Which approach would most likely aid a client with aphonia?

• A. Pairing the production of /s/ and /z/
• B. Development of phonation through coughing or throat clearing
• C. Respiratory exercises
• D. Easy initiation of phonation

Answer: (B)

When someone has aphonia, getting the vocal folds to start vibrating again is the goal. Using a controlled cough or throat clearing can jump-start phonation by triggering the laryngeal muscles to adduct and then vibrate, giving a tangible voice sensation to work from. This approach helps re-establish the ability to phonate and provides a foundation for later, more controlled voice exercises, as the client learns to fade the cough into a steady, easy-onset voice.

Pairing /s/ and /z/ targets articulation, not the initiation of phonation. Respiratory exercises improve breath support but don’t directly restore voice. Easy initiation of phonation is useful, but it usually comes after phonation has been re-established, and the cough-based method is a practical way to reawaken the vocal folds and start the process.