OSF HealthCare Newsroom

Maintaining your voice

Tue, 19 May 2026 08:00:00 -0500

Author's note: This is part two of a two part story on voice disorders and maintaining your voice. Read part one here.

Auctioneers and sports announcers have to fill a room with their voice. Singers like Taylor Swift and Bruce Springsteen belt on stage for three-plus hours. How can they – and you – keep the voice strong and avoid hoarseness or worse, such as a voice disorder?

Some voice issues are unavoidable, but experts like Ashley Brim, a speech language pathologist at OSF HealthCare, want you to have the full picture. She says there are everyday tips to keep your speech mighty.

Maintain a healthy lifestyle through diet, exercise and keeping up with doctor appointments. Brim says this reduces your risk of a stroke, which can lead to a voice disorder. It can also prevent everyday illness and coughing.

“If someone has had the flu or COVID and they’ve had a consistent cough, it can cause trauma to the vocal cords,” Brim explains. “The vocal cords are closing so rapidly with each cough.”

Using a humidifier and taking lozenges without menthol can help with that pesky cough, Brim adds.
Aim for 40 to 60 ounces of water per day.

“That’s very helpful in maintaining a healthy environment for your vocal cords. It makes sure they’re not getting too strained,” Brim says.
Watch your caffeine. High amounts can strain your vocal cords, Brim says.

“Do you really need that second latte at noon?” she asks with a smirk.
Don’t yell all the time. Obvious, right? But it’s tricky if you use your voice for a living.

“Maybe you have a job like an auctioneer or a teacher trying to yell over a group of students. You have to make your voice louder [for your job],” Brim says.

“Try to focus on more projection. And take vocal rests,” she adds. “Take 10 minutes to let your vocal cords reset. Drink water. Try to decrease the trauma to the vocal cords as much as possible.”

Learn more

Read about all the ways medical professionals help restore voices on the OSF HealthCare website.

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Restoring your voice

Thu, 06 Mar 2025 12:04:07 -0600

Author's note: This is part one of a two part story on voice disorders and maintaining your voice. Click here for part two.

Julie Andrews, Shania Twain and Selma Blair are among the many celebrities who have dealt with a voice disorder. When the gossip magazine headlines end, health care providers are there to dive deep into what causes these problems and give hope to people who want to communicate with confidence again.

Types of disorders

Ashley Brim, a speech language pathologist at OSF HealthCare, breaks down common voice disorders:

Dysarthria (pronounced diss-ARR-three-ah): Brim says this common voice disorder could be brought on by a neurological issue, such as the effects of a stroke, Parkinson’s disease or a traumatic brain injury. Muscle issues and medication side effects can also play a role. It all leads to the most common symptom: slurred speech. Brim says to picture trying to talk with a mouth full of marbles. The person’s speech could also be a different volume (too quiet or too loud) and speed (too slow or too fast).

“There’s a restorative approach where we do different types of [vocal] exercises. Try to get that voice to where it sounds better and clearer,” Brim explains. “Then there’s a compensatory approach. For a person with Parkinson’s or amyotrophic lateral sclerosis [ALS] where their voice probably isn’t going to improve in the long run, we might look at an alternative communication device. Or, do we need environmental assistance to help them communicate?”

A communication device could include a voice box to amplify speech or, if someone has lost their voice entirely, a speech generating tablet.

“The [speech generating device] has a bunch of communication presets on it,” such as common phrases conveying hunger or pain, Brim says. “They can have it pre-programmed with their actual voice before they lose it.”

Dysphonia (pronounced diss-PHONE-ee-ah): This is a general term to describe a voice abnormality, Brim says. Neurological issues and brain injuries are common causes.

“The most common dysphonia people know is spasmodic dysphonia. We really don’t know a specific cause. We assume it’s neurological,” Brim says. “This brings voice tremors. The vocal cords are not abducting or adducting correctly.

“When they’re adducting, the vocal cords are coming together. If you have an adductor-type spasmodic dysphonia, the vocal cords aren’t wanting to go away from each other. They’re wanting to stay together. So there’s a really strained voice. It sounds very harsh, almost like people are trying to force the voice out,” Brim outlines.

