VOICE DISORDERS
What are voice disorders?
A voice disorder is an umbrella term for disorders affecting the quality, pitch, and loudness of an individual’s voice. This can range from voice disorders with an unknown cause to voice disorders caused by trauma, such as surgical procedures or cancers/treatments for cancer such as radiation. A voice disorder can also be caused by abnormalities of the vocal folds, such as vocal nodules or polyps. There are two categories of voice disorders:
Functional: Includes diagnoses such as muscle tension dysphonia and vocal fatigue. Sometimes the cause of a functional voice disorder is unknown, or misuse of the vocal folds can be present.
Organic: There is some sort of physiological cause for the voice disorder, as mentioned above, such as vocal nodules, polyps, or cancer.
An individual with a voice disorder might require speech therapy or sometimes even surgical intervention in order to correct their voice disorder, depending on the cause and type of voice disorder they are suffering from.
The only way to know if someone truly needs voice therapy is to make contact with a medical professional, e.g. a physician or a speech-language pathologist. A few physical indicators that voice therapy might be needed, include:
Chronic hoarseness (Dysphonia): Someone experiencing hoarseness for several hours a day without primary cause may need to seek out voice therapy/examination to rule out any causes such as a voice disorder.
Wet vocal quality: Similar to hoarseness, a chronic wet vocal quality can be an indicator of a voice disorder of some kind.
Difficulty breathing during speech: This can be an indicator of what is known as Vocal Cord Dysfunction (VCD). During typical speech, the vocal folds open and close rapidly as they vibrate to allow sound and air to pass through. When an individual has VCD, their vocal folds close at inappropriate times, making breathing difficult.
Consulting a qualified speech-language professional or voice therapist can provide clarity. They will conduct a thorough assessment of your voice, considering factors such as vocal quality, pitch, and any discomfort you may be experiencing. With their expertise, you can gain a comprehensive understanding of your voice's health and receive guidance on whether voice therapy is recommended. Remember, seeking professional advice ensures a tailored approach to address any voice-related concerns you may have.
VOICE THERAPY
What are the goals of voice therapy?
For many individuals with a voice disorder though, therapy focuses on improving the quality, pitch, and loudness of their voice. The goals of voice therapy depend heavily on the individual and what sort of voice disorder/difference they may have. For example, an individual who has received a laryngectomy is going to have very different goals from an individual with vocal nodules. A patient with a laryngectomy might attend voice therapy, not with the intention of improving their voice (as they have had their larynx removed or partially removed) but they may have the intention to learn alternative ways of communicating, such as being taught how to utilize an electrolarynx.
On the other hand, an individual with vocal nodules (or who is recovering from vocal nodule removal) might have a goal of improving their vocal quality. In such cases, the main goal of voice therapy might be to improve their confidence surrounding their ‘new’ voice, rather than attempting to reobtain their ‘old’ voice.
VOICE DISORDER DIAGNOSIS
What should you expect from a voice therapy evaluation?
A voice evaluation can look different for each patient, as the speech-language pathologist may tailor their particular evaluation to fit the needs and concerns of the patient. Many speech-language pathologists will want some sort of visualization of the vocal folds before beginning voice therapy to rule out any organic causes that might need some other treatment, such as surgical intervention.
A speech-language pathologist might also want to follow up with questions about the individual’s feelings towards their voice, and how much they may feel it is affecting their everyday life. Following this, if the visualization of the vocal folds reveals no organic cause for the voice disorder, the speech-language pathologist might have the individual perform a series of vocal tests that include:
Reading aloud
Performing vocal pitch glides
Producing an s/z ratio
Depending on the results, either speech therapy or some other treatment will be recommended (or non-treatment if the speech therapist feels a voice disorder is not present).
VOICE DISORDER TREATMENT
What are voice therapy techniques?
Voice therapy is typically tailored to the individual's unique needs and may involve a combination of techniques to achieve the best possible outcomes. Depending on the cause/type of voice disorder, voice therapy might include:
Vocal fold exercises (i.e. pitch glides)
Vocal relaxation and tension release exercises (i.e. using stretching, massage, and relaxation techniques to reduce vocal tension and stress).
Pitch and intonation exercises (i.e. achieve a more balanced and natural-sounding voice)
Breathing exercises (i.e. improving breath patterns through weighted breathing, which can improve their vocal control and reduce vocal strain)
Changing daily habits (i.e. improving hydration and vocal hygiene, avoiding smoking or excessive alcohol consumption)
Discussing the emotional impact of one’s voice disorder on their everyday life.
These are just a few therapy interventions that might be implemented in treatment, but there are many more that can be used to assist in treating voice disorders.
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