Blog

Recently, I have had quite a few kids on my caseload who have a “horse” or “raspy” voice. When I bring this up to parents, many of them respond “oh she’s always just had a raspy voice!”. But did you know that this “raspy” vocal quality is often a sign of vocal abuse? Vocal strain and nodules are caused by stress to the larynx. This stress is generally referred to as “vocal abuse” or misuse, and can eventually lead to the development of vocal nodules.

Usually children develop nodules or strain due to the interaction of two or more of the following done in excess:

• Talking and singing excessively without quiet “recovery time”
• crying, laughing, and loud prolonged outburst of emotion
• throat clearing
• forcefully using their voice
• Excessive coughing or loud forceful sneezing
• Shouting
• restricted fluid intake

Vocal nodules and strain are diagnosed by an Ear, Nose and Throat provider (ENT). Once the child has an ENT examination, speech therapy for the voice is usually recommended. The goal of voice therapy is to teach a healthy, non-abusive voice production patterns so the vocal cords can heal, allowing a return to a normal voice.

A typical vocal hygiene program will consist of:

• isolating medical conditions (like GERD) that aggravate vocal problems, then undergoing treatment
• modifying behaviors that cause distress to the vocal cords, like yelling
• learning how to take deep breaths and relax the muscles in the throat
• taking time to speak slowly and clearly
• staying properly hydrated throughout the day
• avoiding caffeinated beverages, like soda, which dry out the vocal cords

If your child presents with a hoarse, breathy or rough voice, consult with a speech pathologist and learn more about the benefits of voice therapy!

Resources

Information for Families: Vocal Nodules in Children

http://www.speech-language-therapy.com/index.php?option=com_content&view=article&id=102:childnodules&catid=11:admin&Itemid=117

Melanie Yovino, MA. CF-SLP