Voice Therapy - Do I Really Need It?
Updated: May 31, 2020
So, you've noticed your voice is not right. You've been to your GP and they've told you, you have laryngitis and not to worry about it. But it still doesn't feel right. Your laryngitis hasn't gone......what do you do?
Our voice is essential to who we are. It gives others an insight into our emotions, our character, our mood, - so having those things taken away from us can be devastating. Additionally, if you work in a call centre, or lecture or sing or teach for a living, then losing your voice may prevent you from earning a salary.
First of all, go back to your GP and ask them to refer you to an ENT (Ear, Nose and Throat Specialist) to have your voice box checked. The reason you should do this is because a voice problem could represent any number of issues: cancer, overuse, nodules, aging.......it really could be anything. So getting your voice box properly checked is the first thing you should do. We normally recommend you do this if your voice isn't better after 2 weeks of continuous hoarseness. This is even more important if you drink or smoke.
Now you've been to your ENT and he has given you some idea of what the problem is and it's probably been at least 3 weeks that you have endured your hoarse voice, even though you've been resting it. In most cases, your ENT will advise you that you need to see a Speech Pathologist or Speech Therapist. I can think of very few cases in that they would probably dismiss your voice problem, without considering some sort of Speech Therapy intervention.
So let's look at some of those cases and decide if you do actually need intervention from a Speech Pathologist:
• Laryngeal cancer - you will definitely need to seek some advice from a Speech Pathologist. There may be a Speech Pathologist on the treating medical team, but if this is not the case, you should definitely see about getting one on board. There are exercises you can do to keep tissue muscle from tightening up and you may experience swallowing problems due to the nature of the cancer. So definitely, definitely, you should make friends with an experienced Speech Pathologist in these cases.
• Vocal nodules/granulomas/polyps - again you should definitely seek help from a Speech Pathologist. Without the help of a Speech Pathologist, it will be difficult for you to change the way you use your voice, that led to the development of vocal nodules or granuloma in the first place. So yes......get yourself a Speech Pathologist on board.
• Vocal fold paralysis - an appropriately trained Speech Pathologist will have some tricks up their sleeve which may help you either exercise the vocal fold that doesn't work or give you exercises to expediate it's movement or move the other vocal fold closer. They may also work closely with your ENT if you need to have some filler or operation, to help get the vocal folds closer together. So yes.....see a Speech Pathologist, at least initially, if you have been told you have a vocal fold paralysis.
• (Silent) reflux - if the ENT has told you that you have reflux affecting your vocal folds, you may or may not choose to see a Speech Pathologist.
In addition to knowing how to reduce your reflux risk and any further irritations, your Speech Pathologist will be able to provide you with some Vocal Hygiene Tips that can help you keep your voicebox as healthy as possible. You can check out our sample of Vocal Hygiene Tips here.
• Functional Voice Disorder or Hyperfunctional Voice Disorder. In these instances, your ENT may or may not tell you the name of your problem, but he may suggest you see a Speech Pathologist.
These two disorders suggest that you have been using your voicebox too much, or too much in the wrong way, or just plainly in the wrong way. In addition to vocal hygiene tips, which should be heeded too, seeing a Speech Pathologist will allow them to assess your voice function including reviewing how you use and when you use it. They will then be able to provide you with some gentler ways to produce voice or gentle exercises, to help you reduce any potential damage that can be occurring in your voicebox area. Research has shown that combining vocal hygiene with vocal exercises results in better outcomes for clients ¹¯². If you choose not to see a Speech Pathologist, then even if your voice gets better with some rest, there is a chance it could come back again - as told to me by a recent client. Whilst she was seeking Speech Pathology treatment for her recent onset of voice difficulties (hoarseness), her colleague, who had previously experienced a similar voice disorder - choose not to. That individual's voice problem re-occurred a few weeks later, and by that time, she was fed up and left her job.
• Spasmodic dysphonia - if your ENT diagnoses you with Spasmodic Dysphonia, you should seek the help of a qualified Speech Pathologist. The origins of spasmodic dysphonia are still debated but they can involve neurological, and emotional/psychological/stress components. Your Speech Pathologist will be able to give you some exercises to help you to produce better voice and they may work collaboratively with the ENT if Botox has been suggested. Botox can cause swallowing problems, so keep your Speech Pathologist around just in case.........So yes, see a Speech Pathologist if you have been diagnosed with a Spasmodic Dysphonia.
So whilst we haven't covered all specific types of voice disorders here, you can see that in the majority of cases, you would benefit from seeking additional help from a trained Speech Pathologist with knowledge of voice problems.
Good luck with your voice problem!! we are sure that with the right treatment choices, you will soon find your voice 😍
1. Behllau M, Olivera G. Vocal hygiene for the voice professional. Curr Opin Otolaryngol head Neck Surg. 2009; 17: 149-154
2. Rodríguez-Parra MJ, Adrián JA, Casado JC. Comparing voice-therapy and vocal-hygiene treatments in dysphonia using a limited multidimensional evaluation protocol. Journal of Communication Disorders. 2011; 44: 615-630
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