What is Aphasia Therapy?

What is Aphasia?

Aphasia is when a person has difficulties with their language (understanding, speaking, reading and/or writing) typically as a result of a stroke or brain injury.

What is Aphasia therapy?

Typically, Aphasia Therapy starts with an assessment of your language. Language can be complex so its important for us to identify your strengths, in order to improve the areas you find difficult. We used standardised communication Aphasia assessments that assess understanding, talking, reading and writing. We discuss the results of these assessments to help you and your loved ones understand your communication difficulties. We provide advice on the best ways to support communication.

Why is Goal setting important in Aphasia therapy?

Many of us set goals in our lives. It might be on new years day when we set a goal to stop eating quite so much chocolate, during sport or part of our working lives. Following a stroke, goals are shown to improve motivation and mood.

Goal setting is a process when we get to know what is important to you as a person, what you might be finding difficult and the impact of your Aphasia. We can involve partners in this process to make it easier. These goals might be remembering family names, using the phone to order a taxi or writing emails. We are all individuals and our goals are unique to each of us.

What is the best therapy for Aphasia?

There are two types of Aphasia Therapy – Impairment and Functional therapy. Impairment based therapy is usually repeated exercises based on your goals, using paper resources or apps. Functional therapy is the focus on real life goals that reflects your everyday communication interactions with others. This might involve training family members in supportive communication skills. It is important to work on both aspects to support your communication.

Does Aphasia improve with therapy?

The treatment for Aphasia is with Speech and Language Therapy. Research shows that Speech Therapy is effective for people with Aphasia following a stroke, compared to no therapy. Research also shows that Aphasia Therapy Online is as effective as face-to-face Aphasia Therapy. You or your family member need to understand to be able to engage in online therapy - we can discuss this further in the free consultation.

How can you help someone with Aphasia?

After an assessment, a Speech Therapist will be able to give you specific advice about the best ways in which to communicate.

Below is some general guidance:  

• Give the person plenty of time to respond. If a person with Aphasia feels rushed or pressured to speak they may become anxious, which can affect their ability to communicate.

• Use short, uncomplicated sentences.

• Do not change the topic of conversation too quickly.

• Avoid finishing a person's sentences or correcting their errors.

• Reduce distractions.

• If you don't understand something a person with Aphasia is trying to communicate, don't pretend you understand.

• Use visual references, such as pointing, gesturing and objects, to support their understanding.

• If they're having difficulty finding the right word, prompt them – ask them to describe the word, think of a similar word, try to visualise it, think of the sound the word starts with, try to write the word, use gestures, or point to an object.

Our Speech and Language Therapists are Clinical Specialists in Aphasia. Arrange a free 15 minute consultation or email thespeechnetwork@hotmail.com

What is a vocal fold paralysis?

What is a vocal cord paralysis?

A vocal fold palsy or vocal fold paralysis is when one or both of the vocal folds do not open or close properly. In most cases, only one vocal fold is affected. Paralysis of both vocal folds is a rare and serious condition.

The vocal folds are two elastic bands of muscle tissue located in the voice box directly above the windpipe. When you use your voice, air from the lungs causes your vocal folds to vibrate between open and closed positions. If you have a vocal fold paralysis, the paralysed fold may remain open. The voice then becomes weak and breathy.

What causes a vocal fold paralysis?  

The most common cause is a viral infection. It can be as a result of nerve damage due to surgery, injury or certain cancers. Neurological conditions such as Parkinson’s disease of multiple sclerosis can also lead to a vocal fold paralysis.

What are the symptoms of vocal fold paralysis?

Symptoms of a vocal fold paralysis are changes to a person’s voice. A breathy, hoarse or weak voice is common. Some people report difficulties swallowing and a swallowing assessment may be required by a Specialist Speech and Language Therapist in Dysphagia. Sometimes people become more breathless with exercise or find it hard to life heavy items.

Can vocal fold paralysis be cured?

Typically, damage is temporary and will improve over several weeks. However, the majority of people will require Voice Therapy by an experienced Speech and Language Therapist to improve their voice. Treatment is available via the NHS for free. We often treat people when there is no voice therapist available or they are waiting for NHS therapy. Online Speech Therapy for Voice is effective.

Our Private Voice Therapists are Clinical Specialists in Voice. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.

What is cluttering?

Cluttering is speech that sounds either overly rapid or sounds irregular in its speed. Should you be regarded by others as speaking quickly, then you may present with cluttering.

