in the literature of the m...

Objective To explore how individuals with a laryngectomy (IWL) from diverse backgrounds make meaning and adjust to the physical and functional changes from a total laryngectomy (TL). To examine the extent primary supporters (PS) and health professionals (HP) are able to support IWL with the psychosocial and existential challenges rendered by a surg...

Background: A total laryngectomy often prolongs life but results in long-term disablement, disfigurement, and complex care needs. Current clinical practice addresses the surgical options, procedures, and immediate recovery. Less support is available longer-term despite significant changes to aspects of personhood and ongoing medical needs. Object...

Adjustment after total laryngectomy is complex, and the resultant support needs are extensive. Current practice is often guided by health‐related quality of life measures. While useful, many of these tools were developed without considering the perspectives of people who have experienced the surgery. To improve understanding of the support needs af...

In this chapter, an overview of the heterogeneous group of functional voice disorders is given, including the psychogenic voice disorder (PVD) and hyperfunctional or muscle tension voice disorder (MTVD) subgroups. Reference is made to prevalence and demographic data, with empiric evidence for psychosocial factors commonly associated with the onset...

Objectives To determine whether emotional expression, alexithymia, illness behavior, and coping strategies differed between women with muscle tension voice disorder (MTVD) and those without voice disorder and between women with and without mucosal pathology of the vocal folds, and to explore possible links between psychosocial constructs and clinic...

Total laryngectomy (TL), a life-preserving surgery, results in profound physical and communication changes for the individual. Physical and psychosocial adjustment to a TL is complex, and quality-of-life (QoL) measures have provided useful knowledge to assist clinical management. However, many tools were developed without considering the perspectiv...

This study aimed to explore psychosocial factors contributing to the development of functional voice disorders (FVD) and those differentiating between organic voice disorders (OVD) and a non-voice-disordered control group. A case-control study was undertaken of 194 women aged 18-80 years diagnosed with FVD (n = 73), OVD (n = 55), and controls (n =...

In the lead article, Hersh (2010) draws attention to the significant phase of ending therapy for clients and in particular, for their therapists. Hersh highlights three main tensions that underpin this process: real versus ideal endings, making and breaking of the therapeutic relationship, and balancing of respect for client autonomy over considera...

It is estimated that disorders of voice affect 3-4% of people from all strata of Australian society and while some voice disorders may be caused by organic conditions, most patients are troubled by non-organic or functional voice disorders (FVD). As professionals dealing with these problems, we wonder about the role of strong negative emotions aris...

The primary objective of this discussion paper is to review the available evidence for the role of psychogenic and psychosocial factors in the development of functional voice disorders (FVD). Current theoretical models linking these factors to the aetiology of FVD and to vocal hyperfunction are then considered. Since there is a paucity of solid emp...

Diversity in nomenclature and on-going dilemmas over the conceptual bases for the classification of voice disorders make it virtually impossible for the collation and accurate comparison of evidence-based data across different clinical settings. This has significant implications for treatment outcome studies. The first aim of this study was to deve...

Psychogenic dysphonia refers to loss of voice where there is insufficient structural or neurological pathology to account for the nature and severity of the dysphonia, and where loss of volitional control over phonation seems to be related to psychological processes such as anxiety, depression, conversion reaction, or personality disorder. Such dys...

The projected speaking voice and the singing voice are highly sensitive to external and internal influences, and teachers of spoken voice and singing are in a unique position to identify subtle and more serious vocal difficulties in their students. Persistent anomalies may herald early onset of changes in vocal fold structure, neurophysiological co...

A brief overview of the field in relation to psychogenic voice disorders is given with reference to past and present terminology used, the common presentations seen, followed by the more subtle or ambiguous examples which may challenge our notions of psychogenic or clear-cut functional versus organic dichotomies. Issues related to aetiology, person...

Four women aged between 27 and 58 years sought otolaryngological examination due to significant alterations to their voices, the primary concerns being hoarseness in vocal quality, lowering of habitual pitch, difficulty projecting their speaking voices, and loss of control over their singing voices. Otolaryngological examination with a mirror or fl...

Resolution of psychogenic dysphonia is often quick and effortless for client and therapist alike. In such instances, the therapeutic interventions are simple and straightforward, insights are reached without difficulty, and once normal voice has been established, resumption of dysphonia or other psychosomatic symptoms rarely occurs. Sometimes, howe...