Voice therapy-The Daily Ledger

Voice therapy consists of techniques and procedures that target vocal parameters, such as vocal fold closure, pitch, volume, and quality. This therapy is provided by speech-language pathologists and is primarily used to aid in the management of voice disorders, or for altering the overall quality of voice, as in the case of transgender voice therapy. Vocal pedagogy is a related field to alter voice for the purpose of singing. Voice therapy may also serve to teach preventive measures such as vocal hygiene and other safe speaking or singing practices.

Orientations

There are several orientations towards management in voice therapy. The approach taken to voice therapy varies between individuals, as no set treatment method applies for all individuals. The specific method of treatment should consider the type and severity of the disorder, as well as individual qualities such as personal and cultural characteristics. Some common orientations are described below.

Voice therapy

Symptomatic

Symptomatic voice therapy aims to directly or indirectly modify the symptoms that are caused by a voice disorder. Techniques are implemented to facilitate the production and maintenance of a voice that is most appropriate for the individual. Symptomatic voice therapy can modify respiration, phonation, resonance, voice, loudness, rate, and laryngeal muscle tension and may assist in gender reassignment voice change.

Voice therapy

Physiologic

Physiologic voice therapy may be adopted when the voice disorder is caused by a disturbance in the physiology of the vocal mechanism. Therapy directly modifies the abnormal physiologic activity affecting respiration, phonation, and resonance. Physiologic voice therapy aims to create a balance between the various subsystems.

Voice therapy

Hygienic

Hygienic voice therapy involves modifying or eliminating inappropriate vocal behaviours that lead to voice dysfunction. Once behaviours are modified, the voice may improve towards a normal state. The voice is improved without directly targeting physiological mechanisms. Hygienic Voice therapy uses different techniques which are used for both management and prevention for voice disorders. For management of disorders, hygienic voice therapy is usually used in conjunction with other voice therapy methods. Vocal hygiene programs can include many different components but usually includes speech and non-speech aspects. Speech aspects include addressing loudness and amount of use. Whereas non-speech components typically address components such as allergies, or laryngopharyngeal reflux. A vocal hygiene program also may include a component about learning about how the voice works (e.g. anatomy and physiology).

Some vocal hygiene guidelines for better vocal health:

Avoid phono-traumatic behaviours (i.e. throat clearing, yelling, cheering, excessive crying, talking over extensive background noise, and increase use voice amplification when appropriate). Decrease or eliminate use of alcohol, caffeine, and drugs (i.e. tobacco, recreational drugs, non-steroidal anti-inflammatories and aspirin). Increase humidification of the upper respiratory tract (i.e. drink more water, increase environmental humidity when possible, and decrease time spent in dry or dusty environments). Decrease quantity of speech (if you're an excessive voice user or post laryngeal surgery).

Psychogenic

Psychogenic voice therapy examines the psychological and emotional factors that cause and perpetuate disordered voice, and focuses on modifying those factors to improve voice functioning.

Eclectic

The various voice therapy orientations are not exclusive of each other. Any combination of orientations can be used in treatment. This is known as eclectic voice therapy.

Procedures

Vocal surgeries

While hormone replacement therapy and gender reassignment surgery can cause a more feminine physical appearance, they do little to alter the pitch or sound of the voice. A number of surgical procedures exist to alter the vocal structure. These can be used in conjunction with voice therapy: Cricothyroid approximation (CTA) (is the most common) Laryngoplasty Thyrohyoid approximation Laryngeal reduction surgery (surgical shortening of the vocal cords) Laser assisted voice adjustment (LAVA)