By using biofeedback in voice therapy, you can see your speech patterns on an external monitor such as a spectrograph or electromyograph and learn to control normally involuntary voice patterns. At first, you learn to control your voice patterns while looking at the monitor and over time, learn to control these issues without being connected to this external device.
Spectrography
A sound spectrograph creates a graph of the sound frequencies of your voice. By creating a spectrograph of your voice patterns, a voice therapist can analyze your vocal output to identify weaknesses that may be causing problems. The therapist teaches you which tones need to be modified and gives you exercises for how to make these changes. You practice the changes while the spectrograph records your vocal output.
Electromyography
If the problems with your voice are due to disordered muscle contractions, the voice therapist may use biofeedback with electromyography. Like a spectrograph, an electromyograph produces a graphic representation but this instrument graphs muscle contractions in the throat, rather than tones you are producing. Biofeedback with electromyography is helpful in the treatment of vocal cord disorders such as dysphonia, in which your vocal tract is contracting so much your voice becomes hoarse and strained, leading to excessive muscular contraction within the vocal tract that leads to vocal fatigue and pain.
Traditional Biofeedback
If problems with your voice are thought to be stress induced or exacerbated by stress, traditional biofeedback may help you learn to control your heart rate, blood pressure, muscle tension, and skin temperature to learn to relax at will. With this type of biofeedback, electrodes are attached to appropriate body areas such as your temples, chest, and fingertips. Measurements of your bodily processes are displayed on a monitor. You practice relaxation techniques to calm yourself and watch your progress displayed visually in terms of returning your bodily processes to normal. Traditional biofeedback can be employed for paradoxical vocal fold movement (PVFM), a disorder in which your vocal cords function properly until you are under stress and they contract and close when they should be open, making it difficult to breathe.
Efficacy
Researchers Lorraine Olson Ramig and Katherine Verdolini conducted a meta-analysis of the research on the effectiveness of biofeedback in voice therapy. A meta-analysis is a systematic review of a wide body of scientific research to date keeping score of what worked and what did not. The researchers found that voice treatment is best used as a preventative, initial treatment modality, when the most effective when voice disorders do not require surgical or medicinal treatments, and as a pre- and post-surgical intervention to bolster long-term effects.
References
- NCVS Vocology Guide: Voice Production
- American Speech-Language-Hearing Association: Paradoxical Vocal Fold Movement
- Journal of Applied Behavior Analysis; Biofeedback Treatment of Paradoxical Vocal Fold Motion and Respiratory Distress in an Adolescent Girl; Emily Warnes, et al.
- University of Maryland Medical Center: Biofeedback
- Journal of Speech, Language, and Hearing Research; Treatment Efficacy Voice DIsorders; Lorraine Olson Ramig, et al.
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