Voice Therapy Techniques Flashcards
Resonant Voice
Any voice production that is both easy to produce and vibrant in the facial tissues
Low-impact, large-amplitude vibrations
Neither pressed nor breathy
Neither taxing nor restricted to low intensity
Resonance
a reinforcement of vocal fold vibration by the vocal tract air column
Sensations of Resonance
Bony structures pick up vibrations from acoustic standing waves in the oral cavity propagated to brain, skull, not so much the air
Sound radiates primarily from mouth and nostrils
Nonlinear Source-Filter Theory
Acoustic pressures in the vocal tract may either help or hinder vocal fold oscillation
Inertance clinical definition
occurs when there is a delay between stimulus (pulse of air from the opening TVFs) and response (acceleration of the vocal tract air column)
-this is one of the mechanisms that sustains vocal fold oscillation
Compliance
occurs when there is a response in advance of the stimulus
-this hinders sustained vocal fold oscillation (e.g., may cause voice breaks)
Inertance research definition
When compression occurs above the glottis during the opening phase, and rarefaction occurs during the closing phase, this facilitates TVF oscillation
Facilitate Inertance
Semi-occlusion of the vocal tract (SOVT)
Semi-occlusion of the vocal tract (SOVT)
already built into many successful voice therapy approaches
may be done in nonspeech and speech exercises
Theoretical effects of SOVT
Modeling studies suggest semi-occlusion may: increase vocal tract inertance (which facilitates TVF vibration), decreased PTP, increased harmonic content, increase vocal economy, decrease hyperadduction
Effects during SOVT
May alter vocal tract spaces (more inertance)
May balance laryngeal muscle activation and improve vocal economy/efficiency
May prevent large collision forces during loud voicing
Effects immediately after SOVT
Several studies suggest improved voice quality
Increased spectral energy around the singer’s formant cluster in one subject and vocal tract configuration remained changed
Treatment considerations
target population rationale (biomechanical target, mechanism of change) Credentialing requirements evidence what-how-if
Lee Silverman Voice Therapy
Population: Parkinson’s Disease (other neurogenic dysarthrias, cp, vocal fold bowling)
Target: LOUD
Rationale: singular focus on increased loudness ot increase neural drive, sensory recalibration, high intensity, quantitative feedback
Lessac-Madsen Resonant Voice Therapy
Population: hyperadduction (e.g., phonotrauma), hypoadduction (e.g., MTD, bowing, paresis)
Target: barely ab/adducted TVFs “resonant” voice quality
Rationale: uses speech-embedded semi-occlusions to train optimal vocal tract configuration for efficient/low-impact voice
LSVT Treatment Schedule
16 sessions, 2 or 4x/week (4 or 8 weeks)
Daily homework BID
Daily “variables”:
Sustain /a/ as long and loud as possible x6
Glide up to highest pitch on /a/, sustain loudly 2-3 seconds
Glide down to lowest pitch on /a/, sustain loudly 2-3 seconds
10 functional phrases, loudly (also reading, conversation)
LMRVT Treatment Schedule
8 sessions over 4-8 weeks
Vocal hygiene, stretches
Exploratory exercises using semi-occluded consonants (nasal, voiced continuants)
Heirarchical progression
Hum-chant-phrases-simple conversation-complex conversation
Daily home exercises; vocal communicator
Emphasis on sensory targets, self-assessment
CSCFT
Improved voice in young women with nodules
CSCFT Treatment Schedule
Begin with establishing airflow (originally unvoiced), move to vowels (/u/), words, phrases, conversation
Tactile/visual feedback (finger, tissue)
Incorporate resonant voice cues m, z, v, zh (flow into resonance)
Similar program structure to LMRVT
Flow-Resistant Tube Exercises
Population: hyper-and hypoadduction
Targe: Barely ab/adducted vocal folds, abdominal breath support, inertive vocal tract
Rationale: narrowing and lengthening the vocal tract creates inertance; glides “stretch” and back pressure “unpresses” vocal folds; nonspeech exercises minimize cognitive load
FRT
Series of nonspeech exercises all performed through a thin tube
glides, accents, singing, reading
Vocal Function Exercises (VFE)
Populatio: hyper- and hypoadduction
Target: “balance” of subsysems; probably also barely ab/adducted TVFs
Rationale: uses semi-occlusions (lip buzz) to train balanced airflow/adduction/resonance; very soft productions train coordination; pitch glides stretch TVFs
VFE Schedule
Four exercises, BID
All exercises performed as softly as possible with voice “engaged”
Warm-up: nasal focused /i/ on C, long as possible x2 (can substitute labial frication)
Stretch: Glide to highest pitch on buzzy /o/ x2
Contract: Glide to lowest pitch on buzzy /o/ x2
Power: Max sustained buzzy /o/ x2 each on C, D, E, F, G
