National Spasmodic Dysphonia Association
Voice Therapy Exercises
Voice and/or speech therapy is one of the Thumb under chin and index finger anchoring
management options for people with on chin, massage in a triangle rotation
spasmodic dysphonia. It can be used alone or in (underneath the front area of the tongue).
conjunction with treatments such as botulinum
toxin injections or pre/post-surgical Tips: Swallow before/after each exercise; your
intervention. Voice therapy can also help with throat may feel looser.
differential diagnosis as there are other voice
disorders that sound similar to SD.
Breathing Properly will help your Speech
The goal of voice therapy is to help manage the
symptoms more effectively. A Speech-Language 1) Scan your body to identify areas of tension
Pathologist (SLP) may work with an and allow them to release.
interdisciplinary team that includes an For voice: Just let the breath relax. Inhale:
Otolaryngologist (ENT) and/or a Neurologist. Breathe in through the nose; feel the air come
Training to be a SLP includes post-graduate in past the nose and then down through the rib
university training, certification from the cage and diaphragm through the body. Exhale
American Speech-Language-Hearing Association (longer than inhale) thru pursed lips relaxing the
(the initials CCC-SLP), and licensing from the throat, tongue, cheeks and mouth. Put hand in
state in which she or he practices. Although all front of mouth; should feel smooth breath on
SLPs receive some training in voice problems, exhale.
considerable additional clinical experience is
required to conduct effective voice therapy. Visual: The diaphragm expands like a bellows -
expanding brings air into the lungs
The following exercises are not specifically for
SD, nor do they replace an individualized 2) Adding Sound to Breath
treatment plan with a Speech-Language Now let the voice ride on the smooth exhale
Pathologist. They are presented as suggestions breath feeling the energy and sound in front of
to help with the management of symptoms. the mouth (not in throat.) Say "who" as
Massage for Releasing Tension Visual: Think of the breath as coming through
an open hose with nothing cutting it off. The
(Try 1 min each; 1-5 times a day) exhalation of air makes the vocal folds vibrate
Directions and the sound and air move up into the mouth.
(Work with it and don't suppress sound by
With the chin neutral or slightly down, (above tightening throat/mouth/jaw. Keep relaxed.)
the Adam's apple) massage on both sides of the
front of the neck. Tips: Don't force the breath. Use a medium
breath; not too deep. Start with high pitch, as
Move up higher on both sides under the chin an easier option, but can go lower to your
(below jaw) pinching the bottom of the tongue. speaking range - find an easy pitch. Overall, if
Massage in the area right below the floor of the the muscles are too tight, you may become
Trilling/Raspberry Exercise Blowing Out Candle Exercise
With the tongue out, make a "raspberry" sound Put hand in front of mouth/breath. Blow out
(vibrate tongue between lips while forcibly like candle. Use consistent, smooth breath (not
blowing air out.) The goal is to release the throat). Start air first, then add sound "oo". Feel
tongue and activate the breath. sound in front of mouth.
Then add sound. Try to get the voice and breath Start with high pitch and then try lower pitches
to work together. with "oo". Higher pitch may be easier, but find
Try "F" then add sound. Have top teeth touch your easy voice and comfortable pitch.
lower lip, then add sound - feel vibration with Try words next using the air/breath. Initiating
air. sound is easier, when we use our breath.
Blowing Bubbles Exercise
Directions Reminders and Daily Affirmations
Use a straw to blow bubbles in a cup of water. 1) Exercises/speech therapy can help us use
Try to make consistent bubbles. Then make the our voices better and with less effort, but it
sound, "Hi Sally." It can be easier to talk won't take away spasms or tremor.
afterward. 2) Accept the voice you have and work with
it--not against it.
Try intermittent blowing in short bursts. If 3) Most important is how you feel about your
catch, reduce pressure. "Try hard not to try voice. Master the positive feeling within.
hard." 4) Your voice quality doesn't diminish the
Say "Where are you?" while blowing bubbles in message (think Katherine Hepburn in On
water. Then take straw out and say again. Golden Pond.)
Should be easier and sound better. This reduces 5) Relax, breathe, exhale more, let go of the
the pressure and uses the air to exhale more larynx.
through it. 6) With SD, whispering is easier, because there
Web resources: Ingo Titze (straw phonation) -
is no voice. When you try for volume/to get
Set Your Voice Free (Roger Love)
louder, you can spasm. So use more air to
7) On the phone, try using less pressure.
8) Hydrate! A healthy body works best.
Special thanks to Sarah Schneider, UCSF Voice
and Swallowing Center for her assistance in
preparing this information.
National Spasmodic Dysphonia Association
Dedicated to improving the lives of people affected by spasmodic dysphonia and related voice conditions
through programs of research, education, awareness and support
What are the best voice exercises?What Makes Up Good Vocal WarmupsBreathing And Posture. Never underestimate breathing and posture. ...General Pitch Sirens. After you do some breathing and posture alignment, you need to prep your vocal cords for singing. ...Specific and Small Interval Training. ...Agility Training. ...Range Stretching. ...
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