However, in order to meet the criteria for having cluttered speech, your speech will also need to include one or more of the following features:

- frequent disfluencies such repetitions of words/phrases, the use of fillers words such as ‘um’ or ‘uh’ or the use of revisions (where you change what you are going to say mid-sentence). Whilst these features occur in the speech of all speakers, the speech of those who clutter show them a lot more frequently.

- the number of syllables in longer words are deleted or blended together (e.g. so a word like ‘computer’ may sound like “comter”)

- pauses in places that are different to what you would expect or the use of less pausing than you would expect which affects a person’s overall speech rhythm. This can result in your speech being described as “jerky” or “spurty”.

These features combined impact upon a speaker’s overall clarity. Often, those who clutter are told by others that they mumble and are often asked to repeat what they have said. They may also come across as having difficulties planning and organising what they are trying to say.

So a fast rate of speech alone does not give us the diagnosis of cluttering - there are many fast speakers that have no problems with people understanding them. The main difference is that those who clutter are regarded as speaking faster than their system can handle and this results in their speech becoming unclear due to the combined features described above.

We often work with adults that have been unaware of any difficulties in their teenage years, but now they find that their speech is impacting upon them within work or in social environments. Managers may reports concern that their clarity of speech is impacting on their performance, presentation or leadership skills at work.

What causes cluttering in speech?

There are many theories of the causes of cluttering. It is considered to be hereditary (others in your family may present with similar speech) and to do with differences in brain function. It is sometimes associated with Attention Deficit Hyperactivity Disorder (ADHD) or Autistic Spectrum Disorder, however not everyone who clutters has any co-occurring conditions.

What does therapy for cluttering involve?

The focus of therapy will vary from client to client and will depend on what aspects of your talking are impacting on your ability to communicate effectively. During therapy, you will become more skilled at monitoring your own speech and identifying what is affecting your overall clarity. For some, we may focus on reducing their rate of speech and developing their use of pausing. For others we may need to practice saying longer words and ensuring that all the syllables in the word are fully articulated. We may also focus on using appropriate word & syllable rhythms.

As you may be experiencing concerns with being misunderstood in various situations or you may have developed a fear of speaking, we may focus on helping you manage your emotions associated with your speech. Our main aim is to improve your confidence to communicate effectively in a variety of situations.

What is the difference between stuttering and cluttering?

Stuttering and cluttering often co-occur together in a person’s speech. However, the features of stuttering tend to be repetitions of sounds/syllables and single syllable words, prolongations and blocking of a sound in speech. Cluttering is rapid speech, that is often described as ‘jerky’ with unusual pauses and rhythm which affects a person’s overall clarity.

Can cluttering be cured?

While there is no cure for cluttering, Speech and Language Therapy can be effective in reducing the impact that cluttering is having on your day to day life. You can develop your confidence to communicate, learn strategies to make your talking easier and clearer, and to reduce the negative thoughts and feelings you have about your speech. Cluttering does not have to hold you back.

Our Clinical Specialist Speech Therapists are Specialists in Cluttering. Book a free 15 minute consultation or email thespeechnetwork@hotmail.com

How do you feminise your Voice ? It's not all about pitch.

Its not all about pitch

Sometimes the assumption of sounding more feminine is to focus on a higher pitched voice. However, a women’s voice is not only a higher-pitched version of a man’s voice. If we only focus on pitch, it is unlikely that you will be satisfied with the results of your therapy. In order to raise your pitch, we also need to change other aspects of your voice and speech. For natural-sounding speech we need to focus upon your intonation, resonance and other aspects to achieve a natural higher pitch. It’s important that you are able to use a flexible feminine voice that matches your personality and lifestyle, in a variety of situations.

What will happen in Voice Feminisation sessions?

Aside from pitch, we will be focusing upon:

Stress and intonation: Stress is often conveyed by using a higher pitch or louder intensity. Intonation patterns are pitch changes at the sentence level. Subtle differences in intonation patterns might hint at the speakers gender so its important to work on these aspects.

Resonance: Resonance amplifies sound and is often referred as projection in voice. We want to diminish the ‘chest’ sound that is often identified with the male voice.

Articulation: we focus on patterns for vowels and consonants that females produce that can be imitated in MTF voice training.

Volume: We might focus on reducing the loudness of your voice

Therapy is like building blocks – we build your voice together gradually. It takes practice and you will be given bespoke exercises after your sessions. The more you practice, the more natural it will feel.

How much does Voice Feminisation Therapy cost?

If you send us an email we can send your further information about number of sessions required and costs.

We are Clinical Specialists in Voice, Voice Feminisation and Voice Coaching. Feel free to book a free consultation or email us for more information.

Can Dysarthria be treated?

