How To Do Resonant Voice Therapy Exercises

Resonant voice therapy gives patients a strong, clean, healthy voice by teaching them to speak with a forward focus and easy phonations.

In this article, you’ll learn resonant voice therapy exercises and steps to use with your speech therapy patients.

For our bestselling patient handouts and worksheets, check out the Adult Speech Therapy Starter Pack!

What Is Resonant Voice Therapy?

Resonant voice therapy is a treatment for voice disorders including muscle tension dysphonia and vocal fold nodules.

It’s a ‘physiologic’ approach, which means that it balances the 3 physiological subsystems of voice production (respiration, phonation, and resonance; ASHA, n.d.)

So how does it work? By teaching patients how to use a ‘resonant voice.’

With a resonant voice, the patient feels vibrations in the front of their face when speaking. This moves the power of the voice off of the vocal folds, reducing tension.

You’ll first teach patients how to feel these sensations during easy phonations and voiced versus voiceless sounds, then build to phrases and conversations.

There are different protocols for this treatment. The most well-known are Lessac-Madsen Resonant Voice Therapy (LMRVT) by Kathrine Verdonlini Abbott and Resonant Voice Therapy (RVT) by Joseph Stemple.

Below, we’ve put together resonant voice therapy exercises to help you get started.

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Is Resonant Voice Therapy Evidence-Based?

Yes! Evidence suggests that resonance voice therapy successfully treats voice disorders.

A 2017 systematic review found that resonant voice therapy improved voice quality and efficiency in people with dysphonia (Yiu, 2017).

Other studies concluded that voice therapy plus confidential voice decreased the appearance of vocal cord nodules and decreased vocal fold inflammation (Verdonlini-Marston, 1995; Verdonolini-Abbott, 2012)

Resonant voice therapy can also successfully treat fold cord paralysis, muscle tension dysphonia, and self-reported voice disorders of professional voice (Kao, 2017; Watts, 2019; Liu, 2022).

Resonant Voice Therapy Exercises

Below is an example resonant voice therapy protocol.

Encourage your patients to also practice their resonant voice at home. Have them record themselves doing their exercises at various times throughout the day.

Provide vocal hygiene education and consider Vocal Function Exercises if your patient needs more help with their voice disorder.

To learn a full protocol, see Verdolini Abbott’s (Lessac-Madsen’s Resonant Voice Therapy) or Stemple’s (Resonant Voice Therapy) courses.

1. Learn What A Resonant Voice With Easy Phonation Feels & Sounds Like

A resonant voice feels like a vibration (or buzzing or tickling) at the front of the face. This includes the anterior alveolar ridge, nose, teeth, lips, and facial bones.

Easy phonation means voicing and articulation feel minimally effortful and not tense.

• Start with good breath support and a relaxed, open throat
• Hum. Feel the vibration at the front of the face

2. Open /m/ Phonemes & Syllables

• Practice resonant voice by sighing an open nasal phoneme or syllable (‘molm’) on a note that’s comfortable for the patient
  • Feel the vibration at the front of the face
  • Feel the open throat
• Negative practice. Practice the phoneme or syllable at the back of the throat
  • Feel that back focus
• Switch back to a resonant voice on the phoneme or syllable
  • Again, feel the vibration at the front of the face and the open throat
• Practice the resonant phoneme or syllable sound at different:
  • Volumes (soft to loud then back to soft)
  • Pitches (high to low pitch and low to high pitch)
  • Speeds (slow to fast to slow)

3. /m/ Sentences

• Add chant talk with /m/ sentences
  • Chant talk is a monotone, easy voice (think Benedictine monks)
• Work towards more normal prosody. Model each sentence with many /m/ initial words and have the patient repeat after you
  • Emphasize a resonant voice and over-articulation

4. Voiced and Voiceless Phrases

Next, practice voiced and voiceless sounds at the word, phrase, and sentence levels.

Model each and have your patient repeat after you. Emphasize a resonant voice.

5. Conversation

Practice using a resonant voice with easy phonation in conversation.

Do negative practice throughout (dropping the voice back into the throat). Point out when the patient accidentally drops back into the throat. Both will help them be more aware of the differences between their new healthy voice and their old voice.

