Voice Disorder
Voice is the sound produced by vibration of the vocal cords (or vocal folds) in the larynx (voice box). A voice disorder occurs when the vocal cords do not vibrate effectively to produce a clear sound.
What are the Symptoms?
- A voice that is chronically hoarse, harsh, breathy, or of poor quality
- The voice that is always too soft
- Inappropriate pitch for the child's age or sex
- Frequent vocal pitch breaks
- Hyponasality or hypernasality
What are the Causes?
Causes of voice disorders can include vocal abuse, such as yelling or making loud "play" sounds, throat clearing, and excessive coughing. These behaviors result in the vocal cords closing hard against each other and causing blister-like bruises. These areas can harden into callous-like lesions called vocal nodules. Other causes can include subglottic stenosis, vocal fold paralysis, vocal fold polyps, granulomas, papilloma, and laryngeal web.
What Happens During an Evaluation?
Most voice evaluations are done by a speech-language pathologist. Children with complex voice disorders may also be referred to the multidisciplinary Voice Disorders Clinic where a speech-language pathologist and a specialist from Otolaryngology (Ear, Nose, and Throat, or ENT) are present. A voice evaluation includes evaluating both acoustic (sound) and aerodynamic (how air from the lungs moves through the vocal folds) measurements of the voice. The evaluation may include looking at the vocal folds through videostroboscopy (which can be done through the mouth or nose, depending on the age of the child).
What is the Treatment?
Following the evaluation, the speech-language pathologist may recommend voice therapy. Voice therapy includes identifying and eliminating vocal abuses and improving vocal hygiene. Instructions are given on hydration (drinking 6–8 glasses of water per day), avoiding caffeine, and eliminating vocally abusive behaviors. Voice therapy may involve a regimen of specific vocal exercises designed to balance and strengthen the vocal folds and other muscles for improved voice quality.
Why Cincinnati Children's?
As a national leader in pediatric speech pathology, Cincinnati Children's has a program for the treatment of voice disorders. This program is staffed by speech-language pathologists who have undergone specific specialty training. We welcome referrals from primary care providers and specialty physicians.
For more information about the Speech Pathology Department at Cincinnati Children's, call 513-636-4341 or e-mail speech@cchmc.org.
Rev. 11/07
