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They speak in a hurry, but they take more time saying something because they have to repeat several times before they are understood. Aphonia in the absence of organic causes has been treated with either counseling and psychotherapy or behavioral therapy. When the aphonic individual then begins to communicate with whispers in a safe or comfortable environment, people's attention may positively reinforce and help sustain it over time. For instance, an aphonic child who is excused from stressful oral presentations to the class is receiving negative reinforcement. However, the person may continue to be aphonic even after the laryngeal disease has been effectively treated or total silence is no longer needed. For example, a laryngeal disease or laryngeal survey may initially prevent phonation, or the patient may have followed the surgeon's advice to remain completely silent for a few days. For example, individuals who have had severe case of flu, upper respiratory illness or other diseases may lose voice after they have recovered from their illness. In most cases, the onset of functional aphonia may be sudden. People with functional aphonia communicate well with whispers, and facial expressions. Functional aphonia by definition has no organic basis. They take more time saying something. The voice may sound too rough, noisy, too high pitched or low pitched, too loud or too soft. They tend to repeat words and phrases. The tone and the quality of the person's voice that they may be pleasant, unpleasant, interested, or indifferent may not be right. They tend to repeat words and phrases and their speech is full of such interjections as 'and', 'um', 'uh' and so forth. Voice help more than what the words say. Voice can reveal whether someone is angry or happy, so the speaker does not have to say it in words. Of all aspects of speech, voice is probably the most aesthetic. During the therapy sessions, clients are encouraged to speak freely about themselves and their psychological problems. All of these problems cause a subjective feeling that the voice is unpleasant. Such successful strategies for avoiding stressful situations may be responsible for aphonia. Functional aphonia may be a behavioral disorder. Aphonia at this stage is obviously organic or a necessary voluntary action for recuperation. In still other cases, functional aphonia may begin as an organic aphonia. Under a stressful situation, an individual may abruptly lose voice. There may be voice when the person coughs, laughs, and clears the throat, so voice production is possible but not available for continuous speech. Aphonia may be described as a psychological disorder due to unconscious conflicts. Initially, aphonia may be negatively reinforced. In other cases, functional aphonia may follow some physical ailment. Aphonia may also be described as a behavioral disorder in the absence of neurological or other structural problems.
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