Dysarthria is the medical term for slurred speech. Speech Therapy Treatment for Dyarthria depends on the cause of the Dysarthria. If Dysarthria is caused by a stroke or head injury, it can improve with Speech Therapy. If it caused by a neurological disorder, that worsens over time (a progressive disorder), such as Motor Neurone Disease, it is likely to get worse. However, in these circumstances, Speech Therapy can also support you with strategies and assistive devices.

For Dysarthria due to Parkinson’s disease, there are recommended intensive treatments called Lee Silverman Voice Treatment (LSVT LOUD) or Speak out! We have trained and certified clinicians that can provide both treatments.

What Assessments do you use in Dysarthria?

We typically start treatment with a standardised assessment for Dysarthria. These assessments look at different aspects of your speech such as your breath support for speech, volume, intonation, voice and how clear your speech is to a listener. It is important to complete an assessment to identify the areas that are impacting on your speech so that we can focus on improving these specific impairments.

What is Goal setting in Dysarthria?

We discuss with you how your Dysarthria is impacting on your day-to-day life and set personal meaningful goals to improve your speech. Goal setting is proven to improve motivation for therapy and mood. These goals will be realistic, achievable and will be reviewed after a short block of therapy.

Dysarthria Therapy may include

-       Working with you and your loved ones to make communication easier

-       Exercises focusing on improving the clarity of your speech

-       Alternative ways of communication to support your speech

-       Biofeedback of recordings to raise your awareness of your speech

Our Speech and Language Therapists are Clinical Specialists in Dysarthria & Voice treatments. Arrange a free 15 minute consultation or email thespeechnetwork@hotmail.com

How do you support students who stutter with oral exams & presentations ?

In an episode of the weekly podcast ‘This American Life – Made to be broken’, Poet Jerome Ellis explained “A time limit assumes that all people have equal access to time through their speech. For me, stuttering is unpredictable and I do not know how long it will take, until I have to say it”

For a Person who Stutters, performance on timed oral assessments at university can impact on a persons ability to demonstrate their knowledge. Examples of these might be presentations, oral exams or the Objective Structured Clinical Examination (OSCE).

Is stuttering a disability?

Stuttering can be viewed as a disability for a person if it ‘has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities'. (Equalities Act, 2010).  ‘Reasonable adjustments’ are ways that the university can prevent disabled people being put at a disadvantage. Reasonable adjustments are changes that the university can make to reduce the impact of the stammer that are specific to you.

How can online Speech Therapy support students who stammer with oral exams?

Some universities require medical evidence about your stammer. We have supported students by completing an assessment and a provided a written report suggesting ways for the university to support students who stutter in their studies. This might be by recommending extended time, identifying barriers, and recommend strategies to make these examinations easier.

How might extra time in oral exams help me?

A recent medical student shared what he gained from a block of Speech Therapy

 “I'm much less anxious when participating in group discussions. Additionally, when talking to people I haven't met before, I'm not bothered by their perception of me as a stammerer than I used to before starting therapy sessions. When slowing down my speech, I stammer much less. This technique has really helped me, especially in harder situations such as public speaking and group discussions”

Despite changes of how he felt about his stutter, and having strategies to make talking easier in certain situations, he requested support for his upcoming OSCE exam and explained why having extra time would be helpful:

“I'm requesting extra time for the OSCE (objective structured clinical examination) exams to ease some of the time pressure off of me. An OSCE exam is essentially a simulated clinical environment where I can be asked anything from performing a medical examination to taking a history from a model patient. Since this is a timed exam, I'm naturally under pressure to speak quickly in order to complete the task in the allocated time. I've completed several practice runs of OSCEs before, and most of the time I finish on time.  However, there were instances where I ran overtime and I would have benefited from the extra 25% that's granted for those with extra time. The extra time would allow me to take things a bit slower and would really ease the pressure off of me, hence contributing to a bit of extra fluency”. 

After he was given extra time he explained how it was helpful:

He felt that having the extra time reduced his nerves since he knew that he had more time to complete everything and that he wouldn't need to rush through the exam. He felt that he stammered less as a result. He felt it made huge difference and he passed his OSCEs with flying colours.

How can Speech Therapy for Stuttering help?

We can provide therapy to improve your confidence, help you manage difficult thoughts and feelings about stuttering to help you with oral exams and presentations.

Our Clinical Specialist Speech Therapists are Specialists in Stuttering. Book a free 15 minute consultation or email thespeechnetwork@hotmail.com

What is Speak out! What is Lee Silverman Voice Treatment (LSVT LOUD)?

