Functional Voice Disorders and Functional Neurological Disorder (FND) in Perth

Understanding Functional Voice and Speech Symptoms

Some people experience significant voice or speech changes even when there is no structural damage to the vocal folds or no neurological disease that explains the symptoms in the usual way. These presentations are often described as functional voice disorders and, in some cases, may occur as part of Functional Neurological Disorder (FND) (previously called “conversion disorder”).

These symptoms are real, involuntary, and treatable, and they can have a major impact on communication, confidence, work, and social participation.

At Palms Physiotherapy & Allied Health, our speech pathologists provide assessment and therapy for functional voice and communication presentations, and we work alongside medical and mental health providers when needed.

What is a Functional Voice Disorder?

A functional voice disorder involves difficulty producing a normal voice due to changes in how the voice system is being used (coordination, tension, breathing/voicing patterns), rather than a problem such as a vocal fold lesion or paralysis.

Functional voice presentations can include:

• Aphonia (loss of voice/whispered voice)

• Dysphonia (hoarse, breathy, strained, or weak voice)

• Intermittent voice loss or variable voice quality

• Voice symptoms that may fluctuate with fatigue, stress, or high voice demand

What is Functional Neurological Disorder (FND)?

FND is a condition where people experience neurological symptoms (e.g., movement, sensory, speech/voice symptoms) due to differences in nervous system functioning rather than structural neurological disease. Diagnosis is typically based on positive clinical features identified by trained clinicians.

Speech/voice symptoms in FND can include:

• Functional dysphonia or aphonia

• Changes in speech clarity or fluency

• Variable speech/voice control (often inconsistent across tasks)

Important: Rule Out Medical Causes First

Because hoarseness or voice loss can have multiple causes, it’s important that appropriate medical assessment occurs where indicated. Depending on symptoms, this may include:

• ENT/laryngology assessment (to visualise the vocal folds/voice box)

• GP review (and/or neurology review if neurological symptoms are present)

Speech pathology works best when we understand what has been ruled out and what has been identified clinically.

How Speech Pathology Can Help

Speech pathology focuses on restoring efficient, comfortable voice production and improving functional communication. Therapy is tailored to the individual and may include:

Voice Re-Establishment and Rehabilitation

• Techniques to help bring voice back safely (for aphonia/near-aphonia presentations)

• Reducing unhelpful tension patterns and improving coordination between breathing and voicing

• Gradual rebuild of voice endurance and reliability

Breathing and Laryngeal Tension Strategies

• Breath support and airflow management for easier voicing

• Strategies to reduce throat/neck tension that can contribute to strain

Symptom Management and Self-Monitoring

• Understanding triggers and early warning signs (fatigue, vocal load, stress)

• Practical pacing and voice-use strategies for work and daily life

Communication Confidence and Participation

• Strategies to support communication in high-demand settings (meetings, phone calls, noisy environments)

• Planning for graded return to voice demands

Coordinated Care and Referrals (When Needed)

Functional voice and FND presentations often benefit from a coordinated approach. With your consent, we can liaise with and/or recommend referral to:

• ENT/laryngology and medical teams

• Psychology/mental health providers (when support with stress, trauma, anxiety, or adjustment is needed)

• Other allied health professionals involved in your care

Speech pathology does not replace mental health care, but it can be an important part of a broader support plan.

Why Early Support Matters

Early assessment and the right therapy approach can help:

• Reduce the risk of entrenched voice patterns

• Improve confidence and participation sooner

• Provide practical strategies to manage symptoms and voice demands

Access Voice Support in Malaga

If you’re experiencing persistent voice loss or significant voice changes and are seeking speech pathology support in Malaga, our team can provide assessment, tailored voice therapy, and coordination with your medical team as appropriate.

Speech Therapy Services in Perth for Children & Adults

Speech Therapy (also called Speech Pathology) focuses on assessing, diagnosing, and treating communication and swallowing difficulties. At Palms Physiotherapy & Allied Health, our speech pathologists support children, teens, and adults to improve speech clarity, language skills, social communication, voice and fluency and swallowing safety.

How Can Speech Therapy Help You?

Speech therapy can help with a wide range of concerns, including:

• Speech delays in children: Supporting speech sound development, clarity, and age-appropriate communication.

