Speech and Language Services

Voice therapy is a treatment approach used to help individuals improve their voice quality, reduce vocal strain, and prevent further vocal damage. It is often recommended for people with voice disorders, which can arise from various causes, including vocal misuse, medical conditions, or psychological factors.

Some types of voice disorders

Vocal Misuse and Abuse

This involves behaviors that put excessive stress on the vocal folds, such as shouting, screaming, excessive throat clearing, or speaking in a pitch that is too high or too low. These behaviors can lead to vocal fold nodules, polyps, or cysts.

Neurological Voice Disorders

Neurological voice disorders result from damage or disease affecting the nerves and muscles that control the vocal folds. Examples include vocal tremor, spasmodic dysphonia, and voice changes associated with Parkinson's disease.

Paradoxical Vocal Fold Movement (PVFM)

PVFM, also known as vocal cord dysfunction, is a breathing disorder in which the vocal folds close when they should be open, particularly during inhalation. This can cause shortness of breath, a feeling of tightness in the throat, and a high-pitched sound (stridor).

Psychogenic Voice Disorders

Psychogenic voice disorders occur when there is no physical cause for the voice problem. They are often linked to emotional stress, psychological trauma, or anxiety. Examples include functional aphonia (loss of voice) and functional dysphonia (hoarse or strained voice).

The Voice Therapy Process

The journey to a healthier voice typically involves these steps:

1. Comprehensive Evaluation: We conduct a thorough assessment of your voice, medical history, and vocal habits. This may include an assessment and videoscope by an ENT, a procedure in which a camera is used to visualize your vocal folds.

2. Individualised Treatment Plan: Based on the evaluation, we creates a customized treatment plan with specific goals and exercises.

3. Therapy Sessions: You will meet with us for one-on-one sessions to learn and practice new vocal techniques.

4. Home Practice: Consistent home practice is crucial for success. You will be given exercises to do daily to reinforce what you learn in therapy.

5. Ongoing Support: We provides ongoing support and guidance to help you maintain a healthy voice for the long term.

Voice therapy is a powerful tool for restoring and preserving vocal health. If you are experiencing a voice problem, a consultation with a speech-language therapist is the first step toward a clearer, stronger voice.

Stuttering and cluttering are both fluency disorders, but they have distinct characteristics. A speech-language therapists performs a comprehensive assessment to correctly diagnose the disorder and create a personalized treatment plan. 

A complete assessment will include speech samples in various contexts, interviews with the individual and sometimes their family, and a review of medical and developmental history. 

Therapy goals are tailored to the individual's needs, focusing on improving communication effectiveness and reducing the negative impact of the disorder, not just achieving perfect fluency.

Stuttering Therapy Approaches

Fluency Shaping: This approach focuses on teaching a new way of speaking that promotes fluency. Techniques include easy onset (starting a sound gently), light articulatory contact, and continuous phonation. The goal is to establish a more controlled and smooth speech pattern.

Stuttering Modification: This therapy helps individuals manage their stuttering moments by reducing physical tension and struggle. Techniques involve strategies like cancellations, pull-outs, and preparatory sets, which help the speaker navigate a moment of stuttering more easily and with less tension.

Cognitive-Behavioral Therapy (CBT): This is often used to address the emotional and psychological aspects of stuttering, such as social anxiety, fear, and avoidance behaviors.

Cluttering Therapy Approaches

Rate Reduction: The primary goal is to slow down the speaking rate to improve intelligibility. This can be achieved through techniques like using pauses and phrasing, metronome techniques, as well as with external devices such as Delayed Auditory Feedback (DAF), which plays back the speaker's voice with a slight delay to encourage a slower pace.

Increasing Awareness: Therapy begins by helping the individual become more aware of their disfluent speech. This may involve video recordings and self-monitoring exercises.

Improving Language and Articulation: We can work on organizing thoughts and improving articulation skills, often through exaggerated pronunciation of multi-syllabic words and focusing on clear speech.

For both stuttering and cluttering, therapy empowers individuals to communicate with greater confidence and ease, leading to a better quality of life.

We are able to see patients at Milpark Hospital for in-hospital assessment and treatment related to most speech, language and hearing disorders.

Along with our hearing screening programmes we can add speech and language screening tools. These screenings are based on developmental norms and check if a child is at performing at the normative level with regards to articulation, vocabulary, syntax, narrative discourse, and other language and speech markers.

Our comprehensive medico-legal speech and language assessment and medico legal reporting is available for the following demographics:

• English first language or fluent speakers

• Afrikaans first language or fluent speakers

• Adults

• Children aged 15 and older.