OHSU Northwest Clinic for Pediatric Voice-Treatment
Comprehensive treatment of a voice disorder may involve medical treatment, surgical treatment, voice therapy, or a combination of these methods. Voice therapy is frequently recommended as a primary method of treatment or to do along with medical or surgical treatment to promote healing and prevent further vocal injury by training the patient to use the best possible vocal technique.
primary goal of voice therapy is to achieve the best possible voice with the
least amount of voicing effort. This will hopefully reduce or eliminate
the voicing difficulties. Voice therapy sessions include: education about
how the voice works, exercises to strengthen and make the most of the voice,
training and practice of the best possible vocal technique, and learning how to
best manage and care for the voice. The best vocal quality is achieved
through a balance of good breath support, phonation (sound created by the vocal
folds), and resonance (how the sound travels through the mouth and nose
cavities). Exercises and treatment tasks will cover each of these
areas. Voice therapy teaches the child to use their voice in a
manner that decreases the force between the vocal folds and to identify the
vocal quality and sensations related to efficient voice use. The principles of
voice therapy are introduced and taught in a manner that is individualized for
each child's age, development and voice disorder. Voice therapy may be
completed with the Speech-Language Pathologists at the Voice Center, through
their school, or with a combination of both. We often work closely with
school-based Speech-Language Pathologists for optimal care.
Treatment for Vocal Cord Dysfunction (VCD):
Vocal Cord Dysfunction (VCD), also known as paradoxical vocal fold motion, is a condition in which the vocal cords move paradoxically during breathing, which means that the vocal cords tend to close when it should open causing noisy breathing and shortness of breath. During a first VCD attack, symptoms can feel severe and frightening. Often the symptoms will resolve quite quickly and the breathing will return to a more normal pattern as soon as the individual is sitting and relaxing.
In order to control and hopefully prevent further VCD attacks from happening, speech therapy from a speech pathologist with a specialization in this area is recommended. Treatment consists of teaching strategies to help maintain open and relaxed breathing throughout the day, strategies to prevent breathing symptoms during exercise or other triggers, and rescue strategies to help get out of an attack. These breathing strategies often help to lessen the panic that usually happens with the shortness of breath of VCD. The speech therapist can also help the individual to recognize the causes for the attacks and to use breathing strategies around those causes, so attacks don't happen. Relaxation techniques may also be used. Treatment is typically quite successful and the problem either goes away completely or is very controllable. Therapy typically takes 3 to 5 sessions to get the symptoms completely under control. For treatment to be successful, however, the individual with VCD must be motivated to use and practice the strategies they have learned outside the therapy session.