Can Voice Feminisation harm my voice?

Many clients that come to us having already attempted some voice therapy independently using YouTube videos or voice Apps.  They are often concerned that they may have harmed their voice. 

Inappropriate voice use may strain or cause tension leading to voice damage known as Muscle Tension Dysphonia.  In some research studies, up to 30% of Male to female Transgender Voice clients had a voice disorder in their initial assessment caused by trauma to the voice box (larynx). Muscle Tension Dysphonia can be caused by excessive effort used when training your voice.

Muscle Tension Dysphonia can be caused by excessive elevation of the larynx, poor vocal hygiene, excessive tension and using an inappropriate pitch level. Excessive breathiness also leads to excessive tension in the larynx. 

Looking after your voice is important - read more here. 

For more information about Voice Feminisation Therapy - click here

Our aim is to prevent trauma by teaching you the best ways to achieve a feminine voice.  We are Clinical Specialists in Voice, Voice Feminisation and Voice Coaching.

What is interiorised or covert stuttering?

Interiorised stuttering is also known as covert stuttering. Someone with an interiorised or covert stutter typically presents as ‘fluent’ to others - this is because they place a great deal of effort into concealing or hiding their stutter from others. They do this by avoiding words, sounds, certain situations, or people so that they do not stutter. An analogy is being like a swan - to others you appear to be gliding through the water, but non-one can see the effort of paddling that goes on below the surface. Avoidance skills can be so well practiced that you may seem to others that you have no stutter at all. Although the stutter may be considered as mild in terms of the amount of outward stuttering in your speech, or as less of a problem as someone that stutters more frequently, we view it as a different type of challenge or as having a different impact on someone’s day to day life. 

 Although your avoidance may have reduced the stuttering, the fear of stuttering remains. You may have the fear of being recognized as ‘a stutterer’ and feel immense pressure not to stutter and to keep your stuttering a secret from otters. When you do stutter, you may feel ashamed, upset or embarrassed. You may have managed until now to keep your stuttering hidden but you feel you are no longer able to cope or to conceal it from others.  It may be affecting you in your work environment and in your relationship with others. 

Speech and Language Therapy can support you in understanding covert stuttering, reducing your avoidance, reducing your negative feelings about stuttering and being a person who stutters to make talking easier and enable you to confidently say all you want to say when you want to say it.  We are Clinical Specialists in Stammering. Feel free to book a free consultation or email us for further information.

How can a Speech and Language Therapist help with dysphagia?

What is dysphagia?

Dysphagia is the medical name for swallowing difficulties.

 What are the symptoms of dysphagia?

Signs of swallowing difficulties when eating and drinking are coughing, a wet voice, foods sticking in the throat, holding food in the mouth or difficulty chewing.

 What are the risks of dysphagia?

People may have recurrent chest infections, weight loss or become dehydrated.

Who does dysphagia affect?

It can affect people with a neurological diagnosis such as a stroke, multiple sclerosis and following head injuries. It can also affect people with head and neck cancer. 

How can Speech and Language Therapy help dysphagia?

Speech and Language Therapy can help by

• Changing the foods and fluids people drink to be safer and/or more comfortable.

•  Improving the swallow through rehabilitation exercises.

• Recommending specialist cups or straws

• Providing training to family members and clients.

Our Speech and Language Therapists are Clinical Specialists in Dysphagia. We are trained in Videofluoroscopy ( a swallow assessment using x-rays) and FEES ( a swallow assessment by endoscopy). We are additionally trained in the McNeil Dysphagia Therapy Program for chronic Dysphagia.

Should I tell my job interviewer that I stutter?

We see many people embracing change and applying for new jobs. They are often thinking about the impact the stutter might have on the interview. Its important to remember that you have been invited to interview because they have been impressed by your CV or application – you have met all the essential criteria.

Its also important to remember communication skills are not just about fluency – employers are looking for an ability to listen, problem-solve, be positive, work in a team and be flexible. They will often ask for examples of these skills within the interview questions. Many people who stutter are exceptional communicators – try to focus on your strengths.

There are also some practice interview events for people who stutter such as 50 Million voices

https://www.50millionvoices.org/

 Should I tell my interviewer prior to the interview that I stutter?

