Chapter 7: Voice Management (Symptomatic Voice Therapy)

Question 1

What are the 6 major components of voice production?

Answer 1

1) respiration
2) phonation
3) resonance
4) pitch
5) loudness
6) rate

Question 2

What are the 6 major components of voice production?

Answer 2

1) respiration
2) phonation
3) resonance
4) pitch
5) loudness
6) rate

Question 3

Symptomatic voice therapy uses __________ _____________ ______________.

Answer 3

Direct symptom modification

Question 4

In direct modification of respiration, what are 2 potential problems?

Answer 4

1) talking on the end of an airstream

2) shallow breathing

Question 5

If the issue with respiration is talking on the end of an airstream, what is the solution (2 steps)? And how can each be done (1, 3)?

Answer 5

1) identify the problem (ear training using audio recorded samples)
2) component modification (say as many numbers as possible on normal exhalation, mark a paragraph with phrase markers, audio record open discussion)

Question 6

If the issue with respiration is shallow breathing, what is the solution? (4)

Answer 6

1) utilize a box diagram to describe breathing strategies
2) book on stomach
3) hands on chest and abdomen
4) words, phrases, paragraph reading, conversation

Question 7

What are potential problems with phonation? (3)

Answer 7

1) hard glottal attack
2) glottal fry phonation
3) breathy phonation

Question 8

If the issue with phonation is a hard glottal attack, what are solutions? (2)

Answer 8

1) garden hose example

2) initiate phonation with /h/ (in vowels, VCs, words, phrases, sentences, paragraphs, and conversation)

Question 9

If the issue with phonation is glottal fry, what is the solution?

Answer 9

train a slight increase in picth and loudness

Question 10

If the issue with phonation is breathy phonation, what are potential solutions (4)?

Answer 10

1) establish a more firm/engaged vocal fold approximation
2) use more precise articulation
3) increase vocal intensity
4) exercise closure with glottal attack and pushing

Question 11

What are 3 types of functional resonance problems?

Answer 11

1) hypernasality
2) denasality
3) tone focus problems

Question 12

What are solutions to functional hypernasality? (6)

Answer 12

1) artic therapy
2) pitch and loudness modification
3) non-speech phonation
4) articulation deep testing
5) the obvious - denasality
6) negative practice

Question 13

What are solutions to functional denasality? (4)

Answer 13

1) utilize the normal nasal phonemes
2) utilize hypernasal resonance
3) non-speech phonation
4) negative practice

Question 14

What are solutions to functional tone focus issues? (2)

Answer 14

1) patient education

2) nasalized phrase production

Question 15

What are the 4 steps of nasalized phrase production?

Answer 15

1) chant the following phrases on a comfortable pitch and loudness: oh no, oh my, oh me, oh my no, oh me oh my
2) introduce the following intensity and rate variations using the same phrases: very slow and soft, faster and louder, fast and loud, slower and softer, very slow and soft
3) introduce inflected phrase and normal speech: soft and slow, louder and faster, exaggerated inflection, normal speech
4) expand to phrases, paragraph reading, conversation

Question 16

What is key about direct modification of pitch?

Answer 16

approach with caution, must determine if a behavior contributes to the cause of disorder or if the pitch problem is a symptom of the disorder

Question 17

Before starting direct modification of loudness, what 2 things do you need to do?

Answer 17

1) check for a hearing issue

2) determine if it is a cause or a symptom

Question 18

What are 4 modification approaches for loudness?

Answer 18

1) patient education using diagnostic recording to point out loudness differences
2) discuss reaction to people who speak too loudly
3) practice direct manipulation of different intensities
4) utilize feedback instrumentation at all levels of speech production

Question 19

What are 5 modification approaches for rate?

Answer 19

1) develop patient awareness of the problem
2) exaggerate vowel prolongation in words within long phrases (as opposed to pausing between words)
3) read song lyrics and poetry
4) paragraph and prose reading (use audio recording)
5) stabilize in conversation (make liberal use of negative practice)

Question 20

What are 5 direct modifications of laryngeal area muscle tension?

Answer 20

1) progressive relaxation
2) chewing exercises
3) digital massage
4) yawn-sigh
5) EMG biofeedback