What is Speak Out! ® & Lee Silverman Voice Treatment (LSVT LOUD) loud for Parkinson’s Disease?

Speak out ! ® and Lee Silverman Voice Treatment (LSVT Loud) ® are intensive Speech Therapy treatments for Parkinson’s disease focusing on improving voice and volume. They both have a strong evidence that they are effective treatments. Both are seen as the best Speech Therapy for Parkinson’s Disease. Certification is provided to Speech and Language Therapists following a training program. Our Speech and Language Therapists are certified in both treatment Techniques and have experience of providing these treatments online with effective results.

How can Parkinson’s Disease affect speech?

Parkinson’s disease can cause people to talk quietly, have reduced variation in pitch and a hoarse voice. People with Parkinson’s Disease are often not aware that they are talking quietly - we need to work with you to recaliberate your sensory feedback to raise your awareness of your loudness, improve voice projection and reduce effort in conversation.

What is Lee Silverman Voice Treatment (LSVT loud)® for Parkinson’s Disease ?

LSVT loud ® stands for Lee Silverman Voice Technique. It is a technique that improves loudness for people with Parkinson’s disease. Studies have shown it can also be used in a variety of neurological conditions to improve Speech.

Lee Silverman Voice Treatment ® (LSVT Loud) focuses on increasing loudness. Research has also shown improvements in swallowing and articulation. LSVT requires an assessment session, and 12 therapy sessions, at 60 minutes each.

What is Speak Out® for Parkinson’s Disease ?

Speak out! was developed by the Parkinson’s Disease Project. It focuses on producing a stronger, clearer voice. It focuses on the concept of intent and strengthens the muscles used for speaking. Speak out! ® requires 8-10 sessions, at 45 minutes each. It can be easier for people to fit Speak out! ® into their daily life, and it can reduce overall cost of treatment. Speak out! provided a free training workbook for clients.

Once treatment is complete, the Parkinson’s Disease project hold LOUD crowd groups and free Facebook practice sessions. This is important in maintaining the gains in therapy.

We offer both SPEAK OUT!® and LSVT loud ® with certified clinicians

Click on the contact us button to arrange a free consultation or send us an email for more information regarding our reasonable fees for Speech Therapy for Parkinson’s Disease.

Why have I suddenly started stuttering?

Many people contact us to tell us that they have suddenly started stuttering. It may be that they stuttered as a child but the stutter either resolved or it was not having an impact on their lives. Rather than starting to stutter suddenly, their earlier stuttering may have come back unexpectedly.

It may be that you are feeling stressed or anxious – that you are having changes in your life such as interviews for a new job, going on dates with new people, or making a wedding speech. These situations may lead you to tense your muscles and lead to more stuttering, or that you are noticing the stutter more than before, in the preparation to these important events.  

It may be that work situations have changed – since the Pandemic, many people are working from home using video conferencing which may have been something you previously avoided. People report seeing themselves on videoconferencing has made them stutter more and to become more aware of the stutter.  

For a few people, stuttering does suddenly start in adulthood as a result of a neurological event, such as a stroke, and is called a neurogenic stammer. Stuttering may also start as a result of an emotional trauma, commonly known as psychogenic stuttering.  

Should you start to stutter suddenly in adulthood, following assessment we may need to make an onward referral to rule out a neurological diagnosis or to seek additional psychological support.

Speech Therapy can support you in increasing your confidence, reducing your stress and anxiety around stuttering and developing strategies to make talking easier. Click on the contact us button to arrange a free consultation or email us for more information.

Can Voice Feminisation harm my voice?

Many clients that come to us having already attempted some voice therapy independently using YouTube videos or voice Apps.  They are often concerned that they may have harmed their voice. 

Inappropriate voice use may strain or cause tension leading to voice damage known as Muscle Tension Dysphonia.  In some research studies, up to 30% of Male to female Transgender Voice clients had a voice disorder in their initial assessment caused by trauma to the voice box (larynx). Muscle Tension Dysphonia can be caused by excessive effort used when training your voice.

Muscle Tension Dysphonia can be caused by excessive elevation of the larynx, poor vocal hygiene, excessive tension and using an inappropriate pitch level. Excessive breathiness also leads to excessive tension in the larynx. 

Looking after your voice is important - read more here. 

For more information about Voice Feminisation Therapy - click here

Our aim is to prevent trauma by teaching you the best ways to achieve a feminine voice.  We are Clinical Specialists in Voice, Voice Feminisation and Voice Coaching.

What is interiorised or covert stuttering?

