Question
How can I treat ventricular phonation in a 4 year old child which is most likely a result of having a trach since birth that has been recently removed? Cognition is normal.
Answer
The goal is to break the phonatory habit that has developed. There are three strategies I have found most helpful with ventricular phonation. The first is inhalation phonation. Have the child make sound on an inhale then continue that sound on the exhale. Because inhalation phonation is a novel task, it is less likely to have the habit behavior. The second approach is to try a voiced lip trill. Have the child do a 'raspberry' with his lips and then add voice to it. The lips need to be relaxed to achieve vibration and it is difficult to have tension in the vocal tract while the lips are relaxed. The third possibility may be too difficult for a 4 year old, but if the child can whistle, try to add voice during a whistle. It may also have a relaxing effect by shifting the tension forward in the vocal tract. Of course, it would also be a good idea to check with the diagnosing physician to be sure that the true vocal folds have normal structure and function.
Lori Lombard, PhD is an associate professor at Indiana University of Pennsylvania specializing in voice and laryngectomy rehab. Previously, seven years experience at the University of Pittsburgh Medical Center.
Lori Lombard, Ph.D
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