Classifying and Identifying Motor Learning Behaviors in Voice-Therapy Clinician-Client Interactions: A Proposed Motor Learning Classification Framework

Abstract

We studied whether concepts in motor skill learning could be operationalized to identify clinical interactions and behaviors in a voice therapy setting. Our aim was to test the feasibility of measuring these behaviors in the prepractice phase so that we could eventually evaluate and apply principles of motor learning and skill acquisition to Speech-Language Pathology. Four general categories of behaviors that have been identified in the client-clinician prepractice phase were identified: motivation, modeling, verbal information, and feedback. All variables were extracted from a proposed Motor Learning Classification Framework. Nine participants categorized clinician behaviors in three voice therapy training videos into specific, described, prepractice variables. Good intrarater reliability was shown across viewings. Inter-rater reliability was high for modeling and verbal information, but raters were not consistent when identifying behaviors classified as motivation and feedback. Raters responded positively to the classification exercise and the categories encompassed nearly all noted behaviors. Behaviors described within the motor learning literature can be identified in the initial stages of voice therapy, providing evidence that motor learning concepts can be used to identify interactions and behaviors in clinical settings. Disagreement in classification among raters was influenced by differences in implicit and explicit interpretations of verbal information. This suggests that greater clarity in specific concepts is needed to support teaching of motor learning principles and implementation of these principles in clinical practice for the treatment of speech-language pathology.