Resonant Voice Therapy empowers individuals to transform their everyday communication. SLPs use optimizing vocal resonance and alleviating strain on vocal folds to help individuals attain stronger and clearer voices.
Resonant Voice Therapy (RVT) is a technique which employs humming and easy onset phonation exercises to increase both the amplitude and clarity of vocal performance. Individuals also utilize semi-occluded vowels and consonants in training their resonant voices.
Techniques
Resonant voice therapy provides relief by decreasing strain and improving closure of vocal folds during voice production, leading to soundwave production. If these vocal folds become irritated or overworked, this may lead to hoarseness; Resonant Voice therapy helps alleviate this symptom by decreasing strain on them and improving closure.
Resonant Voice Therapy (RVT) is founded on the notion that the articulators, vocal folds and resonating cavities should all function smoothly during easy phonation to produce a strong and clear voice with balanced resonance and articulation. Trained speech-language pathologists (SLPs) using RVT employ various techniques such as humming, voiceless sounds, vocal shape alteration techniques and gentle onset techniques in order to reach this goal.
RVT techniques are developed using evidence-based studies. These analyses have examined how various techniques influence various aspects of voice quality, such as reduced strain, breathiness and roughness; improved clarity; reduced roughness; overall dysphonia reduction. In addition, auditory-perceptual constructs such as voice stress or breathiness might differ based on which treatment methods are chosen.
RVT therapy was found to significantly improve overall voice quality for people suffering from voice disorders, most often through decreases in breathiness and roughness while not changing pitch, intensity, or volume levels. A 2017 systematic review confirmed this finding.
Resonant voice therapy entails teaching individuals to feel their voice vibrations in front of the face (including nose, teeth, lips and facial bones). Furthermore, RVT includes exercises designed to facilitate easy phonation; patients learn how to produce sounds with minimal effort by copying what their therapist models and then they apply this knowledge on word, phrase and sentence levels.
Other techniques utilized by Resonant Voice Therapy include vocal fold adduction to increase loudness intensity and resonance frequency of voice production. These methods should be employed alongside gentle onset techniques in order to ensure smooth beginning phonation that reduces strain on vocal cords. Finally, Resonant Voice Therapy entails positive reinforcement to reinforce these healthy vocal practices through verbal/written information on negative behaviors as well as repeated exposure of its model voice model.
Goals
Resonant voice therapy targets the natural resonances of the vocal tract – the series of cavities such as mouth and throat which generate sound waves during phonation – through tapping into its natural vibrations to teach patients to use their voices healthily that optimizes production while decreasing strain on vocal folds. Resonant voice therapy can benefit professional singers looking for increased range, power and endurance with less issues of fatigue; or speakers aiming for more impactful presentations with less effort than ever. Resonant voice therapy also can assist everyday individuals overcome issues like hoarseness, voice fatigue or breathiness allowing clearer communications in all settings.
Resonant voice therapy techniques aim to enhance the quality of one’s voice through increasing vibratory sensations felt in the oral cavity – including alveolar ridge, lips or higher in the face (in the nose). RVT may be combined with other voice therapies like Lessac-Madsen or Verdolini Abbott in order to maximize effectiveness; specifically it uses oral sensations with easy phonation techniques ranging from basic speech gestures through sentence level conversational speech in order to develop strong, smooth, clear voices while minimizing forceful impacts between vocal cords so as to minimize risks or polyps.
Resonant voice therapy incorporates biofeedback principles as a core element, using real-time feedback to assist individuals in controlling physiologic functions of their bodies, such as breathing and body positioning. Feedback may come in the form of visual, auditory or tactile stimuli to allow individuals to make adjustments in voice production when necessary.
Resonant voice therapy incorporates breathing exercises designed to strengthen the diaphragm and increase airflow, thus relieving strain from vocal folds and increasing resonance. Semi-occluded phonation exercises such as lip trills or straw phonation allow more controlled closure of vocal folds without oversqueezing them; other resonant voice therapy techniques include flow phonation which utilizes gentle humming in order to promote more balanced articulation and coordination between the vocal folds and flow massage which relieves tension from neck and shoulder muscles.
Assessment
Resonant Voice Therapy involves speech therapists conducting thorough assessments to assess an individual’s vocal quality and resonance, then using these results to create customized treatment plans tailored specifically to them. These treatments aim to give clients healthy, functional voices.
Resonant voice therapy goes beyond traditional speech therapy exercises by applying biofeedback principles to increase self-control over physiologic functions, such as breathing and voice production. Biofeedback may take the form of tactile, auditory or visual stimuli in order to raise awareness of physical sensations related to vocal pitch, loudness and quality as well as vocal effort – thus helping individuals produce desired voice qualities with minimal phonatory effort and thus minimize risks of strain or injury to their voices.
Forward Focused Vocal Technique (FFVT), or Resonant Voice Training, is an evidence-based vocal training approach characterized by targeted vibratory sensation training of the glottal area to enhance vocal quality. Studies have revealed significant reductions in severity of voice disorders and associated symptoms when implemented through this practice.
Resonant voice therapy does not address the underlying causes of voice disorders or serve as a replacement for surgery; in severe cases it may require surgical restoration; however, in many instances less serious conditions respond well to resonant voice therapy – both subjectively and objectively improving measures of vocal quality.
Since 2000, ASHA’s Special Interest Group 3 for Voice and Voice Disorders has been actively creating standard guidance for voice assessment. This effort is driven by the belief that consistent evaluation protocols can greatly facilitate clinical and research comparisons and ultimately promote more valid treatments for voice disorders. A recent multi-institutional study created instrumental assessment protocols for laryngeal endoscopic imaging, acoustic analysis and aerodynamic procedures; their recommendations are informed by existing evidence, expert consensus and VoiceServe feedback from SIG 3 members.
Evaluation
Resonant voice therapy aims to teach individuals how to recognize the sound produced by their voices, in order to ensure it produces the best and healthiest sounds possible. This can be accomplished through optimizing vocal resonance, decreasing strain on vocal folds and developing healthy habits; SLPs use various evaluation tools – Stimulability Assessment tool CAPE-V tool or listening/rating during sessions – in order to assess its quality.
At the initial resonant voice therapy evaluation, your speech-language pathologist will listen to and assess your voice for several minutes, asking any pertinent questions about specific aspects. They then guide you through a series of exercises focused on identifying and increasing sensations in front of the mouth/face as well as producing sounds with increased energy or buzzes in front of them, such as lip trills, humming, voiced/voiceless m/n productions, straw phonation techniques such as y-buzz etc.
The Resonant Voice Therapy program emphasizes oral vibratory sensations and easy phonation – which allows for effective voice use without straining larynx and vocal fold closure – through forward vibrations that intensify during normal, relaxed voice production. Resonance voice can easily be identified by forward vibratory sensations in front of mouth/face that amp up during voice production.
Joseph Stemple developed the Accent Method as a resonant voice therapy technique to treat various functional voice disorders, such as nodules. This voicing method uses various acoustic and perceptual evaluation measures to assess how voice improvements have occurred during treatment and post treatment.
The Accent Method was found to be an effective voice therapy technique. Acoustic analysis revealed significant improvement in various areas, including pitch perturbation quotient and amplitude perturbation quotient (measures of voice intensity). Perceptual assessment techniques also indicated that their voice had become easier for listeners. Unfortunately, without a control group included in this study’s overall validity it’s impossible to ascertain whether improvements may have come about from factors unrelated to speech-language pathologists’ manual techniques used.