“Or you have abductor dysphonia, where the vocal cords are pulling away. The person has a breathy voice because the vocal cords are open all the time. Speech comes out very quiet and whispery. They’re losing all their air in one go,” Brim adds.

Treatment could include voice exercises or Botox injections. Or, if the person has a nodule or polyp on the vocal cords, those can be removed surgically.

“We go over healthy voice habits, such as increasing water intake,” Brim says, describing how she might work with someone after surgery. “Have a humidifier in the house to help increase moisture in the air. Use more of a quiet voice. Try not to yell or project too loudly because that can strain the vocal cords. Try to make your voice sound different but not in a way that causes harm.”

Something else Brim will preach to patients that you might not connect with voice issues: reduce your caffeine intake. Caffeine can increase muscle tension in your vocal cords, she says.

Vocal cord paralysis: Brim says this is commonly caused by trauma to the throat, such as a car accident or having a breathing tube.

“It’s similar to a bruise or fracture or torn ligament. When there’s trauma to the vocal cord area, there’s damage. And that causes paralysis sometimes,” Brim says. “You can have, most commonly, unilateral vocal cord paralysis, where one doesn’t move. Or you can have bilateral [paralysis] where both aren’t moving.”

Brim says this is often treated with Botox or surgery to get the vocal cords vibrating again. The person would follow up with speech therapy.

There is hope

Brim is up front with her patients: You might not get your voice back to where it was, but you can make improvements. So don’t give up.

“I’d love to wave a magic wand and make your voice great,” Brim suggests with a smile. “But there are other steps we can take so you don’t feel locked in. You don’t feel like no one can understand you and no one can communicate with you.”

Learn more

Read about all the ways medical professionals help restore voices on the OSF HealthCare website.

Interview clips

Non-verbal Learning Disorders Affect All Ages

Fri, 08 Apr 2022 08:00:00 -0500

“The slap heard round the world” involving Will Smith and Chris Rock at the Academy Awards has shone a light on important issues like hair loss and anger problems. But one part of the incident has left some wondering: why did Rock appear to strike a welcoming stance – smiling, arms in back, leaning forward, even a humorous “Uh oh!” – as Smith approached with the opposite demeanor?

The answer may lie in a revelation Rock made in 2020, according to several media reports at the time. The comedian suffers from a nonverbal learning disorder (NVLD), making things like social cues and spatial awareness difficult.

NVLD affects the young and old and is treatable, says Ashley Brim, a speech language pathologist at OSF HealthCare in Alton, Illinois. Brim says the issue could be inborn or the result of something like a traumatic brain injury that affects the frontal lobe of the brain.

“It's another area of speech pathology that's called pragmatics,” Brim explains. “And what that is, is those social communication cues that we just follow innately because it's just how we've been taught. Things such as appropriate space in between each other whenever you're talking for proximity. And depending on the different cultures that you're in, certain cultures like to be closer. Other ones are like, you need to stay far back away from me.”

“If I make a joke, this is what I need to look for in your face and your body language that tells me that I have unintentionally made you unhappy,” Brim notes as another example. “Whenever I thought that it was more humorous on that side.”

While the more well-known physical therapy may involve stretching or other exercises, therapy for a NVLD, Brim says, usually involves a social script activity.

As part of this therapy, Brim instructs an adult patient, “I want you to tell me what identifications you can find in this picture, in this video that tells you this person is upset or that tells you that this person is happy.”

“And then vice versa. It's very similar for kids. Usually people with autism have some more difficulties with pragmatics, kind of understanding that,” she says. “And then identifying, OK, this is what this emotion is. This is how I respond to this emotion.”

Therapy also includes sending the patient around the rehabilitation office to talk to Mission Partners (OSF HealthCare employees). This gets the person real-life practice in social interaction.

Brim adds that young people are at an age where they’re learning how to interact socially and build long-lasting friendships. So it’s important that if a parent, teacher, or other caregiver sees signs of a learning disorder, they talk to a health care provider right away.

OSF HealthCare Newsroom

Maintaining your voice

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Restoring your voice

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Non-verbal Learning Disorders Affect All Ages

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