Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Health Sciences


Rehabilitation Sciences

First Advisor

Dr. Joseph Stemple

Second Advisor

Dr. Dana Howell


This dissertation focuses on the aging voice - specifically the aging elite vocal athlete. It is comprised of four components; a series of research studies and a viewpoint piece designed to explore the awareness, struggles, and vocal compensations of aging singers dealing with age related vocal and performance problems. The overarching goal of these studies is to inform the development of a voice care protocol for the aging rock star to guide customized intervention for these elite vocal athletes that is focused on optimizing both vocal output and performance.

First, the dissertation introduces and identifies characteristics of the exceptional voice. This involves a new vocal continuum that includes the normal voice, the trained voice, and the exceptional voice. The second component is a qualitative study of older contemporary commercial music (CCM) singers adjustments and accommodations associated with their aging. From this, four overarching themes are identified: modest self-perception of their vocal prowess and its relationship to performance, acute sensitivity to changes in vocal quality, recognition of the critical association of voice quality with their identity as a performer, and an array of accommodations to aging-related vocal changes.

The third component of the dissertation is a randomized control trial examining the efficacy of Vocal Function Exercises as a treatment modality for presbyphonia. Analysis revealed that the experimental group improved in select outcome measures including decreased glottic gap, increased upper range, and maximum phonation time at the 6-week post-treatment re-evaluation with no such changes in the control group. The final study investigated the vocal and performing trajectories of six CCM male singers through analysis of video performances across their career. Singers were shown to make accommodations consistent with the reported findings from component two. Such accommodations include decreased total time singing for some singers, accommodations for range changes, and changes to performance. From this study, the Exceptional Voice Protocol was created to provide a customized vocal and performance blueprint for each artist that meets their unique needs for their exceptional voices.

Overall, this research indicates that aging CCM singers appear to be experiencing age and performance related vocal changes and are making detectable accommodations to their performance. Additional findings show that Vocal Function Exercises appear to be an efficacious treatment modality for aging voice. Findings from these studies confirm the need for continued research on age-related vocal and performance changes for these performers and guidelines for appropriate habilitation and rehabilitation so these rock stars can continue performing for as long as they desire.

Digital Object Identifier (DOI)