Speech Therapy for Voice Disorders

Voice Disorders

We usually take our voices for granted and don’t pay much consideration to how the vocal folds (cords) generate sound. Having a voice disorder can make it difficult to communicate and execute everyday tasks. Our voices are a big part of who we are and how we connect with others. Every time we use our voice, a complicated set of movements occur in our larynx (also known as the voice box). This is a structure at the base of the throat that allows people to speak. Our vocal folds (or vocal cords) are located within the larynx . Air passes from our lungs and through our vocal folds when we speak, causing them to vibrate and produce sound. The larynx and the muscles associated with voice are very delicate and when disturbed or damaged, a voice disorder may develop. The inability to utilize our voice efficiently may have a significant influence on our quality of life, impacting interpersonal connections, school or job performance, and general confidence and self-esteem. The speech therapists at Therapy Works Together assembled this informational guide about voice disorders, signs and symptoms of a problem with voice, when someone needs speech therapy for voice disorders, activities to improve voice and more.
  • What is a voice disorder?
  • Common types of voice disorders.
  • Who often gets voice disorders?
  • Symptoms of a Voice Disorder.
  • Causes a Voice Disorder.
  • How are voice disorders diagnosed?
  • Speech therapy for voice disorders.
  • Helping a Child with a Voice Disorder
  • How to prevent voice disorder and problems.

What is a Voice Disorder?

When our vocal folds are unable to vibrate properly, we might develop abnormalities. When vocal folds become inflamed, develop nodules, polyps, or other growths, or are unable to move correctly, this can occur. Pitch, loudness, or quality of a person’s voice can all be impacted.

Common Types of Voice Disorders

There are many different types of voice disorders but here are some common ones:
  • Vocal Nodules/Polyps: Both vocal nodules and polyps are lesions on the vocal chords. These can result from overuse or misuse of the vocal folds. Which results in swelling, formation of callous or enlarged vocal folds. Vocal polyps are usually bigger than nodules and can be similar to a blister. Polyps can develop after a single bout of vocal abuse, whereas nodules develop over time (screaming at a sporting event). Both nodules and polyps can produce hoarseness, a rough or scratchy voice and other symptoms.
  • Spasmodic Dysphonia: Caused by nerve issues and results in vocal cords spasming or tightening during speech. A person’s voice may be inconsistent. So sometimes they may be able to produce  no sounds and other times the voice will be absolutely normal.
  • Vocal Fold Paralysis: This is when one or both of your vocal folds are unable to move or vibrate correctly. This can result in a range of breathing and swallowing symptoms, such as hoarseness, voice pitch and loudness issues, choking or coughing when eating, and more.
  • Paradoxical Vocal Fold Movement (PVFM): This is when the vocal folds close partially and can result in breathing and voice issues like coughing, breathing issues, tightness in the throat, losing one’s voice, or changes in vocal quality.

Who Often Gets Voice Disorders?

The American Speech-Language-Hearing Association reports that voice disorders occur more often in the following populations:
  • Elderly adults, with estimates ranging from approximately 5% to 29%.
  • Adults females develop voice disorders 50% more often than males.
  • Boys develop a voice disorder more than girls.
  • Teachers, factory employees, salespeople, and singers develop voice disorders more often

Symptoms of a Voice Disorder

Here are some of the most prevalent signs that you may have a voice disorder. It’s crucial to remember that the symptoms of different forms of voice issues might vary. If you detect any of these symptoms, you should consult a doctor or a speech-language pathologist.
  • Tension/pain in your throat when talking
  • Difficulty talking/breathing
  • Raw/strained throat
  • Hoarse, rough, raspy voice
  • Weak or breathy voice
  • Changes to pitch/volume
  • Repeated throat clearing
  • Feeling a lump in the throat when swallowing
  • Pain when touching the outside of the throat (neck area)

Causes a Voice Disorder

The vocal cords must touch each other smoothly within the larynx for normal speech. A voice issue can be caused by anything that prevents vocal cord movement or touch. When discovered early, many vocal abnormalities can be treated with speech therapy. Cedars-Sinai reports that these voice disorders can be caused by many factors (sometimes the cause is not known) including:
  • Vocal Abuse: Any activity that strains, harms, or injures your vocal folds is considered vocal abuse. Excessive talking or yelling, breathing irritants, smoking, coughing, or cleaning your throat can all cause this. The formation of nodules, polyps, or other growths on your vocal folds as a result of vocal abuse might alter the tone of your voice. Regularly engaging in activities that damage your vocal folds and induce vocal abuse can have both temporary and lasting consequences on your voice quality and function.
  • Abnormal Growths: Extra tissue can develop and affect the ability to speak. Injury, vocal abuse, disease, or sickness are all possible reasons for these growths. Nodules, polyps, cysts, papillomas, lesions, and other growths are examples of these growths.
  • Nerve Issues: Speech and swallowing functions are controlled by the central nervous system, so diseases like Multiple sclerosis, Huntington disease, Parkinson disease, and Amyotrophic lateral sclerosis (commonly known as ALS or Lou Gehrig’s disease) can impact these nerves and affect voice.
  • Inflammation and Swelling: Surgery, respiratory disease, allergies, smoking, vocal misuse, drug addiction, and other factors can cause inflammation and swelling of the vocal folds.
  • Hormonal Changes: Thyroid hormones and growth hormones might create voice issues.

