Physiologic<unk>  Accent Method There are many different physiologic<unk>  approaches that can be used in treatment. An example of a holistic approach used in<unk>  is the Smith Accent Method, introduced as a method to improve both speech and voice production. This technique can be used to treat stuttering, breathing, dysprosody, dysphonia, and to increase control of breathing, phrasing, and rhythm. The main targets of accent methods are: * To increase the pulmonary output * To reduce tension in muscles * To reduce glottis waste * To stabilize the vibratory pattern of the vocal folds while speaking. The accent method is implemented two to three times a week, in 20 minute sessions. The procedure is two-part: diaphragmatic breathing and rhythmic vowel play. During diaphragmatic breathing, the patient is trained to elicit and monitor abdominal breathing and muscle relaxation. Rhythms are then introduced in two beats, with an accent on the second sound. The accented rhythm is then generalized to longer phonation at three speeds (largo, andante, and allegro), while maintaining proper breathing techniques. The rhythms are then generalized to real speech, through the use of repetition, reading passages, conversations, and monologues. Symptomatic<unk>  Chant-Talk There is a wide variety of treatments that fall under symptomatic<unk> . An example of a symptomatic voice treatment method is the chant-talk approach. The chant-talk approach uses pre-existing characteristics found in chanting-styled music, such as rhythm and prosodic patterns. The<unk>  is used to reduce phonatory effort, which causes vocal fatigue. Chant<unk>  is used to minimize hyperfunctionality by affecting loudness and voice quality. The technique employs the continuous tone quality found in music chanting. More specifically, it elevates the pitch of the voice during phonation, prolongs the vowels, de-stresses syllables, and lessens word-initial glottal attacks. The goals of the chant-talk approach are to use voice quality and pitch techniques to decrease the effort used while talking. The technique is first demonstrated through the use of recordings, with the patient subsequently asked to imitate the specified voicing patterns. Once the chant has been mastered, the patient is asked to read aloud in chant and in normal register in 20 second alternation. Patients are asked to reduce chanting to a minimal, while maintaining vowel prolongations and softened glottal word onsets. Sessions are recorded in order to provide auditory feedback. Resonant<unk>  Resonant voice is a technique often taught to actors and singers to improve voice production. Resonant<unk>  teaches clients to use resonant voice in order to reduce vocal fold trauma. Resonant voice is produced with minimally adducted (closed) vocal folds. This technique reduces the force of the vocal folds vibrating against each other, which reduces trauma and allows healing. A variety of different programs, including Lessac-Masden Resonant<unk>  (LMRVT), Humming, and Y-Buzz, have been studied and used to help teach resonant voice. Each program uses slightly different strategies to teach resonant voice. However, they all have similar hierarchical structures and share the goal of producing a strong, clear voice with minimal effort. In the aforementioned programs, the client begins by trying to produce resonance during nasal consonants and vowels, then progresses to using this technique in words, sentences, and conversations. During<unk> , clinicians often help patients conceptualize resonant voice by discussing where the patient "feels" their voice. Patients with dysphonia often describe their voices as vibrating in the throat. Resonant voice is described as vibrating higher and further forward, and being felt at the alveolar ridge and in the maxillary bones. Range Expansion and Stabilization Techniques (REST) and Exercises Range Expansion and Stabilization Techniques (REST) and exercises target symptoms such as reduced pitch range, reduced loudness, and voice instability which are often related to a variety of different voice disorders. There are three main exercises that work to target these symptoms. The first is called a “stretching” exercise and targets pitch range. The client is asked to find their comfortable pitch, and then slowly go up 1/3 of an octave using a gliding technique, and then gently go back to their comfortable pitch on one inhale. This procedure is followed by an exhale and rest for 1–2 seconds, then should be repeated 2-3 times. As the client improves, octave levels can be increased. The second is called a “resistance” exercise and focuses on loudness. The client is asked to use their comfortable pitch and go from a soft to loud voice for 3–4 seconds, followed by an exhale. It is important to train the client to do this without straining their voice. The third is called an “endurance” exercise, the client is instructed to hold a note as long as they can by controlling their exhale (this should be done with 3-4 comfortable pitches). Vocal pedagogy Vocal pedagogy for singing, particularly opera * Dialect training for actors who need to speak with a particular dialect or accent While many transgender women wish to sing like cisgender women, it will require a lot of training for one to achieve a feminine-sounding voice. This is why most prepubescent males who begin hormone replacement<unk>  have a higher chance of retaining this quality. See castrato for more information. * Debate * Public speaking<unk>  in transgender individuals : Non-surgical techniques undertaken by trans women and trans men as a part of gender transition to make the perceived gender of their voices match their gender. Voice feminization is the desired outcome of surgical techniques, speech<unk> , self-help programs and a general litany of other techniques to acquire a female-sounding voice from a perceived male-sounding voice. Voice masculinization is the use of the same procedures and techniques to acquire a male-sounding voice. Voice management after laryngectomy # Some laryngectomized patients may succeed in achieving communication through the use of esophageal speech, in which air is swallowed, then gradually released while producing speech. # Others may make use of an electrolarynx (external vibrating device), which produces vibrations in the patient's oral cavity that they can no longer produce themselves without air passing through their vocal folds. # The current medical standard after a laryngectomy is a tracheoesophageal puncture, which includes the insertion of a voice prosthesis. Voice prosthesis<unk>  with prostheses A voice prosthesis is an artificial device, usually made of silicone, that is used to help laryngectomized patients speak. A tube is inserted into the neck, below the vocal folds, allowing air to go through the tube instead of through the mouth and nose. Following a total laryngectomy, air will no longer pass through the vocal folds, significantly altering the person's ability to communicate orally. In some instances, the person may be able to block the tube with their fingers and breathe as they did before the surgery or attach a valve to their tube, which serves to allow air to enter while preventing food from passing into the windpipe. In others, this is not a viable option due to resistance, infection, and insufficient air.<unk>  may then be turned to as a means for a person to regain the ability to communicate orally. Voice prostheses and ventilators may affect the volume of the speaker and the overall quality of the speaker's voice. With the help of<unk>  as well as possible adjustments to ventilator settings, the goal is to become accustomed to using the device functionally and to learn the techniques and skills needed to participate in daily communication. Other types of speech and language<unk>  after laryngectomy: Communication strategies If the person is using a ventilator with their tube, there are long pauses between cycles of the ventilator. During these moments of silence, someone else may begin to speak, thus taking away the turn of the person with a ventilator. The person who has undergone a laryngectomy can use tools and techniques, such as those provided by a Speech-Language Pathologist (SLP) to self-advocate during conversations, in order to ensure that they are given the space that they need to participate in conversation. An SLP can also provide information to the person and to the people who interact with them frequently on communication strategies that would benefit them.
Voice therapy
Voice prosthesis
Audio therapy
Palatal lift prosthesis
Goeckerman therapy
Craniofacial prosthesis
Online speech therapy
Dance therapy