Information Wellness Blog

Resonant Voice Therapy (RVT) is a physiologic approach that promotes efficient phonation. Patients learn to easily and effortlessly produce their optimal sound while simultaneously minimizing vocal strain.

Ten voice experts were selected, representing both clinical researchers and frontline clinicians, to provide their perspectives. We then asked these professionals about their most frequently utilized techniques and exercises.

Warm-Ups

Resonant Voice Therapy (RVT) helps patients suffering from muscle tension dysphonia produce their best voices without much effort. This physiologic approach emphasizes laryngeal alignments specific to producing resonant voices, which increase health of vocal folds and throat (Kao et al, 2019). RVT is an evidence-based method that incorporates sensory processing along with repetitions of training stimuli at increasingly complex levels to produce results (Kao et al, 2019).

Speech-language pathologists teach their RVT patients to speak with forward focus and easy phonations, gradually progressing towards phrases and conversations. Additionally, they instruct patients in breathing techniques that support resonant voices such as thoracic diaphragm breathing or yawning/sighing to aid a full voice range.

Patients who suffer from tight or breathy voices can use yawning/sighing as an exercise to lower the back of their tongue and raise their velum (soft part of roof of mouth). Chanting simple monotone or reading aloud with whispered tone are other exercises patients can practice; other RVT exercises include the finger under nose technique, nasal consonant sounds and humming while keeping lips closed to increase vibrations of sound vibrations.

RVT is an increasingly popular and effective method for improving vocal quality, including decreasing strain. This technique is often employed as part of treatment plans for voice disorders like muscle tension dysphonia and vocal nodules; there have also been multiple studies which demonstrate its efficacy against various vocal issues (Kao et al, 2017; Verdolini Abbott and Stemple 2019).

Pitch Variation

Pitch variation is an integral component of engaging speech. It allows listeners to distinguish questions from statements and focus their attention on key words, while simultaneously clarifying syllable meaning by marking stress patterns – e.g. a rising intonation can indicate excitement while flat intonations may indicate boredom or uncertainty; and can express emotions without using explicit emotion words, for instance by suggesting enthusiasm while lower intonations convey seriousness.

Pitch variation can be challenging without consistent practice and an understanding of how your voice works, so it is crucial that patients develop pitch awareness through exercises designed to encourage fluctuation while working on consonant and vowel sounds. One method is by cupping hands around mouth to amplify vibrations of voice – helping patients control pitch without straining or losing breath.

Listening and studying native speakers’ voices is another helpful way of developing pitch awareness, and an excellent way to do this is by paying close attention to how they use pitch variation to express emotion and tone, as well as identify areas in your own pitch variation that could use improvement. When practicing pitch variation it is also important to keep context of conversations in mind; adjusting pitch when speaking in formal settings versus informal ones or due to cultural differences (i.e. rising intonations might signal respect while it can signal uncertainty elsewhere).

Start exploring your voice’s potential by making simple nonsense sounds such as “da” at your baseline pitch. Next, gradually increase the pitch one or two steps above it before returning back down again several times; doing this repeatedly will familiarize yourself with its range.

As you become more adept with resonant voice therapy, begin integrating it into everyday conversations by asking simple questions such as, “What did you have for breakfast?” or, “How is your day going?”. This will enable your patients to practice using their newly acquired resonant voices within social contexts and gain real experience speaking in that voice.

Somatic Awareness

Somatic awareness practices like yoga or breathwork provide an excellent way to connect to the physical sensations of your body, which allows you to tune into internal cues which indicate when your voice feels tight or strain. Somatic awareness also can help with learning to release tension in neck and shoulders – an integral component of maintaining a healthy voice.

Resonant voice therapy is an evidence-based practice with proven effectiveness, as evidenced by its scientific review in 2017. A 2017 systematic review demonstrated how it significantly improves vocal quality, voice fatigue and endurance for those living with dysphonia (voice disorder).

Your speech-language pathologist will begin an evaluation by assessing how responsive your voice is to various exercises. They’ll pay particular attention to its pitch and loudness responses and also assess your overall tone and quality of speaking voice.

Once your therapist has an in-depth knowledge of your voice, they’ll work with you to develop an experiential self-management treatment plan tailored specifically to meet your individual needs. They’ll walk you through the RTSS voice treatment protocol while showing how it fits into your everyday life both at home and work.

