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Voice Handicap Index (VHI-10)

10-item self-report of voice-related handicap (Rosen 2004). Each 0 (never) to 4 (always). Total 0–40. A score above 11 is abnormal (Arffa 2012).

Q1. My voice makes it difficult for people to hear me*

Q2. People have difficulty understanding me in a noisy room*

Q3. People ask, 'What's wrong with your voice?'*

Q4. I feel as though I have to strain to produce voice*

Q5. My voice difficulties restrict my personal and social life*

Q6. The clarity of my voice is unpredictable*

Q7. I feel left out of conversations because of my voice*

Q8. My voice problem causes me to lose income*

Q9. My voice problem upsets me*

Q10. My voice makes me feel handicapped*

Score interpretation

Within the Normal Range (≤ 11) 0–11

Healthy adults average 2.8 (Arffa 2012).

→ No specific voice intervention. Vocal hygiene advice if at-risk occupation (teachers, singers).

Abnormal Voice Handicap (> 11) 12–40

VHI-10 above the normal limit of 11 (Arffa 2012).

→ Laryngoscopy and speech and language therapy for voice therapy; treat reflux, vocal-fold lesions or atrophy. NICE NG12: people aged 45 and over with persistent unexplained hoarseness — suspected cancer pathway referral. Multidisciplinary voice clinic if severe or neurological features.

Interpretation bands for the VHI-10. Apply clinical judgement and local guidance.

References

Curated clinical cross-links plus same-class fallbacks.

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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