1. Vocal Health Frances Ascott

2. 2 When to seek professional help Persistent warning signs Cold that does not clear up Suspected reflux Frequent sinusitis Frequent tonsillitis

3. 3 How to seek professional help Speak to Sue Roper Go to GP and explain problem If advice not help ask for referral to ENT dept. If here that will be Mr Karagama at MRI or Mrs Kwaja at Wythenshawe. If not local asked to be referred to a voice clinic if for voice Ensure GP mentions you are a singer at the RNCM

4. 4 Possible problems The process may take a while Don’t leave until the last minute Many clinics monthly If ref to general ENT clinic may get junior member of staff. Good for simple ear problems Minimum assessment is a fibre-optic or rigid scope. Ideal with stroboscopy

5. 5 Fibre-optic laryngoscopy

6. 6 Rigid Endoscopy

7. 7 Indirect laryngoscopy

8. 8 Direct Laryngoscopy EUA

9. 9 Referral on to SLT Not all speech and language therapists are voice experts Not all SLTs are confident with classical singers- do not worry Mainly SLT will work with speaking technique which is usually at least part of the problem

10. 10 What you can expect from SLT Unless problem very unusual should notice changes after a couple of sessions You are required to do the work Some are very skilled on psychological issues Encourage contact with singing teacher

11. 11 What you can expect from SLT Assessment of your speaking technique Aims set so you know what you are working towards There are different ways of approaching the same problem Advice relating to your specific problem Advice regarding voice usage Exercises

12. 12 Vocal Warm-up  It is recommended that everyone warms-up at the start of the day. Whether speaking or singing. Remember no athlete would run without first stretching the muscles.  Exercising muscles to their full extent in exercises makes it easier to use them at their most efficient in speech and so prevents your voice becoming tired.  This is particularly important if you are having some voice problems or have a cold or had a late night.

13. 13 Posture  Relaxation: shake out, stretch whole body. Clench and unclench the jaw. Roll shoulders and raise to ears. Gently tilt the head from side to side: ears to shoulders and look over each alternate shoulder. Arm up to stretch intercostals  Posture: remember check: easy head / neck / back alignment. Space above waist

14. 14 Breathing  Breathing: 3 slow deep breaths then a long “ sh ” on some out breaths.

15. Siren Start quiet/off voice sound Mm/nn/ng Revving Spirals Rolled R Aim to warm up the full stretch of the vocal cords in a safe way. Can do silently

16. Yawning False yawn mouth open wide Stifled yawn Notice space at the back, raised palate Notice the space as you draw the breath in Feel the openness afterwards

17. Chewing Start small, chewing gum Large sticky toffee Add voice Aim to loosen jaw muscles, allow more natural mouth opening. Be careful if have clicking jaw

18. Tongue stretch Stick your tongue out and down as far as you can Feel the stretch at the base of your tongue Breathe though your mouth Notice the open feeling in your throat Hold for 20 seconds

19. Tongue stretch with speech Put your tongue out Try speaking clearly as you can Recite a nursery rhyme Notice the stretch in your tongue root

20. Giggle Smile Silent hee hee hee No air noise Wide feeling Maintain feeling when stopped Relaxation manoeuvres- breath, open and close jaw, move tongue round teeth, vocalise on vowels,

21. Sob Sad voice “oh” “meow” Crying Hold position and speak Protects vocal cords, good for marking music, essentially quiet voice

22. Humming Mm Many men Monday morning Many men make money Mind your manners Magpies mean much mess My mum makes marvellous marmalade

23. Muscular energy Lips- peter piper picked a peck of pickled pepper Horse blow Tongue tip – little lily lee Back of tongue – Greek grapes Soft palate ng-ah

24. Muscular energy 2 He scattered tarantulas over the roads Put thorns on the cactus and horns on the toads He sprinkled the sands with millions of ants So the man who sits down must wear soles on his pants!