Voice therapy has been demonstrated to be effective for dysphonia across the lifespan from children to older adults. Voice therapy is the first line of treatment for vocal fold lesions like vocal nodules, polyps, or cysts. These lesions often occur in people with vocally intense occupations like teachers, attorneys, or clergy. Another possible cause of these lesions is vocal overdoing often seen in sports enthusiasts; in socially active, aggressive, or loud children; or in high energy adults who often speak loudly. Voice therapy, specifically the Lee Silverman Voice Therapy method, has been demonstrated to be the most effective method of treating the lower volume, lower energy, and rapid-rate voice/speech of individuals with Parkinson’s disease.
Voice therapy has been used to treat dysphonia concurrently with other medical therapies like botulinum toxin injections for spasmodic dysphonia and/or tremor. Voice therapy has been used alone in the treatment of unilateral vocal fold paralysis, presbyphonia, vocal process granuloma, and has been used to improve the outcome of surgical procedures as in vocal fold augmentation or thyroplasty. Voice therapy is an important component of any comprehensive surgical treatment for dysphonia.
Voice therapy is a program designed to reduce dysphonia through guided change in vocal behaviors and lifestyle changes. Voice therapy consists of a variety of tasks designed to eliminate harmful vocal behavior, shape healthy vocal behavior, and assist in vocal fold wound healing after surgery or injury. Voice therapy for dysphonia generally consists of 1 to 2 therapy sessions each week for 4 to 8 weeks. The duration of therapy is determined by the origin of the dysphonia and severity of the problem, co-occurring medical therapy, and importantly, to patient commitment to the practice and generalization of new vocal behaviors outside the therapy session.
The American Speech Language and Hearing Association (ASHA) is an excellent resource for finding a certified speech-language pathologist by going to the ASHA website (www.asha.org) or by accessing ASHA’s online search engine called ProSearch at: http://www.asha.org/proserv. You may also contact ASHA’s Action Center, Monday through Friday (8:30am-5:00pm) at: 1-800-498-2071; Fax: 301-296-8580; TTY (Text Telephone Communication Device): 301-296-5650; E-mail: firstname.lastname@example.org.
Generally, Medicare, under the guidelines for coverage of speech therapy, will cover voice therapy if provided by a certified and licensed speech-language pathologist, ordered by a physician, and is deemed medically necessary for the diagnosis. Medicaid varies from state to state but generally covers voice therapy, under the rules for speech therapy, up to the age of 18 years old. It is best to contact your local Medicaid office, as there are state differences and program differences. Private insurance companies vary and the consumer is guided to contact their insurance company for specific guidelines for their purchased policies.
Speech therapy is a term that encompasses a variety of therapies including voice therapy. Most insurance companies refer to voice therapy as speech therapy but they are the same thing if provided by a certified and licensed speech-language pathologist.
Stachler RJ, Francis DO, Schwartz SR et al. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update). Otolaryngol Head Neck Surg. 2018; 158(1 Suppl):S1-S42.