Voice Disorder Treatment in Lahore
When a person’s voice quality, pitch, and volume are out of place or improper for their age, gender, cultural background, or geographic area, it is known as a voice disorder. Even though others may not notice, the American Speech-Language-Hearing Association (ASHA) defines a voice disorder as when a person expresses concern about having an atypical voice that does not satisfy their everyday demands.
There are numerous varieties of voice problems as well as a wide range of underlying causes for voice disorders in humans. They are typically classified as either functional (voice disorders resulting from incorrect use of the voice even when the structural components of the voice are normal) or organic (anything structurally or neurologically causing change to the voice, e.g., vocal nodules).
Certain child demographics are at a higher risk of developing vocal issues. Among them are kids with Attention Deficit Hyperactivity Disorder (ADHD), who frequently speak loudly or in an excessively expressive manner.
There are different kinds of voice disorders, according to their main cause:
Organic:
As a result of anomalies in the respiratory, laryngeal, or vocal tract systems, the voice disease has a physiological basis.
Structural:
A specific type of organic voice problem brought on by structural alterations, including inflammation or vocal nodules causing changes to the tissues of the vocal folds.
Neurogenic:
An organic voice disorder stemming from nervous system irregularities in the larynx can disrupt the vocal mechanism, leading to symptoms like vocal tremors and paralysis of the vocal folds. This condition, often arising from central or peripheral nervous system issues, hampers speech fluency and quality. Treatment methods may involve speech therapy, botulinum toxin injections, or surgical interventions.
Functional:
This type of vocal disorder occurs when the vocal mechanism is improperly utilized. Although there are no physical ailments, individuals may still suffer from symptoms such as vocal fatigue, ventricular phonation, and muscle tension dysphonia or aphonia.
Psychogenic voice disorders:
Rarely occurring, these voice disorders stem from psychological stressors, resulting in maladaptive aphonia or dysphonia. Often, individuals afflicted with these conditions are the primary ones to detect anomalies in their speech, even if those around them remain oblivious. Such self-awareness typically initiates the recognition and diagnosis of these disorders
Symptoms Of A Voice Disorder
If you suspect that you or someone you know might have a voice disorder, here are some of the symptoms to look for:
Increased vocal effort when speaking
Fatigue with prolonged voice use
Running out of breath quickly
Frequent coughing or throat clearing
Throat or laryngeal tension, pain, or tenderness.
Variable vocal quality throughout the day
Rough or raspy voice
Breathy voice or bursts of breathiness
Strained, tense or harsh voice
Strangled voice (as if talking with your breath held)
Abnormal pitch (too high, too low, etc.)
Abnormal volume (too high, too low, unsteady, etc.)
Loss of voice , Weak voice
Wet-sounding voice
Pulsed voice (audible creaks or pulses in sound)
Shrill voice (high, piercing sound)
Shaky voice
Individuals suffering from a voice disorder may encounter multiple symptoms concurrently or sporadically experience just a few. However, diagnosing a voice disorder solely based on listening to individuals’ voices is challenging. Therefore, obtaining a medical evaluation is advised to assess the severity of the condition and identify any associated injuries.
Causes Of Voice Disorders
Our ability to generate sounds and communicate hinges on the coordination of the respiratory system, activation of laryngeal muscles, and the intricate interplay of vocal mechanisms within internal structures such as the pharynx and oral cavity. Any disruptions in these processes can result in voice disorders, as previously mentioned, originating from organic, functional, and/or psychogenic factors.
Here is a list of the most common causes for voice disorders:
Structural:
Vocal nodules, cysts, polyps, edema, inflammation of the larynx, laryngitis, trauma to the larynx, chemical exposure, etc.
Neurologic:
Parkinson’s disease, multiple sclerosis, pseudobulbar palsy, etc.
Functional:
Yelling, screaming, excessive throat clearing/coughing, speaking in too high or too low pitch, vocal fatigue due to effort, etc.
Psychogenic:
Chronic stress disorders, anxiety, depression, etc.
