How does the Voice Work?

Voice1

The larynx or voice box as it is known is the primary organ responsible for voice production.When we speak, air from our lungs travels up through the trachea (wind-pipe) and into the larynx (voice-box) which houses our vocal cords. Our vocal cords, which are two delicate muscles, then vibrate to create sound which is then shaped into different sounds in the mouth. Voice disorders may develop if interference with this normal vocal mechanism occurs.

Video of the Voice

Click on the play symbol on the left below the picture to see a video of vocal cords working.

These cords have tiny vocal nodules.

What is a Voice Disorder?

A voice disorder occurs when the sound that the voice box produces has an abnormal pitch, volume, or quality. Symptoms may include hoarseness, harsh or rough voice, breathy voice or a decrease in pitch range. THese symptoms may be associated with changes in the vocal cords such as a “singer’s” nodule. Symptoms may also include deterioration of the voice as the day progresses, increased strain in speaking, or tension in the neck muscles.

People usually attend their Doctor because of persistent hoarseness and are then referred to an Ear Nose and Throat Surgeon. The ENT surgeon then looks at their throat to see what is causing the problem. Initially, ENT (ear, nose and throat) examination is required to establish whether there are changes in the structure of the vocal cords. A referral is then usually made to the Speech and Language Therapist for further assessment and treatment of the voice disorder.

ARC Speech and Language Clinic assesses and treats a broad range of conditions affecting the voice box including:

    • Chronic Hoarseness
    • Vocal Nodules
    • Vocal Fold Paralysis
    • Spasmodic Dysphonia
    • Vocal Polyps
    • Singer’s Voice Problems
    • Vocal Fold Cysts
    • Bowed Vocal Folds
    • Voice Misuse

Voice Assessment

Voice assessment takes approximately one hour. During assessment the Therapist goes through the individual’s history, looking at different lifestyle/ occupational/health /factors that might affect the voice. A detailed assessment of the different areas of voice is conducted including respiration/breathing, vocal quality, pitch and volume of voice and resonance or tone of voice. Once assessment has been completed, targets to work on in therapy such as vocal tone or breathing technique can be identified. Following assessment a detailed report is compiled for the referring surgeon and copied to the client.

Voice Therapy

Once the factors contributing to the voice disorder are identified, the client, together with the Therapist, decides how to proceed and whether therapy is indicated .Voice Therapy involves eliminating the behaviours contributing to the voice disorder as appropriate. This may include, identifying and eliminating damaging vocal habits, relaxation techniques to eliminate tension, optimising breathing to support the voice as well as specific vocal exercises to strengthen or modify vocal use.

Some Vocal Advice

Ways to keep your voice healthy include:

  • Drink plenty of water/ non-caffeinated fluids. – 8 glasses per day.
  • Stop smoking – smoking damages the delicate tissue of the vocal cords.
  • Avoid screaming /shouting and consistent loud talking.
  • Avoid consistent throat clearing. The vocal cords come together abruptly when you clear your throat and repetitive throat clearing is damaging to the vocal cords
  • Don’t whisper or speak at a higher or lower pitch than is natural.
  • Make sure to get voice training if you are engaged in singing.
  • Relax your head and neck area.
  • If you have indigestion, have it treated since heartburn/reflux can damage your voice.

TOP TEN TIPS FOR THE TEACHER”S VOICE. 

           HYDRATION HYDRATION HYDRATION!!!

  • Drink at least two litres of water per day. Have water on your desk and drink frequently as you teach
  • DON’T TALK OVER NOISE. The students can ALWAYS go louder than you. Try having a system that the children are familiar with to get silence e.g. when you raise your hand, they need to raise their hands and stay silent. With younger children you could have something like a picture of a cartoon character that you hold up to get silence. ONLY TALK AS LOUDLY AS YOU NEED TO. You can get in the habit of talking louder than you need to. Only go as loud as you need to for the children to hear you.
  • WARM UP YOUR VOICE. It is helpful to warm up your voice before teaching. You can try.
  • Yawning gently to stretch the voice – you can also do this between classes/when you get a break.
  • Humming from low to high on an mmm sound
  • BUILD IN VOICE BREAKS. Try to vary classroom activities so that your voice gets a break for approximately 5 minutes an hour.
  • DON”T TEACH OVER A THROAT INFECTION. During times of infection, the membrane of the vocal cords is vulnerable. Talking loudly over it can cause permanent vocal fold damage. Take the time out to allow your voice to recover. You have a long career of teaching ahead.
  • GO ON, GIVE UP SMOKING. Smoking damages the mucosa of the vocal cords and can lead to cancers. There’s lots of help out there. Try the HSE’s website www.giveupsmoking.ie for lots of help.
  • USE A SUPPORTIVE BREATHING TECHNIQUE.  Try to breathe low down rather than just breathing from your upper chest. This provides more support for your voice and prevents you pushing your voice at vocal fold level.
  • USE GOOD POSTURE. Try to keep your back straight; when standing have hips aligned with feet. When getting down to child’s level, “hunker” down so that you can keep your back straight rather than stooping over.
  • GET TREATMENT FOR HEARTBURN (also known as oesophageal reflux). The acid that causes heartburn can leak onto your vocal cords and cause damage.
  • 10.  MODERATION IN ALL THINGS..
  •            The following habits can be damaging to your voice, so be

moderate in their use.

  • Alcohol – very dehydrating- try to intersperse it with soft drinks. Drink lots of water before you go to bed if you’ve had a lot of alcohol on a night out.
  • Very hot drinks- cool with milk/water
  • Hot/spicy foods eaten very regularly
  • THROAT CLEARING. For some people, throat clearing is a habit. When you throat clear, your vocal cords come together forcefully and can cause damage. Try taking a drink instead.