Aronson Psychogenic Approach

All voice disorders whether functional or organic exhibit a degree of musculoskeletal tension. Musculoskeletal tension may be the cause of a functional disorder and a way for an organic disorder to compensate, thus adding to the problem. Aronson suspects that functional voice disorders have the ability to phonate at the appropriate pitch, however the muscular tension has pulled the larynx out of position. Once the normal muscular state has returned the correct pitch will follow.

The following are the underlying principals to therapy for musculoskeletal tension associated with vocal hyperfunction.

1. Extrinsic and intrinsic laryngeal muscles are responsible for the abnormal voice. The tension of
    these muscles inhibit the capability of the larynx to produce a normal voice.

2. When the muscles are massaged, the tension is released.

3. Lowering the laryngeal position in the neck permits normal phonation.

Aronson's treatment approach is two-part. First, precipitating or maintaining factors must be probed. Second, physical manipulation of muscle tension and lowering of the laryngeal position. Aronson also suggests chewing therapy, progressive relaxation, and biofeedback as well as, yawn-sigh and increased air flow during speech to relax hypertension.

Aronson's Pressure and Massage Technique

1. Identify the tips of hyoid bone and exert pressure in a circular motion.

2. Move into the thyrohyoid space and massage in a circular motion moving posteriorly
    from the thyroid notch area.

3. Massage the posterior borders of the thyroid cartilage.

4. With fingers, move along the superior border of the thyroid cartilage exerting pressure
    in a downward manner in order to move the larynx down.

5. During maneuvers the client is asked to phonate vowels. When a positive change in
    the voice is noticed, the focus becomes producing that voice with and without manipulation.