Essay: Production of a sound

The sound continues through the upper vocal tract and is modified by various resonators in the pharynx, oral, and nasal cavities. This process results in the production of a sound. A sound, by definition, is not always speech. For example, infants are prone to babble, dogs are prone to bark, and grown adults laugh. A voice disorder can be diagnosed when the vocal cords do not produce a clear sound. Specifically, a voice disorder can be defined as “a disturbance of pitch, loudness, or quality of the voice in relation to an individual’s age, gender, or cultural background” (“Voice Disorders,” 2018). These dysfunctions result from a compromise in vocal quality, including pitch, loudness, resonance, sound quality, and duration. Perceived pitch is the highness or lowness or a sound based on the frequency of the sound waves. Perceived loudness describes the volume, or amplitude, of a particular sound. In a voice disorder, these qualities will differ from what is considered to be standard for speakers of similar age, gender, and culture. Voice disorders can come in many different forms, transforming a speaker’s voice to be rough and hoarse, or strained and choppy, or whispery and breathy. These qualities are only the surface of the complex reality of voice disorders.
The prevalence for voice disorders can be contingent upon a multitude of factors including age, gender, and occupation; however, phonation abnormalities are by no means uncommon. The National Institute on Deafness and Other Communication Disorders (NIDCD) reports that, in the United States, approximately 17.9 million people have had trouble using their voice. These abnormalities in phonation are vast and can affect men, women, and children. According to data from the NIDCD, of these 17.9 million people that reported voice difficulty, 9.4 million were adults and 1.4 million were children that reported having persistent problems that lasted over twelve months or longer. Further, though the prevalence for voice disorders clearly has the ability to affect anyone, research has suggested that those who work specific types of jobs are more prone to be affected by some type of voice disorder throughout the course of their lives. The University of Iowa published an article that focused specifically on teachers and their increased likelihood for being diagnosed with a voice disorder. The article stated that teachers make up about 4% of the workforce in the United States, and they account for about 20% of the patient load in voice centers across the country. Though the research cited does not seem to be able to pinpoint an exact explanation as to teachers are more vulnerable than other occupations that have high levels of voice-usage, it does offer several possible reasons for why this is the case. One explanation is that because children have less language experience than adults, they must be able to hear their teacher’s voice incredibly well over any background noise in order to be able to learn effectively. In an attempt to make sure that all students are learning most optimally, many teachers are likely to raise their vocal volume higher than is necessary. Another hypothesis details the differences in the vocal tract between men and women. Since women phonate at much higher pitch than men, their vocal folds collide more times per a given period of time than those of men. This example could explain why women may be more prone to specific voice problems, like nodules. More research conducted by Roy, Merrill, Thibeault, Gray, and Smith (2004) sought to examine the frequency and adverse effects of voice disorders in teachers versus the general population. After conducting an encompassing survey, the researchers found that, compared to the general population, teachers were more likely to report multiple voice symptoms, attribute these symptoms to their occupation, and miss work more often because of these voice problems.
When diagnosing an abnormality of phonation, the American Speech-Language-Hearing Association (ASHA) states that “a voice disorder is present when an individual expresses concern about having an abnormal voice that does not meet daily needs—even if others do not perceive it as different or deviant. Aside from the many relevant voice disorders, a number of systems are used for classifying these disorders. ASHA describes the organic classification as a voice disorder that is “physiological in nature and result[s] from alternations in respiratory, laryngeal, or vocal tract mechanisms.” Structural classification is defined as an “organic voice disorder that results from physical changes in the voice mechanism.” An example of structural classification includes vocal nodules and changes that occur in the larynx as a result of aging. Neurogenic classification is described by ASHA as an “organic voice disorder that results from problems with the central or peripheral nervous system innervation to the larynx that affects functioning of the vocal mechanism.” An example of a voice disorder that is classified as neurogenic includes spasmodic dysphonia and paralysis of the vocal folds. Finally, functional voice disorders “result from improper or inefficient vocal mechanism when the structure is normal.” An example of this includes the example of teachers mentioned earlier. Further, there is a high chance of comorbidity among voice disorders, making them rarely mutually exclusive when being diagnosed. A great example of this that is included on the ASHA website is as follows: “the etiology of nodules is functional, as they result from behavioral voice misuse. The voice misuse results in repeated trauma to the vocal folds, which many then lead to structural changes in the vocal fold tissue.”
Speech-language pathologists play an important part in a range of tasks associated with diagnosing and treating voice disorders. SLPs work to identify normal versus abnormal phonation and to assess the vocal habits and constraints of a patient, to provide treatment, to document the progress of the treatment, and to determine the extent and intensity of treatment needed. Many times speech-language pathologists will refer a patient to other medical professionals if more severe treatment, like surgery, is needed.