Functional Speech and Voice Disorders: Approaches to Diagnosis and Treatment

Verbal communication is a primary vehicle for the human expression of needs,thoughts, and feelings as well as a crucial element of social participation. The impact of impairments in communication is extensive, affecting a person’s social interactions,relationships, vocation, and overall quality of life. Disruptions to aspects of motor speech, voice, and language often develop in the setting of neurobiological disorders with a multitude of structural underpinnings including injury and disease. However, it has been well established that biopsychosocial factors may also contribute to communication difficulties, particularly those affecting the neuromotor aspects of speech production.2 Functional neurological disorder (FND) encompasses a range of neurologic disturbances including motor,sensory, and cognitive symptoms that develop from disruptions in neural networksthat mediate both neurophysiologic and intrapsychic processes as opposed to a physiologic cause alone.