The Voice Care Team

Philadelphia Voice Center
Professional Voice Care, Otolaryngology-Head and Neck Surgery
What is a Voice Care Team?

  • A voice care team is ordinarily under the direction of a physician, who is usually a  laryngologist. 

  • The team also includes a voice therapist, a singing voice specialist, an acting voice specialist, and consultant physicians in other specialties. 

What is a Laryngologist?

  • The leader of the voice care team is ordinarily a laryngologist.

  • A laryngologist is an ear, nose, and throat physician (otolaryngologist) who subspecializes in the care of the voice, vocal folds, larynx, and airway.  Otolaryngologists (ENT's) are physicians/surgeons who specialize in problems of the ears, nose, and throat (ENT).  All laryngologists are otolaryngologists who have had additional training in the treatment of the voice and airway.
  • Laryngologists typically have more training and knowledge of the variety of ailments that can affect the voice than does a general otolaryngologist (general ENT).
  • Professional voice users having difficulties with their voice benefit most from treatment by a laryngologist.
Optimal voice care is delivered by an interdisciplinary team consisting of physicians and nonphysicians:  the Voice Care Team

What is a Voice Therapist?

  • The voice therapist is a speech-language pathologist that is certified and licensed by the American Speech-Language Hearing Association. 

  • Like otolaryngology, speech-language pathology is a broad field that includes care of patients who have strokes or other neurological problems affecting speech and swallowing disorders, have articulation problems, stutter, craniofacial disorders, or other related fluency disorders of speech.  A voice therapist is a speech-language pathologist who subspecializes in voice care, in particular.

  • Voice therapists are responsible for voice therapy and rehabilitation that is analogous to physical therapy.  The voice therapist analyzes voice use and teaches proper voice placement to optimize use of the voice during speaking.  A variety of techniques is utilized to accomplish this goal. 

  • Like laryngologists, speech-language pathologist who subspecialize in voice care provide more incisive, state-of-the-art treatment for voice disorders than most general speech-language pathologists who care for patients with various problems encompassing the entire field.  Consequently, it is worthwhile for patients with voice disorders to seek out a subspecialist in order to improve the likelihood of a rapid, excellent treatment result.  Referrals to speech-language pathologists specializing in voice are usually obtained through a laryngologist.
What is a Singing Voice Specialist?

  • The singing voice specialist is a singing teacher with special training equipping him or her to practice in a medical environment with patients who have sustained vocal injury.

  • Most singing voice specialists have a degree in voice performance or pedagogy.  Nearly all have professional performance experience, as well as extra training in laryngeal anatomy and physiology of phonation, training in the rehabilitation of injured voices, and other special education.

  • Some singing voice specialists have dual degrees in speech-language pathology and voice performance or vocal pedagogy.  This combination is optimal.

  • In individuals with vocal injuries or problems, the fundamental approach to training the singing voice is different in important ways from that usually used with healthy students in a singing studio.  Hence, even an excellent and experienced voice teacher may harm an injured voice, if he or she is not familiar with the special considerations for this population. 

  • Virtually all singing voice specialists are affiliated with voice care teams.  In many cases, their practices are limited to work with injured voices.  They work not only with singers, but also with other patients with voice disorders.  As members of a voice treatment team working with nonsingers, they help teach speakers the “athletic” techniques utilized by singers for voice production.  Singing is to speaking as running is to walking.  When rehabilitating some-one who has difficulty walking, if the person can be helped to jog or run, leg strength and endurance improve and walking rehabilitation is expedited.  The singing voice specialist helps apply similar principles to voice rehabilitation, in collaboration with the speech language pathologist and other voice care tem members.
What is an Acting Voice Specialist?

  • Acting voice specialists are also called voice trainers, voice coaches, drama voice teachers, and voice consultants.  Traditionally, these professionals have been associated closely with the theater.  Their skills have been utilized as part of a medical voice team only since the mid-1990s.  Consequently, there are few acting voice trainers with medical experience; but their contributions have proved invaluable.

  • Acting voice specialists use a variety of behavior modification techniques to enhance vocal communication, quality, projection, and endurance in theatrical settings.  They train actors to speak or scream through theatrical runs that may last years, without tiring or causing injury to their voices.  They also teach techniques for adding emotional expression to vocal delivery, and they work with body language and posture to optimize vocal delivery and communication of information. 

  • Acting voice specialists are a great asset to the voice team in teaching people how to apply the many skills learned through the voice therapist and singing voice specialist to their every-day life.  Acting voice trainers are especially valuable for people who speak professionally, such as teachers, lecturers, politicians, clergy, sales personnel, and others concerned with effective vocal delivery and with vocal endurance.
What is the Role of Consultant Medical Professionals?

  • Otolaryngologists often refer voice patients for consultation with other medical professionals.  Other specialists consulted commonly include neurologists (who assess nerve function), pulmonologists (who assess lungs), gastroenterologists (who assess the esophagus, stomach and intestinal system), psychologists, and psychiatrists.  However, physicians in virtually any medical specialty maybe called upon to help care for voice patients. 

  • Orthopedic surgeons, neurologists, pulmonologists and others who are accustomed to working with performing artists (dancers, wind instrumentalists, etc.) are most likely to have the insight, sensitivities, skills, and state-of-the-art information needed to provide optimal care to voice professionals. Many such physicians tend to be associated with arts medicine centers or are performers themselves.

  • Referrals can be obtained through the laryngologist or voice specialist.
Do I really need to see the members of the voice team?

Yes, most of the time. 
  • The voice therapist is invaluable in diagnosing and correcting errors in voice usage that can cause or aggravate voice dysfunction.  In nearly all cases, patients use hyper-functional voicing in an attempt to compensate for their voice disorders.  It is always important to eliminate this to unmask the true nature of the voice disorders.  Moreover, in many cases, voice therapy alone is enough to cure the problem.

  • The singing voice specialist can teach non-singers some of the athletic exercises and tricks used by singers to improve vocal control, volume, projection, quality, and variability.  Even in someone with no skill or interest in singing, these athletic techniques can be applied to the speaking voice quickly and can speed voice therapy.

  • The acting voice specialist can be extremely helpful in identifying how vocal techniques are being used in the context of daily vocal activities.  The acting voice specialist helps integrate optimal techniques into daily use, and teaches additional methods for improving vocal expression and the overall impact of personal communication.

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