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Lessac-Madsen Resonant Voice Therapy

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Kierra Villines

on 4 December 2013

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Transcript of Lessac-Madsen Resonant Voice Therapy

Journey Through Resonant Voice Therapy
Guiding Principles
Systematic Approach
Foundations are the "what", "how,"
"if" of voice therapy
WHAT: Direct Therapy
HOW: Learning Process
IF: Indirect Therapy

All inclusive therapy that addresses vocal hygiene, voice modification, and post-therapy self care.

General methods
Basic training gesture (RVT)
Scan-gell-show-tell principle
Target behavior on simple phonemes
Target behavior in conversational speech
Vocal hygiene program
Self-treatment schedule/transfer
Clinical Application
-RVT (LMRVT) can be applied in a clinical setting and is useful to patients who experience difficulties with their voice. The goal is to achieve sound volume through resonance.

- Research has shown that this technique is effective for voice clients; most studies done using teachers.

- ENT evaluation and diagnosis is required before implementing this therapy approach to ensure efficacy.

- Be sure to use clinical judgment, ENT evaluation report, SLP evaluation report, and evidence- based practice to determine which vocal parameter client is having difficulty and if LMRVT is most appropriate therapy for that client.

Clinical Critique
- Our thoughts...

- Interested in training?
Webinars available for students and SLP's.

What is it?
Who Is It For?
Appropriate Patients
Credits & Acknowledgments

Evidence Based Practice
Terms to Know

1. Resonant Voice
2. Biochemical
3. RVT

Voice: Our Acoustic
Group Presenters:
Brittani Hightower
Tracey Calvo Clarke
Alicia Thompson
Kierra Villines

Thank you to Ms. Kimbrough for an amazing learning experience!
• Developed by Dr. Katherine Verdolini Abbott in the early 2000s
• Dr. Verdolini Abbott named the technique after her two mentors, Dr. Arthur Lessac and Dr. Mark Madsen
• LMRVT corrects both hypo- and hyperadducted vocal fold posturing by guiding vocal behavior toward barely-abducted or barely-adducted laryngeal posturing

• After a series of body stretches, the patient is guided through full-body introspection and observation to produce their best resonant voice
Stage 1: Neck stretches and Vocal Warm Ups
Stage 2: Voiced and Voiceless Contrasts
Stage 3: Phrases
Stage 4: Combining phrases in to paragraphs
Stage 5: Targets controlled conversation with forward focus
Stage 6: Environmental manipulation to challenge the client to use forward focus in loud places
Stage 7: Adding emotional manipulation to continue resonant voice to continue laughter, anger and other emotions.
- Bovo, Galceran, Pertuccelli, & Hatzopoulos, 2007.
- Chen, Hsiao, Hsiao, Chung, & Chiang, 2006.
- Roy et al., 2003.
- Verdolini-Marston, Burke, Lessac, Glaze, & Caldwell, 1995.
- Ziegler, Gillespie, & Abbott, in press
Inappropriate Patients
Muscle Tension Dysphonia (MTD)
Hypofunctional voice disorders
Organic lesions
Mild vocal atrophy and paralysis
Laryngeal Carcinoma (Following Radiation)

Neurologic voice disorders
Immediately after a hemorrhage
Large Glottal insufficiency
Parkinson’s disease
Chen, et.al (2007) showed that after resonant voice therapy the severity of the following voice symptoms and signs were reduced:

- strain
- monotone
- resonance
- hard attack
- glottal fry in auditory perceptual judgments
- the severity of vocal fold pathology
-mucosal wave
-vocal fold closure in videostroboscopic examinations
- phonation threshold pressure
- the score of physical scale in the Voice Handicap Index
- The speaking Fo, maximum range of speaking Fo, and maximum range of speaking intensity were significantly increased after therapy.

Lessac-Madsen Resonant Voice Therapy?
ASHA (1997-2013). Introduction to Evidence Based Practice. Retrieved from: http://www.asha.org/Members/ebp/intro/

Bovo, R., Galceran, M., Petruccelli, J., & Hatzopoulos, S. (2007). Vocal Problems Among Teachers: Evaluation of a Preventive Voice Program. Journal of Voice. 21(6), 705-722.

Chen, S. H., Hsiao, T. Y., Hsiao, L.C., Chung, Y.M., & Chiang, S.C. (2007). Outcome of resonant voice therapy for female teachers with voice disorders: perceptual, physiological, acoustic, aerodynamic, and functional measurements. Journal of Voice. 21(4), 415-425.

Everything Speech. (2011, May 3). Resonant Voice Therapy. Retrieved from Everything Speech: http://www.everythingspeech.com/articles/resonant-voice-therapy/

MultiVoiceDimensions (2013). Where Can I Read More About LMRVT?. Retrieved from: http://multivoicedimensions.org/?p=93

Roy, N., Weinrich, B., Gray, S., Tanner, K., Stemple, J.C, & Sapienza, C.M.(2003). Three Treatments for Teachers with Voice Disorders: A Randomized Clinical Trial. Journal of Speech. Language and Hearing Research. 46: 670-688.

Roth, F.P. and C.K. Worthington (2001). Intervention for voice and alaryngeal speech. Treatment resource manual for speech-language pathology. Singular Thomson Learning: Albany, NY.

Seligmann, E. R. (2005). Lessac-Madsen Resonant Voice Therapy (LMRVT): A Brief Description and Review. Summer Vocology Institute.

Verdolini-Marston, Burke, Lessac, Glaze & Caldwell (2007). Preliminary study of two methods of treatment for laryngeal nodules. Journal of Voice. 9(1), 74-85.

Vess, G. (n.d.). Voice Therapy Concepts. Retrieved from http://www.msha.ca/documents/G.Vess-4-VoiceTherapyConcepts.pdf
Ziegler, Gillespie, & Abbott (2010). Behavioral treatment of voice disorders in teachers. Folia phoniatricaet Logpaedica, 62(1-2), 9-23.
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