Voice Therapy: Clinical Case Studies

Sixth Edition

Joseph C. Stemple, Edie R. Hapner, Lauren Timmons Sund

Details: 499 pages, B&W, Softcover, 7" x 10"

ISBN13: 978-1-63550-731-7

Release Date: 08/15/2025

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About

Now with videos!

The sixth edition of Voice Therapy: Clinical Case Studies continues to offer a comprehensive approach to voice therapy, focusing on management strategies derived from real-world clinical cases. Authored by leading voice clinicians, the cases now feature an updated format that integrates comprehensive voice evaluations, detailed treatment plans with long- and short-term goals, and new decision-making sections to guide therapeutic choices. New to this edition, videos by master clinicians enhance practical learning through visual demonstrations. The new chapters, videos, and evidence-based cases are well-suited for classroom instruction. Both novice and seasoned clinicians alike will discover invaluable insights for managing even the most challenging voice and upper airway cases.

Key Updates in the Sixth Edition

Expanded Content:
- Three new chapters addressing:
  - The comprehensive voice evaluation
  - Clinical decision-making
  - Gender affirming voice care
- Over 25 new clinical case studies offering in-depth exploration of voice and upper airway interventions.
- 37 video demonstrations that provide practical examples of a range of voice therapy techniques. Find the full list here
Enhanced Structure:
- Chapters reorganized by disorder category to facilitate seamless navigation, allowing clinicians to easily locate relevant information.
- Revised chapter introductions clarify key concepts and set the stage for deeper learning.
Detailed Interventions:
- Each case now offers greater detail on therapeutic interventions, helping readers follow treatment progress step-by-step.
New Co-Editor:
- Lauren Timmons Sund, BM, MS, CCC-SLP

Additional Features

In addition to the clinical cases and videos, this text offers:
- The voice evaluation in documentation format.
- Each case includes a dedicated decision-making section, aiding clinicians in creating personalized treatment plans.
- Cases highlight both in-person and telehealth service delivery models, reflecting current clinical practices.
- “Call-Out” Boxes spotlight critical topics and provide supplementary information to deepen understanding.

Sample Video

In this video, Maia Braden demonstrates Inspiratory Phonation.

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Videos

Contents

Foreword
Preface
Acknowledgments
Contributors
A Tribute to Prior Contributors
Video Contents

Chapter 1. The Voice and Upper Airway Evaluation
Edie R. Hapner and Lauren Timmons Sund
A Brief History of the Voice and Upper Airway Evaluation
Models of Care
The Importance of an Accurate Laryngeal Diagnosis
   Who Is Responsible?
   Laryngeal Diagnosis Informs Treatment Decisions
Components of the Voice and Upper Airway Evaluation
   The Physician’s Medical Examination
   The Speech-Language Pathologist’s Assessment
       The Case History
       Patient-Reported Outcome Measures (PROMs or PRO measures)
       Auditory-Perceptual Assessment
       Visual-Perceptual Assessment
       Cranial Nerve Examination
       Motor Speech Assessment
       Manual Assessment
   Instrumental Assessment
       Laryngeal Imaging
       Acoustic Assessment
       Aerodynamic Assessment
   Stimulability
   Documentation
Conclusions
References

Chapter 2. From Evaluation to Intervention: Decision Making in Voice Therapy
Edie R. Hapner and Lauren Timmons Sund
Is Voice Therapy an Appropriate Treatment for the Presenting Problem?
Is the Person a Good Candidate for Therapy?
Options for Care: Where Does Voice Therapy Fit?
Are You the “Right” Clinician?
Treatment Option Summaries by Disorder: Selected Examples
   Treatment Options for Muscle Tension Dysphonia (MTD)
   Treatments Options for Vocal Fold Motion Impairments
   Treatments Options for Laryngeal Dystonia and Voice Tremor
Decision Making in Therapy Planning: What Therapy to Use?
   Recalibration Strategies
   Exuberant Strategies
   Indirect and Augmentative Strategies
Decision Making in Voice Therapy Planning: How Much, How Long, and How Intense?
Putting It All Together in Decision Making: The Silent Factors
Conclusions
References

