Resonance Voice Therapy (RVT) uses adaptive strategies that promote vocal resonance while decreasing strain during phonation, making communication simpler, more confident, and clearer for you.
RVT provides voice disordered patients with training to produce a strong and resonant voice that minimizes intensity of voicing and impact on the larynx. It supports an abducted/adducted laryngeal configuration for optimal vocal fold health.
What is Resonance Voice Therapy?
Resonance voice therapy is an approach for optimizing vocal quality, improving breath support and relieving strain on vocal folds. By teaching individuals the basics of voice production and treating common vocal disorders with personalized therapies, speech-language pathologists enable people to unleash their resonant voices.
Human voices are complex instruments with numerous moving parts, which is why many individuals find it challenging to maintain healthy vocal sounds. While there may be various causes for hoarse or tired voices (pneumonia or vocal cord nodules are two possible culprits), resonance voice therapy provides relief by restoring balance between oral and nasal resonance for each intended speech sound.
Voice therapists employ various techniques to optimize vocal function, such as breathing exercises, resonant humming, and easy onset phonation (EOP). EOP helps warm vocal muscles by creating vibrations within vocal folds and upper throat. Furthermore, it improves coordination between voice production and body posture promoting proper positioning and alignment during each sound produced by producing EOP sounds.
Under Resonant Voice Therapy, EOP involves keeping mouth and throat partially closed to simulate an open glottal stop (a consonant produced by closing or opening of the glottis), producing fuller sounds with more even articulation while minimizing vocal strain. A speech-language pathologist (SLP) will give feedback regarding each sound to ensure that appropriate tone levels are attained during EOP sessions.
Resonant voice therapy also employs first formants (the elements responsible for creating each sound). By manipulating these elements, speech-language pathologists can maximize radiated voice spectra of speakers in noisy environments or with background noises and increase perceived loudness of their message.
Resonant voice therapy has proven its efficacy in treating various voice disorders, such as nodules, polyps, and dysphonia. In particular, this therapy can help address persistent hoarseness by relieving vocal fold irritation while improving closure of vocal folds – leading to improved airflow and stabilizing voice performance.
Resonance Voice Therapy Techniques
Resonance voice therapy techniques are designed to maximize vocal production while alleviating strain on vocal folds, providing increased stamina and ease for optimal vocal production – and helping you communicate clearly in all aspects of life.
Resonant voice therapy begins by teaching yourself how to utilize your body as a sound chamber. This step allows you to recognize and utilize the resonant spaces within your head, neck, chest and throat area in order to enhance vocal quality – ultimately leading to the creation of a resonant, clear and powerful voice that accurately expresses who you truly are.
Utilizing resonance voice therapy exercises and modalities, you can address specific problems related to breathing issues, pitch instability and other vocal concerns. Resonance voice therapy also teaches ways to optimize vocal posture, articulation and placement for improved production and performance of the voice.
One of the easiest and quickest ways to detect vocal resonators is through simple humming exercises or lip trills, in which you may feel buzzing or tickling sensations around the front of your mouth and face, such as anterior alveolar ridge, lips, teeth and facial bones (Stemple, 2005). This practice promotes easy phonation which is essential to building your voice holistically with efficient power and flexibility.
Other resonant voice therapy techniques include rhythmic vocalizations with semi-occluded consonants to train the voice to produce optimal sounds with minimum effort and impact on vocal cords. Lessac-Madsen Resonant Voice Therapy (LMRVT) is another approach, designed to train patients how to produce fricatives (/m/, /n/ and /ng/) without exerting too much force (Kotby & Fex, 1998).
These and other methods help enhance the sensitivity of your vocal cords by teaching them to vibrate freely without strain or tension, which can decrease symptoms such as hoarseness and fatigue while treating conditions like vocal cord nodules and polyps. Furthermore, these techniques can help build stronger voices for singing and other higher-pitched communication with ongoing guidance and motivation from experts – which ultimately will enable you to create one that truly expresses who you are as an individual.