• Speech sound disorders: Including articulation (sound production) and phonological (sound patterns) difficulties.

•  Language disorders: Helping with both receptive language (understanding) and expressive language (using words and sentences).

• Swallowing and feeding difficulties (dysphagia): Supporting people who have difficulty swallowing safely due to conditions such as stroke, traumatic brain injury, or neurological conditions.

• Social communication differences: Supporting conversational skills, turn-taking, perspective-taking, and understanding non-verbal communication.

•  Stuttering and fluency disorders: Helping clients manage fluency, reduce effort/tension, and build confidence in communication.

Speech Therapy Services We Provide

Paediatric Speech Therapy

• Paediatric speech therapy supports children with speech, language, communication, and early literacy needs using evidence-based and child-friendly approaches. Sessions may be play-based (especially for younger children), while still being structured and goal-directed.

• Common areas we support include:

  1. Speech sound development (clarity and intelligibility)

  2. Language delays and developmental language disorder

  3. Social communication support

  4. AAC (Augmentative and Alternative Communication) where appropriate

  5. Early literacy foundations (e.g., phonological awareness)

Adult Speech Therapy

• Adult speech therapy supports adults with communication and swallowing needs related to neurological conditions, injury, medical events, or age-related changes. Therapy is practical, functional, and designed around everyday participation (home, work, community).

• Common areas we support include:

  1. Communication changes after stroke, traumatic brain injury (TBI), or neurological illness

  2. Dysarthria and motor speech changes

  3. Cognitive-communication difficulties (attention, memory, organisation impacting communication)

  4. Voice therapy where indicated

  5. Dysphagia support and mealtime strategies

NDIS Speech Therapy Services

• NDIS speech therapy is available for self-managed and plan-managed participants. Therapy may focus on functional communication goals, speech clarity, social interaction and participation, and AAC support where required. We collaborate with participants, families, support coordinators, schools, and relevant providers to support practical, meaningful outcomes.

Speech Therapy for Swallowing Disorders (Dysphagia)

• Dysphagia (swallowing) support helps when swallowing difficulties affect hydration, nutrition, safety and confidence with eating and drinking. Our speech pathologists can complete clinical assessments (as appropriate), provide strategies for safer swallowing, recommend targeted exercises when indicated, and support shared-care referral pathways with GPs/ENT/medical teams when needed.

• Why Choose Palms Physiotherapy & Allied Health for Speech Therapy?

• Experienced Speech Pathologists: Skilled in paediatric and adult communication and swallowing support.

• NDIS Provider (self- and plan-managed): Therapy is aligned to participant goals and everyday function.

• Family-Centred Approach: We involve parents, carers, and supports where appropriate so strategies carry over into real life.

• Collaborative, Multidisciplinary Care: We work alongside our broader allied health team when integrated support is beneficial.

Sensory Room and Kids Therapy Gym

• Our sensory room and kids therapy gym can support therapy goals through a motivating, functional environment—particularly helpful for children who benefit from movement-based learning and sensory regulation strategies. These spaces may be used when clinically relevant to support engagement, attention, participation, and goal progress.

Locations

• We offer speech pathology services in Perth, including our Malaga and Noranda clinics.

Australian Resources for Psychogenic Disorders and Voice Therapy

For more information on psychogenic disorders and voice therapy, explore these trusted Australian resources:

• Speech Pathology Australia: Information on speech therapy services and resources for voice disorders.
  www.speechpathologyaustralia.org.au

• Australian Psychological Society (APS): Resources and support for psychological conditions, including conversion disorder.
  www.psychology.org.au

• Beyond Blue: Provides support for mental health issues, including anxiety and stress management strategies.
  www.beyondblue.org.au

• Black Dog Institute: Offers information and resources for mood disorders and their impact on health, including voice-related issues.
  www.blackdoginstitute.org.au

Important disclaimer: This webpage contains general information only and is not intended to be relied upon as personal clinical advice. While we aim to keep information accurate and up to date, it may not reflect the most current research or your individual circumstances. Palms Physiotherapy & Allied Health does not accept liability for decisions made based on this information without an individualised assessment by an appropriately qualified health professional. If you have concerns, please contact us to book an assessment or speak with your GP/medical team.