Interiorised stuttering is also known as covert stuttering. Someone with an interiorised or covert stutter typically presents as ‘fluent’ to others - this is because they place a great deal of effort into concealing or hiding their stutter from others. They do this by avoiding words, sounds, certain situations, or people so that they do not stutter. An analogy is being like a swan - to others you appear to be gliding through the water, but non-one can see the effort of paddling that goes on below the surface. Avoidance skills can be so well practiced that you may seem to others that you have no stutter at all. Although the stutter may be considered as mild in terms of the amount of outward stuttering in your speech, or as less of a problem as someone that stutters more frequently, we view it as a different type of challenge or as having a different impact on someone’s day to day life. 

 Although your avoidance may have reduced the stuttering, the fear of stuttering remains. You may have the fear of being recognized as ‘a stutterer’ and feel immense pressure not to stutter and to keep your stuttering a secret from otters. When you do stutter, you may feel ashamed, upset or embarrassed. You may have managed until now to keep your stuttering hidden but you feel you are no longer able to cope or to conceal it from others.  It may be affecting you in your work environment and in your relationship with others. 

Speech and Language Therapy can support you in understanding covert stuttering, reducing your avoidance, reducing your negative feelings about stuttering and being a person who stutters to make talking easier and enable you to confidently say all you want to say when you want to say it.  We are Clinical Specialists in Stammering. Feel free to book a free consultation or email us for further information.

How can a Speech and Language Therapist help with dysphagia?

What is dysphagia?

Dysphagia is the medical name for swallowing difficulties.

 What are the symptoms of dysphagia?

Signs of swallowing difficulties when eating and drinking are coughing, a wet voice, foods sticking in the throat, holding food in the mouth or difficulty chewing.

 What are the risks of dysphagia?

People may have recurrent chest infections, weight loss or become dehydrated.

Who does dysphagia affect?

It can affect people with a neurological diagnosis such as a stroke, multiple sclerosis and following head injuries. It can also affect people with head and neck cancer. 

How can Speech and Language Therapy help dysphagia?

Speech and Language Therapy can help by

• Changing the foods and fluids people drink to be safer and/or more comfortable.

•  Improving the swallow through rehabilitation exercises.

• Recommending specialist cups or straws

• Providing training to family members and clients.

Our Speech and Language Therapists are Clinical Specialists in Dysphagia. We are trained in Videofluoroscopy ( a swallow assessment using x-rays) and FEES ( a swallow assessment by endoscopy). We are additionally trained in the McNeil Dysphagia Therapy Program for chronic Dysphagia.

Should I tell my job interviewer that I stutter?

We see many people embracing change and applying for new jobs. They are often thinking about the impact the stutter might have on the interview. Its important to remember that you have been invited to interview because they have been impressed by your CV or application – you have met all the essential criteria.

Its also important to remember communication skills are not just about fluency – employers are looking for an ability to listen, problem-solve, be positive, work in a team and be flexible. They will often ask for examples of these skills within the interview questions. Many people who stutter are exceptional communicators – try to focus on your strengths.

There are also some practice interview events for people who stutter such as 50 Million voices

https://www.50millionvoices.org/

 Should I tell my interviewer prior to the interview that I stutter?

You may have thoughts regarding whether you should tell your employer whether you stutter. By telling the employer beforehand, this might reduce the pressure you feel in the interview. This is called self-advertising. We can discuss the pros and cons of this in your therapy session. You can additionally ask the employer for adjustments such as extra time. There is more information regarding this on Stammering Law

https://www.stammeringlaw.org.uk/employment/recruitment-promotion/should-i-tell-employer-i-stammer/

 What jobs can I do with a stutter?

You are not limited by the stutter. You can do any job. We treat people that are working successfully as teachers, psychologists, actors, radio presenters and many more professions that require public speaking.

 If you are not offered a job, it is useful to request feedback from your employers. Some people who stutter may assume it is because of the stutter that they are not offered the job. However, there is a set marking criteria that interviewers use and they can give you the ideal answers to support you in future interviews. This may help increase your confidence as most interviewers are keen to give positive feedback.

Speech Therapy can support you in preparation for an important job interview – to increase your confidence so that you are able to relax and perform your very best.

Here is some additional advice for interviews or employment:

 Insider secrets from a human resources professional who stutters

https://westutter.org/wp-content/uploads/ace_your_next_job_interview_july2019.pdf

 Reasonable adjustments for people who stutter

https://stamma.org/sites/default/files/2019-06/19%20Reasonable%20Adjustments%20at%20work.pdf

 Resources for employers

https://stamma.org/resources/professionals/employers

High-Pitched Adult Voice? Voice Therapy for Puberphonia – Updated 2025

High-Pitched Adult Voice? Voice Therapy for Puberphonia

Orginally Published in 2022 but updated in 2025 to fully reflect latest information for voice therapy

Do you feel like your voice never fully lowered after puberty? Many adult males struggle with a high-pitched voice that doesn’t match their age. This condition, known as Puberphonia or mutational falsetto, is more common than you might think.

