A Multidisciplinary Approach to Vocal Cord Dysfunction: A Novel Pilot Study

Study Overview
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Brief Summary
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Vocal Cord Dysfunction (VCD) is characterized by involuntary closure of the vocal cords while inhaling. Children and adolescents with VCD may experience multiple symptoms, including difficulty breathing, coughing, wheezing, neck tightness, and voice changes. There is limited information on optimal management of VCD. In our proposed study, we will use cognitive-behavioral therapy (CBT) techniques to change how patients respond to their VCD symptoms. Measurements of airflow during breathing as well as symptom frequency and intensity will be examined prior to and following a series of four therapy sessions with a clinical psychologist that are focused on teaching patients strategies to decrease symptom reactivity.

Official Title
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A Multidisciplinary Approach to Vocal Cord Dysfunction: A Novel Pilot Study

Conditions
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Vocal Cord Dysfunction

Intervention / Treatment
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* Behavioral: Four therapy sessions with a psychologist utilizing cognitive-behavioral therapy techniques


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adolescent patients presenting to West Virginia University, Charleston Division Sub-specialty Clinic for Pediatric Pulmonology with a clinical diagnosis of vocal cord dysfunction. Diagnosed with VCD within 12 months prior to study enrollment. between the ages of 13 and 18 years old. Currently symptomatic for VCD. Must have a baseline PFT to reference at the time of diagnosis. Additionally in patients who were diagnosed with VCD 6 months or more prior to study enrollment, current PFT results as part of routine care, are required. A parent or guardian must agree to participate in the four behavioral therapy sessions with his or her child. Exclusion Criteria: Severe psychiatric disorders (ex. psychosis, suicidal ideation) Developmental delay Previous speech therapy for the treatment of VCD. Currently receiving psychological counseling. In open Child Protective Services cases.

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: Four therapy sessions with a psychologist utilizing cognitive-behavioral therapy techniques|At the four therapy sessions, subjects will work with the psychologist to identify the triggers of their VCD episodes, learn to self-monitor symptoms and reactions, and be taught breathing retraining/relaxation techniques. The goal is to decrease patterns of subjects' thinking or behaviors that exacerbate distress from VCD symptoms.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in frequency and intensity of VCD symptoms | Self-reported number of symptomatic episodes and mean intensity of episodes pre and post-CBT intervention will be compared. Symptom intensity will be measured using an 11 point Likert Scale for self-reported distress for each recorded VCD episode. | Post intervention at 1 to 3 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in pulmonary function testing (PFT) measures |  | Post intervention at 1 to 3 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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paradoxical vocal fold motion, cognitive-behavioral therapy