Abstract
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The title of this book, The Accent Method of Voice Therapy, was intriguing in its promise of a new look at voice intervention. The book is supplemented by audiotaped examples of Dr Kotby's accent method of voice therapy. In his book, Dr Kotby moves easily and well through the traditional classification and management of voice disorders. His discussion of management, which is well referenced by internationally known voice professionals, includes diagnosis, treatment, phonosurgery techniques, pharmacotherapy, behavior readjustment strategies, and vocal hygiene advice.
Dr Kotby introduces the accent method as a holistic process for voice therapy that involves integration of abdominodiaphragmatic breathing, body movements, and voice rhythms, as reportedly used with West African drum rhythms. The audiotapes demonstrate the use of monosyllables and multisyllables in concert with breath support and rhythmic variation of pitch and intensity.
The accent method is recommended by Dr Kotby for managing most organic and functional voice disorders, vocal problems of professional voice users, and several speech and language disorders: dysarthria, stuttering, delayed language development, and prosody problems in hearing-impaired children.
As I read the book and listened to the supplemental tape, I had difficulty understanding how the method could effectively manage several of the disorders listed (eg, vocal fold paralysis, hyperfunctional dysphonia, acute vocal trauma, ventricular dysphonia, and vocal nodules). Whereas most adductor dysphonias respond well to the use of correct breath support and reduction of hyperfunctional voicing, the taped lesson examples appeared to provide coup de glotte and reduced airflow vocal models.
The accent method would seem appropriate for habituating correct articulation sounds in conversational speech, enhancing prosody for hearing-impaired children and adults, and modifying accents. However, the method seems incomplete for managing disorders of voice, language, and motor speech disorders.
In summary, I might recommend the book to speech-language pathologists for the purpose of modifying accents, habituating articulation, and enhancing prosody. I would not, however, recommend the book and supplemental tape to patients because they might be misled and perhaps mismanaged by its therapeutic promises.