You may have thoughts regarding whether you should tell your employer whether you stutter. By telling the employer beforehand, this might reduce the pressure you feel in the interview. This is called self-advertising. We can discuss the pros and cons of this in your therapy session. You can additionally ask the employer for adjustments such as extra time. There is more information regarding this on Stammering Law

https://www.stammeringlaw.org.uk/employment/recruitment-promotion/should-i-tell-employer-i-stammer/

 What jobs can I do with a stutter?

You are not limited by the stutter. You can do any job. We treat people that are working successfully as teachers, psychologists, actors, radio presenters and many more professions that require public speaking.

 If you are not offered a job, it is useful to request feedback from your employers. Some people who stutter may assume it is because of the stutter that they are not offered the job. However, there is a set marking criteria that interviewers use and they can give you the ideal answers to support you in future interviews. This may help increase your confidence as most interviewers are keen to give positive feedback.

Speech Therapy can support you in preparation for an important job interview – to increase your confidence so that you are able to relax and perform your very best.

Here is some additional advice for interviews or employment:

 Insider secrets from a human resources professional who stutters

https://westutter.org/wp-content/uploads/ace_your_next_job_interview_july2019.pdf

 Reasonable adjustments for people who stutter

https://stamma.org/sites/default/files/2019-06/19%20Reasonable%20Adjustments%20at%20work.pdf

 Resources for employers

https://stamma.org/resources/professionals/employers

Why is my voice so high?

What causes high pitch voice in males?

During puberty, the male voice breaks and drops an octave. When a High pitch voice persists after puberty in males is called ‘Puberphonia’. Typically, the vocal folds are normal upon examination with a camera (endoscopy) that views the larynx. You may feel that you voice has never broken and lacks power. Your voice may feel effortful and sometimes painful.  You may be able to produce a deep voice but are unable to sustain it for long periods.

Why is my voice so high?

Your larynx is being held high due to inappropriate use. Puberphonia is habitual and can be treated effectively with Voice Therapy. Voice Therapy can also improve your comfort when speaking.

What does Puberphonia sound like?

• High pitch voice that does not match your age

• Pitch breaks

• Difficulty projecting your voice

• Laryngeal Muscle Tension

How do I get a deep voice?

The results of Online Voice Therapy for Puberphonia are excellent. Puberphonia Treatment is shown to be successful in achieving a deep voice if you have the desire to change your voice. Most people require 6-8 once weekly sessions following an assessment. Voice Therapy for Puberphonia focusing on lowering your pitch, reducing tension and improving projection and stamina.

Our UK based Private Voice Therapists are Clinical Specialists in Voice. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.

How can I train my voice to sound feminine?

Trans* Voice - Tips for learning and exploring your voice

In therapy you will be exploring your voice. Repetition outside the clinic room is important to change. It is comparable to going to the gym for your voice. You are developing flexibility and freedom for your voice. When learning and exploring try to:

Be Playful – try out new things

Be Mindful – notice without judging

Be Curious – use all of your sense to explore your voice

Be Imaginative – find your own images, hand gestures to support exercises

Be Positive

Be Regular – Be creative about when and where you practice – little and often.

Be Patient – Let things develop and transfer to situations that are easiest first

Be Reflective – record your voice, keep a diary

Be Sociable – try to step out of solo practice into getting support from others

Adapted from The Voice Book for Trans and Non-Binary People – Matthew Mills and Gillie Stoneham

For more information about Voice Feminisation Therapy click here

We are Clinical Specialists in Voice, Voice feminisation and Voice Coaching. Send us an email or book a free consultation for more information.

What is a cognitive communication disorder?

What is a cognitive communication disorder?

A cognitive communication disorder is a difficulty with communication caused by cognition rather than language or speech difficulties.

What causes a cognitive communication disorder?

Cognitive communication disorders occur due to damage to the brain as a result of a stroke, brain injury or any neurological disorder. It can affect someone’s cognitive processes including attention, memory and reasoning.

How do cognitive difficulties affect communication?

Cognitive difficulties are reflected in a person's communication. They may not be affected by all of the items below but you may recognise elements that you might be able to support with the guidance given.

Attention: A person’s ability to concentrate may be affected by difficulties maintaining attention. This may cause them to miss important information in a conversation.

What can you do to help someone with attention difficulties?

• Reduce distractions such as turning off the radio or television to talk in a quiet environment so they can concentrate.
• One task at a time
• Gain the persons attention before beginning an important conversation
• Give information in shorter chunks .
• Take frequent breaks when tired.

