Tuning Into Your Child’s Voice

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Georgie Burridge

Georgie Burridge

Tuning Into Your Child’s Voice

As a parent, teacher, or somebody who spends a lot of time around children, have you ever noticed a child’s voice that doesn’t sound quite right?

Perhaps it may have sounded a bit rough and husky, or high pitched and ‘nasally’?

Voice disorders (otherwise known as ‘dysphonia’) in children are relatively common, in fact research suggests that between 6% and 36% of children have a voice disorder. Children with a voice disorder may have difficulty being heard and understood, therefore having an impact on the way they go about their everyday life (for example, going to school or participating in sports or social events). A child with a voice disorder that is left undetected may experience difficulties with self esteem, increased stress or anxiety, with the potential of the voice disorder persisting into adulthood.

This blog provides the ins- and- outs of pediatric voice disorders- read on to learn more!

How is ‘voice’ produced?

When you breathe in deeply, you fill your lungs with air, and as you breathe out, the stored air travels back up through your windpipe (the trachea). The larynx is a box-shaped area located at the top of your windpipe. This larynx is nicknamed the voicebox as it holds some of the body parts that help us to speak. In other words, the larynx is the source of your voice. Your larynx is that small bump on your throat’s front and is below your chin.

Inside of the larynx are two very thin, stretched out bands of muscles known as the vocal cords. Whenever you breathe in, these cords open to allow air passage through the larynx, going into the trachea and progressing down to the lungs. The vocal cords close when you breathe out and when you want to talk. The air from the lungs that are trying to pass over the closed vocal cords start to vibrate, which creates sound.

Once the air travels to your oral cavity you move the articulators (tongue, teeth, lips, soft palate) to manipulate and transform the sound.

For more information about how voice is produced, check out the link below:

https://voicefoundation.org/health-science/voice-disorders/anatomy-physiology-of-voice-production/understanding-voice-production

The human body is amazing and is one of the most complex instruments producing sound. To see the vocal cords in complete action check out the video below which shows how they work when beat boxing. https://www.youtube.com/watch?v=LqdFL0u2HLY

But what if the voice does not seem to be performing as it should?

”A voice disorder occurs when voice quality, pitch, and loudness differ or are inappropriate for an individual’s age, gender, cultural background, or geographic location” (Aronson & Bless, 2009; Boone, McFarlane, Von Berg, & Zraik, 2010; Lee, Stemple, Glaze, & Kelchner, 2004). Your voice is a product of vibration of the vocal cords. When the vocal cords are unable to function properly and produce clear sound (which may occur for a number of reasons), the voice produced may sound ‘abnormal’.

Risk factors in children
  • Spending long days in large groups (e.g. daycare), or places with high levels of background noise (e.g. in the playground at school),
  • Often talking or shouting loudly, or whispering,
  • Often mimicking a ‘cartoon’ voice,
  • Inadequate water consumption,
  • Recurrent infections of the upper airway,
  • Ongoing acid reflux,
  • Asthma or allergies
young family all smiling at home
Voice disorder red flags
  • Harsh, croaky, hoarse or strained voice quality,
  • Abnormally high or low pitch of voice,
  • Complete voice loss at times,
  • Hypernasal (e.g. too much air coming through the nasal passage) or hyponasal (e.g. sounding like the nose is blocked) voice quality,
  • Difficulty with voice projection

Where to next?

If you’ve spotted some reg flags- perhaps your child’s hoarse or strained voice isn’t improving, or they are constantly losing their voice for no apparent reason. The first person to seek help from is your GP. Your GP may decide to refer on to an Ear, Nose and Throat Specialist (ENT) to determine whether the vocal cords have any medical reasons for the voice difficulties (e.g. nodules, polyps). They may use a small camera to look down your child’s throat to view the vocal cords and check their functioning. A speech pathologist may also be involved in the evaluation of your child’s voice characteristics.

Treatment Treatment may involve input from a team of specialists, including a speech pathologist and an ENT. Treatment varies depending on the severity, cause and characteristics of the child’s voice disorder. Treatment may involve;
  • Vocal hygiene: ‘Vocal hygiene’ refers to the use of strategies aiming to reduce dryness and irritation of the throat and improving vocal behaviors to promote healthy voice use. A speech pathologist can provide information on vocal hygiene and hydration and assist to implement these into the child’s day-to-day life (e.g. increasing water intake, avoiding coughing/ throat clearing, avoiding smoky/ dusty environments),
  • Increasing the child’s self-awareness: This may involve the child being taught the difference between an ‘inside’/ ‘quiet and ‘outside’/ noisy voice and when it is appropriate to use each one,
  • Behavioral support: Alternative anger management strategies may be taught to decrease the occurrence of yelling/ screaming episodes (e.g. hitting a pillow rather than screaming),
  • Breathing strategies: The child may be taught and encouraged to use breathing exercises to aid breathing and vocal cord function,
  • Vocal exercise: The speech pathologist may provide the child with tailored vocal exercises and techniques to practice daily (for example using principles of Resonant Voice Therapy or techniques from a program such as Voicecraft),
  • Reducing tension: The child may be taught and encouraged to use exercises which focus on reducing tension within the neck and/or shoulders when talking loudly,
  • Resonance: This involves looking at voice projection strategies and the child practicing using their voice in the most effective and ‘efficient’ way to reduce vocal cord damage,
  • • Liaising with the child’s preschool or school teachers: The speech pathologist may provide the child’s teachers with strategies to reduce behaviours that may be unhealthy for the vocal cords (e.g. using a ‘talking stick’ at group time, ringing a bell when they need help rather than shouting).

Hopefully you have learnt something new from this blog. If you know a child that may potentially have a voice disorder, please get in touch with us.

Happy Talking,

Georgie

References: Aronson, A. E., & Bless, D. M. (2009). Clinical voice disorders. New York, NY: Thieme Medical Publishers. Boone, D. R., McFarlane, S. C., Von Berg, S. L., & Zraick, R. I. (2010). The voice and voice therapy. Boston, MA: Allyn & Bacon. Lee, L., Stemple, J. C., Glaze, L., & Kelchner, L. N. (2004). Quick screen for voice and supplementary documents for identifying pediatric voice disorders. Language, Speech, and Hearing Services in Schools, 35, 308–319. Verdolini Abbott, K. (2013). Some Guiding Principles in Emerging Models of Voice Therapy for Children. Seminars in Speech and Language, 32(2), 80-93.