Direct voice therapy This condition is most often treated using voice therapy (vocal exercises) by speech-language pathologists (SLPs) or speech therapists who have experience in treating voice disorders. The duration of treatment is commonly one to two weeks. Techniques used include: * Vocal exercises: Any vocal exercise to be always done under the supervision of Speech Language Pathologist (SLPs) expert in treating voice disorders. Wrong way of doing vocal exercise or wrong vocal exercise may damage voice or vocal cords some time permanently. Wrong vocal exercise is a kind of vocal abuse. Vocal abuse results into vocal nodule, muscle tension dysphonia, vocal polyp , hoarse and breathy voice. * Cough: The patient is asked to apply pressure on the Adam's apple and cough. This results in the shortening of the vocal folds which is the physiological mechanism that reduces pitch. The patient can thus practice voicing at a lower pitch. * Speech range masking: This procedure is based on the theory that when speaking in noisy backgrounds, people speak louder and more clearly in order to be heard. The patient practices speaking while a masking noise is playing. Then, the patient listens to a recording of his/her voice during the masking session and tries to match it without the masking. By doing this, the patient practices their 'loud and clear' voice. * Glottal attack before a vowel: A glottal attack is when the vocal folds are fully closed and then pushed open by the air pressure from breathing out or making a sound. In this technique, the patient breathes in and then makes a vowel as he/she breathes out. *Effortful closure techniques: this procedure is based on pushing, pulling, or isometric exercises to forcefully close the glottis, while the patient phonates, which effectually lowers the pitch due to the lowering of the larynx. The targeted sounds or words can then be shaped from the phonation produced during the exercises. In pushing exercises, the patient pushes against a structure (e.g., a wall) or object; in pulling exercises the patient pulls an object (e.g., a chair they are sitting on); in isometric exercises the patient holds a position (e.g., pushing hands together). Additionally, effortful closure techniques can be achieved through holding one’s breath or grunting. * Laryngeal musculature relaxation techniques: Laryngeal muscles surround the vocal folds and by relaxing them, there is reduced pressure on the vocal folds. This can be done by yawning and subsequently sighing, exaggerated chewing while speaking, and speaking or singing the 'm' sound. * Lowering of larynx to appropriate position: The larynx is lowered by the patient by putting pressure on the Adam's apple. By lowering the larynx, the vocal folds relax, and thus pitch is lowered. The patient does this while speaking to practice speaking with a lower pitch. * Humming while sliding down the scale: The patient starts humming at the highest pitch that they can reach and then keeps lowering the pitch while humming. This allows the patient to practice using a lower pitch and also to relax the laryngeal muscles. * Half swallow boom technique: The patient says 'boom' just after swallowing. This is repeated with the patient turning his/her head to either side and also while lowering the chin. After practice, the patient adds more words. This technique helps to close the vocal folds completely. Indirect voice therapy Indirect treatment options for<unk>  focus on creating an environment where direct treatment options will be more effective. Counselling, performed by the S-LP, a psychologist, or counsellor, can help patients identify the psychological factors that contribute to their disorder and give them tools to address those factors directly. Patients may also be educated about good vocal hygiene and how their behaviour could have long term effects on their voice. Audiovisual feedback In<unk> , the use of audiovisual feedback allows the patient to observe graphic and numerical representations of their voice and pitch. This allows the patient to determine an ideal pitch range based on normative data on age and gender, and incrementally work through speech tasks while working in that desired pitch range. As the patient improves, speech tasks progress to become more natural, involving tasks such as reciting automatic information, to reading, to spontaneous speech and conversation. Incorporating audiovisual feedback in speech and voice therapies has been successful in intervention by improving motivation and guidance. Surgery In some cases when traditional voice therapy is ineffective, surgical interventions are considered. This can occur in situations where intervention is delayed or the patient is in denial, causing the condition to become resistant to voice therapy. There are different types of surgical interventions which have been successful in lowering the vocal pitch in men with<unk>  who had previously received ineffective voice and psychotherapy. The first surgical intervention developed, called relaxation thyroplasty or tetrusion thyroplasty, involves a bilateral excision of 2 to 3 mm vertical strips of thyroid cartilage which lowers the vocal pitch through anteroposterior relaxation and shortening of the vocal folds. It can be performed under local or general anaesthesia. Relaxation thyroplasty by a medial approach is a modified approach of traditional relaxation thyroplasty. This version involves lowering the vocal pitch by creating an incision bilaterally in the thyroid lamina and then depressing the anterior segment of the thyroid cartilage. A more recent, less invasive intervention is the window relaxation thyroplasty. This approach involves creating a window at the anterior commissure, which is then displaced posteriorly.
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Tourettism
Autism
Dysgraphia
Klismaphilia
Latrodectism
Hypomimia
Machiavellianism