Voice Disorders

How Speech Pathologists Help With Voice Disorders

When you think of a speech pathologist, people often think that we help people who stutter, or need help developing their speech sounds. This is true of course. But did you know that we also work with people who have voice disorders?

In this blog, I will take you through what a voice disorder is, the signs of voice disorders and how speech pathologists can help children with voice disorders.

What is a Voice Disorder?

A voice disorder is when the quality, pitch and loudness differ or are inappropriate for an individual’s age, gender, cultural background or geographic location. The American Speech-Language-Hearing Association (ASHA) also includes that a voice disorder is when an individual expresses concern about having an abnormal voice that does not meet their daily needs – even if others do not perceive it as different.

There are many different types of voice disorders and reasons why people have or develop voice disorders. They are usually either organic (there is something structurally or neurogenically causing change to the voice e.g. vocal nodules) or functional (voice disorders that results from wrongful use of the voice even when the structural components of the voice is normal).

There are specific groups of children who are more likely to develop voice disorders. These include children with Attention Deficit Hyperactivity Disorder (ADHD) who can often have a loud voice or use their voice in a hyperfunctional way.

What Causes a Voice Disorder?

Voice disorders in children are usually caused by excessive shouting or loud talking, frequent screaming or ‘loud meltdowns’ or excessive use of their voice during play.

Children can also have voice difficulties after common childhood infections, or even for emotional of psychological reasons (e.g. a child who whispers due to shyness). There are also some rare medical conditions that can cause voice disorders in children.

How Do I Know if My Child Has a Voice Disorder?

Children with voice disorders may show the following signs:

  • A harsh or hoarse sounding voice
  • Voices that are much higher or much lower than other children of their age or gender identity
  • Voices that are very loud or very quiet.
  • Voices that are hyponasal (sound like they have a blocked nose while talking).
  • Voices that sounds like there is too much air coming out of their nose.
  • They might clear their throat consistently or cough a lot (when they are not sick).
  • Children with voice disorders might also lose their voice completely.

What if My Child Has a Voice Disorder?

A voice disorder might not seem like it will have a significant impact on your child, but sometimes without support, your child may develop chronic voice disorders that persist into adulthood.

Having a voice disorder can lead to issues around self esteem and confidence. It can also also cause anxiety and stress in situations where your child is required to use their voice (e.g., giving a speech in class).

What Can Speech Pathologists Do to Help Children with Voice Disorders?

As paediatric speech pathologists, we often have a role in the assessment and treatment of voice disorders for children. The most common type of voice disorders we see here at A Growing Understanding are called misuse or abuse disorders. These are mostly functional voice disorders where a child might scream or talk too loudly, which leads to them losing their voice, or even developing an organic voice disorder such as vocal nodules.

One of the first suggestions speech pathologists may make is around “vocal hygiene.” This is a term we use to talk about maintaining healthy vocal habits, including eliminating habits that may be abusive or misusing the voice. Some great vocal hygiene tips for any child are:

  • Ensure adequate water intake throughout the day. Small, regular sips are encouraged.
  • Ensure that your child is away from known vocal irritants, such as cigarette smoke or aerosol sprays.
  • Encourage your child to go to the person they are wanting to speak to, rather than yelling across the house.
  • Encourage voice rest throughout the day. This could be in the form of quiet reading time or even have some fun competitions to see who can stay quiet the longest.
  • Discuss what volume of voice is appropriate to certain situations (e.g. Yelling outside to your friend vs speaking softly in the mornings when people are still in bed.) Give your child praise if they can use the correct volume of voice.
  • Encourage different ways of your child expressing themselves if they commonly scream or yell. Can they punch their pillow or go and jump on the trampoline if they are upset?
  • If your child clears their throat a lot, encourage them to take a sip of water instead of clearing their throat.
  • Have reminders around the house to encourage appropriate vocal use behaviours

What Should I Do to Help My Child with a Voice Disorder?

If you are concerned about your child’s voice or suspect they have a voice disorder, it is recommended that you seek advice from an Ear Nose and Throat (ENT) specialist to determine the cause of the voice disorder. Your speech pathologist can then collaborate with your ENT to formulate an individual plan for your child.

If you feel as though your child may have a voice disorder, talk to your GP, ENT or speech pathologist. We will be able to help you come up with a plan to support appropriate vocal use.

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