FND Education Project

REFERENCE · RECOVERY TECHNIQUE

Making Speech More Comfortable: Breath, Posture and Muscle Release

Most likely fit: Assessment finds extra jaw, neck, laryngeal or breathing effort during speech, and a tailored adjustment may reduce strain. [Professional consensus and adjacent voice guidance; generic deep breathing is not a prescription]

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For the Person With FND

Speech can become tiring when you are bracing your jaw, shoulders or throat in an effort to get words out. A therapist may help you find a more comfortable position or coordinate an easy phrase with breathing.

“Relax” is rarely enough instruction on its own. You need to know which change is worth trying and what it should feel like. The goal is comfortable communication, not a perfect posture or a large breath. You should be able to say when an adjustment hurts or makes you light-headed.

A few useful words

The larynx is the voice box. Respiration means breathing; phonation means producing voice. These need to coordinate during speech, while the tongue, lips and jaw shape words. More air or more muscular effort is not automatically better.

What this might look like

A therapist might first check whether your chair and arm support let you speak without bracing. They may then try a short phrase on a comfortable breath, with a pause before the next phrase. The exact starting point depends on your assessment.

Do not force deep breaths, hold your breath, push the abdomen or press on the throat. Hands-on work around the larynx is a skilled clinical intervention, not a neck-massage recipe for a supporter. During a familiar flare, pause speaking if needed and use your communication support; an exercise is not a treatment for acute breathing distress.

The examples here are suggestions to discuss with your clinician, not a fixed exercise prescription. [1][2]

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For Family, Friends, and Other Supporters

Help arrange a comfortable setting if asked. Avoid pulling shoulders back, moving the jaw or placing hands on the person’s neck to make them “release.”

If a phrase is difficult, allow a pause instead of repeatedly instructing the person to breathe. Let them use text or gestures while they recover comfort.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For Clinicians and the Care Team

Selecting the approach

Assess respiratory and laryngeal function, posture, pain and effort during the relevant task. Coordinate medical review where needed. Voice symptoms with airway difficulty, pain or another changed pattern should not be managed through relaxation advice alone.

Putting it into practice

  1. Identify the specific excess effort or coordination issue during a meaningful utterance.
  2. Explain one proposed change and check consent, comfort and physical access.
  3. Trial a supported position or comfortable airflow/phrase adjustment without forced inhalation.
  4. Compare effort and message delivery with the original attempt.
  5. Use manual techniques only within relevant training, after assessment and explicit consent.
  6. Agree an individualized home version only if safe, with clear stopping and review instructions.

Review and stopping points

Stop for dizziness, pain, breathlessness or worsening voice strain. Review later fatigue before extending practice. Do not introduce generic strengthening, loudness training or intensive respiratory exercises simply because speech is weak or quiet.

The procedure is an educational adaptation for individual clinical review, not a validated standalone protocol. [1][2]

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

Research and Sources

The consensus includes selected breathing, posture and muscle-release approaches. ASHA describes the interacting respiratory and voice systems and assessment needs. Neither source makes generic deep breathing or unsupervised laryngeal manipulation a universal FND treatment.

Citation Full citation Figure
[1] Baker J, Barnett C, Cavalli L, et al. Management of functional communication, swallowing, cough and related disorders: consensus recommendations for speech and language therapy. Journal of Neurology, Neurosurgery & Psychiatry. 2021;92(10):1112–1125. FND-CIT-0025. Source —
[2] American Speech-Language-Hearing Association. Voice Disorders. Practice Portal. Accessed September 17, 2026. FND-CIT-0109. Source —

Sources checked September 17, 2026 · Speech-language pathology, relevant medical specialties, lived-experience, supporter and accessibility review pending.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —