Question
If the vocal folds are too wide apart from misuse and abuse of the voice, what exercises can be done to get the vocal folds corrected? The student's voice is very husky.
Answer
My interpretation of the condition you describe is that your student has a vocal fold lesion(s) that is preventing complete closure of the vocal folds. Phonotraumatic behaviors such yelling, hard onsets, throat clearing, etc. can cause those benign lesions. (By the way, 'phonotrauma' is the latest term in voice lingo to replace vocal abuse/misuse). We often classify voice disorders caused by phonotrauma as hyperfunctional.
Therapeutically, hyperfunctional voice disorders respond best to treatment techniques that minimize the impact stress on the vocal folds. To do this, you want to create an efficient phonatory system that balances vocal fold vibration with the appropriate amount of airflow. Resonance voice therapy techniques tend to work well for this purpose. As a general overview, a 'resonant' voice is produced with vocal folds that only have light contact during vibration. The power for voice production is provided by an easy, exhalatory air stream. The most facilitating method of finding a student's resonant voice is with a hum at a speaking pitch. The hum should be short in duration (2-3 secs) so as not to add tension and with conversational loudness or less. Patients often report effortless voice production and vibratory sensations in the face when the technique is right. Once the resonant hum is established, you now have a perceptual referent for all other phonatory stimuli. You gradually increase the complexity of target stimuli from CV syllables with /m/ as your consonant, to /m/ words, /m/ phrases, and then carry-over to non nasal stimuli. You can find several resonant voice therapy techniques published in the works of Dr. Daniel Boone and Dr. Katherine Verdolini. (See references below).
As a supplement to therapy, you would also want to include some vocal hygiene education for your student and/or caregivers. Vocal hygiene teaches patients how to optimize the care of their vocal folds as part of preventative vocal health. Vocal hygiene strategies include hydration of the vocal folds systemically by drinking adequate amounts of water and avoiding diuretics such as caffeine and superficially with moisture supplied from humidified air or vaporizers. General health strategies also apply such as adequate rest, minimizing stress, and proper nutrition. See this website for a vocal hygiene handout developed by the National Center for Voice and Speech. www.ncvs.org/ncvs/library/pubs/bkmrk.pdf
As a final note, there are some benign vocal fold lesions (e.g.s., polyps, cysts) that will not resolve completely with therapy alone. The lesion may need to be addressed surgically. However, most surgeons will not operate on pre-pubescent vocal folds. So, even if your student implements the optimal speaking technique, some 'huskiness' may persist.
Verdolini-Abbot, K. (2008). Lessac-Madsen Resonant Voice Therapy. Plural Publishing.
Boone, D., McFarlane, S. & VonBerg, S. (2004). The Voice and Voice Therapy (7th ed.). Allyn & Bacon.
Please visit the SpeechPathology.com eLearning Library to view courses on voice disorders and many other topics in the field.
Lori Lombard, PhD is a professor at Indiana University of Pennsylvania specializing in voice and laryngectomy rehabilitation. She has over ten years experience in the evaluation and treatment of voice disorders from the University of Pittsburgh Voice Center.