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Voice Handicap Index (VHI)
Availability
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Classification
NeuroRehab Supplemental - Highly Recommended
Recommendations for Use: Indicated for studies requiring a measure of speech. Recommended for TBI.
 
Supplemental: Acute Hospitalized, Concussion/Mild TBI, Epidemiology, Moderate/Severe TBI: Rehabilitation Traumatic Brain Injury (TBI)
Short Description of Instrument
The Voice Handicap Index (VHI) is a 30-item instrument that is used to quantify the psychosocial consequences of voice disorders (Jacobson et al., 1997). The VHI questionnaire assesses the functional (10 questions); emotional (10 questions); and physical (10 questions) aspects of voice and effects of voice on quality of life.
Comments/Special Instructions
NeuroRehab Specific: Nothing was found specific to TBI to justify recommending VHI; however, several other neurological disorders have used the VHI to measure voice disorder severity and are sensitive for measuring treatment outcomes.
Scoring
Scoring: Never = 0 points; Almost Never = 1 point; Sometimes = 2 points; Almost Always = 3; points; Always = 4 points
 
Total Score:
A change of 18 points in a total score or 8 points on any subscale (emotional, functional, or physical) is considered statistically significant.
Scoring and Psychometric Properties
Scoring: Never = 0 points; Almost Never = 1 point; Sometimes = 2 points; Almost Always = 3; points; Always = 4 points
 
Total Score:
A change of 18 points in a total score or 8 points on any subscale (emotional, functional, or physical) is considered statistically significant.
Rationale/Justification
NeuroRehab Specific:
Strengths: Low burden with good psychometric properties.
References
Key Reference:
Jacobson BH, Johnson A, Grywalski C, Silbergleit A, Jacobaon G, Benninger MS, Newman CW. The Voice Handicap Index (VHI) Development and Validation. Am J Speech-Lang Pathol. 1997; 6(3):66-70.
 
Additional References:
Bogaardt HC, Hakkesteegt MM, Grolman W, Lindeboom R. Validation of the voice handicap index using Rasch analysis. J Voice. 2007 May;21(3):337-44.
 
Cohen SM, Jacobson BH, Garrett CG, Noordzij JP, Stewart MG, Attia A, Ossoff RH, Cleveland TF. Creation and validation of the Singing Voice Handicap Index. Ann Otol Rhinol Laryngol. 2007 Jun;116(6):402-6.
 
Naraghi M, Adil S, Bastaninejad S, Dabiran S. Evaluation of pediatric voice handicap index and pediatric voice related quality of life before and after adenotonsillectomy in pediatric population. Int J Pediatr Otorhinolaryngol. 2015 Mar;79(3):388-91.
 
Portone CR, Hapner ER, McGregor L, Otto K, Johns MM 3rd. Correlation of the Voice Handicap Index (VHI) and the Voice-Related Quality of Life Measure (V-RQOL). J Voice. 2007 Nov;21(6):723-7.
 
Rosen CA, Murry T, Zinn A, Zullo T, Sonbolian M. Voice handicap index change following treatment of voice disorders. J Voice. 2000 Dec;14(4):619-23.
 
Stuut M, Tjon Pian Gi RE, Dikkers FG. Change of Voice Handicap Index after treatment of benign laryngeal disorders. Eur Arch Otorhinolaryngol. 2014 May;271(5):1157-62.
 
Woisard V, Bodin S, Yardeni E, Puech M. The voice handicap index: correlation between subjective patient response and quantitative assessment of voice. J Voice. 2007 Sep;21(5):623-31.
 
Document last updated January 2022