Increase the challenge by practicing a resonant voice outside of the controlled environment of the therapy room. Have therapy in a cafeteria, waiting room, coffee shop, etc.

Resonant Voice Therapy Video

The University of Michigan Medicine offers a great video for how to feel a resonant voice. The presenter also demonstrates a short protocol:

• Hum to feel a ‘buzzy’ voice
• Maintain the buzzy voice with ‘m’ plus a vowel sound: “Mmmme-me-me. Mmmoh-moh-moh”
• Maintain the buzzy voice with words that start with an ‘m’ or ‘n’: mom, man, maid, mine, noon, name
• If you lose the buzzy sensation, notice your body. Are you breathing? Are your body, face, and throat relaxed?
• If you feel tension, go back to humming or m-plus-vowel sounds
• Maintain the buzzy voice in phrases and conversation

Adult Speech Therapy PDFs

References

• American Speech-Language-Hearing Association. (n.d.). Voice Disorders. (Practice Portal). Retrieved Feb, 5, 2024, from www.asha.org/Practice-Portal/Clinical-Topics/Voice-Disorders/.
• Kao, Y., Chen, S., Wang, Y., Chu, P., Tan, C., & Chang, W. D. (2017). Efficacy of Voice Therapy for Patients With Early Unilateral Adductor Vocal Fold Paralysis. Journal of Voice, 31(5), 567-575. https://doi.org/10.1016/j.jvoice.2017.01.007
• Liu, H., Chen, S., Gao, L., Li, J., Liu, B., Raj, H., Xie, Q., Duan, H., Jiang, Z., Liu, Y., Chen, B., Liu, Y., & Jiang, J. (2022). Comparison Between Combination of Resonant Voice Therapy and Vocal Hygiene Education and Vocal Hygiene Education Only for Female Elementary School Teachers. Journal of voice : official journal of the Voice Foundation, 36(6), 814–822. https://doi.org/10.1016/j.jvoice.2020.09.028
• Stemple, J. A. (n.d.) Resonant Voice Therapy: Generalizing the Balanced Voice. Medbridge. https://www.medbridge.com/course-catalog/details/resonant-voice-therapy-generalizing-the-balanced-voice-joseph-stemple-speech-langauge-pathology/
• Stemple, J. A., Roy, N., & Klaben, B. K. (2018). Clinical voice pathology : Theory and management, sixth edition. Plural Publishing, Incorporated.
• Theis, S. M., Carlson, A. (2022). Voice Therapy. International Journal of Head and Neck Surgery, 13, (1): 27-31. https://doi.org/10.5005/jp-journals-10001-1518
• [University of Michigan Medicine]. (2019, September 19). Resonant Placement: Exercises for Vocal Therapy [Video]. Michigan Medicine Patient Education. https://careguides-videos.med.umich.edu/media/t/1_5i8unqa4
• Verdolini Abbott, K., Li, N. Y., Branski, R. C., Rosen, C. A., Grillo, E., Steinhauer, K., & Hebda, P. A. (2012). Vocal exercise may attenuate acute vocal fold inflammation. Journal of voice : official journal of the Voice Foundation, 26(6), 814.e1–814.e13. https://doi.org/10.1016/j.jvoice.2012.03.008
• Verdolini-Marston, K., Katherine Burke, M., Lessac, A., Glaze, L., & Caldwell, E. (1995). Preliminary study of two methods of treatment for laryngeal nodules. Journal of Voice, 9(1), 74-85. https://doi.org/10.1016/S0892-1997(05)80225-5
• Watts, C. R., Hamilton, A., Toles, L., Childs, L., & Mau, T. (2019). Intervention Outcomes of Two Treatments for Muscle Tension Dysphonia: A Randomized Controlled Trial. Journal of speech, language, and hearing research : JSLHR, 62(2), 272–282. https://doi.org/10.1044/2018_JSLHR-S-18-0118
• Yiu, E. M., Lo, M. C., & Barrett, E. A. (2017). A systematic review of resonant voice therapy. International journal of speech-language pathology, 19(1), 17–29. https://doi.org/10.1080/17549507.2016.1226953