From the Guidelines
Voice therapy is a specialized treatment approach that involves working with a speech-language pathologist to improve vocal function and address voice disorders through exercises and techniques that modify vocal behaviors, strengthen vocal muscles, and establish healthier voice production patterns. According to the most recent and highest quality study 1, voice therapy typically includes education and explanatory strategies, symptomatic strategies, and psychological strategies. The education and explanatory strategies involve clearly explaining the nature of the disorder and the rationale for the diagnosis, while the symptomatic strategies include natural, reflexive, or instinctive behaviors usually accompanied by sound, such as coughing and clearing the throat, yawning, and whimpering sounds. The psychological strategies involve communication counseling, identifying and addressing patterns of avoidance of speaking or excessive dependence on aids to communication, and identifying social or other phobic anxiety.
Some of the key techniques used in voice therapy include:
- Vocal hygiene education to avoid vocal strain and stay hydrated
- Resonance exercises to improve vocal quality
- Breath support training to establish efficient breathing patterns
- Specific vocal exercises tailored to the individual's condition, such as phonation on inhalation, playful pre-linguistic vocal sounds, and siren exercises
- Physical and postural maneuvers, such as reposturing, repositioning, and lowering of the larynx, including circumlaryngeal massage with concurrent vocalization
- Redirection of attentional focus, such as bubble blowing, large body movements, and use of amplification or headphones to alter or enhance auditory feedback
The approach is non-invasive and often serves as a first-line treatment before considering surgical interventions for voice disorders. Voice therapy is effective for conditions like vocal nodules, muscle tension dysphonia, vocal fold paralysis, and voice changes from aging or neurological disorders, as supported by studies 1. However, the most recent and highest quality study 1 provides the most comprehensive and up-to-date guidance on the treatment of functional voice disorders.
In terms of outcomes, voice therapy has been shown to be effective in improving vocal function, reducing symptoms, and enhancing quality of life, with moderate-to-good evidence for its efficacy in treating functional dysphonia 1. The therapy is typically provided in 1-2 sessions per week for several weeks or months, with daily home practice exercises, and is often tailored to the individual's specific needs and condition. Overall, voice therapy is a highly effective treatment approach for voice disorders, and its use should be prioritized as a first-line treatment before considering surgical interventions.
From the Research
Definition of Voice Therapy
- Voice therapy is a treatment approach for voice disorders, guided by a speech-language pathologist 2
- It is considered the cornerstone of treatment for patients with voice disorders, including functional and organic voice disorders 3
Techniques and Applications
- Behavioral voice therapy approaches have been found to lead to significant improvements in voice outcomes 2
- Techniques used in voice therapy include voice rest and other treatment options, which are examined in various studies 3
- Voice hygiene and speech therapy are often recommended for treating vocal cord disorders, such as benign masses on the vocal folds 4
Effectiveness of Voice Therapy
- Studies have found statistically significant improvements in voice outcomes after voice therapy, but further research is needed to establish the clinical meaningfulness of these results 2
- The effectiveness of voice therapy can vary depending on the type of voice disorder being treated, with different approaches being used for different conditions 2, 3
Treatment of Vocal Cord Disorders
- Vocal cord disorders can present with a range of symptoms, including dysphonia, respiratory symptoms, and stridor 4
- Treatment options for vocal cord disorders include voice therapy, surgery, and empiric treatment, although empiric treatment is not recommended without direct visualization of the vocal folds 4