A. is an 11-year-old girl and takes solfège and drama lessons. She was registered on the advice of the class teacher and the music school. A. regularly suffers from hoarseness and is sometimes completely aphone. She also experiences a sore throat. Singing is no longer possible. These complaints already started at the age of three years and increase with voice strain and fatigue. A. perceives the hoarseness and sore throat as a serious problem (VAS scale 6/7) and is willing to do something about her voice (VAS scale 6/7). She rates her speech activity quite high (VAS scale 5/7) and also talks quite loudly (VAS scale 5/7). Self-reports show that the voice causes significant impairment (p-VHI 45/92) with the physical aspects predominating (Functional 12/28, Emotional 10/28, Physical 23/36). The use of the voice is strongly deviating and this is objectified in a deviating DSI (0.92) and a deviating AVQI (4.03).

 

The laryngostroboscopic examination shows the following images.

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You can listen to the sound fragment below. 

What is your GRBAS score?

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