DIRECT VOICE REHABILITATION

Direct Voice Rehabilitation is a technique to help individuals recover from all types of organic voice disorders such as polyps, nodules, and contact ulcers, neurological voice disorders such as Parkinson's Disease and cerebral palsy, and functional voice disorders such as Spasmodic and Spastic Dysphonia. This technique is a variation of the Instant Voice Press technique and therefore, should not be used on individuals who are pregnant or have medical problems involving the stomach or area of the solar plexus.

Direct Voice Rehabilitation Technique:

Method 1:

1. The first step is locating and identifying the optimal or natural pitch level and range as well
    as the correct, balanced tone focus.

2. Tell the patient to say "um-hum" spontaneously and sincerely as if agreeing with someone
    in conversation.

3. The patient should feel a slight buzz or tingle in the mask area around the lips and nose if
    the "um-hum" is produced with the proper pitch and tone focus.

Method 2:

1. Have patient bend over from the waist. Keep legs straight and let arms fall forward toward
    the floor with the head hanging downward in a relaxed position (chin on the chest).

2. While the patient is in this position a hum ("um-hum") or "oh" is sustained. This position
    often breaks the body tension, allowing the production of the real voice to come forth.

Method 3:

1. Have the patient hum in the bent chin-on-chest position.

2. The patient or clinician should then gently jiggle with the fingers in a staccato fashion on the
    patient's midsection or higher (at about the level of the solar plexus).

Method 4:

1. The patient is in an upright or bent-over position.

2. With the hands, jiggle both sides of the patient's midsection (at about the bottom of the rib
    cage) in the staccato fashion while the patient is humming.

If the patient does not have midsection or central breath support, the correct breath control should be developed. Dr. Cooper suggests having the patient lie on his or her back, placing one hand on the midsection (waist) and the other on the chest. The patient should breath easily through the nostrils as if they were going to sleep. The patient should feel the midsection move out while the chest remains stationary. The exercise is then repeated while breathing through the mouth. The next step is to have the patient practice the entire exercise while standing, and then while sitting.

The patient must learn to use proper breath support along with the new voice in the therapy environment and then apply it to outside situations. Without concentrating on the proper speaking techniques, the patient can easily slide back into his/her old ways.