Facilitating behavioral learning and habit change in voice therapy—theoretic premises and practical strategies

Abstract

A typical goal of voice therapy is a behavioral change in the patient's everyday speech. The SLP's plan for voice therapy should therefore optimally include strategies for automatization. The aim of the present study was to identify and describe factors that promote behavioral learning and habit change in voice behavior and have the potential to affect patient compliance and thus therapy outcome. Research literature from the areas of motor and behavioral learning, habit formation, and habit change was consulted. Also, specific elements from personal experience of clinical voice therapy are described and discussed from a learning theory perspective. Nine factors that seem to be relevant to facilitate behavioral learning and habit change in voice therapy are presented, together with related practical strategies and theoretical underpinnings. These are: 1) Cue-altering; 2) Attention exercises; 3) Repetition; 4) Cognitive activation; 5) Negative practice; 6) Inhibition through interruption; 7) Decomposing complex behavior; 8) The ‘each time–every time’ principle; and 9) Successive implementation of automaticity.

Key words::

• Behavioral learning
• habit change
• voice therapy

Acknowledgements

This study was inspired by the essential work of Professor Katherine Verdolini Abbott at the University of Pittsburgh, who has been a pioneer in the application of motor learning and skill acquisition to the area of speech and voice. My appreciation also goes to Professor Ann-Christine Ohlsson at the University of Gothenburg, Sweden, for her long experience and creative development of clinical and preventive voice training.

Declaration of interest: The author reports no conflicts of interest.