Voice Therapy

Joseph C. Stemple, PhD, CCC-SLP, ASHAF is Professor Emeritus, Department of Communication Sciences and Disorders, College of Health Sciences, University of Kentucky. Prior to his academic career he was the founder and director of the Blaine Block Institute for Voice Analysis and Rehabilitation, Dayton, Ohio and the Professional Voice Center of Greater Cincinnati. As co-director of the UK Laryngeal and Speech Dynamics Lab, his research focused on understanding voice disorders, specifically cell to society translational research. The overarching research goal was to enhance vocal function in those with voice disorders. He is a Fellow and Honors recipient of the American Speech Language Hearing Association.Edie R. Hapner, PhD, CCC-SLP, is the George W. Barber Junior Endowed Professor of Otolaryngology at the University of Alabama at Birmingham where she also serves as the Co-Director of the UAB Voice Center and the Director of Hearing and Speech. She is a fellow of the American Speech Language and Hearing Association and Associate Fellow of the American Laryngological Association. Dr. Hapner has served on the Board of Directors for the American Speech Language and Hearing Association as the Vice President of Planning, Coordinator of the SIG 3 Voice and Voice Disorders and chaired the ASHA Annual Convention in both 2020 and 2022. She has served as a member of the Voice Committee for the American Academy of Otolaryngology and the Education Committee for the American Bronchoesophageal Association and served on the AAOHNS Guidelines Committee for Dysphonia. She is a founding member of PAVES, Pathway for Advanced Voice Education and Service and currently serves on the Advisory Board.Dr. Hapner's research interests include aging voice, dystonia and adherence to voice therapy. She has co-edited Voice Therapy Clinical Case Studies Editions 4, 5 and now 6. She is co-developer of Phonation Resistance Training Exercises (PhoRTE (R)), an evidence-based treatment for aging voice. She developed and implemented the voice curriculum for Medbridge Inc, an online learning system for speech language pathologists. She has presented hundreds of lectures, workshops, and seminars on voice and voice disorders. She has over 70 published articles in the area of voice and voice disorders and multiple book chapters. Dr. Hapner's greatest professional accomplishment remains the mentoring of 23 consecutive voice centric clinical fellows into this incredible world of care of the voice.Lauren Timmons Sund, BM, MS, CCC-SLP is the Speech Pathology Director for the USC Voice Center in Los Angeles, CA. She is the Clinical Fellowship Director at the USC Voice Center and an instructor and clinical educator for the graduate SLP program at the University of Southern California.Lauren earned her master's degree in communicative disorders from California State University, Northridge, completed a research internship at the University of Pittsburgh Voice Center, and trained as a clinical fellow in voice, upper airway, and swallowing disorders at the USC Voice Center under the mentorship of Edie Hapner, PhD. She holds a Bachelor of Music in voice performance from Illinois Wesleyan University.Lauren specializes in the care of patients with voice and upper airway disorders with particular clinical and research interest in performance voice, aging voice, laryngeal dystonia, and interprofessional practice. She has published 20+ peer-reviewed articles and regularly presents locally and nationally. Lauren served as course co-director for the Fall Voice Conference 2024, is a past president of the Southern California Chapter of the Voice Foundation, a current committee chair for PAVES (Pathway for Advanced Voice Education and Service), and is on the Advisory Board for the Voice Foundation.

