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Misuse?
Abuse?
Phonotrauma?
Controversial Terminology
1. Andrews (1999):
– Distinguishes vocal abuse from misuse
– Inappropriate pitch is a form of vocal misuse
– Inappropriate volume is a form of vocal misuse
– Definition: Inappropriate and injurious vocal
practices
Latest Preferred Terminology
z Development of nodules
z Development of polyps in some cases
z Development of Contact ulcers
z Thickening of the vocal folds
z Poor hydration (or lack thereof) leads to
dryness of laryngeal tissues and increases
risk of misuse/abuse (Andrews, 1999)
Causes of Vocal Fold Irritation
z Contribute to phonotrauma
– Depression
– Lack of self confidence
– Fears
– Guilt
– Anxiety
Other Causes (Stemple, 2000)
z GERD
z Allergies
z Sinus infections
z Meds
z Poor diet or generally poor nutrition
z Fatigue
z Illegal Drug Usage
Psychotrauma and Voice Transition
z Psychologists
z Counselors
z Social Workers
– Understand the dynamics of the need for voice
change during the transition process
– SLPs work on habituating and carry-over of the
new voice and non-verbal aspects of transition
SLPs Awareness of Psychosocial
Issues for Voice Transition: FEAR
z Guilt
– Family Strife
– Family is non-accepting
– Rejection by children
z Vocal polyps/nodules
z Spastic Dysphonia
z Chronic throat clearing
RAGE/ANGER
z Anger at God
z At Family
z At ‘the system’
z At their children
z At him/herself
– Severe phonotrauma
– Inappropriate or poor Fo
– Obtrusive yelling or screaming
DENIAL
z Close mouth
z Gather and swallow saliva once
z Clear the throat with usual pharyngeal and laryngeal
movements used for swallowing but do not use the
vocal folds; repeat five times
z Swallow immediately
z Repeat steps three to four times
z Discuss benefits of this technique
Safe Coughing
z Progressive Relaxation
z Tea
z Diaphragmatic Breathing
z Easy onset of speaking
z Decrease or eliminate caffeine
z Decrease use of citrus juices
z Keep hydrated: This does not necessarily mean excessive pop
z Use of Low Sugar juices: No aspertaine or saccharine
z Avoid Smoking or second hand smoke
z Decrease or avoid alcoholic beverages
Components Continued
z Journaling
z Safe throat clearing goal
z Safe coughing goal
z Identify two emotions or psychosocial issues
that affect the voice at work, home, social
situations
z Describe ways to deal with these issues
when are you “read”
Counseling for TG Clients
Voice Transition