The good news is that online voice therapy is highly effective in treating it, helping you achieve a strong, natural adult voice.

What causes a high-pitched voice in males?

During puberty, the male voice typically breaks and drops about an octave. When a high-pitched voice persists after puberty, it is called Puberphonia (or mutational falsetto).

• Typically, the vocal folds are healthy and normal upon examination.

• You may feel your voice never fully broke and lacks power.

• Speaking can feel effortful or even tiring.

• You might occasionally produce a deeper voice but cannot sustain it for long periods.

• Puberphonia is usually functional, meaning your vocal cords are physically capable of producing a normal adult pitch, but habitual speaking patterns keep your voice high.

The good news: Private online voice therapy can retrain your voice so it sounds deeper, helping you feel more confident.

Why is my voice so high?

A high adult voice often results from:

• Holding your larynx too high due to habitual speaking patterns

• Anxiety or self-consciousness affecting vocal tension

• Difficulty adjusting to voice changes during puberty

• Compensatory habits after throat strain

Private online voice therapy can lower your pitch safely, reduce tension, improve projection, and increase vocal stamina.

What does Puberphonia (mutational falsetto) sound like?

Puberphonia (mutational falsetto) sounds like:

• A high-pitched voice that doesn’t match your age

• Pitch breaks or cracking

• Difficulty projecting your voice

• Tension in the laryngeal muscles

• Vocal fatigue or strain after speaking

Many men report feeling like they “sound like a teenager” or are misunderstood on the phone. Therapy helps achieve a deeper voice.

Do I need surgery to fix a high-pitched voice?

Surgery is almost never required for Puberphonia. In most cases, the condition is functional, meaning the vocal cords are physically normal but speaking habits keep the voice high. The most effective treatment is voice therapy, which retrains the voice to produce a deeper, natural pitch, reduces tension in the throat, improves projection, and builds vocal stamina. With consistent therapy, most men achieve lasting results without the risks or recovery time associated with surgery.

Can I do therapy for puberphonia (mutational falsetto) online?

Yes. Private online voice therapy for puberphonia is highly effective and can be done from the comfort and privacy of your own home. Therapists guide you through exercises, monitor your progress, and help you achieve a deeper voice safely and conveniently.

How many sessions are required for Puberphonia (mutational falsetto)?

The results of voice therapy are excellent. Most people require 6–8 weekly sessions following an assessment. Therapy focuses on:

• Lowering your pitch

• Reducing tension in the throat and laryngeal muscles

• Improving projection and vocal stamina

With dedication, most men achieve a deeper voice that boosts confidence in social and professional situations—all while learning online at home.

Our UK based Private Voice Therapists are Clinical Specialists in Voice. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.

How can I train my voice to sound feminine?

Trans* Voice - Tips for learning and exploring your voice

In therapy you will be exploring your voice. Repetition outside the clinic room is important to change. It is comparable to going to the gym for your voice. You are developing flexibility and freedom for your voice. When learning and exploring try to:

Be Playful – try out new things

Be Mindful – notice without judging

Be Curious – use all of your sense to explore your voice

Be Imaginative – find your own images, hand gestures to support exercises

Be Positive

Be Regular – Be creative about when and where you practice – little and often.

Be Patient – Let things develop and transfer to situations that are easiest first

Be Reflective – record your voice, keep a diary

Be Sociable – try to step out of solo practice into getting support from others

Adapted from The Voice Book for Trans and Non-Binary People – Matthew Mills and Gillie Stoneham

For more information about Voice Feminisation Therapy click here

We are Clinical Specialists in Voice, Voice feminisation and Voice Coaching. Send us an email or book a free consultation for more information.

What is a cognitive communication disorder?

What is a cognitive communication disorder?

A cognitive communication disorder is a difficulty with communication caused by cognition rather than language or speech difficulties.

What causes a cognitive communication disorder?

Cognitive communication disorders occur due to damage to the brain as a result of a stroke, brain injury or any neurological disorder. It can affect someone’s cognitive processes including attention, memory and reasoning.

How do cognitive difficulties affect communication?

Cognitive difficulties are reflected in a person's communication. They may not be affected by all of the items below but you may recognise elements that you might be able to support with the guidance given.

Attention: A person’s ability to concentrate may be affected by difficulties maintaining attention. This may cause them to miss important information in a conversation.