Memory: A person’s ability to remember things that have happened recently (short-term memory) and sometimes longer term. They may repeat information or be unable to recall things that have happened to them earlier in the day.

What can you do to help someone with memory problems?

• It doesn't always help to ask them questions about things that have happened recently – most people find this distressing and it will not help their memory. Give them the information and comfort them.
• Use familiar objects such as photos on your phone or a newspaper to share information together
• Talk about the past if they are able to remember as this is not reliant on short-term memory.
• Ask family and friends to write in a book and this can be used as a conversation starter of who has visited and what you may have talked about together.
• Use memory aids such as a diary and apps on phones for reminders

Reasoning/problem solving skills: A person’s ability to think through and solve a problem may be affected leading them to make poor decisions.

How to help with poor reasoning:

• break down the problem
• brainstorm solutions together
• talk about the positives or negatives of each solution
• pick a solution
• talk about what happened.

It might be that someone is unable to discuss their decisions – and they may be reliant on others to support them in making decisions in their best interest. This often involves an assessment of capacity if it is a big decision about their life. A team of professionals is normally involved in these decisions, with the patient and family.

Other aspects of cognition that are affected:

Insight: A person’s ability to understand their limitations. An example of poor insight might be a person that has a left sided weakness and are at risk of falling but they still think that they can walk by themselves.

Slowed information processing: People might find it difficult to keep up with a conversation and feel overloaded with information.

Impaired social communication skills:
When a person may not recognise ‘normal’ or ‘natural’ ways of communicating with others. This means that they sometimes are seen as rude or passive.

• Turn taking skills: talking over someone, interrupting, talking only about themselves or not starting conversations
• Not understanding body language
• Being sexually explicit or swearing lots.

What can a speech therapist do for cognitive communication disorder?

We assess using cognitive communication assessments and gather information about the person themselves to ensure we are providing patient-centered and motivating therapy to improve the persons communication and support to family members.

Is Online Speech Therapy Effective?

Online Speech Therapy (often called Tele-health in research studies) has been shown to be effective and often better in treating many conditions. Studies have looked at comparing online Speech Therapy vs seeing the clinician in person, often referred to face-to-face therapy.

Research shows us that Online Speech Therapy has shown be effective and has high levels of satisfaction for clients.

If you are interested in whether Online Speech Therapy is effective in your condition please see the relevant research below.

Is Online Speech Therapy effective for Language difficulties (Aphasia)?

The Efficacy of Telepractice on Expressive Language Outcomes for Adults with Aphasia: A Systematic Review Morgan Bailey B.S., Lauren Burningham, B.S., B.A., Erin Fifield, B.A (2018)

This study examined whether online Speech Therapy produces positive expressive language outcomes that are comparable to face-to-face therapy for adults with aphasia. They looked at all studies that have compared online Speech Therapy to face-to-face.

The results indicated that online therapy produces similar outcomes when compared to traditional face-to-face therapy.  Most studies showed positive patient satisfaction and quality of life.

Is Online Speech Therapy effective for Dysarthria (Slurred Speech)?

Telemed J E Health 2009 Nov;15(9):840-50.The Redesign and Re-Evaluation of an Internet-Based Telerehabilitation System for the Assessment of Dysarthria in AdultsAnne J Hill 1, Deborah G Theodoros, Trevor G Russell, Elizabeth C Ward

 This study showed high levels of satisfaction from patients being assessed Online. It also showed good strength of agreement between Online Speech Therapy in comparison to face – to –face assessment.

Is Online Speech Therapy effective for dysphagia (Swallowing difficulties)?

Morrell, K., Hyers, M., Stuchiner, T., Lucas, L., Schwartz, K., Mako, J., Spinelli, K. J. & Yanase, L. (2017). Telehealth Stroke Dysphagia Evaluation Is Safe and Effective. Cerebrovascular Diseases, 44 (3-4), 225-231. 10.1159/000478107.

 For swallowing difficulties (dysphagia) 100 patients were assessed comparing face to face with Tele-health (online speech therapy assessment) showing excellent agreement between therapists. This study indicated that online speech therapy was a safe and effective way to deliver dysphagia assessments online.

Evaluation of a Clinical Service Model for Dysphagia Assessment via Telerehabilitation. Elizabeth C. Ward,1,2 Clare L. Burns,3 Deborah G.Theodoros,l and Trevor G. Russell1

100 patients were assessed online and face to face. Results for swallowing difficulties were comparable to face to face assessment. There were high levels of patient satisfaction and patients felt comfortable with online assessment.

