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Functional Dysphonia

That happens to me!

Indicate the extent to which the following statements apply to you. Use a scale of 1 – 5, where 1 = ‘never’ and 5 = ‘every time I use my voice’.

  1. My voice is hoarse / husky / rough / croaky
  2. My voice tires with use
  3. My voice occasionally breaks or cracks
  4. My voice can sometimes disappear completely
  5. My voice is lower in pitch than usual
  6. My voice is higher in pitch than usual
  7. I have difficulty making myself heard (not as loud as needed)
  8. My voice doesn’t project as well as needed
  9. I keep running out of breath or gasping
  10. Using my voice is effortful
  11. I need to clear my throat or cough
  12. My throat feels dry, scratchy or tickly
  13. My throat aches or feels sore
  14. I feel pain in my throat
  15. I sometimes feel as if I have a lump in my throat

If you scored more than 1 on any item, you would probably benefit from learning more about how to care for your voice. Also, you’re not alone! Many people experience some sort of voice difficulty. Read on – it’s worth it!

Risky business

Are you in a job that requires you to talk for several hours, perhaps without much of a break?

  • Teacher?
  • Call center worker?
  • Sales rep?
  • Other job with high vocal demands?

If you’re in a job with high vocal demands (or perhaps you just talk a lot – for socializing or other hobbies/sports) and you experience some of the above difficulties, then you may be experiencing functional dysphonia (also known as a functional voice difficulty or muscle tension dysphonia (MTD)).

Teachers, people who work in call centers, sales representatives, and others whose jobs have high vocal demands are at risk of functional dysphonia. If the place in which you work has a lot of background noise this often leads to you straining the voice in order to be heard. The largest group of people referred to Voice Clinics for functional dysphonia in the UK is teachers. Around 20% of teachers will experience a voice difficulty of some type each year.

Definition of functional dysphonia

A voice difficulty in which the voice quality is poor in the absence of any obvious anatomical, neurological, or other organic difficulties affecting the larynx.

In sum, functional dysphonia is not an organic voice difficulty, it’s more to do with the way we use our voices – the way we function. Having said this, it is not uncommon for people to experience functional voice difficulties following a heavy cold or flu, and laryngitis.

What can I do about it?

If you’re having difficulties with your voice (e.g. it tires easily, it doesn’t seem to carry anymore, you have constant sore throats), then what can you do about it? Is there anything that you can do now to prevent or ameliorate the risk of getting any sort of voice difficulty in the future?

First, it needs to be said that there are no instant cures for a functional voice difficulty. There are no drugs or other treatments that can be offered that can ‘cure’ it. However, the good news is…you CAN do something about it by. In summary, you are encouraged to do the following:

  • adopt good vocal hygiene strategies
  • identify and eliminate any vocally abusive behaviors, such as throat clearing
  • use effective breathing methods
  • eliminate any strain or extreme effort in producing the voice by using so-called easy onset
  • as far as possible, eliminate the cause of the voice difficulty – this could involve changes to your environment/work place

The Australian Department of Education and Early Childhood Development in Victoria (DEECD, 2009) recommends that successful voice care requires the following.

NB: It is always recommended that you consult a qualified speech-language pathologist for assessment and appropriate advice before embarking on any voice therapy program. Several of the symptoms listed above can have an underlying organic cause (e.g. vocal nodules, polyps). It’s important to rule out any possible organic difficulties that may require different treatments (e.g. medication, surgery). Also, whilst functional dysphonia has no organic cause, if the person experiencing the voice difficulties does not eradicate harmful vocal patterns appropriately or efficiently, this can lead to secondary difficulties that my then result in organic changes. To repeat: always consult a qualified speech-language pathologist.


DEECD (2009) Voice Care for Teachers Program Victoria, Australia: Department of Education and Early Childhood Development.