Resonance Voice Therapy Exercises
Resonance Voice Therapy (RVT) is a series of exercises intended to optimize vocal resonance, quality and function. Speech-language pathologists provide individuals with breath control, voice warm-ups, and relaxation techniques designed to enable them to use their bodies’ natural resonating cavities – the series of chambers in their mouth, nose, throat and vocal cords – in perfect harmony for powerful yet effortless singing and speaking performances. Singers benefit from increased range, power and endurance as their strain and risk of injury decreases. Speakers benefit from improved clarity and projection that increases audience engagement for more impactful presentations; everyday individuals overcome hoarseness to communicate confidently and easily across various communication settings.
Joseph Stemple introduced the Resonant Voice Therapy Technique. This approach to oral vibratory sensations that are felt throughout the front body – including alveolar ridge, lips, teeth, facial bones and nose. The emphasis here is forward focus and easy phonation so articulation and voice production feel minimally effortful and tension free; individuals start practicing these sounds on word, phrase and sentence levels before progressing to conversational speech.
As part of their resonant voice therapy process, individuals also engage in negative practice – switching back and forth between their “old” voice and a newly acquired one, with an eye toward making it the “old” one (Iwarsson 2015). This practice helps individuals develop an internal sense of control and empowerment regarding their voice quality while improving their ability to distinguish resonant voices from non-resonant, straining or weak ones.
SLPs teach resonant voice therapy techniques during guided therapy sessions and assist individuals in learning how to incorporate these strategies into daily life. SLPs closely track progress along an individual’s therapy journey, providing advice as necessary on adjusting exercise routines as required.
Resonance voice therapy exercises involve performing various techniques like the straw phonation technique: individuals use this exercise to generate backpressure that regulates airflow and encourages balanced vocal cord vibrations. Other exercises include semi-occluded vocal tract exercises involving narrowing one part of the vocal tract to increase acoustic pressures there as well as humming and easy onset phonation exercises to promote forward focus and easy phonation.
Resonance Voice Therapy for Children
Children suffering from resonance disorders can reap similar rewards as adults from voice therapy techniques, including behavioral approaches that aim to enhance vocal technique. Studies on behavioral voice therapy show promising improvements in perceptual and acoustic ratings of voice quality, speech intelligibility, vocal stamina resolution of benign lesions and improved quality of life following treatment for vocal nodules or muscle tension dysphonia.
Children may present special difficulties when it comes to voice therapy, due to factors like their age and vocal maturity. Children may also have enlarged tonsils or adenoids which interfere with sound production in the oral resonance chambers – these may contribute to an unbalanced resonance that produces either an over-nasalized voice (hypernasal) or under-nasalized one (hyponasal). Resonant voice therapy can help address such concerns for more balanced, healthy sound production.
Pediatric voice therapy typically employs strategies designed to achieve easy phonation through a barely abducted/barely adducted glottal configuration with high amplitude vibration and low impact stress (Verdolini, 1998). This approach is known as resonance voice therapy and involves producing voiceless and rhythmic consonants such as fricatives as well as nasals /m/, /n/, and /ng/. Humming or other easy-onset phonation exercises may be included within this therapy approach.
Studies assessing resonance voice therapy‘s effectiveness in treating children with resonant disorders have included a randomized controlled trial of Katherine Verdolini Abbott’s Adventures in Voice (AIV) program, designed by Katherine Verdolini Abbott. AIV integrates various approaches to resonance voice therapy using child-friendly language and motor learning principles, home practice strategies and carryover practices; its comparison study with vocal hygiene education alone revealed both groups showed improvements in terms of acoustic, perceptual and quality-of-life ratings ratings of their voice usage.
Fujiki and Thibeault 2021 found that AIV was associated with better patient-reported voice outcomes than vocal hygiene evaluations (Fujiki & Thibeault). Unfortunately, however, no information regarding how many sessions are necessary before discharge was available in this study or other randomized clinical trials of pediatric voice therapy.
