Services for the Voice & Upper Airway

The goal of Gender Affirming Voice & Communication Training is to provide you with the tools to explore and develop a communication style that reflects your unique sense of gender - whether fluid, fixed, questioning, non-binary, androgynous, agender, gender-neutral, masc, femme, or anywhere in between - in a healthy, sustainable way.

When outer expression is congruent with an inner sense of self, our clients find increased comfort, confidence, and improved function in everyday life. Together, we can help you explore and find your true voice.

Phonation Resistance Training Exercises (PhoRTE) is targeted voice therapy for pathologic age-related voice changes (presbyphonia) which often occur in older adults; this approach is used to systematically rehabilitate the vocal mechanism and improve vocal endurance.

Most of our clients have been surprised to learn that presbyphonia is not only common, but treatable! Our PhoRTE graduates have been successful in returning to a variety of voice-related activities, including new careers, engaging in public speaking, singing, and advocating for change in their communities.

Lee Silverman Voice Treatment / LSVT LOUD® is an effective speech/voice treatment for individuals with Parkinson disease (PD) and other neurological conditions.

SPEAK OUT!® & The LOUD Crowd® is a clinically-proven speech therapy approach for individuals with Parkinson's Disease, helping patients regain and maintain their speaking abilities with a combination of education, individual speech therapy, daily home practice, group sessions, and regular re-assessments.

Chronic refractory cough (CRC) is a truly distinct clinical entity, defined as a cough that persists despite addressing potential aggravating factors (eg, asthma, acid reflux, angiotensin-converting enzyme medications).

Some of our clients have dealt with this never-ending, embarrassing cough for years, despite having been seen by numerous specialists.

We use behavioral suppression techniques and counseling to help you “re-wire” brain pathways - in order to help you return to normal functioning.

We believe singing is the language of the soul. We also understand at a visceral level what it feels like to have lost your full voice as a form of artistic expression - and connection to yourself.

Quite frankly, it’s the reason we do this work.

As singing voice professionals, we work with you to develop a personalized treatment plan to get you back up on stage, hitting those notes and finding a sense of ease in your singing - in order to feel your best.

Whether you are concerned about voice changes due to a recent illness or disease, dealing with a vocal injury as an avid voice user (vocal fold nodules, polyps, granuloma, etc.) or just need help with overall projection, we are here to provide tailored voice treatment and help you return to your vocal baseline with confidence.

As specially trained voice and healthcare professionals, we listen to your story, help you develop specific vocal goals, and provide carefully crafted voice training - while simultaneously reducing any harmful, maladaptive vocal habits - in order to keep your voice strong and healthy for the things that truly matter.

ILO/VCD is an intermittent, yet debilitating condition which can effect the ability to breathe fully or talk, often effecting participation in everyday activities; it often occurs during exercise (EILO) or other stress-inducing tasks. Inducible laryngeal obstruction (ILO) is also known as vocal cord dysfunction (VCD) or paradoxical vocal fold motion (PVFM).

We have successfully treated patients with ILO/EILO/VCD/PVFM through a combination of education, vocal hygiene, cough suppressant strategies, and psychoeducational counseling to help them regain normal functioning.

Reflux laryngitis is a voice disorder that results from irritation and swelling of parts of the voice box due to the backflow of stomach fluids into the voice box area; this can also be referred to as laryngopharyngeal reflux disease (LPRD).

People with reflux laryngitis usually complain of hoarseness, frequent throat clearing, a sensation of a lump in the throat (globus pharyngeus), cough, or sore throat.

Heartburn, which is commonly thought of as a classic reflux symptom, does not typically occur with LPRD; heartburn is instead a common symptom occurring with Gastro-Esophageal Reflux Disease (GERD).

Treatment for LPRD by a voice therapist includes specialized counseling on non-pharmaceutical approaches to reflux management and may also include referrals to multidisciplinary specialists to help you manage the symptoms effecting your voice.

Pediatric voice therapy can be especially helpful for kiddos who use their voice aggressively or have learned unhealthy voice behaviors to combat vocal hoarseness due to a variety of voice disorders (eg. vocal nodules, cysts, etc).

We work along with you and your child’s Voice Care Team to introduce alternatives to rough play noises, learn techniques for translating comfortable voice to comfortable projection during their daily activities, and help your child learn about their vocal anatomy/physiology in a fun way.

Partial (paresis) or complete loss (paralysis) of nerve function to voice box muscles results in abnormal vocal fold function, affects the ability to speak and sing and, in some cases, also breathe and swallow. Attempts to compensate for loss of muscle function often leads to voice tiring after prolonged use (vocal fatigue).

Vocal fold paresis and paralysis comprise a range – from mild to severe – of abnormal voice box muscle functions due to varying degrees of abnormal nerve input, which may be temporary or permanent, partial or complete, and may affect one or more voice box muscles.

Vocal Fold Paresis is often missed as the cause of a voice disorder because symptoms tend to be relatively mild (eg. vocal fatigue at the end of the day).

Since there are many causes of vocal fold paresis and paralysis, the cause for each patient needs to be evaluated systematically by your voice therapist and your laryngologist. As with all voice disorders, finding out the cause assists in creating an effective treatment plan.

Also referred to as functional falsetto or mutational falsetto, puberphonia occurs when the typical change* in a maturing voice does not take place during puberty. This condition occurs more frequently in people assigned male at birth (AMAB), and they may notice a higher pitch, breathy vocal quality, difficulties with projection, neck/throat muscle tension, or frequent voice breaks.

Fortunately, as qualified voice therapists, we can easily treat puberphonia with a series of guided behavioral and manual voice techniques combined with specialized counseling.

*Typically during puberty, the natal male voice lowers by approximately one octave (eg. from C4 down to C3 on a piano), while the natal female voice lowers by only 3-4 semitones or half steps (eg. the distance between C4 down to A3 on a piano).

(Zamponi et al., 2021)

Spasmodic Dysphonia (SD) is a voice disorder resulting from involuntary movements (or spasms) of the voice box muscles, which interrupt normal voice (dysphonia) in abrupt spurts.

SD is a type of dystonia, a disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production; SD is not a psychiatric or psychological disease.

Luckily, working with a voice therapist as part of a multidisciplinary voice team can help those with SD communicate more effectively, through learning helpful strategies/techniques and voice-related counseling.