Vocal Misuse
Vocal misuse refers to specific ways you may use your voice that contribute to the development of laryngeal pathologies. These include behaviors of vocal abuse and the use of inappropriate vocal components, such as pitch, loudness, breathing strategies, phonation habits, and speech rate. Listed below you will find common vocal misuse behaviors to help you gain a better understanding of how chronic vocal abuse may cause vocal pathology.
Vocal abuse occurs whenever the vocal folds are forced to adduct (come together) too vigorously causing hyperfunction of the laryngeal mechanism. This hyperfunction, when repeated or habitual, may contribute to laryngeal tissue change, strain, and maladaptive behavior of the laryngeal musculature. Forceful behaviors associated with hyperfunction include excessive shouting and loud talking, such as children shouting on a playground or a factory worker talking loudly over machine noise. Vocal abuse also occurs during screaming and in the production of vocal noises. Vocal noises refer to those non-speech laryngeal sounds that children make while playing. The standard sounds may include the roar of car, truck, motorcycle, and spaceship engines; the piercing scream of sirens; and various growls, barks, and howls of animals.
One of the most prevalent forms of vocal abuse is incessant, habitual, nonproductive throat clearing. Throat clearing is often identified as a secondary abusive factor for patients who present with various laryngeal pathologies. Individuals frequently develop this behavior as a response to perceived laryngeal sensations. These laryngeal sensations may be caused by the presence of the pathology. Common sensations reported by patients include dryness, tickling, burning, aching, lump in the throat, or a “thickness” sensation. Patients often become hypersensitive to the laryngeal area as the result of the pathology. When this is the case, even normal sensations, such as those associated with drainage, become magnified, and a common response is habitual throat clearing. In these cases, throat clearing serves both as a symptom of the pathology and as a maintaining contributor to the disorder.
Coughing is also a vocally abusive behavior. Coughing may be the symptom of many different types of respiratory diseases. When associated with a disease process, a physician treats coughing. Coughing may also be a symptom of gastroesophageal reflux. Chronic cough, as with throat clearing, may be developed as a response to laryngeal pathology and is not always associated with disease processes. When this is the case, the voice pathologist often is called upon to extinguish this behavior as a part of the vocal management protocol.