From Song to Speech

Misinterpreting Research Results or "A Little Knowledge Is a Dangerous Thing"

Jean Westerman Gregg

Clients coming to my studio from the office of an otolaryngolo-gist always bring with them the re-sults of voice study from past years. It is the responsibility of the speech-language pathologist to determine what muscular patterns and behav-ioral habits have contributed to a la-ryngeal disorder diagnosed by the doctor. Over the years, certain recur-ring problems have emerged, which might be helpful for the voice teacher to review.

One of the most prominent of these is difficulty with the upper passaggio, which often is coupled with a diagnosis of inflamed and edematous vocal folds. In addition to problems with the upper voice, a clinical vibrato may be present and also possible protrusion of neck muscles during singing. Questioning the client sometimes reveals some-thing such as the client's voice teacher from years past using the

imagery "down and back, up and over."

This brings to mind the several research projects on vertical laryn-geal position undertaken by the late Dr. Thomas Shipp at the Veterans Administration Medical Center in San Francisco. Dr. Shipp has stated, "I believe that vertical laryngeal po-sition is important to aspects of voice production such as pitch and quality and, perhaps, vocal fold tis-sue damage."' Because the method used in his research involved filming laryngeal profile, only subjects who had prominent thyroid cartilages were used, which eliminated women from the study. (The most promi-nent thyroid cartilage and larynx I have ever seen appeared on the cov-er of the April 15, 2001 New York Times Magazine, which showed Dar-ryl Strawberry in profile. With that larynx, he should have been a singer instead of a baseball player!)

One of Dr. Shipp's findings in-dicated that the larynx in most trained male professionals remained in a relatively low position during singing. Looking at the structure of the larynx and its function in vari-ous life activities is helpful in under-standing the problems that can oc-cur when a voice teacher takes the results of that research and inter-prets those findings to mean that students should be taught to force the larynx down into a lowered posi-tion as a requisite for good singing.

All bodily structures are de-signed to accomplish a primary func-

tion that is always a life-sustaining one. It must be remembered that speaking and singing are secondary uses of structures that are designed primarily for other functions. One must never lose sight of the prima-ry use of a structure and force it to be used in a manner inappropriate or counter to such function, as the result can be muscle tension and possible tissue damage, which does not promote longevity in a singing career.

The larynx lies in the neck at the top of the trachea (windpipe). It is in effect a three-way valve to pro-tect the trachea, bronchi, and lungs from foreign particles that could im-pede respirationa vital function for human beings. When the larynx serves in this fashion, the vocal folds, false vocal folds, and epiglottis close tightly to protect the airway. This action is also used to impound air in the lungs during such activi-ties as lifting, child bearing, evacua-tion, and being tackled in football, because the abdominal muscles are tensely setall downward bearing activities, which is the opposite of singing. During deep inhalation, the larynx lowers as the folds open to al-low passage of air into the lungs.

Deglutition (swallowing) is a primary function of several struc-tures in the mouth and neck, includ-ing the larynx. Teeth and tongue are involved in masticating food prior to swallowing. The tongue then drives the bolus of food back into the pillars

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Jean Westerman Gregg

of the fauces (two curves of mucous membrane containing muscular fi-bers that arch lateraiward and down-ward from the uvulain other words, the lower border of the soft palate, which hangs almost as a cur-tain between the mouth and phar-ynx). As the tongue pushes the food back, it presses against the hard palate with its base retracted, and the larynx and pharynx rise. The en-trance to the larynx is closed by the forward movement of the arytenoid cartilages toward the epiglottis, pro-duced by the contraction of the thy-roarytenoid muscle and muscles re-lated to the aryepiglottic folds. The food is prevented from entering the nose as it passes by the posterior sur-face of the epiglottis by the contrac-tion of the constrictors of the fauces, the palatine velum being raised by the levator veli palatini and tensed by the tensor veli palatini while the pharynx is pulled upward over the food bolus by the action of the pharyngopalatini muscles coming nearly together, the space between them being filled by the uvula.2 Thus, the food descends into the lower part of the pharynx and into the esophagus. During this process, the larynx moves up and down in the throat with an excursion that has been measured up to 30 mm in extent. This, of course, means that not only are the muscles in the soft palate and pharynx used, but the tra-chea is also stretched, explaining why it can hurt to swallow if you have a sore throat or tracheitis. Thus, one sees that vertical move-ment of the larynx occurs naturally in life activities.

Pressed phonation has been de-scribed by Sundberg as "high sub-glottal pressure combined with high adductive force." In contrast, flow

phonation is "lower subglottal pres-sure and lower adductive force. 113 A change from pressed to flow phona-tion can increase the amplitude of the fundamental by as much as 15 dBa not inconsiderable change in acoustic output. When a singer is trained to use the vocal folds in this more efficient manner, air is not al-lowed to escape during phonation that is not being used to vibrate the folds, but the stress on the larynx is greatly reduced.

