Voice Disorders

Voice is the sound produced by vibration of the vocal folds (or vocal cords) in the larynx (voice box).

A voice disorder occurs when the vocal folds do not vibrate well enough to produce a clear sound.

The most common voice disorder in children is the result of “phono trauma” or voice misuse such as yelling or making loud "play" sounds, throat clearing, and excessive coughing. These voice behaviors cause the vocal folds to close tightly against each other, causing blister-like bruises. These bruised areas can harden into callus-like bumps called vocal nodules.

Other causes of voice disorders can include:

  • Subglottic stenosis (narrowing of the airway)
  • Vocal fold paralysis (immobility of one or both vocal folds)
  • Vocal fold cysts (fluid-filled sac)
  • Granuloma (area of tissue inflammation due to injury or surgery)
  • Papilloma (wart-like growths)
  • Laryngeal web (band of tissue between vocal folds)
  • Muscle tension dysphonia (excessive muscle tightness), resulting in a strained voice
  • Hoarseness
  • Breathiness
  • Raspiness
  • Strain
  • Volume that is too loud or too soft
  • Pitch that is too high or low for age
  • Recent loss of voice (such as after an upper respiratory infection) that did not resolve

Some voice disorders can be treated with voice therapy. Other voice disorders are treated by medication or surgery. Usually, voice therapy is prescribed after surgery and sometimes before and after surgery. Voice therapy consists of learning new patterns of voice production and eliminating old ones. Some of the therapy includes: 

Some of the therapy includes:

  • Identifying and eliminating harmful voice patterns (such as yelling, screaming and making superhero sounds)
  • Improving vocal health by increasing water intake and avoiding caffeine
  • Using specific voice exercises designed to balance, strengthen or promote best vibration of the vocal folds and other muscles of the larynx. These are designed to improve the sound of the voice.  
  • Learning to use the new voice production in everyday communication

The purpose of voice therapy is to teach your child a new way to produce voice. For this skill to improve, the child should practice the voice exercises daily. Family members should also look at their own voice use. Changing your own voice and reinforcing positive voice behaviors will serve as a good model for your child.

Demonstrate good vocal use. This is important for all family members. If the adults in the family yell, so will the children.

  • Do not yell to communicate. Walk to your listener, then talk.
  • Turn down the TV or radio when you talk. Keep the radio turned down in the car when you talk.
  • Drink plenty of water and avoid soft drinks or coffee. Urine color should be clear or the color of lemonade. Yellow urine indicates poor hydration.
  • Encourage “voice naps.” For example, play a game without any words. This helps your child give his or her voice a rest.
  • Reward your child when they use the “better” voice, or practice good vocal health. Telling your child about their good voice habits is much more effective than complaining about poor voice habits. 

For more information, contact the Division of Speech Pathology, 513-636-4341. 

Last Updated 03/2016