Chapter 3. Phonotrauma
Introduction
Ryan C. Branski
Case Studies
   Case Study 3.1: Conversation Training Therapy (CTT) to Treat an Adult With Benign Midmembranous Lesions
   Jackie L. Gartner-Schmidt and Amanda I. Gillespie
   Case Study 3.2: Treating a Child With Dysphonia Using Concepts From “Adventures in Voice”
   Rita Hersan
   Case Study 3.3: Multimodality Voice Therapy to Treat an Adult Female Opera Singer With a Vocal Fold Pseudocyst
   Christine Murphy Estes
   Case Study 3.4: Perioperative Therapeutic Care for an Adult With a Vocal Fold Cyst
   Austin Collum and Megan Lee
   Case Study 3.5: Multidisciplinary Treatment for an Adult With Vocal Process Granulomas After TBI
   Heather Starmer
   Case Study 3.6: Vocal Function Exercises to Treat an Adult With Undifferentiated Phonotrauma
   Joseph C. Stemple
   Case Study 3.7: Lessac-Madsen Resonant Voice Therapy to Treat an Adult With Vocal Fold Nodules
   Diana Marie Orbelo, Nicole Y. K. Li-Jessen, and Katherine Verdolini Abbott
References

Chapter 4. Muscle Tension Dysphonia
Introduction
Nelson Roy
Case Studies
   Case Study 4.1: Manual Circumlaryngeal Techniques to Treat an Adult With Primary Muscle Tension Dysphonia
   Nelson Roy
   Case Study 4.2: Boot Camp Voice Therapy for an Adult With Functional Dysphonia
   Claudio F. Milstein and Michelle Adessa
   Case Study 4.3: Flow Phonation to Treat a Teenager With Primary Muscle Tension Aphonia
   Jackie L. Gartner-Schmidt
   Case Study 4.4: Multimodality Voice Therapy for an Adult With Vocal Fatigue
   Chaya Nanjundeswaran
   Case Study 4.5: Intensive Voice Therapy for a Teenager With Mutational Falsetto (Puberphonia)
   Lisa Fry
   Case Study 4.6: Postsurgical Voice Therapy for a Child With Recurrent Respiratory Papillomatosis and Ventricular Phonation
   Maia Nystrum Braden
   Case Study 4.7: Interprofessional Assessment and Treatment for an Adult With Muscle Tension Dysphagia
   Christina Kang Rosow
References

Chapter 5. Glottal Gaps
Introduction
Aaron Ziegler
Case Studies
   Case Study 5.1: Inspiratory Muscle Strength Training to Augment Vocal Function Exercises in an Adult With Presbyphonia
   Heather Bonilha and Maude Desjardins
   Case Study 5.2: Phonation Resistance Training Exercises (PhoRTE®) to Treat an Adult With Presbyphonia
   Aaron Ziegler and Edie R. Hapner
   Case Study 5.3: Expiratory Muscle Strength Training and PhoRTE® to Treat an Adult With Presbyphonia
   Adam Lloyd and Maria Murljacic
   Case Study 5.4: Postoperative Voice Therapy to Treat an Adult With Unilateral Vocal Fold Paralysis
   Maria Dietrich
   Case Study 5.5: Interprofessional Treatment for an Adult With Unilateral Vocal Fold Paresis
   Desi Gutierrez and Matthew Hoffman
   Case Study 5.6: Multimodality Teletherapy for an Adult Avocational Singer With Unilateral Vocal Fold Paresis
   Lauren Timmons Sund
   Case Study 5.7: Interprofessional Treatment for an Adult With Sulcus Vocalis
   Amanda I. Gillespie and Clark A. Rosen
References

