Speech and language therapists (SLTs) are trained to assess, diagnose and treat people of all ages affected by communication and swallowing disorders. Most SLTs nowadays work either with children or adults. They may specialise in a particular clinical area, such as stroke, brain injury, learning disability, speech sounds disorders or autism. Voice is a clinical area that is of great interest to me!
Here are some interesting facts about our voice…
- To breathe and protect our airway when swallowing! Our voice box sits right above the trachea and oesophagus. Air is drawn into our lungs when the two vocal cords open. The vocal cords close when we swallow, so food and drinks do not go down the wrong way.
- On average, men’s vocal cords vibrate 110 times/second; women’s vocal cords vibrate 200 times/second; children’s vocal cords vibrate 300 times/second. So the higher our voice goes, the faster our vocal cords vibrate.
- Our vocal cords are a small and delicate structure in the human body, yet they are capable of moving at such fast speeds. Therefore, inappropriate use of the voice, such as screaming, speaking loudly and poor singing techniques, can injure the vocal cords and cause voice problems. The voice could sound hoarse, croaky, breathy or strained. The voice can also be affected by infections, psychological stress, muscle tension and injuries of the neck.
Two different causes of voice disorders can result in the same quality of voice, for example a singer who developed vocal nodules (lumps on vocal cords) due to poor singing techniques and a woman with chronic stress can both have a hoarse and breathy voice.
So how do we differentiate between the two? During my placement in a voice clinic, I observed SLTs using flexible nasoendoscopy, which is passing a thin, flexible tube with a camera attached through the nose and down to the voice box - to examine the patient’s voice box. I found it fascinating to watch the vocal cords vibrate during the procedure and you can see for yourself on YouTube! Just search ‘vocal cord vibration’.
For patients with visible muscular tension in the neck, SLTs use a hands-on approach to palpate their patients’ voice box in order to assess the degree of tension. Massage around the voice box may be an appropriate treatment for some patients with muscle tension.
Apart from massage, SLTs also use a number of voice techniques to help patient achieve a better sounding voice. Try the following exercises and notice what you feel:
- Humming for 5 seconds (‘mmm……’)
- Chew while you hum for 5 seconds
- Imagine a hot potato in your mouth and hum for 5 seconds.
Do you feel any sensation? Is the feeling different/ the same across the three exercises? This is an example that therapists use to guide their patients in a series of voice exercises.
Further, we use voice to convey our gender expression. Some SLTs specialise in helping transgender and non-binary people explore their authentic voice that aligns more closely with their gender expression. I have volunteered at the transgender voice and communication workshop in Manchester. Learning about their lived experience while carrying out therapy was a rewarding experience. Many of them struggle to access local support and high-quality transgender health care and I am proud to have made a difference to transgender people’s lives.
A final interesting fact about the speech and language therapy profession: only 2.9% of SLTs are male!
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