 Is Online Speech Therapy effective for Voice?

Voice Therapy Using Telecommunications Technology Pauline A. Mashima et al. American Journal of Speech Language Pathology. Vol 12. 2003.

This study showed that there was no difference in face-to-face outcomes vs online therapy. All patients had positive changes following rehabilitation for their voice through speech therapy.

 The effectiveness of Lee Silverman Voice Treatment therapy issued interactively through an iPad device: A non-inferiority study. Journal of Tele-medicine and Tele-care. 2017 Murray Griffin et al.

Lee Silverman treatment is the recommended Speech Therapy treatment for Parkinson’s Disease. It is intensive requiring four sessions a week for four weeks. For those people that struggle to travel, online therapy is ideal. This study even showed that online showed superior improvements than face-to-face therapy.

 Is Online Therapy effective for Stammering?

Research is in its infancy for stammering and online therapy. An NHS trust completed an improvement project in 2018 that looked at treating patients using online Therapy. The Therapy showed a reduction in the negative impact of stammering and many clients preferred therapy in their home environment rather than in a clinical setting.  

What can I do to look after my Voice?

• Stop smoking. If you can’t give up, cut down. Smoking irritates and damages the vocal folds. Talk to your GP about advice to support stopping smoking.

• Avoid eating spicy foods. Spicy foods can cause stomach acid to move into the throat or oesophagus, causing heartburn or reflux. If you do experience reflux, talk to your GP about possible medications.

• Avoid too much coffee, fizzy drinks and alcohol. These can dry out the vocal cords. Try drinking decaffeinated tea or coffee or follow an alcoholic drink with a soft drink.

• Avoid shouting and whispering

• If your voice feels tired or strained then rest it. This is your bodys way of telling you to rest your voice

• Try not to clear your throat unnecessarily. It can create excessive mucous and lead to a further need to clear your throat. Try drinking water instead or swallowing.

• Avoid dry and dusty atmospheres as they may dry out the vocal cords. Wear a mask in a dusty environment.

• Try to drink 2 litres (3 ½ pints) of liquid a day (not including coffee, alcohol or fizzy drinks). This will prevent dehydration of the vocal cords.

• Try steaming to keep the vocal folds hydrated

Our Private Voice Therapists are Clinical Specialists in Voice. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.

What is Aphasia?

 How is aphasia caused?

 Aphasia is caused by damage to the language areas of the brain. In most people, this is typically the left hand side of the brain. It is most commonly caused by a stroke or a brain injury. It can also be caused by progressive disorders such as brain tumors.

How does aphasia affects communication?

 It can affect a persons understanding, speaking, reading and writing. Symptoms can vary in severity from people not being able to express themselves by any means, to milder symptoms of a delay in accessing words. However, even mild symptoms can have an impact on peoples confidence requiring Speech Therapy.

Does aphasia go away?

 It depends on the cause and severity of the aphasia. If it is caused by a brain injury and stroke, it is likely to improve. If it is caused by a progressive disorder this is means that it will unfortunately not improve.

Can aphasia be cured?

Speech therapy aims to restore a persons language through exercises but also support them

Can Aphasia be treated?

The treatment for Aphasia is with Speech and Language Therapy. Evidence shows that Speech Therapy is effective for people with Aphasia following a stroke, compared to no therapy.

How can you help someone with Aphasia?

After an assessment, a Speech Therapist will be able to give you specific advice about the best ways in which to communicate.

Below is some general guidance:  

• Give the person plenty of time to respond. If a person with Aphasia feels rushed or pressured to speak they may become anxious, which can affect their ability to communicate.

• Use short, uncomplicated sentences.

• Do not change the topic of conversation too quickly.

• Avoid finishing a person's sentences or correcting their errors.

• Reduce distractions.

• If you don't understand something a person with Aphasia is trying to communicate, don't pretend you understand.

• Use visual references, such as pointing, gesturing and objects, to support their understanding.

• If they're having difficulty finding the right word, prompt them – ask them to describe the word, think of a similar word, try to visualise it, think of the sound the word starts with, try to write the word, use gestures, or point to an object.

Our Speech and Language Therapists are Specialists in Aphasia. Feel free to book a free consultation or email us for further information.