Chapter 6. Movement Disorders Affecting the Voice: Laryngeal Dystonia, Vocal Tremor, and Parkinson’s Disease
Introduction
Katherine L. Marks
   Laryngeal Dystonia
   Vocal Tremor
   Parkinson’s Disease
Case Studies
   Case Study 6.1: Medical and Behavioral Management for an Adult With Laryngeal Dystonia–Adductor Type
   Edie R. Hapner and Michael M. Johns III
   Case Study 6.2: Voice Therapy Without Medical Management for an Adult With Adductor Spasmodic Dysphonia
   Joseph C. Stemple
   Case Study 6.3: Teletherapy Without Medical Management for an Adult With Abductor Laryngeal Dystonia and Vocal Tremor
   Lauren Timmons Sund
   Case Study 6.4: Reducing Voicing Duration to Treat an Adult With Vocal Tremor
   Julie Barkmeier-Kraemer
   Case Study 6.5: Multimodality Voice Therapy for an Adult Classical Singer With Vocal Tremor
   Kristen Bond
   Case Study 6.6: The SLP’s Role in Deep Brain Stimulation for Vocal Tremor
   Elizabeth DiRenzo
   Case Study 6.7: Maintaining Gains from Voice Therapy Using the SpeechVive for an Adult With Parkinson’s Disease
   Jessica Huber
References

Chapter 7. Upper Airway
Introduction: Refractory Chronic Cough
Laurie Slovarp
Case Studies
   Case Study 7.1: Behavioral Cough Suppression Therapy (BCST) for an Adult With Chronic Refractory Cough
   Lisa Zughni
   Case Study 7.2: Using the Chronic Cough Clinical Checklist With an Adult With Irritant-Induced Chronic Cough
   Mariah Morton-Jones
   Case Study 7.3: Behavioral Cough Suppression Therapy for an Adult With Underlying Respiratory Disease
   Laurie Slovarp
   Case Study 7.4: Interprofessional Use of SLN Injection and BCST for an Adult With Chronic Refractory Cough
   Edie R. Hapner and C. Blake Simpson
   Case Study 7.5: Interprofessional use of Neuromodulators and BCST for an Adult With Chronic Refractory Cough
   Juliana Litts and Daniel Fink
Introduction: Inducible Laryngeal Obstruction (ILO)
Mary J. Sandage
Case Studies
   Case Study 7.6: Long-Term Management of PVFM in an Adult Following an Environmental Fume Exposure
   Carissa Maira
   Case Study 7.7: Treating Irritable Larynx in an Adult Within the Framework of Central Sensitivity Syndrome
   Linda Rammage
   Case Study 7.8: Behavioral Management for Exercise-Induced Laryngeal Obstruction (EILO) in a Collegiate Swimmer
   Mary J. Sandage
   Case Study 7.9: EILOBI Techniques to Treat an Adolescent Nordic Skier With EILO
   Emily A. Nauman
References

Chapter 8. Performance Voice
Introduction
Marina Gilman
Case Studies
   Case 8.1: Multimodality Voice Therapy for an Adult Voice Actor/Singer With a Translucent Polypoid Lesion
   M. Eugenia Castro and Megan Urbano
   Case Study 8.2: Onsite Voice Therapy for an Adult Theater Actor With Vocal Injury During Preparation and Performance
   Debra Phyland
   Case Study 8.3: Myofascial Release for an Adult Touring Musical Theater Performer With Vocal Fatigue
   Wendy LeBorgne
   Case Study 8.4: Voice Recalibration With the Cup Bubble Technique for an Adult Country Singer With Chronic Phonotrauma
   Jenny C. Muckala
   Case Study 8.5: Timing Multimodality Voice Therapy to Treat an Adult Singer With a Vocal Fold Polyp and Mild Atrophy
   Juliana Codino
   Case Study 8.6: Perioperative Voice Therapy for an Adult Praise and Worship Leader With Phonotraumatic Lesions
   Marina Gilman
   Case Study 8.7: Perioperative Voice Therapy for a High School Music Teacher With a Vocal Fold Polyp
   Maurice Goodwin
   Case Study 8.8: Perioperative Management for an Adult Jazz Singer With a Vocal Fold Cyst
   Sarah L. Schneider and Mark S. Courey
   Case Study 8.9: Multimodality Voice Therapy for a Prepubescent Singer With Vocal Nodules
   Patricia Doyle and Starr Cookman
References

