Voice therapy is a program of exercises intended to bring the voice back to a level of adequacy that can satisfy your occupational, emotional and social needs. Physical and vocal exercises are involved along with adjustments in vocal hygiene and related behavior.
The conditions and factors that lead to the voice disorder are unique to the person involved, so voice therapy must be tailored to your individual health situation. Your therapist will draw up the program of vocal exercises after making a health assessment. Not everyone who has suffered vocal damage can have their voice restored to normal functioning. This is especially true in those with irreversible neurologic problems or lesions in the vocal cords (also called the vocal folds). Your assessment should provide you with realistic expectations.
Most importantly, voice therapy can only be provided by a speech-language pathologist with additional training and substantial experience in treating voice disorders. He or she must have postgraduate university training, a state license to practice and a certificate from the American Speech-Language-Hearing Association.
There are several voice therapy techniques available to the speech-language pathologist. These may be used in combination appropriate to the overall aim of maximizing relief from voice disorder symptoms and achieving a satisfactory voice.
Lee Silverman Voice Therapy
This technique has been specially developed for those having Parkinson’s disease, although it has since been used for other neurologic conditions. Patients are trained to exhale greater amounts of air with increasing force, while working toward full closure of the vocal cords. This helps them make their weak voices stronger and louder. This is a very intensive program, needing 16 sessions in all spread over four weeks. A special certificate is required for clinicians assigned to handle this program.
The technique trains the individual to produce voice by closing the vocal folds only lightly, but not too tightly. This produces enough resonance to strengthen sound. The patient can feel the vibrations produced by the voice on the tongue, lips and nose and gradually learn to strengthen voice projection. It is applied to those with muscle tension dysphonia, in which the vocal cords are unable to vibrate fully.
Patients learn to produce a gentle, breathy sound with partially open vocal cords. The voice produced is not adequate for normal communications needs, but the technique does give the voice a rest. This promotes repair of mucosal tissues and reduces further deterioration of the vocal folds. It is helpful to those with short-term voice problems.
This technique is based on the premise that voice clarity increases when breathing technique is improved. The therapist trains the individual to coordinate the rhythmic movement of breathing muscles with the vocalization of increasingly difficult words. The consonants serve as accents set to the rhythm of the body movements. The holistic technique works on voice loudness, timber and pitch at the same time instead of working on each separately.
Therapists teach patients to massage the area around the throat while speaking. This helps them learn to relax the corresponding neck muscles and reduce overall tension. This is useful for those who experience upper body and neck tension together with vocal problems.
Vocal Function Exercises
This consists of a set of exercises, such as prolonged vowel phonation and pitch glides, that aim to strengthen the different parts involved in voice production (breathing, resonance and vocalization). The key to correct execution is producing the sounds with a resonant voice and avoiding excessive strain on the vocal folds.
Although seldom used, singing therapy is useful in cases of total or nearly total absence of voice. It aims to relax the muscles of the upper body and neck by asking patients to produce singing sounds while exaggerating the movements of the mouth, tongue and lips. The idea is to develop confidence in using their vocal cords by unrestrained production of simple phrases and sounds.