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voice disorders exam #2

Key Concepts:

Terms in this set (38)

1. Semi-occluded vocal tract exercises (SOVT)
• Narrowing at any supraglottic point along the vocal tract in order to maximize interaction between vocal fold vibration (sound production) and the vocal tract (the sound filter) and to produce resonant voice
• Narrowing vocal tract increases air pressure above vocal folds, keeping them slightly separated during phonation and reducing impact collision force --> dec hyperfunction, there will be air pressure above and below
• Straw phonation: semi-occludes vocal tract by phonating through a straw or tube. Resistance can be manipulated by varying length/diameter of straw. Practice sustaining vowels, performing pitch glides, humming songs, and transitioning to the intonation and stress patterns of speech
• Semi-occlusion at level of lips = lip trills: Smooth movement of air through oral cavity and over lips, causing a vibration (lip buzz), similar to blowing bubbles underwater. Often trills are paired with phonation and pitch changes. Focus is to improve breath support and produce voicing without tension

2. Manual Circumlaryngeal Techniques
• Reduce musculoskeletal tension and hyperfunction
• Reposturing of the larynx during phonation (return larynx to relaxed, normalized position)
• Clinician may get a glimpse of improved voicing
i. Reinforce position with sensory feedback
•3 maneuvers: push back, pull down, meidal compression and downward traction
•Applying maneuvers during vocalization allows client to hear resulting changes in voice quality

3. Accent method
•Designed to increase pulmonary output, improve glottic efficiency, reduce excessive muscular tension, and normalize the vibratory pattern during phonation
•facilitate abdominal breathing by getting patient to lay down
•use rhythmic play w/ models of accented phonation patterns
--> patient imitates
•rhythm --> artic speech, first w/ model then progress to convo speech
• Build new respiratory and voice patterns
• Pulsed abdominal breaths to facilitate glottal closure

4. Resonant Voice Therapy
• Pressed voice:
1. Rich in harmonic content
2. Strenuous, excessive mechanical stress on laryngeal tissues, unhealthy
ii. Breathy voice:
1. Poor harmonic content
2. Inefficient
iii. Resonant voice:
1. "middle ground" laryngeal adduction
iv. Reinforcement of oscillatory glottal airflow by the vocal tract
1. Biofeedback
• Provide clear and reliable feedback in response to alterations in voice production to address improvements in pitch, quality, loudness, effort
• Can be visual/auditory/tactile
• Increases awareness and perception
• Basis is that self-control of physiologic functions is possible with continuous, immediate information about internal bodily state

2. Relaxation
• Reduce whole-body and laryngeal area tension
• Goal is to reduce effortful phonation
• Frequently used techniques: progressive muscular relaxation (slowly tensing and then relaxing successive muscle groups), visualization (forming mental images of a peaceful, calming place or situation), deep breathing
• May be helpful in cases of vocal hyperfunction

3. Chant-talk
• Recitation of syllables using one continuous tone
• Characterized by a rhythmic, prosodic pattern that serves as a template for spoken utterances
• Used in Tx to help reduce phonatory effort that results in vocal fatigue and decrease in phonatory capabilities.
• Requires pitch fluctuations and coordination among respiratory, phonatory, and resonance subsystems.
• Increased lung pressure required for these tasks may also decrease reliance on laryngeal resistance and reduce fatigue

4. Yawn-sigh
• Lowers larynx position to widen supraglottic space
• Produce relaxed voice and encourage natural pitch
• Uses natural functions of yawning and sighing to overcome symptoms of vocal hyperfunction (e.g., elevated larynx and vocal constriction)

5. Amplification
• Devices such as microphones can be used to amplify the voice in any situation that requires increased volume (e.g., when speaking to large groups, or during conversation when the individual's voice is weak)
• Can function as a supportive tool or as a means of augmentative communication
• Can help prevent vocal hyperfunction as a result of talking at increased volume or for extended periods of time