Voice Service

The speech and language therapy team’s specialist voice service offers assessment, therapy and advice for any adult experiencing difficulties with their voice or requires assistance and/or advice to improve their voice for a specific reason. 

Who requires help with their voice?

People in vocally demanding jobs, such as teachers, singers/actors, receptionists, are more inclined to experience problems with their voice. 

Timely intervention can help, especially if your voice problem is impacting upon your ability to work. 

Voice therapy may be helpful for:

  • Muscle Tension Dysphonia / Hyperfunction
  • Vocal nodules 
  • Transgender voice
  • Psychogenic voice disorders
  • Globus / Persistent throat clearing
  • Chronic cough

What does treatment involve?

An initial voice questionnaire will be sent to you for completion prior to your appointment with the voice specialist speech and language therapist so that they have an understanding of your current voice use. This will enable the voice therapist to determine the most appropriate intervention for your voice difficulties.

Your initial appointment will involve a comprehensive assessment of your voice to explore:

  • The underlying vocal cord structure and function, as outlined in the ear, nose and throat (ENT) assessment report.
  • The duration of symptoms.
  • Co-existing medical conditions, accounting for any environmental factors which may be impacting on your voice.
  • Vocal parameters using specialist equipment, such as a Laryngograph.
  • Self-rating assessment. 

Subsequent therapy sessions can then be designed to focus on the identified areas of difficulty and your specific requirements. These may include:

  • Education on how the voice works
  • Vocal hygiene
  • Release of vocal constriction
  • Breath support/control for speaking and/or singing
  • Vocal projection and forward placement
  • Adjusting pitch, volume and nasality
  • Relaxation techniques
  • Advice regarding any underlying medical issues such as reflux

How are referrals received?

Inpatient Referrals:

  • Inpatients must have had a nasendoscopic examination by a competent ENT doctor before a referral can be accepted.
  • This is essential to identify current vocal cord structure and function prior to starting therapy.

Outpatient Referrals:

  • Outpatient/community referrals for voice therapy are only accepted following a nasendoscopic examination either by an ENT doctor or a GP with Specialist Interest (GPwSI) in ENT.
  • Any referrals from GPs or other hospital consultants should be returned together with a covering letter requesting a referral for nasendoscopy prior to being able to offer voice therapy.
  • Once the patient has been examined and details of the nasendoscopy findings have been received, an initial appointment will be sent to the patient.
  • Patients referred as part of their gender reassignment must be taking regular hormones and ideally be under the care of a specialist centre (e.g. Charing Cross Hospital) before starting voice therapy. However patients can self-refer via their GP if they are not on the aforementioned pathway.
  • Patients requiring elective surgery e.g. for removal of nodules, should ideally be seen pre-operatively to explain any specific vocal care required and to commence a short course of therapy to change vocal practice. They should then be reviewed post-operatively to monitor their progress and to have any additional exercises or techniques explained.