Frequently Asked Questions About Therapy

What is a Speech Pathologist Voice Specialist? When most people think of a speech pathologist, or “speech therapist,” they often think of people who help children speak more clearly or who work with those who have had strokes or other injuries causing speech or language problems. In fact, there are many areas in which speech therapists, or “speech-language pathologists” work, and a small minority choose to specialize in the evaluation and treatment of vocal cord-related disorders (known as “Voice Specialists”). While Voice Specialists receive the same extensive training as other speech-language pathologists, a Voice Specialist also receives additional training in, and focusses primarily on, the evaluation and treatment of vocal cord-related disorders, including problems with singing/speaking voice, coughing/throat clearing, and shortness of breath (as well as other throat-related problems). As described below, therapy for vocal cord and throat-related problems is, in some ways, unlike the common notion of “speech therapy,” in that it focusses on retraining and re-strengthening the body to eliminate problems, in a similar manner to physical therapy. More questions? Contact DOUGLASS Voice Help

Speech pathologists with a specialization in voice disorders mostly practice in large cities, however, at DOUGLASS Voice Help, you can work with Drew Douglass, MS, CCC-SLP, a highly-experienced Voice Specialist, from wherever you live.

Why did my provider suggest that I try therapy to treat my symptoms? (The short answer: 1) Your provider may have seen patients in the past with diagnoses or symptoms similar to yours who’s symptoms significantly reduced or were eliminated through therapy, or 2) your provider may be investigating potential causes or exacerbators of symptoms.)

-- The medical providers who refer patients for therapy to address throat, voice, cough/throat clear, or breathing-related problems are familiar with the types of symptoms and diagnoses that a Voice Specialist can help effectively reduce or eliminate (see DouglassVoiceHelp.com for more info).

-- With a few exceptions, patients who are referred for therapy are likely to be good candidates for experiencing a reduction in, and possibly elimination of, some-to-all of their symptoms, through completing the recommended therapy (varies based on diagnoses, type of symptoms, the severity).

Why was I referred to a “speech therapist” for my throat, voice, cough/throat clear, or breathing-related problem? (The short answer: Some speech therapists, called “Voice Specialists,” are extensively trained in, and focus exclusively on, the evaluation and treatment of these types of problems.)

-- Although most people have never heard of using therapy to treat throat, voice, cough/throat clear, or breathing-related problems, it is both highly effective and based on well-established medical research. For information visit ASHA.org: www.asha.org/practice-portal/clinical-topics/voice-disorders.

-- Therapy to treat these types of problems is actually more similar to physical therapy than the common notion of “speech therapy,” because the methods don’t focus on teaching language or speech, but instead on 1) soothing of chronic physical irritation, muscle tightness, and/or discomfort by reducing exacerbators, 2) training strategies for reducing and/or managing symptoms when they arise, and 3) repetition of isometric exercises to “reprogram” optimal functioning in the voice and breathing mechanisms.

-- Voice Specialist Drew Douglass, MS, CCC-SLP has practiced full time as a Voice Specialist in the Eugene/Springfield area since 2012, treating patients exclusively for throat, voice, cough/throat clear, and breathing-related problems. Additionally, as a graduate of Berklee College of Music, Drew is a trained singer and further specializes in the treatment of voice problems for occupational singers and speakers.

Are there online resources which can help my symptoms? (The short answer: No.) Although there are online forums and groups which discuss these types of symptoms, they often convey misleading information and promote ineffective and even harmful techniques which are not backed by science.

Why is therapy helpful for throat, voice, coughing/throat clearing, and breathing-related problems? (The short answer: For most patients who are referred, therapy can either reduce or eliminate problems in these areas because it optimizes how the body functions in a way that can relieve symptoms even if the initial cause was medical in nature.)

-- Throat, voice, coughing/throat clearing, and breathing-related problems can have many causes; however, regardless of the specific cause, keep in mind that it is the vocal cords themselves that create the voice, do the coughing/throat clearing, and allow air to pass through while breathing. Therefore, irritation and/or muscle tension in or near the vocal cords can significantly exacerbate these problems.

-- Although chronic problems in these areas are often initially caused by injuries or by medical conditions such as allergies or GERD, the chronic presence of the symptoms themselves can easily cause a self-perpetuating throat irritation or muscle tension problem to develop, called a “secondary functional disorder,” which can persist with identical symptoms long after any medical causes have subsided.

-- “Primary functional disorders” (e.g. tissue irritation or muscle tension as the main cause of symptoms) can also cause symptoms that mimic medical problems. In fact, the symptoms caused by primary functional disorders are often assumed to be caused by medical conditions, yet, ironically, are usually only successfully treated with therapy.

-- Therapy with a Voice Specialist can often eliminate and/or significantly reduce the severity of primary and secondary functional disorders. Therapy is often the only effective treatment for such disorders because medications and procedures are unable to achieve the neuro-muscular re-programing required for improving the body’s functioning.

What will be accomplished during the Therapy Evaluation?

-- The therapy evaluation (first session) provides an in-depth analysis of the potential causes of symptoms, as well as insight into which of your symptoms may need further investigation or treatment medically vs. which may require treatment through therapeutic methods.

-- The Voice Specialist will study your case history and your physician’s notes, and together you will discuss the details of your symptoms. You will then complete voice and/or breathing activities to identify areas to work on in therapy.

-- The Voice Specialist will determine which of your symptoms are likely caused by functional disorders (treatable through therapy), explain why these problems may have come about, and describe how therapy will address the symptoms.

-- You will receive several customized activities to start using right away at home for reducing/managing your symptoms.

-- New patients often experience some immediate relief from symptoms within a few days after beginning therapy (this varies based on causes, severity, and behavioral habits).

What are the Therapy Follow-up sessions like?

-- Most patients return for 2 or more weekly follow-up sessions after their therapy evaluation (average 3-6 sessions).

-- You should expect to see improvements in your symptoms each week throughout therapy until you “graduate” (when your body has maximized and can sustain the improvements independently without symptoms returning).

-- Typically, each therapy follow-up session consists of a verbal check-in about current symptoms, a review of current home activities, discussion about how to best manage the week ahead, and practice of new activities to use at home.

For more information on the science behind therapy for vocal cord-related disorders, visit The American Speech-Language-Hearing Association:

https://www.asha.org/practice-portal/clinical-topics/voice-disorders.