Voice Therapy Techniques

1
-Voice Therapy Techniques-

• Margaret Singer
• Lead Speech Voice Therapist
• Aberdeen Royal Infirmary

2
-DEFINITION OF VOICE-

• The acoustic outputs from the vocal tract that
  result from the vibration of the vocal folds
  (Tirze I R 1994)

3
What is Normal Voice?

• Based on sex and age.
• Listeners background.
• ..mainly it should be appropriate in pitch and
  volume to the situation and have balanced
  resonance (Greene Mathieson 1989)
• Shows no evidence of pathology.

4
-Changing Voice-

• ... voice like appearance, does not stay
  constant. It changes throughout the lifespan, it
  changes in reaction to emotion, to environment
  and reflects the state of health of the body and
  mind (Colton Casper 1990)

5
What is Voice Disorder?

• A voice problem is a deviation from the norm in
  one or more of the following
• voice quality
• oral and nasal resonance
• volume
• pitch

6
-Reasons for Voice Disorder-

• Organic
• Functional
• Psycholological
• A mixture

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-Underlying causes of Voice Disorder-

• Hyperkinetic voice disorders.
• Inflammatory disease.
• Neuromuscular disease.
• Benign and malignant neoplasms.
• Psychogenic voice disorders.

8
-Goal of Voice Therapy-

• Varies from patient to patient.
• To restore the best voice possible.
• Patient is the final judge.
• Avoid idealized goals.

9
-Clinicians Assessment-

• Case history.
• Observation of the patient.
• Patients perception.
• Perceptual evaluation.
• Objective measures.
• Stroboscopy.

10
-Guidelines for Therapy-

• Explanation of normal vocal physiology.
• Explanation of the disorder.
• Help the patient to assume responsibility.
• Use of auditory and visual feedback.

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-Vocal Care-

• Drink plenty of water.
• Limit intake of caffeine and alcohol
  (dehydrating)
• Avoid irritants such as smoke, dust, sprays etc.
• Avoid eating late at night, especially spicy or
  fatty foods.
• Use steam inhalations.
• Avoid violent or habitual coughing or throat
  clearing.
• Dont sing or shout with a sore throat.
• Avoid whispering , the tension caused can be
  harmful.
• Watch your posture when talking, especially on
  the phone.
• Avoid talking against background noise.
• Try to produce your voice gently and
  effortlessly.

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-Voice warm up exercises-

• Breath relaxation.
• Lip trills.
• Tongue trills.
• Humming.

13
-Voice Therapy Treatment Categories-

• Education and explanation.
• Vocal tract care.
• Voice conservation/vocal hygiene.
• Improved vocal techniques.
• - vocal note quality modification.
• - soft/easy onset of vocal note.
• - pitch modification.
• - developing resonance.
• - reducing articulatory tension.
• - vocal fold adduction in hyperfunctional
  glottic chink.
• - speech/breathing techniques.
• Facilitating techniques.
• Indirect treatments.

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-SUMMARY-

• Voice therapy is a complex process influenced by
  the patient, the clinician and the chosen
  treatment programme.
• Most treatment programmes employ a combination of
  techniques and are tailor made to the individual
  patient depending on the case history and other
  assessment results.
• Effective treatment depends on changing vocal
  behaviour and the generalisation of these changes
  to everyday life.
• The effects of medical intervention should be
  taken into account during the voice therapy
  treatment programme.

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• Thank you
• margaretsinger_at_nhs.net