Stretch and Flow

*bubbles not included

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 I am Kristie Knickerbocker.

My mission is to help SLP's,

singers and voice teachers

better their knowledge of

research-based voice

techniques to help all voice

users be efficient and safe

with their instrument.

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 Terms of Use Thank you for respecting all the hard work I put into

my resources.

- This product is my own COPYRIGHTED material.

ONE license to use this with your patients and clients.
- You have

-You CANNOT SHARE this with colleagues in print, digitally or in an email without

purchasing additional licenses.

-You CAN PRINT copies of pages for your students and patients to send home as
part of your home practice protocol.

-You CANNOT RESELL as your own or shared in a DIGITAL FILE or LIBRARY for
others to access.

-Please contact me at [email protected] for any questions, and for

information about multiple license discounts.

Credits for this

product

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E-Manual for Voice Printable activities for your Video Demonstration of common
Therapy techniques, Different entire schoolyear to help you voice therapy techniques for
Versions for Adults, Kids & in Spanish. treat voice in pediatric clients. behavioral retraining.
If you like this freebie, try the whole
product: Stretch and FLow Bubbles

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 Disclaimer
Any individual who experiences hoarseness for more than 2 weeks
should be evaluated by an otolaryngologist or Ear Nose Throat
physician. An examination by this physician is an important part of
diagnostic testing prior to seeing any patient for voice therapy.

recommendations in this resource are meant as a starting point for

Speech Language Pathologists who are treating voice disorders in
their clients and patients. Kristie Knickerbocker and a tempo Voice
Center did not invent these techniques, nor do we claim to be
presenting any copyrighted treatment method. This is simply a
resource for clinicians needing voice Therapy guidance for clients
with voice disorders. Any clinician attempting to use these
materials for therapy should consult resources necessary for
training in their use.

All materials in this PDF should be utilized by a trained

professional who is licensed in Speech-Language Pathology to
help guide behavioral, acoustic/aerodynamic and instrumental
voice evaluations and treatment. Assessment must be completed
prior to treatment, as voice therapy could be contraindicated for
some patients.

Copyright 2019 www.atempovoicecenter.com

 How To Use
The purpose of this game is for speech-language pathologists (SLP’s) to have a resource for treating voice

in pediatric populations. All around the world, SLP’s are expected to treat voice disorders without

researched-based education before initiating treatment. My hope is that this Resource will provide

education and easy access to materials for clinicians who may not have had a strong base education in

voice disorders.

This resource will provide activities for use with teachings from Ed Stone and Robert Casteel from their

1982 book chapter on Stretch and Flow. Flow voice and Confidential Voice was further studied by

Casper and Colton. The inspiration for this game came from Lisa Kelchner from CCHMC during a

lecture she gave at the 2019 Fall Voice Conference. I hope this makes it even more fun.

Stretch and Flow is a type of physiologic voice therapy working on balancing among vocal

subsystems. It helps manage airflow in a way other approaches do not. It is the only known approach

that maintains articulation while taking voicing away, then slowly puts it back into the subsystems. It's

appropriate for strain, tension or phonotrauma for this reason. Tissue or bubbles in front of the mouth

gives feedback and the patient climbs a hierarchy of single "oooo" sounds, to rote words, to words

with easy onsets, to sentences, paragraphs, conversational speech, all while fading the tissue or

bubbles.

This hierarchy is first created with no vocalizations, then at an appropriate point during therapy,

switches for phonation paired with breathy (overly breathy initially) while fading into less breathy and

a more optimal phonation.

Hierarchy can be explained with:

1) Air only (open throat, sound of air at lips, articulation is maintained)

2) 80% air/ 20% sound (sound mimics wind through trees, barely audible phonation, sigh)

3) 50% air / 50% sound (healthy, balanced phonation with easy sound/feel)

References:
-Chapter 6 “ Restoration of Voice in Nonorgancially Based Dysphonias” written by Edward Stone Jr. and Robert L Casteel.

