Is there a relationship between stuttering and spasmodic dysphonia? Some people who are diagnosed with secondary stuttering do exhibit severe speech-triggered vocal cord spasms. Although secondary stuttering and spasmodic dysphonia may share some similar vocal symptoms, they are not causally related nor are they effectively treated in the same manner. Stuttering often affects multiple sites of the speech system (voice, articulation, and breathing), while SD only affects the vocal cords. Do you recommend singing as a way of improving one's speaking voice? Singing exercises can be very helpful. The motor programming for singing is different from that of speaking. Singing exercises can release some of the tension and stiffness that have crept into the neck and chest when one is getting ready to start talking, especially early in the morning. Why is my voice better at some times and worse at others? This phenomenon probably has to do with motor programming. We may program the muscles to move differently when we are experiencing emotional stress. The chemicals in the brain are probably functioning differently from when we are normally talking. Is SD the same as Muscle Tension Dysphonia (MTD)? Muscle Tension Dysphonia is a type of voice disorder that often "masquerades" as SD and many such people are misdiagnosed with it. MTD involves a consistent tightening of the laryngeal muscles and is often called Hypertensive Dysphonia. This problem responds very well to vocal rehabilitation. In very severe cases, when vocal therapy does not help, botulinum toxin injections can be tried to help relieve symptoms.