Stretch and Flow Phonation. An Intervention Strategy for Functional A(dys)phonia

Jackie Gartner-Schmidt

Functional aphonia and dysphonia are defined as voice disorders in the absence of any structural or neurologic laryngeal involvement. These non-organically based voice problems may be unsettling to Speech-Language Pathologists who have no structured intervention strategy. This workshop outlines a hierarchical intervention strategy named Stretch and Flow Phonation adapted from Stone (1982).

Skill 1: Control of Airflow

Often, patients with functional a(dys)phonias hold their breath while speaking. The patient’s task in Skill 1 is learning to relieve the laryngeal mechanism from strain and effort by letting unimpeded airflow through the glottis.

Skill 2: Stretch and Increased Airflow
This skill incorporates unimpeded voiceless airflow through the glottis in conjuncture with slow and relaxed (stretched out) movements of the articulators while maintaining relaxed muscular states.

Skill 3: Stretch and Increased Voiced Airflow
Adding voice, while maintaining Skill 2 is the third vocal skill in this progression. Stretched out speech (one/two syllables per second) with increased voiced airflow is the skill at this level.

Skill 4: Reduced Stretch and Increased Airflow
Reduction of speech rate risks the patient’s resuming habitual a(dys)phonic vocal patterns; accordingly, while regaining more appropriate rate, increasing airflow is used to aid in weakening former vocal patterns. This skill incorporates speaking at a normal rate with increased airflow.

Skill 5: Reduced Stretch and Reduced Airflow
These skills results in successful reinstatement of coordinated vocal production.

Case presentations will be used.

JackieGartner-Schmidt, Ph.D.(gartnerschmidtjl@upmc.edu)
University of Pittsburgh Department of Otolaryngology
200 Lothrop Street, Suite 500
Pittsburgh, PA 15213
412-647-2112 Fax 412-647-2080

Skill 1: Control of Airflow Often, patients with functional a(dys)phonias hold their breath while speaking. The patient’s task in Skill 1 is learning to relieve the laryngeal mechanism from strain and effort by letting unimpeded airflow through the glottis.

Skill 1: Control of Airflow

Often, patients with functional a(dys)phonias hold their breath while speaking. The patient’s task in Skill 1 is learning to relieve the laryngeal mechanism from strain and effort by letting unimpeded airflow through the glottis.