Karen Esposito

Specialist speech and language therapist, voice coach and vocal consultant.

Most of us take our voices for granted until something goes wrong. Our voices form a vital part of our identity and how we present our feelings, emotions and opinions to the world. If you are experiencing difficulties with your voice, it can be frustrating, upsetting and can cause difficulty with relationships, social lives and career.

Karen Esposito

About Karen

Karen Esposito, BSc (Hons) Cert MRCSLT

Karen completed her professional training in Speech & Language Pathology and Therapy at Manchester University in 1996, going on to specialise in the assessment and treatment of dysphonia (voice disorders).

Karen works at Sheffield Teaching Hospitals during her NHS time, as part of specialist teams providing regional clinics for patients with voice problems (dysphonia or vocal dystonia) and upper respiratory tract disorders (Inducible Laryngeal Obstruction and chronic cough).

Karen provides regular training to health professionals within the NHS, is an honorary lecturer at Sheffield University and is an adviser to the Royal College of Speech and Language Therapists.

During her private work, Karen sees patients at Claremont Private Hospital in Sheffield. Occasionally, it may be possible to arrange home visits.

She provides therapy to patients with voice problems, coaching and advice to professional voice users and education, guidance and training for any individuals, groups or organisations who wish to learn more about how the voice works, how to improve vocal and communication skills and how to protect the voice against future problems.

Dysphonia (voice disorder)

Most of us take our voices for granted…until something goes wrong. Our voices are a vital part of our identity and how we present our feelings, emotions and opinions to the world. If you are experiencing difficulties with your voice, it can be frustrating, upsetting and can affect relationships, social lives and careers.

If you are experiencing changes to your voice, you could be suffering from dysphonia (voice disorder). Your voice may be:

  • hoarse
  • strained
  • weak
  • breathy
  • low in volume
  • reduced in pitch range
  • difficult to control/unpredictable

Your voice may even have disappeared altogether (aphonia).

In the first instance, you should seek advice from your GP, who may refer you on to an Ear, Nose and Throat (ENT) Surgeon for assessment. There are many possible causes of dysphonia, including:

  • muscle tension
  • infection
  • nodules or cysts
  • haemorrhaging (burst blood vessels)
  • vocal cord paralysis (temporary or permanent damage to the nerves supplying the vocal cords)
  • neurological conditions (eg dystonia, Parkinson’s Disease)
  • psychological factors such as anxiety or depression
  • allergies
  • hormonal variation
  • in very rare cases, cancer

Your ENT Consultant will either advise surgery or, more likely, referral to a speech and language therapist who specialises in voice disorders for a course of voice therapy.


Individual Voice Therapy

“The work Karen did with me she did in such a way I did not feel embarrassed, rushed or uncomfortable. Karen explained exactly what she was doing and how this would help with my recovery”. – PC

Your first session will typically be an hour long with the aim of giving you the chance to discuss your voice concerns in depth, according to your personality, vocal needs and the way you live your life.

During this initial session, Karen will:

  • Provide information on how your voice is produced to help you understand why voice problems occur and discuss your individual diagnosis in detail
  • Advise you how to best care for your throat and vocal cords
  • Suggest realistic changes to your working or private life to ease the load on your voice
  • Begin a customised programme of voice therapy techniques designed to rehabilitate your voice and protect it from future damage

“I can’t explain the amazing difference. I was so tense, worried and tired all the time but now I understand what is wrong. Everything was explained with such enthusiasm and kindness” – LS

Follow on voice therapy sessions are usually shorter. Therapy will be holistic and address every aspect that can influence the way you use your voice:

  • Posture
  • Breath support and breathing patterns
  • Vocal stamina
  • Muscular control and release of unhelpful tension
  • Resonance
  • Pitch and volume range and control
  • Environmental factors
  • Lifestyle
  • Co-existing health conditions
  • Personal and vocational issues
  • Social and psychological influences

“Further sessions with Karen helped restore my confidence and one particular session resulted in me walking into her room without a voice and walking out talking. She also gave me the means to ‘restore’ my voice if it did go again” – PC

A singer on stage

Performers and Voice Coaching

Many actors and singers achieve extremely high levels of vocal agility and skill. However, it is not unusual for performers to encounter issues as some point in their career due to the heavy demands and expectations placed upon their voices.

