Preventing Voice Disorders in Children

by Jacky G.

If you’re a sports fan, you’ve probably watched or listened to “Mike and Mike” on ESPN. The duo are among the funniest sports broadcasters around, but even the mighty Mike Golic was not immune to something that your child might experience at some point: a voice problem. Golic tried to work on the show this morning, but he was sent home pretty quickly when his voice simply couldn’t handle it.

Everyone comes down with a sore throat every now and then, but what happens when it turns into a voice disorder? We all know that taking vitamin C and other healthy supplements can help carry you through cold and flu season, but how do you prevent voice disorders in children?

What Are They?

Voice disorders affect about four to six children out of 100. Voice disorders refer to a range of problems that affect the quality of sound. It may present as abnormal pitch or loudness. You might notice that your child’s voice sounds hoarse, breathy, nasal, or too high or low. Your child might also lose his voice entirely. Voice disorders in children often occur due to abuse of the vocal cords. That is, your child yells loudly and frequently on the playground or at a sports event. Voice disorders might also be caused by childhood infections.

If you notice that your child’s voice seems abnormal, discuss the issue with his pediatrician and speech-language pathologist (SLP). In the meantime, use the following tips to promote good vocal health in your child and prevent voice disorders.

Preventing Voice Disorders – Lifestyle Tips

Environment

Create an environment that is conducive to good vocal health. Avoid turning the volume up too high on the TV, radio, and other electronic devices. Turn these devices off entirely during a conversation with your child. This encourages a moderate speaking volume.

While at a ball game or other event during which cheering and yelling is common, encourage your child to cheer visually. Bring along signs to support the team or encourage your child to clap instead of yell.

Create a “quiet time” in your home. For example, for an hour after dinner (or any other time), each family member is encouraged to engage in quiet activities to rest their voices.

Other Tips

Encourage your child to stay hydrated, especially if he is doing a lot of talking. However, avoid giving him drinks that contain caffeine. While your child is probably not a coffee drinker yet, select caffeine-free hot chocolate and other popular kids’ drinks. As well, keep a humidifier running in your child’s room and other areas that he frequents.

If your child frequently clears his throat, encourage him to swallow, suck on a sugar-free hard candy, or take a drink of water instead. Throat clearing can be pretty harsh for the vocal cords.

Discourage whispering, especially for long periods of time. This can stress the vocal cords.

These tips are especially important when your child has a cold. He can easily lose his voice if he abuses his vocal cords while battling an infection. Encourage him to rest and drink plenty of fluids.

Preventing Voice Disorders – Speech Therapy

Voice disorders aren’t always temporary, as with the case of losing one’s voice because of a cold. Some children may need to work with a speech therapist to learn good vocal habits, such as moderating the pitch and volume of the voice. Speech therapists can treat voice disorders in children by helping them to become more aware of their vocal patterns, teaching them about muscle relaxation techniques, and encouraging diaphragmatic breathing.

Tips to keep your child’s voice healthy:

• Take talking breaks. Aim for 30-60 minutes of voice rest each day. This may consist of several shorter periods each day based on your child’s age.
• Encourage quiet time. Include non-vocal activities in the day, like reading or computer time.
• Teach turn taking. Teach your children to take turns during conversations so they aren’t compelled to use a loud voice to talk over each other.
• Turn down the volume. No need for the television or mobile devices to be at high volume. You can all speak to each other more quietly and reduce the need for noisy activities – and the need to talk over the sounds – when the volume is turned down.
• Be a good role model. Don’t yell in the house or use loud voices. Encourage your child to do the same.
• Explain inside and outside voices. Emphasize the appropriate places to use each type of voice.
• Spend one-on-one time with your child. It reduces the need for your child to compete for your attention at other times in the day.
• Encourage healthy voice habits. Sipping water throughout the day will keep your child’s vocal cords hydrated and lubricated and less prone to injury.
• Discourage constant throat clearing. It contributes to throat irritation and hoarseness. Instead, encourage your child to sip water when feel the need to clear their throat.
• Seek help. If your child’s voice is hoarse, raspy, or weak, you may want to consider having him or her work with a voice therapist. They can teach techniques to help your child’s vocal health.

How is voice produced?

Voice is produced by vibration of the vocal folds. The vocal folds are two bands of smooth muscle tissue that lie opposite each other. They are located in the larynx or voice box. The larynx is positioned between the base of the tongue and the top of the trachea (windpipe), the passageway to the lungs.

When at rest, the vocal folds are open to allow an individual to breathe. To produce voice, the brain precisely coordinates a series of events. First, the folds come together in a firm but relaxed way. Once the folds are closed, air from the lungs passes through them, causing vibration and thus making sound. The sound from this vibration then travels through the throat, nose, and mouth (resonating cavities). The size and shape of these cavities, along with the size and shape of the vocal folds, help to determine voice quality.

Variety within an individual voice is the result of lengthening or shortening, tensing or relaxing the vocal folds. Moving the cartilages, or soft, flexible bone-like tissues to which the folds are attached, makes these adjustments possible. For example, shortening and relaxing the vocal folds makes a deep voice; lengthening and tensing them produces a high-pitched voice.

Who may be at risk for a disorder of vocal abuse or misuse?

Disorders of vocal abuse and misuse are the most prevalent and preventable of the types of voice disorders. Anyone, from infants to the elderly, who uses his or her voice excessively may develop a disorder related to vocal abuse. Lawyers, teachers, clergy, cheerleaders, and professional voice users such as singers and actors often develop these types of voice disorders. Much of the chronic hoarseness experienced by children is caused by vocal abuse or misuse.

How are disorders of vocal abuse and misuse treated?

Most disorders of vocal abuse and misuse are reversible. The best treatment is to identify and eliminate the vocal behavior that created the voice disorder. In many cases, a brief period of voice therapy is helpful so that the individual can learn good vocal techniques such as proper breath support for speech or eliminating forceful voicing.

In some instances, eliminating the abuse or misuse and voice therapy are not enough. In these cases, medication to block the production of stomach acid may be helpful. In some cases, an operation may be necessary to remove growths from the vocal folds. Since most disorders of vocal abuse and misuse easily recur following surgery if the vocal misuse continues, another period of voice therapy by a speech-language pathologist after surgery may help prevent recurrence of the problem.

Children with disorders of vocal abuse and misuse are often the most difficult to treat because it is not easy for them to change their vocal behaviors. Fortunately, most children outgrow these disorders by the time they are teenagers. For these reasons, many surgeons do not operate on children who have disorders of vocal abuse or misuse. A period of voice therapy, however, may help the child to learn proper voice behaviors.