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.