Resonant Voice Therapy
Resonant Voice Therapy
Resonant voice therapy involves training the patient to increase intraoral air pressure and is associated with vibratory sensations in nasal and facial bones. It is often used for organic lesions, functional dysphonias, mild vocal fold atrophy, and even vocal fold paralysis. Resonant voice is produced with vocal folds in a slightly abducted (open) or barely adducted (closed) position. This laryngeal posture is favorable for patients who present with laryngeal hyperfunction, hyperadduction (ie, pressed voice), or both. This vocal fold positioning appears to produce the clearest and most prominent voice with little effort and decreased risk of injury. Laryngeal imaging has revealed that the glottal closure pattern associated with resonant voice is ideal. There is just enough closure to produce a strong voice, but not so much that tissue damage occurs. The stronger voice is highly useful to the client and using the technique was reported to be better than other approaches such as those in which a breathy voice is produced. Resonant Voice therapy approach focuses on maximizing oral resonance, but it has been shown to be effective in resolving vocal nodules. (Lessac, 1994; Verdolini-Marston et al., 1995)
Chen, et.al (2007) showed that after resonant voice therapy the severity of roughness, strain, monotone, resonance, hard attack, and glottal fry in auditory perceptual judgments, the severity of vocal fold pathology, mucosal wave, amplitude, and vocal fold closure in videostroboscopic examinations, phonation threshold pressure, and the score of physical scale in the Voice Handicap Index were significantly reduced. The speaking Fo, maximum range of speaking Fo, and maximum range of speaking intensity were significantly increased after therapy.
First the patient is to perform streching/massage. The shoulders, neck, jaw, floor of the mouth, lips, tongue, pharynx and throat should be streteched for 3/10 seconds per stretch for a total of 5-10 minutes. Make sure the patient is breathing comfortably during stretching.
1. Have the patient produce Hum-um-um-um. It should be on a comfort pitch in the patient’s speech range. Go for NO control and very little effort. Ask the patient where he/she feels a “tickle”/”buzz”
2. Hummmmmmmmmm. On a sustained comfort pitch. Ask “Where do you feel the vibrations?” Cut your effort level in half, then half again, in half again. Have the pitch go higher and ask “What happens to your vibrations?”
3. Voiced exercises. On a comfortably pitch chant:
- Have the patient go from slow/soft to louder/faster to slow/soft again
4. Produce voiced sentences:
Mary made me mad.
Mother made marmalade.
Many men make money.
My merry mom made marmalade.
My merry mom may marry Mary.
Melvin made mother merry.
No onne knew nanny.
Nanny knew nothing.
No onee knew Norman’s nickname.
Now Nan knew Nelly.
Nine knew nothing..
Name nine new names now.
5. Voiced/Voiceless. Chant on a comfortable pitch:
- Go from slow/soft to louder/faster to slow/soft
6. Use Voice/Voiceless Sentences:
My mom put Pete on the moon.
Mom told Tom to copy my manner.
My manner made Pete and Paul mad.
Maggie may move Polly’s move to ten.
Mom’s movie made Tom and Tim merry.
Marv mows his lown all year.
No one knew Tim too well.
Now Tom and Time knew Nelly.
Name nine new hand tools now.
Nancy found Fred nine new names.
Nancy told Tim no news.
After sentences have the patient do paragraph reading and then have the patient apply the new voice to everday situations.
Lessac, A. The Use and Training of the Human Voice. Mountain View, CA: Mayfield Publishing Company; 1994.
Chen SH, Ssiao, TY, Hsiao, LC, Chung, YM, Chiang SC. The Journal of Voice. Outcome of resonant voice therapy for female teachers with voice disorders: perceptual, physiological, acoustic, aerodynamic, and functional measurements; 2007.
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