The Effects of Respiratory Training on Voice

Inclusion Criteria:

• Ages 18 or older

• Self-report of general good health other than voice disorder

• Self-report of normal pulmonary function

• Non-smoker status for at least the last 5 years

• English as their primary language to avoid potential linguistically-baseddifferences in acoustic measures of voice

• Adequate visual acuity (with or without corrective lenses) to read basic graphs andprint, as determined with visual screening

• No evidence of current organic or neurologic laryngeal pathology, as assessed bynasolaryngoscopy examination and reviewed by a laryngologist

• No prior surgery to the vocal folds

• Do not report difficulty with swallowing

• Not currently receiving voice therapy or other voice treatment that cannot bediscontinued

• Do not report a bilateral, severe to profound hearing loss

• Willingness to be recorded for data collection that is necessary for this study

• Have a confirming diagnosis of Muscle Tension Dysphonia from an otolaryngologist andspeech-language pathologist

• Demonstrate quantified auditory-perceptual dysphonia and acoustic dysphonia (Cepstral/Spectral Index of Dysphonia) that exceed normative values for theparticipant's age and sex

• Based on the nasolaryngoscopy examination and assessment performed by theotolaryngologist, show one or more patterns of supraglottic activity that areconsistent with adducted vocal fold hyperfunction

• Show no evidence of abnormal, incomplete vocal fold closure patterns as determinedon the videostroboscopy assessment (patterns of posterior glottal gaps are normaland expected)

• Show no evidence of additional neurological voice disorders such as spasmodicdysphonia or vocal fold paralysis

• Show elevated hyolaryngeal position that exceeds normative expectations asdetermined through quantitative analysis of ultrasonographic laryngeal imagesmeasuring change from rest to phonation

• Demonstrate voice problems that have persisted for ≥2 months

• Demonstrate self-reported increase in speaking effort

• Show evidence of speech breathing abnormalities relative to accepted normativevalues

Exclusion Criteria:

• Ages 17 or younger

• Self-report of major health problems

• Self-report of pulmonary disease such as asthma, chronic obstructive pulmonarydisease, or emphysema

• Current smoker status or prior smoker status within the last 5 years

• English not the primary language

• Inadequate visual acuity (with corrective lenses if applicable) to read basic graphsand print as determined by failing a visual screening

• Evidence of current organic or neurologic laryngeal pathology, as assessed bynasolaryngoscopy examination and reviewed by a laryngologist

• Prior surgery to the vocal folds

• Currently receiving voice therapy or other voice treatment that cannot bediscontinued

• Self-report of a bilateral, severe to profound hearing loss

• Not willing to be recorded for data collection that is necessary for this study

• No confirming diagnosis of Muscle Tension Dysphonia from an otolaryngologist andspeech-language pathologist

• Do not demonstrate quantified auditory-perceptual dysphonia and acoustic dysphonia (Cepstral/Spectral Index of Dysphonia) that exceed normative values for theparticipant's age and sex

• Based on the nasolaryngoscopy examination and assessment performed by theotolaryngologist, do not show one or more patterns of supraglottic activity that areconsistent with adducted vocal fold hyperfunction

• Show evidence of abnormal, incomplete vocal fold closure patterns as determined onthe videostroboscopy assessment (patterns of posterior glottal gaps are normal andexpected)

• Show evidence of additional neurological voice disorders such as spasmodic dysphoniaor vocal fold paralysis

• Do not show elevated hyolaryngeal position that exceeds normative expectations asdetermined through quantitative analysis of ultrasonographic laryngeal imagesmeasuring change from rest to phonation

• Demonstrate voice problems that have persisted for less than 2 months

• Do not demonstrate self-reported increase in speaking effort

• Do not show evidence of speech breathing abnormalities relative to acceptednormative values