• ContentsForewordPrefaceAcknowledgmentsContributorsA Tribute to Prior ContributorsVideo ContentsChapter 1. The Voice and Upper Airway EvaluationEdie R. Hapner and Lauren Timmons SundA Brief History of the Voice and Upper Airway EvaluationModels of CareThe Importance of an Accurate Laryngeal DiagnosisWho Is Responsible?Laryngeal Diagnosis Informs Treatment DecisionsComponents of the Voice and Upper Airway EvaluationThe Physician's Medical ExaminationThe Speech-Language Pathologist's AssessmentThe Case HistoryPatient-Reported Outcome Measures (PROMs or PRO measures)Auditory-Perceptual AssessmentVisual-Perceptual AssessmentCranial Nerve ExaminationMotor Speech AssessmentManual AssessmentInstrumental AssessmentLaryngeal ImagingAcoustic AssessmentAerodynamic AssessmentStimulabilityDocumentationConclusionsReferencesChapter 2. From Evaluation to Intervention: Decision Making in Voice Therapy Edie R. Hapner and Lauren Timmons SundIs Voice Therapy an Appropriate Treatment for the Presenting Problem?Is the Person a Good Candidate for Therapy?Options for Care: Where Does Voice Therapy Fit?Are You the "Right" Clinician?Treatment Option Summaries by Disorder: Selected ExamplesTreatment Options for Muscle Tension Dysphonia (MTD)Treatments Options for Vocal Fold Motion ImpairmentsTreatments Options for Laryngeal Dystonia and Voice TremorDecision Making in Therapy Planning: What Therapy to Use?Recalibration StrategiesExuberant StrategiesIndirect and Augmentative StrategiesDecision Making in Voice Therapy Planning: How Much, How Long, and How Intense?Putting It All Together in Decision Making: The Silent FactorsConclusionsReferencesChapter 3. PhonotraumaIntroductionRyan C. BranskiCase StudiesCase Study 3.1: Conversation Training Therapy (CTT) to Treat an Adult With Benign Midmembranous LesionsJackie L. Gartner-Schmidt and Amanda I. GillespieCase Study 3.2: Treating a Child With Dysphonia Using Concepts From "Adventures in Voice"Rita Hersan Case Study 3.3: Multimodality Voice Therapy to Treat an Adult Female Opera Singer With a Vocal Fold PseudocystChristine Murphy EstesCase Study 3.4: Perioperative Therapeutic Care for an Adult With a Vocal Fold Cyst Austin Collum and Megan LeeCase Study 3.5: Multidisciplinary Treatment for an Adult With Vocal Process Granulomas After TBIHeather StarmerCase Study 3.6: Vocal Function Exercises to Treat an Adult With Undifferentiated PhonotraumaJoseph C. StempleCase Study 3.7: Lessac-Madsen Resonant Voice Therapy to Treat an Adult With Vocal Fold NodulesDiana Marie Orbelo, Nicole Y. K. Li-Jessen, and Katherine Verdolini AbbottReferencesChapter 4. Muscle Tension DysphoniaIntroductionNelson RoyCase StudiesCase Study 4.1: Manual Circumlaryngeal Techniques to Treat an Adult With Primary Muscle Tension DysphoniaNelson RoyCase Study 4.2: Boot Camp Voice Therapy for an Adult With Functional DysphoniaClaudio F. Milstein and Michelle AdessaCase Study 4.3: Flow Phonation to Treat a Teenager With Primary Muscle Tension AphoniaJackie L. Gartner-SchmidtCase Study 4.4: Multimodality Voice Therapy for an Adult With Vocal FatigueChaya NanjundeswaranCase Study 4.5: Intensive Voice Therapy for a Teenager With Mutational Falsetto (Puberphonia)Lisa FryCase Study 4.6: Postsurgical Voice Therapy for a Child With Recurrent Respiratory Papillomatosis and Ventricular PhonationMaia Nystrum BradenCase Study 4.7: Interprofessional Assessment and Treatment for an Adult With Muscle Tension DysphagiaChristina Kang RosowReferencesChapter 5. Glottal GapsIntroductionAaron ZieglerCase StudiesCase Study 5.1: Inspiratory Muscle Strength Training to Augment Vocal Function Exercises in an Adult With PresbyphoniaHeather Bonilha and Maude DesjardinsCase Study 5.2: Phonation Resistance Training Exercises (PhoRTE (R)) to Treat an Adult With PresbyphoniaAaron Ziegler and Edie R. HapnerCase Study 5.3: Expiratory Muscle Strength Training and PhoRTE (R) to Treat an Adult With PresbyphoniaAdam Lloyd and Maria MurljacicCase Study 5.4: Postoperative Voice Therapy to Treat an Adult With Unilateral Vocal Fold ParalysisMaria DietrichCase Study 5.5: Interprofessional Treatment for an Adult With Unilateral Vocal Fold ParesisDesi Gutierrez and Matthew HoffmanCase Study 5.6: Multimodality Teletherapy for an Adult Avocational Singer With Unilateral Vocal Fold Paresis Lauren Timmons SundCase Study 5.7: Interprofessional