Positive and Negative Practice

Positive/negative practice is a behavioral treatment prescribed primarily for patients with nonorganic voice disorders. A patient with a nonorganic voice disorder has been diagnosed with aberrant voice production due to the abnormal use of a normal mechanism, often due to stress or some sort of secondary gain. She or he may have been ‘stuck’ with […]

Mucosal Chatter

Mucosal chatter is an audible phenomenon of injured vocal cord vibration. It is commonly heard in the softly-sung upper voice of persons with nodules, polyps, etc. Hoarseness or roughness are broad and nonspecific descriptors useful only for severe injuries. Small injuries that are nevertheless impairing the singing range may leave the speaking voice sounding normal. […]

Segmental Vibration

In the normal larynx, segmental vibration occurs when both chest and falsetto (head) registers are produced by vibration of the anterior 2/3 of the vocal cords. The posterior 1/3 is “inhabited” by the arytenoid cartilage and does not vibrate. In certain pathological circumstances such as displayed in the photo sequences below, only a small part […]

Popping Onset

A popping onset refers to the sudden start of the voice after a little hiss of air, but once the voice begins, it is very clear. It doesn’t sound like laryngitis, or scratchy like one would hear after a nodule popping onset. Tags

Vocal Instability

Vocal Instability is a characteristic that might manifest most clearly during sustained phonation as a glitch, catch, wavering, tremor, in-and-out vocal fry, or other such finding. In each case, the patient would be unable, partially able, or only intermittently able to produce a steady and predictable voice. Tags

Dystonic tremor of the voice or larynx

A tremor that sometimes accompanies laryngeal dystonia and its effects on voice function (spasmodic dysphonia), breathing function (respiratory dystonia), or both. This dystonic tremor is heard as a “wavering” in the voice (if the person has spasmodic dysphonia) or in the sound of inhaled or exhaled air (if the person has respiratory dystonia), or it […]

Vocal Tremor

Vocal tremor: A regular, wavering quality of voice, analogous to a singer’s vibrato but occurring, to an individual’s distress, during speaking, not just during singing. May occur as a sole abnormality in essential voice tremor, or in combination with spasmodic dysphonia. Teaching demonstration (mimicked): Patient example dystonic tremor: Note accompanying squeezedowns and difference in two […]

Vocal fry

The name given to a quality of sound produced at low pitch. Vocal fry is produced in what some call pulse register, as compared with chest and falsetto registers.


In the voice, a pulsating effect produced by small variations of pitch, typically occurring five or six times per second. The opposite of singing with vibrato is to sing with straight tone.

Squeezedown (of the voice)

A vocal phenomenology term coined to refer to adductory spasms that do not “complete” all the way to a phonatory arrest. Virtually exclusively a manifestation of spasmodic dysphonia.