Light(e)ning therapy for Glottal Fry
Light(e)ning therapy for Glottal Fry
Kaitlyn C. Kishbaugh CCC-SLP, Kavya K. Pai, MD, Isabelle E. Snyder, BS, Kenneth W. Altman MD PhD MBA
Geisinger Health
Background: Glottal fry is a form of low-pitched, gravelly-sounding dysphonia with components of muscle tension, poor breath support, and cultural behaviors. Although not uncommon, habitual speaking with glottal fry is inefficient and often negatively perceived by listeners. The purpose of this review was to examine patients’ responses to behaviorally instructed vocal techniques by speech language pathology.
Methods: An observational study format was used to examine pre and post treatment responses to therapy. Data was collected through retrospective chart review. The sample included all patients referred to Speech Language Pathology (SLP) for glottal fry by Otolaryngology-Head and Neck Surgery (ENT) from August 2025 to present. Baseline measurements, vocal techniques implemented, and post implementation measurements were analyzed. Acoustic vocal analysis measurements included fundamental frequency, jitter, shimmer, maximum phonation time (MPT), and cepstral peak prominence (CPP). Vocal techniques, implemented by the SLP team, were instructed and documented using the pneumonic (BOLT).
Results: This retrospective chart review showed the benefits of “BOLT” as applied to vocal behaviors with timely and efficient reduction versus elimination of glottal fry. Furthermore, it was noted that the SLP/ENT team created a coined term of light(e)ning therapy to coach patients into pitch elevation and to address quicker resolution with fewer therapy sessions. “Light(e)ning BOLT” therapy was comprised of 1) Breath support, 2) Over-enunciate, 3) Lighten the pitch, and 4) Talk with a forward manner. Review of repeat acoustic analyses post therapy revealed improvement in vocal measurements with patients identifying a quick understanding and execution of applied vocal behaviors.
Conclusion: Otolaryngology assessments are crucial for identifying and assessing various medical and behavioral pathologies of the voice. Referring to appropriate services, such as SLP, can help train patients in behavioral awareness and correction of glottal fry. Light(e)ning BOLT vocal techniques show the efficiency and effectiveness of behavioral changes to the voice for glottal fry.