As your first step, you’ll begin practicing resonant humming – an effective and effortless technique for engaging your entire vocal system healthily. At first, simply quietly humming to feel vibrations in your throat and head will do. However, over time as you become more comfortable you can increase volume gradually as well as explore different pitches – this helps warm up vocal muscles quickly while improving coordination and increasing resonance.

As your voice practice evolves, you will progress from single words, phrases and sentences to complete conversations using your modified resonant voice in daily dialogue.

As you practice, patience and consistency are both key. Voice changes take time and it may take some time before any significant differences in your voice can be noticed. Try setting realistic expectations and celebrating small improvements like how your voice feels after a day’s use or how well it sounds in class.

Tongue Trills

Tongue trills are an effective vocal exercise which involves rapidly vibrating one’s tongue to produce sounds such as “dr” or “br.” Tongue trills should form part of any singer’s voice therapy routine because they help warm up vocal cords and loosen articulatory muscles while improving pitch accuracy, articulation, vocal flexibility, overall quality and tone.

To perform a tongue trill, place the tip of your tongue behind your upper teeth near the gum and rapidly move it back and forth without tension, repeating several times until you become comfortable with this exercise. As soon as it feels natural to you, slowly increase speed and intensity as desired – tongue trills can be used alone or alongside other forms of vocal training such as scales or arpeggios.

Practising tongue trills can be of great assistance to singers of any age or range. This exercise helps develop balanced coordination between vocal folds and breath support, making it easier to sing different styles without straining their voice. Furthermore, this practice reduces jaw and tongue tension and thus protects against straining their voice.

One of the primary challenges singers face is tongue tension, which can result in issues such as shaky notes, flat vocals, strain in their voice, cloudy diction and clouded notes. Tongue trills can help singers prevent and treat tongue tension by strengthening the articulatory muscles in both lips and tongues.

Tongue trills are simple yet effective vocal exercises that can easily be integrated into daily speech and singing, helping integrate resonant voice techniques into communication while improving clarity, efficiency, reducing strain and fatigue and saving vocal cords from strain-induced fatigue.

Resonance is one of the major components that determine how speech sounds; its influence depends heavily on the shape and size of one’s vocal tract.

Cul de sac resonance typically manifests itself as low volume and muffled voice quality, so a thorough evaluation with a speech therapist is key to identify its source.

Oral Resonance

Normal voices possess the perfect combination of oral and nasal sound energy to maximize articulation, speech intelligibility, comfort, and resonance disorders. If an imbalance arises, symptoms can manifest themselves through resonance disorders. They could stem from size/shape issues with mouth/nose/throat; structural issues which cause airflow problems; motor planning issues that interfere with production; or motor planning problems which change how sounds are produced.

Hypernasality, where oral sounds are produced through the nose, can be identified easily by asking clients to produce an utterance with no nasal consonants and then repeat it without closing their noses – and listen out for any volume reduction or intensity decrease in sound production in response.

Hyponasality is another type of resonance disorder, in which nasal consonants produce with reduced resonance or energy. This often results from blockages or obstructions within the nasopharynx or nasal cavity or neurological conditions affecting breathing.

Cul-de-sac resonance refers to a form of resonance disorder in which sound circulates around a nasal, oral or pharyngeal cavity before becoming “trapped” at its exit point. It’s often caused by an enlarged tonsil causing hypernasality on oral consonants as well as decreased nasal resonance on nasal consonants.

Cul-de-sac resonance is sometimes known as Velopharyngeal Closure Dysfunction (VPD), though this term refers to various disorders that interfere with the closure of the Velopharyngeal Valve during production of oral sounds. VPD affects children and adults who have craniofacial abnormalities like cleft lips or palates; its causes vary, though treatment typically includes speech therapy as well as surgery depending on its cause(s); in such cases an evaluation of mouth, nose and throat condition(s) will help identify conditions as well as devise the most suitable strategy(s); for instance if birth defect(s or injury is involved then surgical intervention might be recommended as it will ensure optimal results.

Nasal Resonance

Cul de sac resonance, also known as blocked resonance, occurs when sounds resonate within a nasal, oral or pharyngeal cavity but are blocked at their exit point, leaving your voice sounding muffled and low in volume – often mistaken for mumbling. Cul de sac resonance differs from hypernasality and hyponasality because it affects both oral and nasal sounds; to simulate it you pinch closed your nose while saying words or sounds to simulate this type of resonance; large tonsils or scar tissue on this wall may cause it whereas an intraoral evaluation should take place to establish whether its symptoms originate due to dysfunction of either structure/function of organ.

