Voice therapy: who, what, and why?
What is Voice Therapy?
The goal of voice therapy is to improve or normalize laryngeal function, regain the best possible vocal quality and provide relief from bothersome vocal symptoms, which may include: hoarseness, breathiness, vocal strain, reduced pitch range, dysphonia, hyperphonia, and the list goes on. However, many factors are involved in patient prognosis of improving vocal function, including anatomic and physiologic capabilities, patient motivation, and most importantly patient perception of their own vocal quality. Does their voice disorder impact their daily life, their career, or are they simply not bothered by their vocal changes? The speech therapist in conjunction with the patient should create goals based on personal preferences.
What to expect from voice therapy:
Once individual goals have been set by the speech therapist and the patient, the therapist will guide the patient through a variety of tasks designed to eliminate harmful vocal behavior, shape healthy vocal behavior, and assist in vocal fold healing after surgery or injury. The speech therapist may introduce techniques or behavioral modifications to improve vocal quality depending on the patient’s specific needs. Some examples of these include using auditory feedback, change of loudness, establishing a new pitch, laryngeal massage, inhalation phonation, modification of head position, respiratory training and coordination of speech breathing, pitch inflection, tongue protrusion, or yawn-sigh. There are also specific therapeutic exercise programs that the speech therapist may use such as vocal function exercises (pitch glides, maximum phonation at varying pitches), or Lee Silverman Voice Treatment.
Just like any exercise program, the frequency and intensity of exercises is an important element to seeing results. A once or twice per week 30-60 minute session with the therapist will not be sufficient to see the desired changes. Home practice is an essential component of any therapy program. As well, it is equally important to incorporate periods of rest need in the treatment program for adaptation of muscles to occur. In general, therapeutic exercises should be completed at least 3 days a week to see improvements.
The success of voice therapy relies heavily on participation and practice. The role of the speech therapist is to educate the patient on healthy vocal behavior, introduce vocal exercises and ensure the patient is doing these exercises correctly, and lastly to provide feedback and encouragement. It is the patient’s role to participate fully in each session and to be compliant with assigned vocal exercises in order to see progress and improve vocal quality, communication, and overall quality of life.