Development of a speech treatment program for a client with essential vocal tremor

Julie Barkmeier-Kraemer, Andrea Lato, Kay Wiley

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Vocal tremor is characterized by involuntary rhythmic modulations of pitch and loudness and is best perceived during sustained phonation of vowels. It is most often present in individuals affected by neurogenic disorders such as Parkinson's disease, amyotrophic lateral sclerosis, spinal muscular dystrophy, spasmodic dysphonia, and essential tremor. Vocal tremor does not appear to be responsive to systemic pharmaceutical management but may benefit from injection of botulinum toxin (i.e., Botox) into affected musculature. However, many individuals do not tolerate the potential side effects of severe breathiness and difficulty swallowing associated with Botox injections. In this article, we summarize the speech evaluation and treatment methods successfully used with an individual with essential vocal tremor. Methods used for characterizing the individual's vocal tremor patterns and the ensuing rationale for behavioral intervention is provided. The outcomes of this case example motivated consideration of speech treatment as a beneficial strategy for some individuals with vocal tremor.

Original languageEnglish (US)
Pages (from-to)43-57
Number of pages15
JournalSeminars in Speech and Language
Issue number1
StatePublished - 2011
Externally publishedYes


  • essential tremor
  • Vocal tremor
  • voice disorder
  • voice evaluation
  • voice treatment

ASJC Scopus subject areas

  • Speech and Hearing
  • LPN and LVN


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