Voice production is characterized by:

1. Quality - pleasant and clear voice versus unpleasant, strained, raspy, and/or hoarse voice.
   
2. Intensity (loudness) - appropriate versus inappropriate loudness for a given situation.
   
3. Pitch - pitch that is appropriate for age/sex versus pitch that is too high or low
   
4. Resonance (nasality) - proper emission or balance of air through mouth or nose.
   

Causes of Vocal Problems

Vocal folds may be “abused” due to screaming, yelling, and speaking loudly frequently throughout the day. If this happens often enough over long periods of time, “vocal nodules” (growths on the vocal folds) may appear and prevent proper function.

Allergies, sinus and adenoid problems may result in a denasal (stuffed up) vocal quality.  Decongestants and antihistamines given to dry up the nose also dry out the vocal folds and can cause voice problems in children.

Vocal Quality Issues

• denasal/ “stuffed up” 

• dry cough 

• persistent throat clearing 

• a voice problem which persists for 2-3 weeks 

• hoarseness 

• harshness/low in pitch and very strained 

• breathiness/whisper-like noise 

• pitch breaks/pitch goes up and down 

• low volume 

If a child demonstrates one or more of the above characteristics:

1. Talk to a Speech-Language Pathologist
   
2. Monitor the child’s speech voice for 3 weeks by simply making notes (“cleared throat constantly” or “voice breathy today”)
   
3. Discourage straining the voice (screaming, clearing throat, etc.)
   
4. Encourage the student to drink lots of water and allow him/her to keep a water bottle at the desk
   
5. Encourage the student to take a sip  of water before speaking
   
6. If the problem continues for 2-3 weeks, it is best practice to have the child seen by an Otolaryngologist/ENT doctor to rule out growths on the vocal folds that may require surgery, as opposed to cases that may benefit from therapy in order to shrink the growth
   

Voice disorders in children can be reduced when we all work together. The first important step is recognizing when a child may have a voice disorder. The proper steps to eliminate the problem may then be taken.