Could Voice Therapy be a Remedy for Stuttering?

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It has been long known that stuttering, especially in severe cases with blocks, stops and interjections, could produce a real voice disorder as a post effect.

In most of these cases of severe stuttering, while the patient is blocking his speech we can see how much pressure is building below the closed vocal cords until they finally open for that interjection of speech production, causing the upper circulatory neck veins to be full of blood,well shown and causing a severe friction effect on the vocal cords themselves.

Thus, there is not much surprise in the clinical connection between stuttering and a secondary voice disorders. The voice of these stutterers is harsh, choppy, and very distinct.

Voice therapy might help with stuttering – really?

Speech pathologists who treated many stutterers throughout the years have seen numerous times that by treating the secondary voice disorder not only is voice quality improved but, surprisingly enough, the stuttering has become less severe and in some cases is gone completely!

This is actually not so surprising…any speech pathologist who has the specialty to treat stuttering will tell you that one of the best remedies clinically proven is to change the output pattern of the patient speech. Since voice therapy is doing just that…it may as well be a wonderful remedy for severe stuttering.

What would be the clinical procedure?

In the evaluation process I see many stutterers with a secondary voice disorde. While testing the voice and speech production of these patients I will decide which of the disorders to tackle first and which technique to use. Most probably if the patient’s voice is harsh and choppy I will choose to treat him with a technique that will try to solve both disorders or, rather, to do voice therapy that will decrease the vocal abuse secondary to his fluency disorder and improve his vocal production while working against his dis fluency behaviors by changing the speech production process all together.

What exactly do we do in voice therapy against stuttering?

There are typically a couple of very good techniques to choose from nowadays. While any voice therapy technique that will work to change the breath support pattern of the patient while advocating vocal cords relaxation physiotherapy is good and will have positive results on both the stuttering disorder as well as on the secondary voice hoarseness, I would much prefer to use state-of-the-art techniques that are more suitable for this complex combined situation of an Hoarse-Stutterer.

Let me briefly discuss 2 specially designed techniques for that:

WMD (Sonorantic) technique:

Introduced by Watterson,McFarlen and Diamond , features use of sonorants ( nasal consonants like /M/ and /N/ and liquids (half a vowel) like /Y/) in the teaching materials while implementing a change to abdominal breath support and emphasizing relaxation drills to the vocal cords. The idea behind this unique technique is that when we produce these sonorants , friction in the vocal cords is much reduced compare to using materials with ordinary common consonants – making this a best match to these stutterers!

MMSM (Minimal Movements Specialization Method) technique:

Introduced by Dr. Weiss, was designed as a voice coaching technique for singers and actors , then was implemented as medical voice therapy and has shown tremendous success with these actors that had dis fluency problems prior to treatment. Again, we see the power of changing the speech pattern in these patients. This relatively new fascinating technique may become a powerful weapon against stuttering since it features not one good voice but a thousand of good voices…the patient is learning how to control his vocal output using minimal movements of his speech muscles, making it possible to change the voice output in thousand different ways, so you could have a different speech pattern every day…which will most probably will have a vast positive effect on any stutterer’s speech outcome, and by decreasing the primary disorder will reduce voice abuse to solve the secondary voice disorder as well.

Gal Levy M.Sc. CCC-SLP, has more than 21 years of experience in clinical treatments of Voice, Fluency, Articulation and Language. Gal is working as a school based SLP, Home health SLP and in his private practice at Frisco, TX. He also writes professional articles on various speech disorders and state of the art treatments on Google’s new Encyclopedia, Helium and AC writers websites. Gal participated on Community Focus radio monthly shows with Dr. Griffin advising KEOM 88.5 FM listeners on voice, fluency and tongue thrust clinical issues.

Comments

  1. Can you please tell me where I might find out more about how to implement these methods? I can’t find anything useful on the net. Are they things that an SLP would feel comfortable doing in therapy, or would they best be addressed by a vocal coach or some other discipline? Thanks.

  2. Ms. Banford , I will answer you directly to your e-mail…Thank you !
    GL

  3. Dear Gal Levy,

    I wish to more about these techniques to help me with my stuttering. Can you please tell me, from which I can learn the techniques.

    Thanking You,

  4. Gail Panik, M.A., CCC-SLP says:

    Dear Gal:
    As a student, I presented a short slide show/talk on the similarities/differences in speaking/singing with another at the Ohio Speech-Language-Hearing Assn.’s conference. This combination of voice/stuttering therapy really interests me, as I enjoy stuttering therapy and have been a singer for years, interested in disorders of the voice.

    Would you please enlighten me as to where I may receive more information on how to administer and perhaps even specialize in this type of therapy? I’m in the Cleveland, OH, area. Additionally, if you are teaching on line or are speaking on the subject somewhere, I’d be interested in participating.

    Thank you.

  5. This is a very interesting topic. I have seen some similarities in the theoretical neurological hypotheses between all three disciplines…since all the same muscle actions.

    After I got that CD from Dr Peter Ramig showing the nasoendoscopy of a block I started thinking of the closer ms. and activations and thinking in reverse…still trying to figure it out but I know that there are therapy procedures that can cross over for sure. I have had stuttering training from him, Walters (Denver), Hegde, Shine, and various trainings and none of them spoke on this e3xcept for Ramig with his associations with that voice disorders video….Thanks for this article and question! May I share in your response to Banford?
    Sandy

  6. Sure you can….as they say in Texas: Don’t mind if I do !

  7. Kimberly May says:

    I am interested in additional information on the above mentioned stuttering therapy techniques. I work in home care and mainly deal with neurogenic stuttering.

    Thanks!

  8. Hi Gal….the last entry on here was over a year ago and I don’t know if this is still an active thread but I thought I’d give it a shot. I’m a professional voice user wrestling with SD for the past 15+ years. It’s a mild case with varied success with botox treatments. Weiss’ MMSD method intrigues me. But I can’t find details on the web…just general observations. Can you point me to where I might get more info? And if you respond here, I’d like to ask you another question related particularly to my fluency/disorder. Thanks!

  9. John – Try to reach out for Prof. Weiss in Canada – He could advise you best regarding his method.
    Best , Gal

  10. Thank you so much for your reply Gal. I’ve googled til the cows have come home and can’t get any substantive or direct hits on Dr. Weiss and MMSM! A number of returns that reference him in a very general way but no further resources or sites are offered. Can you link something for me? Thanks again!

  11. Hi.
    I am an SLP. I have a kiddo that has a very interesting disfluency. He seems to have a spasm or some type of fleeting disruption in his speech flow. It is random and usually in the middle of speech…not on initiation. It’s almost like a hiccup that is silent, though there is no noticeable air intake or release…just a disruption in speech. He resumes the word that was interrupted from the point of interruption. Have you ever seen a disfluency like this or can you tell me if it would be something similar to abductor SD? I’m thinking that exercises similar to those for SD could be beneficial either way. Would this be correct?
    Thank you for any insight or assistance.