Speech therapy offered by a speech language pathologist (SLP) involves training the person to alter voicing techniques. For instance, the speech therapist may point out that the patient is producing his or her voice with poor breath support or poor tongue placement in the mouth. Through exercises and practice, the patient can gain better insight into how to speak more efficiently and effectively.
Unfortunately, this approach often produces incremental benefit for the typical SD patient since SD is a neurologic condition over which the patient has little or no control. While some have suggested that SD can be cured through speech therapy, few practitioners or patients have had this experience. Speech therapy is generally seen as a possibly helpful adjunct to other therapies such as botulinum toxin (BTX) injection and to help SD patients who have excess voice strain to “unload” some vocal muscle tension.
Some people with spasmodic dysphonia benefit from the use of a voice amplifier for the phone or that of a self-contained microphone used in conjunction with any FM radio.
Understanding what causes the SD patient's voice to be better or worse is an important step in managing symptoms of SD. Susan Shulman, MS, CCC-SLP surveyed individuals with SD regarding what affects voice quality, and the following findings were presented:
What often helps make voice quality better?
- Vocal exercise (humming, speaking slowly, reciting nursery rhymes)
- Volume control (talking softly or loudly)
- Feeling relaxed
- Breathing deeper breaths, exhaling before speaking, not holding onto the breath
- Environmental control (talking one-on-one, not being interrupted)
- Using voice early in the morning
- Sensory gestures (neck muscle massage, covering eyes, pinching nose)
- Physical exercise
- Mental aspects ("not thinking about it", keeping a good attitude)
- Miscellaneous (physical rest, vocal rest, warm liquids, laughing)
What often makes voice quality worse?
- Stress (being tense, being in a hurry)
- Speaking on the telephone
- Speaking in a loud or large space
- Trying to talk over noise
- Lack of sleep
- Negative thinking
- Miscellaneous (overuse, weather changes, having a cold)