What can you do to help someone with attention difficulties?

• Reduce distractions such as turning off the radio or television to talk in a quiet environment so they can concentrate.
• One task at a time
• Gain the persons attention before beginning an important conversation
• Give information in shorter chunks .
• Take frequent breaks when tired.

Memory: A person’s ability to remember things that have happened recently (short-term memory) and sometimes longer term. They may repeat information or be unable to recall things that have happened to them earlier in the day.

What can you do to help someone with memory problems?

• It doesn't always help to ask them questions about things that have happened recently – most people find this distressing and it will not help their memory. Give them the information and comfort them.
• Use familiar objects such as photos on your phone or a newspaper to share information together
• Talk about the past if they are able to remember as this is not reliant on short-term memory.
• Ask family and friends to write in a book and this can be used as a conversation starter of who has visited and what you may have talked about together.
• Use memory aids such as a diary and apps on phones for reminders

Reasoning/problem solving skills: A person’s ability to think through and solve a problem may be affected leading them to make poor decisions.

How to help with poor reasoning:

• break down the problem
• brainstorm solutions together
• talk about the positives or negatives of each solution
• pick a solution
• talk about what happened.

It might be that someone is unable to discuss their decisions – and they may be reliant on others to support them in making decisions in their best interest. This often involves an assessment of capacity if it is a big decision about their life. A team of professionals is normally involved in these decisions, with the patient and family.

Other aspects of cognition that are affected:

Insight: A person’s ability to understand their limitations. An example of poor insight might be a person that has a left sided weakness and are at risk of falling but they still think that they can walk by themselves.

Slowed information processing: People might find it difficult to keep up with a conversation and feel overloaded with information.

Impaired social communication skills:
When a person may not recognise ‘normal’ or ‘natural’ ways of communicating with others. This means that they sometimes are seen as rude or passive.

• Turn taking skills: talking over someone, interrupting, talking only about themselves or not starting conversations
• Not understanding body language
• Being sexually explicit or swearing lots.

What can a speech therapist do for cognitive communication disorder?

We assess using cognitive communication assessments and gather information about the person themselves to ensure we are providing patient-centered and motivating therapy to improve the persons communication and support to family members.

Is Online Speech Therapy Effective?

Online Speech Therapy (often called Tele-health in research studies) has been shown to be effective and often better in treating many conditions. Studies have looked at comparing online Speech Therapy vs seeing the clinician in person, often referred to face-to-face therapy.

Research shows us that Online Speech Therapy has shown be effective and has high levels of satisfaction for clients.

If you are interested in whether Online Speech Therapy is effective in your condition please see the relevant research below.

Is Online Speech Therapy effective for Language difficulties (Aphasia)?

The Efficacy of Telepractice on Expressive Language Outcomes for Adults with Aphasia: A Systematic Review Morgan Bailey B.S., Lauren Burningham, B.S., B.A., Erin Fifield, B.A (2018)

This study examined whether online Speech Therapy produces positive expressive language outcomes that are comparable to face-to-face therapy for adults with aphasia. They looked at all studies that have compared online Speech Therapy to face-to-face.

The results indicated that online therapy produces similar outcomes when compared to traditional face-to-face therapy.  Most studies showed positive patient satisfaction and quality of life.

Is Online Speech Therapy effective for Dysarthria (Slurred Speech)?

Telemed J E Health 2009 Nov;15(9):840-50.The Redesign and Re-Evaluation of an Internet-Based Telerehabilitation System for the Assessment of Dysarthria in AdultsAnne J Hill 1, Deborah G Theodoros, Trevor G Russell, Elizabeth C Ward

 This study showed high levels of satisfaction from patients being assessed Online. It also showed good strength of agreement between Online Speech Therapy in comparison to face – to –face assessment.

Is Online Speech Therapy effective for dysphagia (Swallowing difficulties)?

Morrell, K., Hyers, M., Stuchiner, T., Lucas, L., Schwartz, K., Mako, J., Spinelli, K. J. & Yanase, L. (2017). Telehealth Stroke Dysphagia Evaluation Is Safe and Effective. Cerebrovascular Diseases, 44 (3-4), 225-231. 10.1159/000478107.

 For swallowing difficulties (dysphagia) 100 patients were assessed comparing face to face with Tele-health (online speech therapy assessment) showing excellent agreement between therapists. This study indicated that online speech therapy was a safe and effective way to deliver dysphagia assessments online.

