Help! My voice is _____!

Treatment depends on the cause and is designed individually on a case by case basis. Your ENT will help determine the course of action if there is a pathology at the level of the vocal folds, such as nodules or polyps. If nodules are present, you will likely try speech therapy. If polyps are present, the ENT may have you try speech therapy, but often they require surgery. If you have nodules or polyps and participate in speech therapy, the SLP will first educate you about your vocal folds and how to take care of them using good vocal hygiene. The SLP may also have you try speaking with glottal fry. Glottal fry is not the speech goal, however, it will help you relax the vocal folds (Voice Disorders, n.d.). For many people, they have breathy phonation due to inappropriate or excessive vocal use. People who are required to use their vocal folds often and loudly, such as teachers or singers, may find that they have breathy phonation. If it is inappropriate vocal use, the SLP will teach you how to firmly engage your vocal folds so they adduct properly. Have you ever tried to push something very heavy? Try it now. Do you feel your vocal folds close? That’s approximation. You and the SLP will work to learn how to appropriately approximate, not too hard and not too soft. You will likely also work on increasing your intensity. When you are loud, you force your vocal folds to approximate! The SLP will also help train your ears to know the difference between when vocal folds are approximating correctly and when they are not. You may also learn how to do a hard glottal attack. This is where the vocal folds are squeezed too hard. So you would then modify that to create an appropriate approximation. The SLP may also have you engage in negative practice. This is where you would purposely be breathy, and then purposefully use your good, nonbreathy voice! The SLP will also help you understand how to have good vocal hygiene. Click here to learn more about vocal hygiene!