Chapter 9. Gender Affirming Voice Care
Introduction
Sandy Hirsch
Case Studies
   Case Study 9.1: Using Acoustic Assumptions in Gender Affirming Voice Care for an Adult Transgender Woman
   Sandy Hirsch
   Case Study 9.2: Pitch-Elevation Surgery and Perioperative Voice Care for an Adult Transgender Woman
   Wynde Vastine and Katherine C. Yung
   Case Study 9.3: Manual Therapy in Gender Affirming Voice Care for a Transmasculine Adult on Hormone Replacement Therapy (HRT)
   Daniel P. Buckley and Felicia A. François
   Case Study 9.4: Developing a Gender Affirming Voice in a Nonbinary Adult
   Desi Gutierrez
   Case Study 9.5: Gender Affirming Voice Care for an Adolescent
   AC Goldberg
   Case Study 9.6: Gender Affirming Voice Care via Teletherapy for a Transmasculine Nonbinary Singer
   Ruchi Kapila
References

Index

Authors

Joseph C. Stemple

Joseph C. Stemple, PhD, CCC-SLP, ASHAF is Professor Emeritus, Department of Communication Sciences and Disorders, College of Health Sciences, University of Kentucky. Prior to his academic career he was the founder and director of the Blaine Block Institute for Voice Analysis and Rehabilitation, Dayton, Ohio and the Professional Voice Center of Greater Cincinnati. As co-director of the UK Laryngeal and Speech Dynamics Lab, his research focused on understanding voice disorders, specifically cell to society translational research. The overarching research goal was to enhance vocal function in those with voice disorders. He is a Fellow and Honors recipient of the American Speech Language Hearing Association.

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Edie R. Hapner

Edie R. Hapner, PhD, CCC-SLP, is the George W. Barber Junior Endowed Professor of Otolaryngology at the University of Alabama at Birmingham where she also serves as the Co-Director of the UAB Voice Center and the Director of Hearing and Speech. She is a fellow of the American Speech Language and Hearing Association and Associate Fellow of the American Laryngological Association. Dr. Hapner has served on the Board of Directors for the American Speech Language and Hearing Association as the Vice President of Planning, Coordinator of the SIG 3 Voice and Voice Disorders and chaired the ASHA Annual Convention in both 2020 and 2022. She has served as a member of the Voice Committee for the American Academy of Otolaryngology and the Education Committee for the American Bronchoesophageal Association and served on the AAOHNS Guidelines Committee for Dysphonia. She is a founding member of PAVES, Pathway for Advanced Voice Education and Service and currently serves on the Advisory Board.

Dr. Hapner’s research interests include aging voice, dystonia and adherence to voice therapy. She has co-edited Voice Therapy Clinical Case Studies Editions 4, 5 and now 6. She is co-developer of Phonation Resistance Training Exercises (PhoRTE®), an evidence-based treatment for aging voice. She developed and implemented the voice curriculum for Medbridge Inc, an online learning system for speech language pathologists. She has presented hundreds of lectures, workshops, and seminars on voice and voice disorders. She has over 70 published articles in the area of voice and voice disorders and multiple book chapters. Dr. Hapner’s greatest professional accomplishment remains the mentoring of 23 consecutive voice centric clinical fellows into this incredible world of care of the voice.

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Lauren Timmons Sund

Lauren Timmons Sund, BM, MS, CCC-SLP is the Speech Pathology Director for the USC Voice Center in Los Angeles, CA. She is the Clinical Fellowship Director at the USC Voice Center and an instructor and clinical educator for the graduate SLP program at the University of Southern California.

Lauren earned her master’s degree in communicative disorders from California State University, Northridge, completed a research internship at the University of Pittsburgh Voice Center, and trained as a clinical fellow in voice, upper airway, and swallowing disorders at the USC Voice Center under the mentorship of Edie Hapner, PhD. She holds a Bachelor of Music in voice performance from Illinois Wesleyan University.

Lauren specializes in the care of patients with voice and upper airway disorders with particular clinical and research interest in performance voice, aging voice, laryngeal dystonia, and interprofessional practice. She has published 20+ peer-reviewed articles and regularly presents locally and nationally. Lauren served as course co-director for the Fall Voice Conference 2024, is a past president of the Southern California Chapter of the Voice Foundation, a current committee chair for PAVES (Pathway for Advanced Voice Education and Service), and is on the Advisory Board for the Voice Foundation.

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Resources

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The companion website is located at: https://www.pluralpublishing.com/publication/vt6e

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