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The purpose of this viewpoint article is to facilitate research on vocal hyperfunction (VH). VH is implicated in the most commonly occurring types of voice disorders, but there remains a pressing need to increase our understanding of the etiological and pathophysiological mechanisms associated with VH to improve the prevention, diagnosis, and treatment of VH-related disorders.

A comprehensive theoretical framework for VH is proposed based on an integration of prevailing clinical views and research evidence.

The fundamental structure of the current framework is based on a previous (simplified) version that was published over 30 years ago (Hillman et al., 1989). A central premise of the framework is that there are two primary manifestations of VH—phonotraumatic VH and nonphonotraumatic VH—and that multiple factors contribute and interact in different ways to cause and maintain …