Hypernasality and cul-de-sac resonance may co-exist, as can any form of nasal obstruction such as velopharyngeal incompetence and any form of nasal septal deviation. Therefore, it is crucial that clients receive an extensive clinical evaluation along with review of their medical history.

Hypernasality and cul-de-sac often arises due to some form of velopharyngeal incompetence. This may have its origins in surgery involving the palate (cleft palate repair, submucous cleft palate or tonsil removal), or it could result from neurological conditions like stroke or tumor, leading to poor movement of palatal structures during speech production.

To assess for nasal or oral cul-de-sacs, listen carefully to the voice to detect whether its consonants produced with mouth open are similar to their nasal cognates (e.g. m/b, n/d and ng). An easy way to distinguish these two is to have client produce nasal and oral plosives for prolongation; if these sound similar to their counterparts then voice is hypernasal and vice versa.

One way of assessing whether a client is suffering from either nasal or oral obstruction is by listening to their voice while speaking without closing their nose; if their voice sounds similar to either nasal or oral variants then this would indicate they have both pharyngeal and nasal dysfunction issues.

Mixed Resonance

Cul-de-sac resonance occurs when sound forms in the pharyngeal cavity but is prevented from entering either nasal or oral cavities when producing speech, producing muffled and low volume vocal sounds; parents may describe it as their child mumbling. Cul-de-sac resonance may result from either hypernasality or hyponasality (or both), so understanding which kind of resonance exists is key in order to develop appropriate treatment methods.

Ideal, voice resonance should span across throat, nasal and mouth regions during speech production. To do this, the velopharyngeal valve must close consistently and completely during speech – otherwise there will be resonance disorders that result.

Resonance disorders come in various forms and have various causes, from structural issues to neurogenic factors. They often manifest themselves with nasal or muffled sounding voice quality, articulation errors and changes in pitch, loudness or timbre.

If the velopharyngeal valve fails to close correctly, this can result in hypernasality or cul-de-sac resonance and cause difficulty producing certain sounds as well as compensatory articulation patterns and feeling of nasal pressure or obstruction resulting in changes to nose shape and size. This may make speech production challenging and could have serious repercussions for children involved.

A nasometer can be an invaluable aid for diagnosing this condition. The device measures how much vibration occurs in frontal, throat, pharyngeal and nasal regions when producing various passages and syllables by children while producing various passages and syllables from them; its results are then compared with those from a normal group to identify which resonance disorder exists.

If a child’s speech exhibits hypernasality or cul-de-sac, a comprehensive evaluation by a certified Speech Language Pathologist should be undertaken. A full evaluation would encompass perceptual evaluation and instrumental assessments such as nasometry or videofluoroscopy to identify the source of their difficulty and find effective treatments that could include voice therapy, surgery to address any anatomical abnormalities or lesions, prosthetic devices like palatal lifts or obturators or lifestyle modifications like refraining from loud speech and staying hydrated to manage symptoms associated with this condition.

Hyponasality

Hyponasality occurs when airflow through the nasal cavity is reduced, leading to decreased sound production from consonants like /m/, /n/ and /ng/. This often makes people sound congested or “stuffy” when speaking and may diminish clarity on these sounds. Possible reasons for hyponasality could include allergies, enlarged tonsils, deviated septum, chronic sinus issues and even colds; though rarely due to motor planning execution errors as in apraxia; more likely due to blockages somewhere within this structure or somewhere within this system.

To determine whether your child has a nasal problem, place a straw in their nose and have them produce syllables that start or extend to nasal consonants. If speech cannot be heard through the straw it is an indicator of obstruction which may point towards hyponasality. Furthermore it would be wise to check both nostrils, since obstruction could occur on only one side at any given time.

Treatment for oral and pharyngeal resonance disorders is similar to treating other muscular conditions; exercises cannot be used as this disorder is structural, not muscular in origin and must be addressed surgically or through other forms of medical treatments.

Speech therapy may help your child learn to breathe and speak through their nose to enhance the quality of their voice, often using a nebulizer to clear nasal passages before speaking. To ensure proper results, work closely with an ENT professional in order to rule out other sources such as sinusitis or deviated septum as potential causes.

SLPs must understand these problems so they can effectively identify treatment options, including nasal or nasopharyngeal resonance disorders, to best manage them. It’s essential to remember that they differ from apraxia which may be treated through muscle strengthening exercises; in these instances other techniques must be utilized instead.