When diagnosing vocal deficits, you may hear a strained, stressed voice pattern. The air may be constrained as the client attempts to speak. Are the client’s shoulders drawn upward? Do they express fatigue when attempting to speak with in this manner? The purpose of this Assignment is for you to gain an understanding of vocal hyperfunction.
This is intended to allow you to show evidence that you have completed the following Learning Outcome:
CLO3: Apply knowledge of anatomy and physiology of communication to diagnose and treat patients with communication disorders (ILO3, PLO3)
Directions
Describe and define deficits of vocal hyperfunction and research the medical conditions or environmental conditions that may lead to vocal hyperfunction. (Hints: think about kids yelling on the playground, a supervisor trying to talk over noise in a manufacturing plant to give employees instructions, and an anxious person attempting to explain their fears and worries.)
Full Answer Section
- oice Quality Changes: The voice often sounds strained, harsh, hoarse, or breathy. It may also have a "pressed" quality, as if the speaker is forcing the sound.
- Vocal Fatigue: Due to increased effort, individuals with vocal hyperfunction often experience vocal fatigue, even after short periods of speaking. The voice may worsen throughout the day.
- Pain or Discomfort: Muscle tension can cause pain or discomfort in the throat, neck, or shoulders.
- Globus Sensation: Some may experience a "globus sensation," a feeling of a lump or tightness in the throat, even when not speaking.
Medical and Environmental Conditions Leading to Vocal Hyperfunction:
Several factors can contribute to vocal hyperfunction. It's rarely a single cause, but a combination of predisposing, precipitating, and perpetuating factors:
- Functional Voice Disorders: These disorders arise from learned vocal misuse or abuse patterns, not structural or neurological issues. Examples include:
- Muscle Tension Dysphonia (MTD): The most common type, involving excessive tension in laryngeal and surrounding muscles.
- Ventricular Phonation: The false vocal folds (ventricular folds) vibrate with the true vocal folds, resulting in a harsh, low-pitched voice.
- Medical Conditions:
- Laryngopharyngeal Reflux (LPR): Stomach acid refluxing into the larynx can irritate the vocal folds and lead to compensatory muscle tension.
- Allergies: Chronic allergies can cause inflammation and irritation in the upper respiratory tract, contributing to vocal strain.
- Asthma: Some asthma medications can dry out the vocal folds, increasing injury risk and leading to hyperfunctional behaviors.
- Neurological Disorders: Certain neurological conditions, such as Parkinson's disease or stroke, can affect vocal control and contribute to hyperfunction.
- Environmental Factors:
- Noise Exposure: Noisy environments can force individuals to speak louder, leading to vocal strain. This is exemplified by the supervisor in a manufacturing plant needing to project their voice.
- Stress and Anxiety: Psychological stress and anxiety can increase muscle tension, including the vocal mechanism. This is relevant to the anxious person explaining their fears.
- Vocal Demands: Vocally demanding jobs (e.g., teachers, singers) increase the risk if proper techniques aren't used. Children yelling on the playground also represent high vocal demand.
- Habitual Behaviors: Habits like throat clearing, coughing, or smoking can irritate the vocal folds and contribute to hyperfunction.
A speech-language pathologist (SLP) evaluation is crucial for diagnosis and determining underlying causes. Treatment typically involves voice therapy with an SLP, focusing on vocal hygiene, muscle relaxation, breath support, resonance therapy, and pitch/loudness control. Addressing underlying medical, environmental, or psychological causes is essential for successful treatment.
Sample Answer
Vocal hyperfunction describes a range of voice disorders characterized by excessive muscle tension and effort during voice production. This strain manifests in several ways, often resulting in a strained, stressed vocal quality, restricted airflow, and noticeable physical tension. Observing the client's posture (e.g., raised shoulders) and reported fatigue during speech attempts are key indicators. Understanding the underlying causes is crucial for effective treatment.
Deficits of Vocal Hyperfunction:
- Increased Muscle Tension: Muscles in the larynx (voice box), neck, shoulders, and even abdomen become overly tense. This restricts the vocal folds' vibration, leading to a strained or choked voice.
- Reduced Airflow: Excessive tension constricts the airway, limiting air available for speech. This can cause breathiness, reduced loudness, and difficulty sustaining sounds.
- Pitch Changes: Hyperfunction can affect pitch control, resulting in a higher than usual voice, pitch breaks, or fluctuations.