Keep in mind that trying to tend to voice disorders on your own is not recommended and that you will need a professional, such as a speech therapist to provide you with the appropriate help.Also, medical history is often required for an assessment, because even when an obvious cause is found, the problem could persist.A good example is when a voice disorder develops from an upper respiratory infection, which is fairly easy to treat, but the voice issues continue even after the infection is gone.This can happen due to the improper use of speech techniques that only an experienced therapist can assist you with.
Screening For Voice Disorders
People who suspect having a voice disorder should get a proper examination from a doctor, but it’s also recommended to get an evaluation from a speech therapist.This is important because every specialist have their unique tests and instrumentation that can help in providing a more comprehensive diagnosis.
These are some the vocal characteristics evaluated during a screening:
- Respiration
- Phonation
- Resonance
- Vocal range
- Pitch
- Loudness
- Endurance
After the initial screening, a comprehensive assessment might be needed in order to identify or uncover impairments, medical conditions or medications that could be triggering certain voice disorders.
Here is what a comprehensive assessment aims to identify:
Impairments in body structure and function:
Strengths and weaknesses in speech and communication.
Comorbid deficits:
Health conditions and medications that could cause voice disorders.
Limitations in activity and participation:
Functional communication and interactions.
Environmental and personal factors:
Factors that affect communication and life participation.
Quality of life:
Communication impairment and functional limitations
A comprehensive assessment typically requires to review the following:
Case History:
The individual will get asked to describe their symptoms and talk about their medical history including surgeries, chronic disorders, and medications.
Self-Assessment:
The individual will get asked about their own perception of their voice disorder and how it’s affecting their lives.
Oral-Peripheral Examination:
Assessment of structural or motor-based abnormalities, that may be affecting communication and voice, including oral muscles and strength.
Assessment of Respiration:
Respiratory patterns and coordination of respiration with phonation.
Auditory-Perceptual Assessment:
The speech therapist will take notes on their own clinical impressions while running speech tests.
Voice Quality:
Roughness, breathiness, strain, pitch, loudness, tremor, vocal fry, wet/gurgly quality, etc.
Resonance:
Hyponasal, hypernasal, pharyngeal/laryngeal, nasal, etc.
Phonation:
Delayed voice onset and quality of voice at onset.
Rate of Speech:
Changes in rate of speech can be an indirect result of a voice disorder when an individual decides to modify it, in an attempt to compensate for their condition and sound more clear.
An instrumental assessment may also be needed for further testing, and this includes:
Laryngeal Imaging:
Measures structure and gross function using video endoscopy.
Acoustic Assessment:
Measures vocal loudness, pitch, and quality.
Vocal amplitude:
Measures the typical sound level of voice during speech.
Some of the tests described above can also apply for children, but there are some voice disorders that are unique to the pediatric population, such as:
Laryngomalacia:
A congenital condition of the larynx characterized by immature laryngeal cartilage, floppy epiglottis, etc.
Laryngeal webbing:
Characterized by membranous tissue that connects the two vocal folds and may cause airway blockage.
Laryngeal cleft:
A rare condition characterized by having an opening between the larynx and the esophagus.
Puberphonia:
A voice disorder that can happen to male adolescents after a voice change during puberty, that causes a high-pitched voice.
Keep in mind that the kind of assessments and tests may vary depending on your speech therapist and/or family doctor, and that this is not a complete list.
How Can A Speech Therapist For Voice Disorders Help?
Early intervention when it comes to voice disorders is very important and speech therapy can help to:
Establish proper vocal hygiene practices
Address weaknesses related to structural and functional issues that affect voice production. Improve self-awareness of voice quality
Encourage the individual to acquire new communication skills and strategies
Reduce barriers and enhance successful communication and participation
Provide proper accommodations and training in how to use them.
There are different approaches that a speech therapist can decide on, depending on your unique case
Direct Approaches:
These focus on manipulating voice-producing mechanisms such as respiration and musculoskeletal function to modify vocal behaviors.
Indirect Approaches:
These are based on education and counselling, so the individual becomes aware of the way voice disorders work and can identify strategies to manage them.
Therapeutic Plan:
A speech therapist can design a unique plan to help manage voice disorders, which includes a combination of direct and indirect approaches.
Speech therapists will also consider behaviours that are causing voice problems, while designing a management plan, such as:
- Shouting
- Talking loudly over noise
- Coughing
- Throat clearing
- Poor hydration