Voice

Understand voice disorders and what your options are.

Voice Disorders

Voice disorders are defined by persistent changes that impact an individual’s ability to communicate effectively. Voice disorders can affect vocal loudness, quality/pitch, and sometimes pain or strain with speaking. Voice disorders can be due to illness or injury, acute misuse of the voice, or as a symptom of neurological conditions. Other related disorders include chronic cough, irritable larynx syndrome, and paradoxical vocal fold motion (Vocal Cord Dysfunction).

Assessment & Treatment of Voice Disorders

Before seeing a speech-language pathologist (SLP), patients must be evaluated by an otolaryngologist (ENT). After the medical evaluation, the ENT will indicate if the patient is a good candidate for voice therapy. If voice therapy is recommended, a speech-language pathology appointment may be scheduled. At the assessment with an SLP, specific qualities of the patient’s voice are measured using computer-based analysis (non-invasive). Assessment also includes an extensive interview of vocal health history, symptoms of the voice concern, and specifics of how the voice problem is impacting the patient’s quality of life.

Holistic treatment sessions combined with evidence-based programs are used for voice disorders. Voice therapy is collaborative and depends on the teamwork of the clinician, patient, and physician. Home practice is an integral part of voice therapy.

Young kid doing speech therapy to improve her voice

Resonance

A resonance disorder is a distortion of vocal quality that can result from abnormalities in the structures of the throat, soft palate, nose, and mouth. This can also result from the way someone uses these structures. Disturbances to the aforementioned structures and/or functions of these structures could result in enough distortion of sounds so as to make speech difficult to understand.

All of us have temporarily experienced changes in our resonance when we have a cold, sinus infection, or throat inflammation. However, more permanent conditions require closer attention by an otolaryngologist and a speech-language pathologist.

Assessment & Treatment

Assessment of a resonance disorder requires an otolaryngologist, in collaboration with a speech-language pathologist to examine the structures of the resonance. The otolaryngologist will perform an instrumental examination using imaging technology. A speech-language pathologist will then evaluate articulation, vocal quality, and language by administering tests that assess each area separately.

At Evergreen Speech and Hearing Clinic, we take a collaborative approach to assessing and treating speech, language, and voice disorders. In the case structural problems are the cause of resonance issues, surgical options may be the first treatment of choice. Often after surgical correction of a structural problem, speech therapy is recommended to maximize the benefit of surgery. In the case of normal structures and functions, (i.e., when resonance issues are the result of misuse of structures during speech), speech therapy is the first treatment option. Speech therapy for resonance disorders can include training appropriate articulation of distorted sounds, and training healthy, efficient use of the voice.

Gender Affirming & Expansive Voice Services

Voices are as unique as the individual. Every voice is different and is an important part of how people express themselves. Individuals may experience a mismatch and distress between their voice and how they—or others—perceive their gender. Structural differences, including the size and length of the vocal folds (vocal cords) and the vocal tract (from the larynx to the oral cavity), determine an individual’s habitual pitch and resonance.

Gender-affirming and expansive voice therapy can help individuals modify attributes of their voice to use a voice in alignment with their authentic selves. Some people may also choose to have surgery and hormone treatment to support how their voice sounds. Voice training is appropriate at any point along your journey to support your vocal health and assist you with meeting your voice goals.

At Evergreen Speech and Hearing Clinic, our speech-language pathologists specialize in gender-affirming and expansive voice therapy and are sensitive to and passionate about the diverse needs of supporting transgender and gender-nonconforming people in finding and developing a voice consistent with their gender identity and communication goals.

Treatment

Gender-affirming and expansive voice therapy consists of holistic treatment sessions combining evidence-based programs with personalized practice techniques designed to fit the patient’s lifestyle and vocal demands. Voice therapy is highly collaborative and depends on the teamwork of the clinician, patient, and other providers on your team. Treatment is highly individualized based on the needs and goals of the patient.

The following are areas of your voice you may choose to work on with a speech-language pathologist:

Gender Affirming Services Icon

Accent Modification

Accent modification is a personally elected service to receive training in Standard American English (SAE) pronunciation and articulation in case a person feels hindered or misunderstood as a result of an accent.

An accent is the result of sounds and patterns of pronunciation from a primary language being transferred to a second language. Although accents are natural and not seen as a speech or language disorder, many people choose to participate in accent modification programs to reduce their accent.

Accent Modification Assessment

Assessment of a person’s accent is conducted by a speech-language pathologist who records samples of the patient’s speech. A thorough interview with the patient is used to determine their individual goals for modifying their accent.

Accent Modification Program

A speech-language pathologist will work with the patient to develop an individualized and personalized program. Training sessions include topics such as auditory discrimination, training articulation of SAE speech sounds, and building an at home-practice regimen. The program typically includes twelve training sessions and the initial assessment.

Locations

Bellevue Clinic

Kirkland Clinic

Redmond Clinic

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