Principles of Voice Therapy

Question 1

What is the goal of voice treatment?

Answer 1

Restore the best voice possible, one that focuses on functional outcomes

The program needs to re-educate the patient on how to most effectively and efficiently use the voice and eliminate the reformation of the voice disorder/pathology

Question 2

Long-term goals are…

Answer 2

Broad and general

Question 3

Short term goals are…

Answer 3

Specific and contain elements that lead to the achievement of the LTG (Long-Term goal)

Question 4

What are the 5 facets (as discussed in class) that should be included in the education/explanation of a patient’s disorder to them?

Answer 4

Normal anatomy of VT

Their Laryngeal status

Causative factors

Management plan

Explanations should be based on emotional status, educational /intellectual level of patient

Question 5

As a rule of thumb, your explanations to patients should be at what grade level of understanding?

Answer 5

8th-grade level

Question 6

Treatment methods are divided into which two categories?

Answer 6

Direct and Indirect

Question 7

What is the indirect treatment method?

Answer 7

Vocal Hygiene

Question 8

What is a direct treatment method?

Answer 8

Therapy, providing methods to improve laryngeal function.

Question 9

Describe Vocal Wellness as a treatment method.

Answer 9

vocal hygiene, the primary goal is to identify and eliminate phontraumatic behaviors.

Question 10

Describe Respiratory Traning/Retraining as a treatment method.

Answer 10

LAB (Lower Abdominal Breathing) - there are specific exercises!

Use of breath in phrases/sentences. Stretch and flow exercise for example.

Expiratory Muscle Training - a lot of evidence. Improves subglottal pressure and airflow for voice.

Question 11

Describe Relaxation Traning as a voice treatment method.

Answer 11

Whole Body Relaxation (some people hold tension in their shoulders and it translates to their voice.)

Stress Reduction, not just in the body, but also mental stress.

LAB (Lower Abdominal Breathing exercises)

Laryngeal Massage (Circumlaryngeal massaging)

Easy onset

Question 12

Describe phonatory retraining as a voice treatment method.

Answer 12

The bulk of the treatment methods we use!!!

Easy Voice
Challenge principles
Rate, intonation
Vocal Function Exercises
Valsalva 
Resonant Voice Therapy (Mask Focus)

Question 13

Describe Singing training as a voice treatment method.

Answer 13

Referral to or coordination with Singing Teacher

Advice about singing

Question 14

Describe medical coordination as a voice treatment method.

Answer 14

Reflux, allergies, asthma, etc.

Question 15

Describe referrals as a voice treatment method.

Answer 15

Psychology, Neurology etc.

Question 16

What is the ULTIMATE GOAL of voice treatment as discussed in class?

Answer 16

Design a series of tasks or exercises that increase the efficiency of phonation, i.e., it is easier and more effective to produce phonation.

Question 17

What should you ALWAYS check before trying a technique or implemented a method in speech therapy?

Answer 17

If its EVIDENCE-BASED PRACTICE!!!

Question 18

Why would it be advantageous to introduce words or phrases that have many “m”s?

Answer 18

It helps move the vocal energy from the larynx out the mouth with a forward focus.

Question 19

When does voice therapy end?

Answer 19

Resolution of the vocal pathology

Patient satisfaction with voice outcome

Clinician satisfaction with voice outcome

Other issues – reimbursement, travel, health

Question 20

List the 7 treatment approaches discussed in class.

Answer 20

Voice Rest and Modified Voice Rest
Vocal Wellness (Hygiene)
Symptomatic Voice Therapy
Psychogenic Voice Therapy
Physiologic Voice Therapy
Eclectic Therapy
Combined Modality

Question 21

Describe the treatment approach of voice rest and modified voice rest.

Answer 21

We ask the patient to not even whisper in voice rest.

Question 22

Describe the treatment approach of symptomatic voice therapy.

Answer 22

just working on the symptoms. Not changing anything physiologically.
Ex. Someone says their pitch isn’t very high. You work on that pitch increase and let the rest go.

Question 23

Describe the treatment approach of psychogenic voice therapy.

Answer 23

use of psychological methods in collaboration with a therapist/psychologist.

Question 24

Describe the treatment approach of physiologic voice therapy.

Answer 24

Direct exercises are used to activate the laryngeal muscle and work other subsystems, such as respiratory and supraglottal systems

Question 25

Describe the treatment approach of eclectic therapy.

Answer 25

Use of multiple methods. A holistic apporach to create a physioloigcal change in the person’s voice.

Question 26

Describe the treatment approach of combined modality.

Answer 26

Combining multiple modalities (biofeedback, tactile cues, SpeakEasy, DAF, auditory feedback, etc.)

Question 27

List some examples of physiological voice therapy exercises. (5 mentioned in class)

Answer 27

Vocal Function Exercises
Flow phonation exercises
Lessac-Madsen Resonant Voice Therapy
Lee Silverman Voice Treatment 
Inspiratory and expiratory muscle strength training