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Ep 58

This week’s guest is specialist Speech and Language Therapist, Lydia Hart. Lydia specialises in the field of Voice and Upper Airway and also works for the NHS and in the Joint Voice Clinic at Wexham Park Hospital. She joins Alexa on Singing Teacher’s Talk to talk about the work she does as an SLT and how that can help you as a singing teacher.


  • Speech and language therapy provides treatment, support and care for children and adults who have difficulties with communication, or with eating, drinking and swallowing. Speech and language therapists (SLTs) are allied health professionals. They work with parents, carers and other professionals, such as teachers, nurses, occupational therapists and doctors.
  • Training to become an SLT involves a two year Master’s or four-year Undergrad Degree. In most places where you might study, voice will only be a small part of your course. You can choose to do your research or dissertation on it, but there are a lot of other components that aren’t related to the voice.
  • The GRBAS scale (grade, roughness, breathiness, asthenia, strain) is the main tool used in the auditory-perceptual evaluation, which physicians. and speech pathologists use to subjectively assess the degree and quality of hoarseness. It does not include pitch or volume.
  • The GRBAS scale is as follows: grade 1 (subjectively normal voice), grade 2 (mild dysphonia), grade 3 (moderate dysphonia), grade 4 (severe dysphonia), and grade 5 (aphonic) plus the use of additional qualifiers used as necessary – for example, breathy, strained


‘The longer I’ve worked in this field… I’m realising that we overpathologize so much’

‘If I hear a voice that sounds a bit unusual then I might do a mental GRBAS of it’

‘If you know your own body then you’ll know if you’re getting reflux’


BAST Training

Guest Website:

Social Media:

  • @lydiahartvoice

Relevant Links & Mentions:


Lydia Hart is a specialist Speech and Language Therapist, working in the field of Voice and Upper Airway. This means she can help people who are experiencing difficulties with their speaking or singing voice, or other throat symptoms. Lydia is known for being vibrant, caring and sensitive, taking time to create and hold a space for clients to work on their voices in a holistic way.

Alongside her work at Voice Care Centre, Lydia works for the NHS and works in the Joint Voice Clinic at Wexham Park Hospital, with leading laryngologist Declan Costello. This involves assessment and management of a range of voice disorders, from muscle tension dysphonia to vocal cord paralysis, and her clinical expertise is constantly expanding.

Lydia is passionate about health and well-being, in both her personal and professional life. She enjoys yoga and breathwork, as well as weightlifting and rock climbing. Lydia is a singer herself, and voice therapy – which ultimately means working with a person, not a diagnosis – is a true vocation for her.

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