Academic journal article Journal of Singing

Integration of Singing into Voice Therapy

Academic journal article Journal of Singing

Integration of Singing into Voice Therapy

Article excerpt

IN 2005 AN AD HOC JOINT COMMITTEE consisting of the American Speech Language Hearing Association, the National Association of Teachers of Singing, and the Voice and Speech Trainers Association issued a technical report which stated, "The fundamental mechanism for healthy phonation is essentially the same for both singing and speaking," and "the most effective path to vocal recovery often will include an integrated approach to optimal voice care and production that addresses both speech and singing tasks. ASHA, NATS, and VASTA, therefore, collectively affirm the importance of interdisciplinary management of speakers and singers."1


The author has observed that typical contributing factors to pathologic occurrence in singers include:

* Excessive predominance of high-pitched chest register phonation.

* Consistent mismatch of tessitura, Fach, or voice part with innate physiologic capacity.

* Sustained excessive loudness or voce piena, and lack of awareness to "mark" or rest when vocally fatigued.

* Ignoring early warning signals of vocal injury:

1) loss of phonatory ease thereby incurring compensatory strain;

2) delayed or disrupted tonal onset;

3) diminished breath control;

4) loss of intensity, or inability to vary intensity;

5) curtailment of pitch range or loss of register, or atypical change in voice category;

6) loss of smooth passaggio transition;

7) persistently undesirable quality such as voice breaks, burring, or diplophonia;

8) atypical delay of vocal recovery after performance, or excessive warm-up times.

* Lack of vocal warm-up before rehearsals or performances.

* Insufficient amplification or feedback monitoring in enhanced acoustic environments.

* Poor vocal hygiene via factors such as smoking, excessive alcohol intake, excessive social voice usage, physical deconditioning, poor hydration, and unattended reflux or allergy control.

Increased awareness and correction of these pathologic triggers is a basic component of voice rehabilitation. Voice therapy also typically utilizes regulatory programs such as Vocal Function Exercises (Stemple), Resonant Voice Therapy variants (Verdolini-Madsen), or Hybrid Voice therapy (Spencer).2 This article posits that singing-based exercise is of additional rehabilitative value. Its range of repair includes behavioral voice dysfunction (muscle tension dysphonia), neuropathy, atrophy, lesion resolution, and phonosurgical recovery.3

In the sense that singing heightens speech, singing also heightens voice therapy. Rationale for the inclusion of singing into voice therapy may touch upon numerous bases:

* Optimized alignment of respiration, phonation, and resonance via tonal sustain.

* Accurate targeting of pitch zones of therapeutic interest, including register exploration and passaggio development.

* Conditioning of extrinsic and intrinsic laryngeal musculature.

* Systematic sustain of vocal fold oscillation may decrease stiffness associated with scarring and fibrosis, and may encourage optimal phenotypic expression of new vocal fold tissue.4 (This new hypothesis provides significant support for therapy after phonosurgery, and therapeutic dissolution of fibrous lesions such as singer's nodules.)

* Musical notation provides objective documentation of changing vocal capacity across treatment; a desirable feature within a contemporary professional climate of "evidence-based practice."

* Exercise variations are limitless in number, fun, and can be tailored to changing phases of recovery.


Speech pathology is a recent profession. The earliest related twentieth century writings primarily concern identification and treatment of stuttering and lisping-and Freud figured prominently.5 In 1939, Charles Van Riper produced a seminal text in which voice disorders were realized as a distinct diagnostic classification. …

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