Empty nest syndrome treatment strategies
Spasmodic dysphonia, a long-term voice disorder that impacts movement of the vocal folds, can significantly impact a person’s quality of life.
Those diagnosed with spasmodic dysphonia often present with a weak, broken, or whisper-like vocal quality that makes it difficult to speak clearly and effectively.
Speech-language pathologists (SLPs) are integral members of the care team for patients diagnosed with spasmodic dysphonia.
They may aid in assessment and treatment of the condition, helping individuals increase their communicative efficacy and quality of life.
For those seeking to find out more about spasmodic dysphonia causes and spasmodic dysphonia treatment, this article contains information to guide SLPs in supporting clients with this complex voice disorder.
What is dysphonia?
First off, to answer “What is dysphonia?”, let’s look at the definition from The American Speech-Language-Hearing Association (ASHA). They describe dysphonia as encompassing “the auditory-perceptual symptoms of voice disorders” which are “characterized by altered vocal quality, pitch, loudness, or vocal effort.”
Generally, dysphonia involves a breathy, strained, strangled, or rough vocal quality.
It can also present as abnormalities in volume, pitch, and resonance.
Some people with dysphonia experience loss of voice, a shaky voice, or phonation breaks.
Unlike apraxia of speech, another neurologically based disorder that impacts communication, dysphonia affects the production of voice rather than the sequencing of speech sounds.
A client with dysphonia may cough or clear their throat often.
They may also run out of breath easily.
Speaking is typically effortful for these individuals, leading them to seek out support from a speech therapist.
Spasmodic dysphonia—sometimes called laryngeal dystonia—is one type of dysphonia that SLPs may encounter when treating clients with voice disorders. It is relatively rare, affecting about 500,000 individuals in the United States, according to Cleveland Clinic.
Types of spasmodic dysphonia
A task-specific movement disorder, spasmodic dysphonia causes involuntary spasms in the larynx muscles when individuals attempt to speak.
The result is compromised vocal quality. Clients may present with a strained, breathy, or whispery-sounding voice.
These spasms do not impact the larynx when individuals laugh, sing, or hum; they are only present during connected speech.
There are three main types of spasmodic dysphonia:
Adductor spasmodic dysphonia
By far the most common variety of spasmodic dysphonia, adductor spasmodic dysphonia accounts for up to 80% to 90% of cases of this voice disorder.
Typically, the thyroarytenoid muscle is impacted, with spasms forcing the vocal folds together and keeping them closed for longer than usual.
Individuals with this type of spasmodic dysphonia have the most difficulty producing voiced sounds. This makes it particularly challenging to speak, since most words contain these types of sounds.
Abductor spasmodic dysphonia
In abductor spasmodic dysphonia—which affects about 10% to 20% of those with spasmodic dysphonia—the posterior cricoarytenoid muscles open as a result of spasms.
This abduction of the vocal folds lasts longer than normal and creates challenges when producing voiceless sounds (like “f” and “s”) in connected speech.
People with abductor spasmodic dysphonia may have a breathy vocal quality.
Mixed spasmodic dysphonia
The most rare type, this form of spasmodic dysphonia involves a combination of adductor spasmodic dysphonia and abductor spasmodic dysphonia symptoms.
What causes spasmodic dysphonia?
While the origin of this voice disorder is not fully understood, it is characterized by tremors in the vocal folds as a result of messages from the nervous system.
There are no structural-anatomical abnormalities within the larynx associated with this condition.
Rather, spasmodic dysphonia causes are neurological in nature.
The National Institute on Deafness and Other Communication Disorders contains health information on spasmodic dysphonia that points to abnormalities in the basal ganglia, the part of the brain that controls and coordinates muscle movements.
These abnormalities may be linked to gene mutations, as there are reports of spasmodic dysphonia running in families.
For some individuals, dystonia (a neurological condition that affects the muscles throughout the body) may precipitate a spasmodic dysphonia diagnosis.
According to ASHA’s overview on voice disorders, long-term stress can also be a contributing factor.
The onset of spasmodic dysphonia typically occurs in middle-age, and women are more likely to be affected than men.
Symptoms often develop gradually, increase in severity for the first year or two, and then remain relatively stable in the longer-term.
Spasmodic dysphonia treatment
Spasmodic dysphonia causes vocal spasms that impact quality of life and communicative efficacy.
Individuals affected with this disorder often seek out therapy with a speech-language pathologist alongside other forms of intervention.
Spasmodic dysphonia treatment may involve botulinum toxin (Botox) injections into the vocal folds, which improves vocal quality for several months by weakening the larynx muscles.
Patients must return for injections periodically to maintain these improvements in voice production. Botulinum toxin is most effective for adductor spasmodic dysphonia.
SLPs are often sought out for voice therapy in tandem with Botox injections.
By offering strategies to support clients in altering voice production, speech therapists can support individuals with spasmodic dysphonia in speaking more clearly and effectively.
Voice therapy for spasmodic dysphonia is typically short-term.
SLPs may help clients learn to:
Reduce strain and tension during phonation
Use diaphragmatic breathing to support vocalization
Change voiceless sounds to voiced sounds
Perform vocal exercises that can improve vocal quality
Alter volume to communicate more effectively
Augmentative and alternative communication (AAC) may also play a role in treatment.
SLPs can be instrumental in guiding clients as they select and learn to use apps or devices that amplify or improve the ease of communication.
As critical members of the care team that supports individuals with spasmodic dysphonia—which may include otolaryngologists and psychologists—SLPs can help restore a sense of hope and confidence in clients by offering techniques that enhance communicative efficacy.
Sources
American Speech-Language-Hearing Association. (2016). Overview on voice disorders.
Cleveland Clinic. (2025). Spasmodic dysphonia.
National Institutes on Deafness and Other Communication Disorders. (2020). Health information on spasmodic dysphonia.
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