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| Hearing Services |
| Speech & Voice Care |
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Speech and Voice Services |
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The Vocal Wellness Center is located in our West office.If you are a singer or professional voice user: For adults and pediatric patients:
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What happens during a voice center visit?
- You’ll meet with one of our speech pathologists to review your past medical history.
- We’ll conduct an analysis of your voice using special computer software.
- We’ll look at the vocal folds with a scope and special light called a Videostroboscopy.
- The physician will then review the exam with you and discuss a treatment plan.
Speech and voice services
Whether you use your voice for a living -- or are looking for advice on your newborn’s “spitting up” problem – ENT Clinic of Iowa can help.
Services for adults and |
Pediatric services |
| Voice disorders | Voice disorders |
| Videostroboscopy | Videostroboscopy |
| Speech disorders | Speech disorders |
| Speech and voice problems due to head and neck cancer patients | Articulation and language |
| Speech problems due to strokes | Swallowing problems |
| Swallowing problems | Breathing problems |
| Voice services for professional voice users | Resonance problems |
Learn more about Videostroboscopy the most advanced technology available for evaluation of voice disorders.
Recognizing when there is a problem
Professional voice users
If you experience one or more of the following symptoms, contact ENT Clinic of Iowa for a complete evaluation:
- Hoarseness lasting for more than two weeks
- Difficulty projecting your voice
- Vocal fatigue, or voice gets tired after talking for any length of time
- Reduced range, breaks or gaps in the range, difficulties through the passagio
- Clearing the throat or excess throat mucus
- In general, an inability to do things with your voice that you could once do
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You or your child
Contact ENT Clinic of Iowa for a complete evaluation if you or your child experience one or more of the following symptoms:
- The voice sounds hoarse after talking for long periods of time or in noisy situations
- The voice is breathy, lower or higher pitched and/or has breaks in pitch
- Difficulty projecting
- Loss of voice or vocal fatigue with persistent hoarseness
- A lump in the throat
- Clearing the throat often
- Reduced range in the singing voice
- Pain or soreness in the neck or shortness of breath
- Inability to do things with your voice that you were once able to do
What causes common vocal problems?
A variety of factors can alter common male and female vocal folds and contribute to voice problems:
- Illness
- Surgery
- Trauma
- How you use your voice to speak and sing
- Reflux disease
- Smoking
- And many more
For example, overuse can result in problems such as nodules or polyps
Reflux disease
Silent acid reflux disease can also cause problems with the speaking. It also affects the singing voice; professional voice users may notice the following common symptoms:
- Reduced range
- Gaps in the range
- Vocal fatigue
- Throat clearing
- Cough
- Feeling as though there is a lump in the throat
Reflux Symptom Index Scale Test: Rate the following items on a scale of 1-5. The composite of these scores should be 10 or below. If it is more than 10, you should consider an evaluation to check for “Silent Gastroesophageal Reflux Disease,” or GERD.
The Reflux Symptom Index
Within the past month, how did the following affect you?
0 = No problem
5 = Severe problem
| Hoarseness or a problem with your voice? | 0 | 1 | 2 | 3 | 4 | 5 |
| Clearing your throat? | ||||||
| Excess throat mucus or postnasal drip? | ||||||
| Difficulty swallowing food, liquids or pills? | ||||||
| Coughing after you ate or lie down? | ||||||
| Breathing difficulties or choking episodes? | ||||||
| Troublesome or annoying cough? | ||||||
| Sensations of something sticking in your throat | ||||||
| or a lump in your throat? | ||||||
| Heartburn, chest pain, indigestion, or stomach acid coming up? |
Gastroesophageal reflux disease (GERD) in infants
“Spitting up” is normal in infants; however, for some it can become a problem and can lead to difficulties breathing, sleeping and getting proper nutrition.
Signs and symptoms:
- Baby squirms after feeding
- Baby arches after feeding
- Baby coughs or gags in crib
- Poor weight gain
- Baby dislikes eating
- Constant hiccups
- Chronic nasal congestion
- Frequent choking
- Baby has sour breath
- Regular cough
Speech disorders
Developing speech skills is not an easy task. Children often make mistakes learning to speak, and while most drop these errors as they get older, some children will continue to struggle to master speech by the “appropriate” ages.
Consider calling a professional if you observe the following:
- Family members or friends have a hard time understanding your child.
- A child gets frustrated because of an inability to express himself/herself.
The chart below provides general guidelines of sound mastery.
90% of Children Have Mastered these Sounds…By Age
| p,d,m,w,h,n | 2 years old |
| t,b,k,g | 3 years old |
| f,v,y | 4-5 years old |
| s,z,j,l,r,sh,ch,th,blends | 5-7 years old |
Reference – Mawhinney, Linda and McTeague, Mary Scott. (2004) Early Language Development. Greenville: Super Duper Publications
Swallowing problems
The act of swallowing is an orchestrated event involving many muscles. Problems may occur in the mouth with the lips or tongue, such as drooling or “pocketing” the food in the cheek. You may experience difficulties in the throat with food or liquid sticking, or going down the wrong way into the lungs. There also can be problems in the esophagus or the tube leading to the stomach.
Symptoms
The most common signs of a swallowing problem include:
- Coughing while eating or drinking, or very soon after eating or drinking
- Your voice sounds wet or gurgly during or after eating
- Increased congestion in the chest after eating or drinking
- Prolonged meal times
- Multiple swallows are needed on a single mouthful of food
- Difficulty or increased effort to chew or swallow
- Fatigue or shortness of breath while eating
- Rise in temperature
- Weight loss associated with increased slowness in eating
- Frequent pneumonia
ENT Clinic of Iowa offers FEESST (Fiberotic Endoscopic Evaluation of Swallowing with Sensory Testing) evaluations. We can conduct this test in our office or in a local care facility via a portable method. The test involves passing a flexible scope through the nose and recording video images while the patient eats and drinks. A physician reviews the exam and makes a medical diagnosis, and a speech pathologist makes recommendations for rehabilitation and/or compensatory techniques to make swallowing easier.
Breathing problems
Breathing problems can occur in all ages – from newborn infants to adults. The links below demonstrate some common breathing difficulties.
Laryngomalacia is the collapse of laryngeal cartilage while breathing. It is most common in infants.
Paradoxical Vocal Fold Dysfunction (PVFD) is a breathing problem that occurs when the vocal folds close instead of open. PVFD is common in athletes and is often misdiagnosed as asthma. In fact, patients may be seen by multiple specialists before a diagnosis is made.
Common symptoms of PVFD include:
- Wheezing
- Shortness of breath
- Tightness of the throat and or chest
- Voice changes
- Dry cough
- Causes of breathing attacks include:
- Exposure to cleaning chemicals
- Exposure to cigarette smoke
- Noxious odors such as perfume or scented candles
- Exercise
Resonance problems
Hypernasality is too much sound through the nose while speaking. It can occur in both children and adults – sometimes following a tonsillectomy or adenoidectomy. Children with cleft palate or history of cleft palate may also experience this problem.
Hyponasality is not enough sound through the nose while speaking. This occurs due to a blockage in the nasal passage, and may occur in patients with enlarged tonsils or adenoids, or nasal congestion.