From the book Phonatory Voice Disorders in Children 1982.

-Casper, J. (1997) The role of confidential voice in a voice therapy protocol. Paper Presented at the Pacific Voice

Conference, San Francisco, CA.

-Casper, J. (2000) Confidential voice In J.C.Stemple (Ed) Voice therapy: Clinical Studies (2nd ed. Pp. 128-139). San

Diego, CA: Singular publishing group.

-Colton, R & Casper, J (1990) Understanding Voice problems : A physiological perspective for diagnosis and treatment.

Baltimore Williams & Wilkins.

-Colton, R. & Casper, J (1996) Understanding Voice problems : A physiological perspective for diagnosis and treatment.

(2nd ed.) Baltimore Williams & Wilkins.

Copyright 2019 www.atempovoicecenter.com

 How To Use
Cut out your tags
and laminate them.
Punch holes in the
circle. Place a key-
ring or binder ring in
the hole and attach
to the wand for the
bubbles.

Have the child

practice voiceless
"ooo" and "w" words
blowing bubbles
through the wand to
target vocal overuse.

Copyright 2019 www.atempovoicecenter.com

 Reminders for Stretch and Flow
How to start with Stretch and Flow Voice Therapy:

1.Your Speech Language Pathologist will have you begin with the bubble wand in

moc.retnececiovopmeta.www 9102 thgirypoC

front of your lips.
2. Start with an easy blow, rounded lips using breath only.

3. Listen to your SLP to know what to say next with that open throat, rounded, air-only

production.
4. You might say many words in "breath only" voice.

5. You might go back to "ooooo" but add a little bit of voicing.

6. Your SLP will say words with mostly air, and very litle voicing.

7. This voice is extra breathy, I know, but we will eventually make it less breathy.

8. It will eventually feel like 50% sound and 50% air.

9.

10.

Reminders for Stretch and Flow

Don't Forget!

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1.This is a healthy voice.
2. Try to add these sounds in your daily speech from

day 1.
3. You are in control!

4. Practice makes perfect.

5. We are doing this to help your voice sound better.

6.

7.
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 moc.retnececiovopmeta.www 9102 thgirypoC
Stretch and Flow
 moc.retnececiovopmeta.www 9102 thgirypoC
Stretch and Flow
Bubble Wand Tags
For Stretch & Flow Voice Therapy
Laminate these tags, cut them out, punch a hole in the circle and attach to the bubble wand with a paperclip

or a binder ring. Have the child blow bubbles through the wand while saying each targert sound on the list.

oooo oooo oooo

moc.retnececiovopmeta.www 9102 thgirypoC

moc.retnececiovopmeta.www 9102 thgirypoC

moc.retnececiovopmeta.www 9102 thgirypoC

ooooo ooooo ooooo

who Will Wizard

why Was What

where Whip When

oooo oooo oooo

moc.retnececiovopmeta.www 9102 thgirypoC

moc.retnececiovopmeta.www 9102 thgirypoC

moc.retnececiovopmeta.www 9102 thgirypoC

ooooo ooooo ooooo

Way We Whip

Wilt Water woot

Wheeze Want wow

Bubble Wand Tags
For Stretch & Flow Voice Therapy
Laminate these tags, cut them out, punch a hole in the circle and attach to the bubble wand with a paperclip

or a binder ring. Have the child blow bubbles through the wand while saying each targert sound on the list.

oooo oooo oooo

moc.retnececiovopmeta.www 9102 thgirypoC

moc.retnececiovopmeta.www 9102 thgirypoC

moc.retnececiovopmeta.www 9102 thgirypoC

one While wand

whale Whirl wink

wind Wing Waddle

wander wade wag

oooo oooo oooo

moc.retnececiovopmeta.www 9102 thgirypoC
moc.retnececiovopmeta.www 9102 thgirypoC

moc.retnececiovopmeta.www 9102 thgirypoC

wafer wall west

waffle web went

wagon weep while

walk well white