Voice

Voice

How we use our vocal folds and breath to make sounds. Our voice can be loud or soft or high- or low-pitched. We can hurt our voice by talking too much, yelling, or coughing a lot.

Voice Disorders

We use our voice to make sounds. Our voice can change when we use it the wrong way. We can lose our voice when we are sick or after talking or yelling a lot. Signs that your child may have a voice disorder include:

  • Having a hoarse, scratchy, or breathy voice.

  • Sounding nasal, or like he talks through his nose.

You can help your child by:

  • Seeing a doctor if your child’s voice sounds different and it does not go away after a short time.

  • Telling your child not to shout or scream.

  • Keeping your child away from cigarette smoke.


Voice Problems:

Voice problems in children are perceived as difficulties with quality, pitch, loudness or resonance. A child may be hoarse or "nasal" sounding, may have an inappropriate pitch for his/her age, or have difficulty modulating loudness. These difficulties could be linked to hearing loss, structural problems of the vocal cords, or other medical conditions.

How Does Your Voice Work?

The sound of our voice is produced by vibration of the vocal folds, which are two bands of smooth muscle tissue that are positioned opposite each other in the larynx. The larynx is located between the base of the tongue and the top of the trachea, which is the passageway to the lungs (see figure).

When we're not speaking, the vocal folds are open so that we can breathe. When it's time to speak, however, the brain orchestrates a series of events. The vocal folds snap together while air from the lungs blows past, making them vibrate. The vibrations produce sound waves that travel through the throat, nose, and mouth, which act as resonating cavities to modulate the sound. The quality of our voice—its pitch, volume, and tone—is determined by the size and shape of the vocal folds and the resonating cavities. This is why people's voices sound so different.

Individual variations in our voices are the result of how much tension we put on our vocal folds. For example, relaxing the vocal folds makes a voice deeper; tensing them makes a voice higher.

How do you know when your voice is not healthy?

If you answer "yes" to any of the following questions, you may have a voice problem:

  • Has your voice become hoarse or raspy?

  • Have you lost your ability to hit some high notes when singing?

  • Does your voice suddenly sound deeper?

  • Does your throat often feel raw, achy, or strained?

  • Has it become an effort to talk?

  • Do you find yourself repeatedly clearing your throat?

If you think you have a voice problem, consult a doctor to determine the underlying cause. A doctor who specializes in diseases or disorders of the ears, nose, and throat, and who can best diagnose a voice disorder, is an otolaryngologist (oh-toe-lar-in-GAH-luh-jist), sometimes called an ENT. Your otolaryngologist may refer you to a speech-language pathologist. A speech-language pathologist can help you improve the way you use your voice.

What causes voice problems?

Causes of voice problems include:

  • Upper respiratory infections

  • Inflammation caused by gastroesophageal reflux (sometimes called acid reflux, heartburn, or GERD)

  • Vocal misuse and overuse

  • Growths on the vocal folds, such as vocal nodules or laryngeal papillomatosis

  • Cancer of the larynx

  • Neurological diseases (such as spasmodic dysphonia or vocal fold paralysis)

  • Psychological trauma.

Most voice problems can be reversed by treating the underlying cause or through a range of behavioral and surgical treatments.

Tips to prevent voice problems:

Stay hydrated:

  • Drink plenty of water. Six to eight glasses a day is recommended.

  • Limit your intake of drinks that contain alcohol or caffeine, which can cause the body to lose water and make the vocal folds and larynx dry. Alcohol also irritates the mucous membranes that line the throat.

  • Use a humidifier in your home. This is especially important in winter or in dry climates. Thirty percent humidity is recommended.

  • Avoid or limit use of medications that dry out the vocal folds, including some common cold and allergy medications. If you have voice problems, ask your doctor which medications would be safest for you to use.

Maintain a healthy lifestyle and diet:

  • Don't smoke and avoid second-hand smoke. Smoke irritates the vocal folds. Also, cancer of the vocal folds is seen most often in individuals who smoke.

  • Avoid eating spicy foods. Spicy foods can cause stomach acid to move into the throat or esophagus, causing heartburn or GERD.

  • Include plenty of whole grains, fruits, and vegetables in your diet. These foods contain vitamins A, E, and C. They also help keep the mucus membranes that line the throat healthy.

  • Wash your hands often to prevent getting a cold or the flu.

  • Get enough rest. Physical fatigue has a negative effect on voice.

  • Exercise regularly. Exercise increases stamina and muscle tone. This helps provide good posture and breathing, which are necessary for proper speaking.

  • If you have persistent heartburn or GERD, talk to your doctor about diet changes or medications that can help reduce flare-ups.

  • Avoid mouthwash or gargles that contain alcohol or irritating chemicals. If you still wish to use a mouthwash that contains alcohol, limit your use to oral rinsing. If gargling is necessary, use a salt water solution.

  • Avoid using mouthwash to treat persistent bad breath. Halitosis (bad breath) may be the result of a problem that mouthwash can't cure, such as low grade infections in the nose, sinuses, tonsils, gums, or lungs, as well as from gastric acid reflux from the stomach.

Use your voice wisely:

  • Try not to overuse your voice. Avoid speaking or singing when your voice is hoarse or tired.

  • Rest your voice when you are sick. Illness puts extra stress on your voice.

  • Avoid using the extremes of your vocal range, such as screaming or whispering. Talking too loudly and too softly can both stress your voice.

  • Practice good breathing techniques when singing or talking. Support your voice with deep breaths from the chest, and don't rely on your throat alone. Singers and speakers are often taught exercises that improve this kind of breath control. Talking from the throat, without supporting breath, puts a great strain on the voice.

  • Avoid cradling the phone when talking. Cradling the phone between the head and shoulder for extended periods of time can cause muscle tension in the neck.

  • Consider using a microphone when appropriate. In relatively static environments such as exhibit areas, classrooms, or exercise rooms, a lightweight microphone and an amplifier-speaker system can be of great help.

  • Avoid talking in noisy places. Trying to talk above noise causes strain on the voice.

  • Consider voice therapy. A speech-language pathologist who is experienced in treating voice problems can teach you how to use your voice in a healthy way.

What is Hoarseness:

If you are hoarse, your voice will sound breathy, raspy, or strained, or will be softer in volume or lower in pitch. Your throat might feel scratchy. Hoarseness is often a symptom of problems in the vocal folds of the larynx.

What is Hoarseness

Additional Resources: