“Voice therapy hasn't worked for me”.
I’ve heard this a LOT. And often times, when I probe further I come to the conclusion of well, in that situation, “duh it didn’t work!”
Neurological Voice Disorder:
I often hear this from those with neurological disorders after they are told “voice therapy won’t work to cure your disorder”. I’ve heard this from those who have engaged in “trial” voice therapy to tease out a correct differential diagnosis of MTD vs. SD but after two sessions if SD is the diagnosis therapy is stopped. What message does that send?
I can tell you because I’ve been there. I was told that I was not making “expected progress” in session two and wasting my time in voice therapy. Once they diagnosed SD they referred for Botox immediately. I was left confused and like I FAILED. But something told me there was more to this voice therapy thing that I wasn’t able to fully dig into. So I dug. Now, I have completely been able to change HOW I use my voice and better control my worst symptoms with how I use my voice therapy techniques.
Questions I ask:
- Has the voice therapist had a lot of experience working with that particular disorder?
- Were the strategies designed to compensate for a neurological disorder (NOT get a “perfect” voice or cure?
- Did they explore a number of different strategies to see what works for YOU?
MTD:
I’ve also seen individuals with MTD struggling for even years with voice therapy that just “hasn’t worked”.
Questions to consider:
- Are we sure the MTD isn’t overlying some other vocal pathology that may have been initially missed (like a subtle paresis or atrophy?)
- Was the speech language pathologist highly specialized in voice (NOT treating a voice patient here and there) ?
- Did they give strategies for real conversation? (If there are just drills and no work in real conversation there will never be a real change and the patient will continue to experience symptoms)!
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