Current Practice

Voice Disorders

Laryngitis, vocal fold nodules, cysts, polyps, muscle tension dysphonia, presbyphonia, pre- and post-operative vocal fold surgery

Professional voice users (e.g. singers, actors, lawyers, clergy) are often acutely aware of the slightest changes in their voice, affecting their sound but also their confidence. My own experience helps me connect with them with empathy and insight, knowing the vulnerability of a voice that won’t behave.  I treat professional voice users who have weakness, voice breaks, roughness, and pitch breaks. Ideally, clients will first see a laryngologist for a medical diagnosis. I also emphasize the importance of attending to and warming up the speaking voice to help maintain vocal health in everyday use.

Seniors may notice voice changes that feel deeply personal or upsetting, can cause reclusiveness. Clients report that “no one can hear me” or “my voice sounds croaky and weak.”   These clients can easily respond to voice therapy, with specific exercises and vocal hygiene recommendations. It’s like going to the “vocal gym,” exercising to improve vocal balance, strength, tone and agility. If the hoarseness and weakness are severe, then an injection laryngoplasty (e.g., with the same material that fills in facial wrinkles) may be performed by a laryngologist, improving vocal fold closure.

Pediatric Voice I’ve had the opportunity to work with many children who experience voice and articulation difficulties. Working with kids comes with its own unique challenges—often, they’re not even aware there’s a problem. It’s usually parents or teachers who raise concerns. Because of this, therapy often involves the whole family to support and model new communication behaviors. I aim to make the process as fun and engaging as possible, incorporating games, art projects, cooking, and other hands-on activities that everyone can enjoy together. This approach helps encourage participation and builds consistency in reaching articulation goals.

Breathing Difficulties

PVFM, chronic cough, throat-clearing, shortness of breath

There are many terms for abnormal vocal cord movement in my scope of practice. They may include laryngospasm, Vocal Cord Dysfunction, Exercise-Induced Laryngeal Obstruction, Irritable Larynx Syndrome, even Diabolical Larynx (!). The name can depend on the cause (exercise-induced, psychogenic, reflux-related).  Generally, breathing difficulty when inhaling can cause tightness and restriction. This can result in panic because “I can’t get enough air,” or “I can’t breathe.” Originating at the larynx  (and not the lungs), it can be often misdiagnosed as asthma. Sometimes, patients have this for years before it’s correctly identified. There are many simple breathing exercises that mitigate this issue, as well as good vocal hygiene practice (e.g., getting enough hydration).

Articulation and Speech Impairments

Treatments for impairments in articulation / speech intelligibility, accent modification

I work with people with intelligibility difficulties; covering both children with articulation problems and adults who want accent modification. Both have trouble being understood in the classroom, public speaking, etc. My background in singing opera in foreign languages has made me appreciate how difficult American English can be!  There is often a separation between how English words are spelled and how they are pronounced. (e.g., blue, through, shoe or cough, rough, bough).