Treatment for an Adult With Sulcus VocalisAmanda I. Gillespie and Clark A. RosenReferencesChapter 6. Movement Disorders Affecting the Voice: Laryngeal Dystonia, Vocal Tremor, and Parkinson's DiseaseIntroductionKatherine L. MarksLaryngeal DystoniaVocal TremorParkinson's DiseaseCase StudiesCase Study 6.1: Medical and Behavioral Management for an Adult With Laryngeal Dystonia-Adductor TypeEdie R. Hapner and Michael M. Johns IIICase Study 6.2: Voice Therapy Without Medical Management for an Adult With Adductor Spasmodic DysphoniaJoseph C. StempleCase Study 6.3: Teletherapy Without Medical Management for an Adult With Abductor Laryngeal Dystonia and Vocal TremorLauren Timmons SundCase Study 6.4: Reducing Voicing Duration to Treat an Adult With Vocal TremorJulie Barkmeier-KraemerCase Study 6.5: Multimodality Voice Therapy for an Adult Classical Singer With Vocal TremorKristen BondCase Study 6.6: The SLP's Role in Deep Brain Stimulation for Vocal TremorElizabeth DiRenzoCase Study 6.7: Maintaining Gains from Voice Therapy Using the SpeechVive for an Adult With Parkinson's DiseaseJessica HuberReferencesChapter 7. Upper AirwayIntroduction: Refractory Chronic CoughLaurie SlovarpCase StudiesCase Study 7.1: Behavioral Cough Suppression Therapy (BCST) for an Adult With Chronic Refractory CoughLisa ZughniCase Study 7.2: Using the Chronic Cough Clinical Checklist With an Adult With Irritant-Induced Chronic CoughMariah Morton-JonesCase Study 7.3: Behavioral Cough Suppression Therapy for an Adult With Underlying Respiratory DiseaseLaurie SlovarpCase Study 7.4: Interprofessional Use of SLN Injection and BCST for an Adult With Chronic Refractory CoughEdie R. Hapner and C. Blake SimpsonCase Study 7.5: Interprofessional use of Neuromodulators and BCST for an Adult With Chronic Refractory CoughJuliana Litts and Daniel FinkIntroduction: Inducible Laryngeal Obstruction (ILO)Mary J. SandageCase StudiesCase Study 7.6: Long-Term Management of PVFM in an Adult Following an Environmental Fume ExposureCarissa MairaCase Study 7.7: Treating Irritable Larynx in an Adult Within the Framework of Central Sensitivity SyndromeLinda RammageCase Study 7.8: Behavioral Management for Exercise-Induced Laryngeal Obstruction (EILO) in a Collegiate SwimmerMary J. SandageCase Study 7.9: EILOBI Techniques to Treat an Adolescent Nordic Skier With EILOEmily A. NaumanReferencesChapter 8. Performance VoiceIntroductionMarina GilmanCase StudiesCase 8.1: Multimodality Voice Therapy for an Adult Voice Actor/Singer With a Translucent Polypoid LesionM. Eugenia Castro and Megan Urbano Case Study 8.2: Onsite Voice Therapy for an Adult Theater Actor With Vocal Injury During Preparation and PerformanceDebra PhylandCase Study 8.3: Myofascial Release for an Adult Touring Musical Theater Performer With Vocal FatigueWendy LeBorgneCase Study 8.4: Voice Recalibration With the Cup Bubble Technique for an Adult Country Singer With Chronic PhonotraumaJenny C. MuckalaCase Study 8.5: Timing Multimodality Voice Therapy to Treat an Adult Singer With a Vocal Fold Polyp and Mild AtrophyJuliana Codino Case Study 8.6: Perioperative Voice Therapy for an Adult Praise and Worship Leader With Phonotraumatic LesionsMarina GilmanCase Study 8.7: Perioperative Voice Therapy for a High School Music Teacher With a Vocal Fold PolypMaurice GoodwinCase Study 8.8: Perioperative Management for an Adult Jazz Singer With a Vocal Fold CystSarah L. Schneider and Mark S. CoureyCase Study 8.9: Multimodality Voice Therapy for a Prepubescent Singer With Vocal NodulesPatricia Doyle and Starr CookmanReferencesChapter 9. Gender Affirming Voice CareIntroductionSandy HirschCase StudiesCase Study 9.1: Using Acoustic Assumptions in Gender Affirming Voice Care for an Adult Transgender WomanSandy HirschCase Study 9.2: Pitch-Elevation Surgery and Perioperative Voice Care for an Adult Transgender WomanWynde Vastine and Katherine C. YungCase Study 9.3: Manual Therapy in Gender Affirming Voice Care for a Transmasculine Adult on Hormone Replacement Therapy (HRT)Daniel P. Buckley and Felicia A. FrancoisCase Study 9.4: Developing a Gender Affirming Voice in a Nonbinary AdultDesi GutierrezCase Study 9.5: Gender Affirming Voice Care for an AdolescentAC GoldbergCase Study 9.6: Gender Affirming Voice Care via Teletherapy for a Transmasculine Nonbinary SingerRuchi KapilaReferencesIndex