You may be wondering why your provider referred you to a speech-language pathologist when your primary complaint or diagnosis is:  

Our voice pathologists (voice-specialized speech-language pathologists) address the behavioral component of these upper airway conditions through a combination of laryngeal control therapy (respiratory retraining) and education on ways to optimize laryngeal health and hygiene. 

Diagnosis of the above upper airway conditions is often made through the process of elimination by first ruling out other possible medical problems. Before your referral to the Voice and Swallowing Center, you will likely have seen a pulmonologist (lung doctor) and/or been given inhalers by your PCP and may have had a cardiac (heart) work-up. If these tests are normal, or the symptoms are not fully managed by inhalers, you are then sent to us. A thorough laryngeal control evaluation with one of our clinicians is an important step in designing an individualized rehabilitation plan to meet your goals.  

Laryngeal Control evaluation: What to expect 

During the laryngeal control evaluation, we will review prior test results and identify any behavioral patterns (chronic throat clearing, hydration, speaking patterns, reflux symptoms) that could be contributing factors. Following a review of your symptoms and medical history, one of our fellowship-trained laryngologists or voice pathologists will perform a video laryngostroboscopy to assess the function of your larynx (voice box). If you have specific triggers for your cough or shortness of breath (e.g. strong odors/perfumes or exercise), the provider may have you walk briskly/run or expose you to the triggering odors in attempt to provoke your symptoms. If we see abnormal vocal fold movement during the exam, we will immediately coach you through breathing exercises to resolve your cough or shortness of breath.

How do I prepare for this evaluation?   

  • Continue taking any prescribed medications 
  • Bring rescue inhalers (if prescribed) 
  • If there’s a scent that consistently triggers your symptoms, bring a sample of it to the evaluation 
  • Wear work-out clothes and appropriate footwear if your symptoms are triggered by exercise  
  • No restrictions on eating or drinking prior to appointment (bring a water bottle if possible) 

If possible, have someone video you for 20-30 seconds during a typical episode of cough or shortness of breath so we can watch it at your appointment.  It’s most helpful if we can see you from the waist up and are close enough to hear you breathing. 

Trial Therapy 

At the end of the evaluation, you will undergo a trial of laryngeal control therapy where you are coached through a variety of breathing techniques to keep your vocal folds open and prevent or resolve episodes of shortness of breath or cough.  This helps determine if you are a good therapy candidate and how many sessions of therapy may be needed. Your voice pathologist will also make recommendations to optimize your laryngeal health and reduce irritation. We usually work with patients an average of one to three sessions with a high success rate.