The Voice & Voice Disorders

A Guide to Finding and Keeping Your Best Voice

What is Voice?

  • Voice is sound produced through the human vocal tract due to vibration of the vocal folds.
  • Voice production occurs in the larynx. The laryngeal body is made up of cartilages, muscles, and tissues.
  • The larynx is located at the top of the airway. The primary function of the larynx is to protect against foods and water from entering the airway, and the secondary function is to produce voice.
  • Voicing occurs as a result of the laryngeal mechanism working together.
  • Our voices reflect our personalities and emotions, and they are unique to each person.

What is considered normal voice?

Normal voice must have/be:

  • the ability to be heard
  • produced safely
  • a pleasant, non-distracting quality
  • the ability to show emotion
  • appropriate for the person's age/sex

What are Voice Disorders?

  • Voice disorders are "characterized by the abnormal production and/or absence of vocal quality, pitch, loudness, resistance, and/or duration, which is inappropriate for an individual age and/or sex" (ASHA, 1993).
  • Voice disorders affect 7% of the US Population, or approximately 20 million people at any given time.
  • Vocal misuse/abuse, dysfunction in vocal fold movement, vocal fold lesions or growths, allergies, respiratory infections, smoking, enlarged tonsils/adenoids, and head and neck cancers may all cause or result in some form of a voice disorder.
  • Voice disorders can be treated with the right professionals, and usually focus on the whole person and not just the vocal symptoms.

Types of Voice Disorders

3 Major Types:

  1. Functional Voice Disorders:
  2. Organic Voice Disorders
  3. Neurogenic Voice Disorders

Functional Voice Disorders

  • These voice problems are the result of improper function or use of the vocal folds.
  • Two types of functional voice are Muscle Tension Dysphonia and Psychogenic voice problems.
  • Examples of functional voice disorders include hyperabduction, hyperadduction, ventricular phonation, vocal fold bowing, aphonia, and puberphonia.
Functional Dysphonia (Nonorganic): A Cause for Unexplained Voice Loss

Organic Voice Disorders

  • These voice problems occur because of a structural issue or lesion within the vocal folds.
  • Examples of organic voice disorders include vocal nodules (nodes), polyps, granulomas, cysts, contact ulcers, papilloma, hemorrhage or other miscellaneous growths.
14 - Bilateral vocal nodules - post - ROVD


  • These voice problems occur as the result of some issue in the nervous system including the brain, cranial nerves, and spinal nerves.
  • Examples of neurogenic voice disorders include vocal fold paresis or paralysis, vocal tremor, spasmodic dysphonia, or voice problems that are secondary to other conditions such as Parkinson's Disease, ALS, Cerebral Palsy, Myasthenia Gravis, etc.
LSVT LOUD Speech Therapy for Parkinson disease

When to Seek Help

You should seek help from a professional if:

  • Your voice sounds hoarse or breathy
  • Your voice sounds "different" or is painful
  • You lose your voice often
  • Your voice sounds "nasal" or like you have a cold ("stuffy")
  • A feeling of "jerky" or tight voice
  • Your pitch is too high or too low
  • Your volume is too soft or too loud
  • You have have a sensation of a "lump" or "frog" in your throat
  • You become short of breath while speaking

Who can help?

  • An Ear, Nose, and Throat doctor (ENT) can view your vocal folds with specialized equipment and diagnose your vocal problem
  • A Speech-Language Pathologist (SLP) can assess your vocal hygiene and help you improve your voice through treatment
  • After seeking help from an ENT or SLP, you may be referred to a Cleft Palate or Cranio-facial Specialist if your problem is related to resonance (too nasal or "denasal")

Local Resources/Specialists

Vocal Hygiene: Do's and Don'ts

Do: Tips for optimal Voice

  • Drink plenty of water (64+ ounces per day)
  • Avoid screaming and talking in noisy places
  • Avoid excessive coughing and throat clearing
  • Use a microphone when addressing a crowd
  • Avoid smoking, excess alcohol, and toxic fumes
  • Take allergy medications if prescribed
  • Manage acid reflux

Don't: Vocally Abusive Behaviors

  • Screaming and shouting
  • Excessive whispering
  • Not resting your voice when sick or tired
  • Not resting your voice when hoarse
  • Talking over noisy environments frequently
  • Excessive craning of the neck or any behavior that causes muscle tension in the neck

Additional Resources/Web Links

CLICK HERE for: ASHA Voice Disorders Overview

A General Overview of Voice Disorders

Click here for: The Voice Foundation Website

The World's Leading Organization for Voice Research and Education

Click here for: NIDCD Information on Voice Health

National Institute on Deafness and Communication Disorders

Click here for: Lee Silverman Voice Treatment (LSVT)

A Voice Treatment Approach for Individuals with Parkinson's Disease

About the Author

Keali Lay is a graduate student pursuing a Master's degree in Speech-Language Pathology at Armstrong State University. Speech-Language Pathologists are trained in the treatment of pediatric and adult voice disorders.


American Speech-Language-Hearing Association. (1993). Definitions of communication disorders and variations [Relevant Paper]. Available from

American Speech-Language-Hearing Association (n.d.). Voice Disorders. [Powerpoint presentation].

Boone, D., & McFarlane, S. (2009). The voice and voice therapy (9th ed.). Pearson.

National Institute on Deafness and Other Communication Disorders (NIDCD). (2014). Taking Care of Your Voice. Bethesda, MD.