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Speech Therapy

Voice & Fluency.

Monkey Mouths Voice & Fluency

Vocal Nodules

Vocal nodules are benign growths that form on the vocal cords due to vocal abuse or misuse. Nodules typically develop due to repeated strain on the vocal cords, such as:

Vocal nodules can cause symptoms like:

It is crucial for children experiencing symptoms of vocal nodules to seek evaluation from an otolaryngologist and follow-up treatment from a speech-language pathologist.

Vocal Cord Dysfunction

Vocal cord dysfunction (VCD), also referred to as paradoxical vocal fold motion (PVFM), is a condition characterized by the abnormal closure of the vocal cords during inhalation or exhalation, leading to breathing difficulties. Unlike asthma, which it can mimic, VCD does not involve inflammation or constriction of the airways but rather a dysfunctional movement of the vocal cords.

Diagnosis usually involves laryngoscopy by an otolaryngologist, pulmonologist, or allergist to visualize the vocal cords during episodes of breathing difficulty.

Once the diagnosis of VCD has been made by a physician, the child or adult is typically referred to a speech pathologist at Monkey Mouths for treatment.

Symptoms of VCD may include:

These are often triggered by exercise, emotional stress, or exposure to irritants.

Monkey Mouths Voice & Fluency

Vocal Cord Dysfunction Treatment

Our speech pathologists at Monkey Mouths play a vital role in helping children and adults with vocal cord dysfunction by providing comprehensive assessment and targeted therapy. At Monkey Mouths, a treatment plan for vocal cord dysfunction typically requires an evaluation and 6-8 follow-up visits. Our SLPs teach breathing exercises and relaxation techniques to help manage episodes of dysfunctional vocal cord closure. They can also provide education on triggers and strategies for avoiding or minimizing them. Our SLPs work closely with other healthcare professionals, such as pulmonologists, otolaryngologists, and psychologists, to ensure a multidisciplinary approach to treatment that addresses all aspects of the individual’s well-being.

Nasality Disorders

Hyponasality – This occurs when there is too little nasal resonance during speech. It can make the voice sound too “oral” and lacking the normal nasal quality.

Hypernasality – This occurs when there is an excessive amount of nasal resonance during speech. It can make the voice sound too “nasal” and may be accompanied by issues such as nasal air escape.

Diagnosis of hypo- and hypernasality typically involves a comprehensive evaluation by an otolaryngologist for evaluation of structural differences and use of nasal endoscopy to view the movement of air through the nose and mouth during speech activities.

Monkey Mouths Voice & Fluency

Nasality Disorder Treatment

Based on the otolaryngologist’s findings and our own voice/articulation evaluation, our speech pathologists at Monkey Mouths develop a treatment plan tailored to your child’s needs.

This may include:


Treatment for fluency disorder involves a combination of techniques and strategies aimed at improving speech fluency and reducing stuttering. You and your child will work directly with a speech pathologist at Monkey Mouths who specializes in stuttering. Our speech pathologists can help identify specific speech patterns and behaviors that contribute to stuttering and provide techniques to improve fluency.

Common approaches used in fluency therapy include:

1. Breathing exercises – Learning proper breathing techniques can help reduce tension and improve speech flow. Techniques such as diaphragmatic breathing and slow exhalation can be beneficial.

2. Relaxation techniques – Stress and anxiety can worsen stuttering. Therapists may teach relaxation techniques, such as progressive muscle relaxation or mindfulness exercises, to help manage anxiety and promote smoother speech.

3. Fluency shaping techniques – These techniques aim to modify speech patterns to achieve more fluent speech. Examples include prolonged speech, gentle onset of sounds, and easy starts.

Monkey Mouths Voice & Fluency

4. Stuttering modification techniques – This approach focuses on managing and embracing stuttering rather than trying to eliminate it entirely. Techniques such as voluntary stuttering, cancellation, and pull-outs help individuals gain control over their stuttering and reduce negative emotions associated with it.

It is important to note that stuttering therapy is highly individualized, and what works for one child may not work for another. Our qualified speech pathologists at Monkey Mouths can assess your child’s individual needs and develop a personalized therapy plan.