Newton's Third Law of Motion states: "To every action there is an equal and contrary reaction or the mutual actions of two bodies are equal and opposite." This law points out that all forces are essentially "double ended. 114 Sundberg has stat-ed that "the main tool for raising loudness of phonation is an increase in subglottic pressure. 115 During loud singing, it might appear that some slight resistance at the laryngeal lev-el to subglottal breath pressure could be present. This might be interpret-ed by some as a feeling of holding the larynx down, rather than just firm-ness of control.

Pitch rise (increase in funda-mental frequency) is also associated with an increase in subglottal pres-sure. When viewing a videostrobo-scopic image of the larynx, it is not-ed that with rising pitch the larynx moves up in the throat, although Shipp's findings indicated that, while some singers demonstrated this movement, others had no corre-lation between pitch rise and laryn-geal position. if, however, the larynx is prohibited from a normal slight rise with increasing pitch by forcing it down, problems with the passag-gio can result. Again, in accordance with Newton's Third Law of Mo-

tion, there might be slight resistance on the part of the larynx to subglot-tal pressure, which may be interpret-ed by some to mean a tendency to maintain a certain amount of down-ward pressure and, therefore that movement should be taught.

The best pedagogical technique for teaching an easy transition through the passaggio, in the view of this author, is very soft singing, which reduces subglottal pressure on the larynx and activates only the cover of the folds, allowing the vocal folds to make adjustments necessary for higher pitches gradually. In other words the larynx is allowed to "do its thing" throughout the whole pitch range without stress. Calling attention to laryngeal height seems to be completely counterproductive and unnecessary. In very soft sing-ing, the amplitude of the fundamen-tal is increased without stress on the larynx. This allows healing of the tissues and movement through the passaggio becomes easy. When the singer learns this, the resulting knowledge of the level in the face/ head of the vibratory feel of any giv-en pitch becomes a reliable sensation that can be duplicated at a higher dy-namic level without adding stress on the larynxnot so you can "place" it there, but so you can "let" it go where you have learned it naturally wants to go. In the meantime, the tis-sue damage/abnormalities present are allowed to heal. Thus, the vocal production becomes a more healthy one that increases the performer's enjoyment of singing, as well as the longevity of his or her career.

Note: My sincere thanks to Robert T Sataloff, M.D., D.M.A. for his review and suggestions on this article prior to publication.

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From Song to Speech

NOTES

1 Thomas Shipp, "Vertical Laryngeal Position: Research Findings and Application for Singers," Journal of Voice 1, no. 3 (1987): 219-19.

2. Henry Gray, Anatomy of the Human Body. Warren, H. Lewis, ed. 24th Edi-tion (Philadelphia: Lea and Febiger, 1942).

3. Johan Sundburg, The Science of the Singing Voice (Dc Kalb, IL: Northern Illinois University Press, 1987), 80.

4. M. Randall Harrison, Neil H., Williams, and Walter F Colby, Gener-al College Physics, rev ed. (New York: Harper & Brothers, 1937).

5. Sundberg, 56.

Jean Westerman Gregg holds A.B. and MA. degrees from the University ofMichi-pan and the MS. de rce in communication

disord ers from Southern Connecticut State University. She is the Vice Chairman of the American Academy of Teachers of Singing, a certified member of the Ameri-can Speech-La nguage-Hea ring Associa-tion, and served as President of the Nation-al Association of Teachers of Singing (NATS) 1994-1997. and President Pro Tern for 1998-1999. Following a career as a singer in opera, oratorio, and recital, her interest in the laryngeal health of the pro-frssional voice user led her to obtain certifi-cation and licensure as a speech-language pathologist in 1986. In demand as a lec-turer and clinician, her private practice is about equally divided between the teaching of singing and the rehabilitation of laryn-geal disorders on referral from the medical profession. She chaired the NATS Com-mittee on Voice Therapy and together with Dr. Ingo Titze of the University of Iowa, represented NATS in the negotiations with the American Speech -Language-Hearing Association that resulted in the joint state-ment "The Role of the Speech-Language Patholoqist and Teacher of Singing in Re-

mediation of Singers with Voice Disor-ders" that appeared in both The NATS Journal and ASHA magazine. She has served on the faculty of the Voice Founda-tion's Symposium on Care of the Profes-sional Voice since 1992 and is member of their Scientific Advisory Board. She served as a panelist at the First International Congress of Voice Teachers in Strasbourg, France in 1987, for the McGill University Workshop on Voice in the summer of 1994, presented at the Third International Con-gress of Voice Teachers in Auckland, New Zealand in 1994, at the Third Brazilian Congress of Laryngology and Voice in Rio dejaneiro in October 1995, at the first In-ternational Symposium on Care of the Professional Voice in Athens, Greece in September 1997, and at the Fifth Interna-tional Congress of Voice Teachers in Helsinki, Finland, in 2001. She is a mem-ber of the Editorial Board oftheJournal of Voice and her column "From Song to Speech" has appeared in the journal of Singing since January 1990.

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