Vocal technique, the particular challenges of a song or role, fatigue, overall fitness levels, anxiety, stress and the performance environment itself can all affect the voice.

Voice problems can be very distressing and can potentially have an impact on confidence, performance, reputation and financial stability. It is very important to seek help from an experienced, qualified professional as soon as possible as the great majority of voice problems can be addressed effectively with speech and language therapy and voice coaching.

Karen can provide individual or group sessions for performers. Group workshops are flexible and customised according to the requirements, skills and interests of your group.

Should you need to contact Karen for advice, rest assured that you will be treated with professionalism, confidentiality and a sensitivity for the pressure experienced by performers with voice issues.

“My first appointment with Karen resulted in me being in floods of tears – not in a bad way I hasten to add – within 10 minutes of meeting and listening to me she made me open up to her and explain all my fears and worries about losing my voice. Karen then went onto explain and assure me that these could be rectified within a few sessions” – PC

A woman in a meeting

Voice in Business Workshops

Many workers are heavily reliant on their voices to be effective in their roles. When vocal overuse or misuse leads to a strained, hoarse, tired voice, there can be serious financial implications for employers and employees alike.

“Vocal training delivered in the workplace significantly reduces the risk of developing physiological voice problems”
“Working Voices”, Institution of Occupational Safety and Health, 2012

Call centre workers are an example of professional voice users who cannot draw on help from gesture or facial expression. Over the telephone, customers and callers make judgements upon voice quality, the tone, speed and pitch of your voice, the sounds and words you use and the way you use them. Even though voice and speech skills are essential tools of the trade for call centre workers, most have little or no training and are among the most at risk of encountering voice problems, leading to potentially high sickness rates, a high turnover of staff and problems with health, wellbeing and finance for the employees.

“All call agents, and especially new starters, should receive vocal training”
“Working Voices”, Institution of Occupational Safety and Health, 2012

Call centre workers are, of course, not the only workers with potential voice problems. Karen’s vocal workshops are customised according to the demands of your business upon staff, your working environment and the level of knowledge required. Contact Karen if you would like to discuss how she could help you address the potential effects of voice problems in your workplace.

“A really useful training afternoon. Think it should be incorporated into corporate training so that we can be proactive regarding caring for the voice, which is our main tool. Thank you, Karen” – DHU Health Care CIC Call Centre Workshop

“My colleagues and I thought you were very dynamic and excellent teacher. They enjoyed participating in the seminar and did not feel threatened as is so often the case” – AK

Karen delivers a lecture on the role of SLT

Teachers and Lecturers

Teachers and lecturers are at a high risk of developing voice problems at some point in their career. Increasing workload, classroom sizes and stress are all contributing factors.

Effective vocal and presentation techniques are core tools in education but many enter the profession with little or no training in these areas.

Teachers and lecturers often describe how they have struggled on with voices becoming increasingly hoarse, strained, weak and sore. Livelihoods can be at stake, so it is vital that voice problems are addressed as early as possible in a teacher or lecturer’s career.

If you are considering training sessions for your staff, please contact Karen to discuss your needs.

Enquiries from individual teachers/lecturers with voice concerns are also welcome.

“Thanks for a really great session the other day. It has got the students all a buzz” – CT Sheffield University

Karen delivers a lecture at the Dystonia Society

Vocal Consultant

Karen has extensive expertise in all aspects of voice production and voice disorders and has acted as a Vocal Consultant in NHS, private healthcare, performance, workplace and media settings.

She welcomes enquiries from anyone requiring advice, information and guidance.

“Thanks so much Karen! I think you do an amazing job, talking with you was a real inspiration. Good luck with all your ventures too!” – Channel 4 researcher


Karen is registered with most healthcare insurance companies.

  • Initial sessions for individual assessment – £POA
  • Follow up therapy/review sessions – £POA
  • Vocal workshops – £POA
  • Vocal consultancy fee – £POA

Karen is a registered full member of the Royal College of Speech and Language Therapists (RCSLT)and the Health and Care Professions Council (HCPC), is fully DBS cleared and is a registered with the Information Commissioners Office (ICO)

Contact Karen