INTEGRATED VOICE THERAPY

Voice difficulties related to organic lesions of the vocal folds or the periphery. Voice therapy targets the symptoms associated with the lesions, including vocal hoarseness and strain. Voice therapy is about training the voice user on how to modify the way he uses the vocal mechanism so that the voice can return to safe and efficient production, irrespective of the organic condition of the vocal folds. Common organic conditions that benefit from voice therapy intervention are:

• Vocal nodules
• Unilateral & Bilateral Paralysis of vocal folds (see relevant section)
• Polyps (pre and post operational)
• Vocal fold scarring
• Vocal fold cysts (post-operational)
• Layngeal papillomatosis (HPV)
• Chronic laryngitis
• Neurological conditions affecting the voice/swallowing mechanism (eg. Parkinson’s disease, myasthenia gravis, multiple sclerosis)
• Chordectomy

Functional voice difficulties are related to the way the voice is used and managed. These difficulties are successfully managed with specialized voice therapy which targets mindful awareness of voice use while also developing skills for efficient and comfortable voicing. The symptoms commonly related with functional voice difficulties include:

• Voice fatigue and discomfort
• Hoarse, strained, harsh, gravely voice
• Breathy, weak, asthenic voice
• Vocal instability – tremulous voice
• Loss of tonal range or a specific part of the tonal range
• Loss of ability to produce or maintain vocal intensity
• Breath – Voice coordination
• Localized pain in jaw or neck area (may require additional intervention from a specialist physiotherapist or manual therapist).

These functional difficulties may appear with or without associated organic pathology of the larynx, in individuals who have excessive vocal demands and are in need of specialized vocal technique, for efficient voice use. In certain cases, these same functional symptoms appear in in the absence of increased vocal loading and may be related to behavioral, muscular or psychological factors.

Psychological voice disorders develop in relation either to intense emotional situations or difficulty with expressing powerful emotions of anger, fear, sorrow, stress and anxiety such that the person is overwhelmed by these emotions.

As the significant third of the triadic synergy of Mind-Body-Emotion, emotional balance is critically related  to healthy vocal expression and is frequently aetiologically related to the development of voice problems. Voice therapy targets guiding the voice user to acknowledge the relevance of emotions to healthy voicing while also integrating vocal techniques to overcome the functional imbalance of the vocal mechanism that these emotions had created.