How are Voice Disorders Diagnosed?

A combination of your medical history and a series of exams and diagnostic tests will usually be used by your doctor to identify voice difficulties. Your doctor may recommend you to an ear, nose, and throat specialist in some instances (sometimes referred to as an ENT or otolaryngologist). Your doctor can begin by asking you a series of questions about your vocal issues. This data will aid them in deciding which tests to do. These questions may include a description of your voice disorders, when they first appeared, how long they’ve lasted, how often they occur, whether they’re made worse or prompted by particular triggers, and other underlying variables like whether you smoke. A series of tests to evaluate your vocal folds and larynx may be performed by your doctor. Voice disorders can have a variety of causes, and figuring out which ones they are can help your care team come up with a treatment plan that is both thorough and successful. But don’t be alarmed by this. Just though your doctor performs more tests doesn’t indicate your voice condition is more serious. Some common tests include:
  • Laryngoscopy: This tool is a thin scope with a light at the end which allows your doctor to examine your throat..
  • Laryngeal Electromyography, or EMG: This measures electrical activity in the muscles of the throat; used to reveal underlying nerve problems.
  • Stroboscopy: A lighted camera used to observe how your vocal folds vibrate when you talk.
  • Acoustic Analysis: A computer analyses any irregularities in how your vocal folds produce sound.

Speech Therapy for Voice Disorders

To begin speech therapy, a medical doctor will need to provide the “OK” to start treatment. This is because the speech therapist would not want to have speech therapy increase the damage on the vocal fold if there is another treatment that needs to be utilized first. A diverse team of experts, including your doctor, an ENT, a pulmonologist, a psychologist, and a speech-language pathologist, may be involved in the treatment of voice issues. The therapy you receive will be determined by the underlying cause of your voice disorder, and it will most likely be a mix of therapies. Here are a few examples:
  • Behavior/Lifestyle changes: Certain lifestyle or behavioral adjustments may be able to help you control or lessen the symptoms of your voice condition. Lowering how loud one speaks, not screaming, and resting your voice at regular intervals are all common modifications.
  • Medicine: Medication might occasionally aid in the treatment of the underlying cause of your voice condition. Before taking any medications, talk to your doctor.
  • Injections: Muscular spasms that are causing voice disorders may require injections. A doctor or ENT will make the best recommendations.
  • Surgery: Sometimes a doctor may advise surgery to remove nodules, polyps, or other forms of growth on the vocal folds.
  • Voice therapy: Doctors may prescribe speech therapy for voice disorders from a professional speech-language pathologist. This can be the primary therapy, in conjunction with other therapies, or as a prelude to additional medical procedures.

Helping a Child with a Voice Disorder

Parents can encourage children to practice speech therapy activities for voice disorders on a daily basis. Family members can also examine their own vocal habits. A child’s voice and how they use it will improve if they have a good model for voice behaviors and receive praise for good voice behaviors. At home, parents can:
  • Avoid screaming and yelling. Demonstrate how to speak in a delicate, gentler tone.
  • Take turns speaking with your children and other members of your household. When two people speak at the same time, they might speak louder.
  • Avoid soft drinks and coffee and drink lots of water. Vocal chords that are adequately hydrated create sound more effectively and with less effort.
  • Encourage taking a “voice break.” Play a game without any words, for example. This allows children to give their voice a chance to relax.
  • When children use a “better” voice or practice excellent vocal health. Concentrate on the positive by complimenting on good vocal habits.

How to Prevent Voice Disorders and Problems

These recommendations are part of good vocal hygiene to avoid a voice disorder from developing:
  • Stay hydrated (six to eight glasses of water per day)
  • Limit alcoholic, caffeinated drinks which are dehydrating
  • Use a humidifier in the winter or dry climates
  • Try to limit over the counter cold and allergy medications which dry out the vocal folds.
  • Avoid smoking/smoke filled areas which irritate vocal folds.
  • Rest well as fatigue impacts how you use your voice
  • Avoid speaking/singing too much if you feel your throat is tired
  • If you are sick, rest your voice.
  • Try not to go to the edges of the vocal range (screaming or whispering).
  • Practice good breath support by breathing from the chest.
  • Try not to talk in a noisy place as it causes you to strain your voice

How Can Therapy Works Together Evaluate and Treat All Ages Online?

Therapy Works  Together helps families connect online with a licensed and certified speech therapist that is a trained expert in diagnosing and treating a variety of speech, language and communication issues. Speech therapy is delivered online at home with video conferencing applications. The age of our clients as well as their diagnosis and goals is important in determining how speech therapy online will be delivered. Speech therapy for babies and toddlers: For kids age 0-3, we usually work on early communication skills like joint attention, social communication, or increasing language skills in late talking toddlers. Parents work with their assigned speech language pathologist, usually in a parent coaching model, to learn tips and strategies that speech therapists use so they can be adept at practicing teaching their child after the session is over and at home. You can read more here about how important it is for parents to be involved in their child’s speech therapy at home. Speech therapy for preschoolers: For kids age 3-6, speech therapists target age appropriate articulation, language delays, reading readiness and more. Parents join in for online video sessions with the child so that both learn the speech strategies and skills from the speech therapist. Learning how to use these skills after the session helps kids improve.
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