Get answers to your questions on voice disorders

Is there a difference between a speech therapist and a voice therapist?

Speech therapists treat patients with swallowing disorders and a range of communication disorders. Communication problems can arise in the areas of speech, language, voice and fluency. Most speech therapists start off by treating patients with speech and language disorders. Some of them may later choose to specialise in the treatment of voice disorders and become voice therapists.

The only way to determine if a given speech therapist is also a voice therapist is to ask them. At times, voice therapists may be associated with a voice centre or an otolaryngologist.

How can a speech therapist help your voice?

During your initial consultation, the speech therapist will take a case history of your voice problem and evaluate your vocal characteristics. This includes features such as vocal quality, pitch, loudness, and breath support. A specialised computer programme may be used to further analyse the acoustics of your voice.

If a voice disorder is diagnosed, you may be offered voice therapy. Voice therapy involves education on preventive measures and direct voice treatment.

Preventative measures include staying adequately hydrated, managing acid reflux symptoms and reducing/stopping vocal abusive behaviours, such as shouting or talking for long periods without rest. During therapy, the speech therapist will explain other preventative measures and formulate an individualised voice care plan.

Direct voice treatment involves altering pitch, loudness, or breath support for good voicing. The speech therapist will often prescribe vocal warm-ups and teach therapeutic vocal techniques to help patients use their voice in an optimal manner and achieve satisfactory voice quality. Voice related computer programmes may be used to provide feedback and help patients achieve their goals.

If the patient is not satisfied with the volume of his/her voice, the speech therapist may teach techniques to achieve voice projection in a safe manner that does not damage the vocal folds. Stress reduction techniques and relaxation exercises are often taught as well, to ensure that the muscles in the head and neck that are used for producing the voice are not overly tense. If necessary, the speech therapist will initiate a referral to an otolaryngologist.

At​ Singapore General Hospital​ (SGH), a member of the SingHealth​ group, patients may be assessed at the Voice Clinic of the Ea​r, Nose and Throat (ENT) Centre​. It is a specialised clinic jointly conducted by an ENT surgeon and a speech therapist. The clinic provides consultation and clinical and stroboscopic examination of the larynx (voice box).

A scope will usually be inserted through the nose or mouth to evaluate the structure and movement of the larynx and vocal folds. The ENT surgeon and the speech therapist will integrate the information provided by patients with the results of their clinical examination, to provide specific diagnosis and management of their voice problem.

How do I see a speech therapist?

In Singapore, a doctor's referral is not needed to see a speech therapist in private practice. However, to see a speech therapist in a public hospital, you will first need to obtain a referral.

Ref: T12