Introduction
Dr. Katherine Verdolini Abbotts Lessac-Madsen Resonant Voice Therapy (LMRVT) is a perceptual and behavioral approach to vocal therapy based on research into resonant vocal production and motor learning, named in honor of two mentors – Arthur Lessac and Mark Madsen.
LMRVT stands apart from other therapies by emphasizing its components rather than simply listing rules to follow. Each clinician creates an individual hygiene program tailored specifically for each patient with emphasis placed on hygiene points relevant to their voice problem and hygiene issues. Furthermore, LMRVT incorporates resonant voice practice into daily lifestyle, which research has indicated promotes long-term learning.
LMRVT emphasizes a posture for laryngeal fold posturing which has been demonstrated in multiple studies to produce the greatest phonatory intensity with minimum vocal damage (Verdolini & Titze, in preparation). The goal of this biomechanical training is to achieve functional goals of clear, strong voice with minimal effort while mitigating effects of phonotrauma such as laryngeal nodules or polyps.
To achieve this, a clinician guides a patient through full body introspection and observation to identify their best representation of resonant voice quality, using perceptual methods like scan-gel-show-tell and sensory feedback, to guide the patient towards this resonant quality. When these perceptual methods fail, mechanical instructions may be introduced when necessary based on research showing that excessive focus on mechanics of new skills impair both immediate and long-term performance (Verdolini 2004) including increasing vocal fatigue while slowing motor learning rates (Verdolini 2004). This practice increases vocal fatigue while slows motor learning rates as research shows (Verdolini 2004).
Techniques
Resonant Voice Therapy employs forward focus and easy phonation techniques to help patients manage the symptoms of muscle tension dysphonia and vocal fold nodules. If vibrations are felt anteriorly in front of their face (including anterior alveolar ridge, nose, teeth and lips) along with easy vocalisation/articulation then they have produced a resonant voice quality.
Resonant voice therapy entails guiding articulation towards barely abducted (or slightly adducted) laryngeal postures to maximize voicing intensity and decrease impact stress on vocal folds. We will teach our patients to refocus their voice from neck muscles into forehead and nose areas for increased energy and reduced vocal fold tension, starting from simple words or phonations before progressing onto phrases and conversations.
Katherine Verdolini Abbott is an internationally-recognized speech-language pathologist, researcher, and trainer in Lessac-Madsen Resonant Voice Therapy (LMRVT). She holds memberships in both the American Speech-Language-Hearing Association and National Association of Teachers of Singing; additionally she holds fellowship of Voice and Speech Trainers Association; she has conducted basic science as well as applied research while training clinicians all around the world in LMRVT method.