Evaluation of a Clinical Service Model for Dysphagia Assessment via Telerehabilitation. Elizabeth C. Ward,1,2 Clare L. Burns,3 Deborah G.Theodoros,l and Trevor G. Russell1

100 patients were assessed online and face to face. Results for swallowing difficulties were comparable to face to face assessment. There were high levels of patient satisfaction and patients felt comfortable with online assessment.

 Is Online Speech Therapy effective for Voice?

Voice Therapy Using Telecommunications Technology Pauline A. Mashima et al. American Journal of Speech Language Pathology. Vol 12. 2003.

This study showed that there was no difference in face-to-face outcomes vs online therapy. All patients had positive changes following rehabilitation for their voice through speech therapy.

 The effectiveness of Lee Silverman Voice Treatment therapy issued interactively through an iPad device: A non-inferiority study. Journal of Tele-medicine and Tele-care. 2017 Murray Griffin et al.

Lee Silverman treatment is the recommended Speech Therapy treatment for Parkinson’s Disease. It is intensive requiring four sessions a week for four weeks. For those people that struggle to travel, online therapy is ideal. This study even showed that online showed superior improvements than face-to-face therapy.

 Is Online Therapy effective for Stammering?

Research is in its infancy for stammering and online therapy. An NHS trust completed an improvement project in 2018 that looked at treating patients using online Therapy. The Therapy showed a reduction in the negative impact of stammering and many clients preferred therapy in their home environment rather than in a clinical setting.  

What can I do to look after my Voice?

• Stop smoking. If you can’t give up, cut down. Smoking irritates and damages the vocal folds. Talk to your GP about advice to support stopping smoking.

• Avoid eating spicy foods. Spicy foods can cause stomach acid to move into the throat or oesophagus, causing heartburn or reflux. If you do experience reflux, talk to your GP about possible medications.

• Avoid too much coffee, fizzy drinks and alcohol. These can dry out the vocal cords. Try drinking decaffeinated tea or coffee or follow an alcoholic drink with a soft drink.

• Avoid shouting and whispering

• If your voice feels tired or strained then rest it. This is your bodys way of telling you to rest your voice

• Try not to clear your throat unnecessarily. It can create excessive mucous and lead to a further need to clear your throat. Try drinking water instead or swallowing.

• Avoid dry and dusty atmospheres as they may dry out the vocal cords. Wear a mask in a dusty environment.

• Try to drink 2 litres (3 ½ pints) of liquid a day (not including coffee, alcohol or fizzy drinks). This will prevent dehydration of the vocal cords.

• Try steaming to keep the vocal folds hydrated

Our Private Voice Therapists are Clinical Specialists in Voice. Book a free 15 minute consultation or email us at thespeechnetwork@hotmail.com to enquire about our reasonable fees for Voice Therapy.

What is Aphasia?

 How is aphasia caused?

 Aphasia is caused by damage to the language areas of the brain. In most people, this is typically the left hand side of the brain. It is most commonly caused by a stroke or a brain injury. It can also be caused by progressive disorders such as brain tumors.

How does aphasia affects communication?

 It can affect a persons understanding, speaking, reading and writing. Symptoms can vary in severity from people not being able to express themselves by any means, to milder symptoms of a delay in accessing words. However, even mild symptoms can have an impact on peoples confidence requiring Speech Therapy.

Does aphasia go away?

 It depends on the cause and severity of the aphasia. If it is caused by a brain injury and stroke, it is likely to improve. If it is caused by a progressive disorder this is means that it will unfortunately not improve.

Can aphasia be cured?

Speech therapy aims to restore a persons language through exercises but also support them

Can Aphasia be treated?

The treatment for Aphasia is with Speech and Language Therapy. Evidence shows that Speech Therapy is effective for people with Aphasia following a stroke, compared to no therapy.

How can you help someone with Aphasia?

After an assessment, a Speech Therapist will be able to give you specific advice about the best ways in which to communicate.

Below is some general guidance:  

• Give the person plenty of time to respond. If a person with Aphasia feels rushed or pressured to speak they may become anxious, which can affect their ability to communicate.

• Use short, uncomplicated sentences.

• Do not change the topic of conversation too quickly.

• Avoid finishing a person's sentences or correcting their errors.

• Reduce distractions.

• If you don't understand something a person with Aphasia is trying to communicate, don't pretend you understand.

• Use visual references, such as pointing, gesturing and objects, to support their understanding.

• If they're having difficulty finding the right word, prompt them – ask them to describe the word, think of a similar word, try to visualise it, think of the sound the word starts with, try to write the word, use gestures, or point to an object.

Our Speech and Language Therapists are Specialists in Aphasia. Feel free to book a free consultation or email us for further information.