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Speech therapist-phoniatrician

A speech therapist is a doctor specialising in working with children and adults to identify the sounds missing in one’s speech and to teach the correct pronunciation of any sounds pronounced incorrectly.

Phonopaedia is a subdivision of speech therapy that combines knowledge of methods and techniques for eliminating voice impairments. The phoniatrician’s scope of competence covers issues related to the assessment of voice function and diagnostics for purposes of speech therapy as well as prevention of voice impairments.

Indications for seeking a consultation?

Voice impairments can occur at any age and are observed in 5-6 per cent of children and 3 per cent of adults. People working in professions based on the use of voice – professional singers, teachers, actors, presenters, barristers etc – are among the regular patients. Complete or partial loss of voice due to overload affects the ability to work and causes discomfort. A large proportion of laryngeal disorders are marked by voice function impairment:

  • Organic disorders: singer’s nodes, polyps, Reinke’s oedema, haemorrhages;
  • Functional disorders: dysphonia (various types), phonasthenia, abnormal voice mutations in children during puberty;
  • Oncological diseases of the larynx (in cases where the client has undergone laryngectomy, an important part of the speech therapist’s or phoniatrician’s work is to teach the use of voice required for communication);
  • Laryngeal nerve paresis etc.

Preparing for a visit

When going to see a speech therapist, you should take with you all abstracts from your medical record or discharge reports provided by hospitals, outpatient clinics and specialists, if any, that are related to the specific disorder or disease. This helps the doctor to obtain maximum information which facilitates establishing the diagnosis and helps choose the most appropriate treatment strategy. Besides, this information saves time and money as it may turn out that some of the medical examinations required have already been performed and it is not necessary to repeat them.

Course of treatment?

Prevention of voice impairments is a team work involving physicians, speech therapists or phoniatricians, psychologists and physiotherapists. Voice therapy is started upon doctor’s recommendations specifying the desired starting time of phonology exercises and the desired stress intensity of vocal cords. In case of individual functional voice impairments, e.g. in case of phonasthenia, a phoniatrician may perform an assessment of the orotundity (degree of fullness, strength and clarity) and quality of the voice and adopt an individual decision on starting exercises. A phoniatrician performs an auditory assessment of the voice.

The purpose of the phoniatrician’s work is to restore the sonority of the voice and to introduce it in the spontaneous speech. In the phoniatrician’s work, a great deal of attention must be paid to the prevention of voice impairments because only a well-trained voice and awareness of the vocal hygiene prevents loss of the voice. The most frequent methods used for the correction of voice impairments are phonopaedic methods which are based on a balanced gradual activation of the laryngeal muscles and development of proper breathing as well as use of orthophonic exercises.

Phonopaedic programme:

  • Regimen to restrict voice usage;
  • Breathing exercises;
  • Exercises for strengthening neck and larynx muscles;
  • Exercises for the voice;
  • Vocal exercises.

Specialist services: speech therapist-phoniatrician Dace STRAUTMANE