Voice Therapy for Kids: Addressing Hoarseness and Improving Vocal Health
- A hoarse, croaky or raspy voice (like Darth Vader in Star Wars)
- Recurring temporary loss of voice (after a sports event, end of the day)
- Tense neck muscles
- Pitch breaks when going from a low to high pitch
- Difficulty sustaining a note when singing
- Upper respiratory tract infections such as laryngitis which leads to inflammation and swelling of the vocal cords.
- Laryngo pharyngeal reflux
- Voice misuse such as:
- Tensing neck muscles and putting stress on the vocal cords.
- Straining the voice: screaming, shouting, loud crying, talking loudly with too much effort.
- Activities that may cause vocal strain include:
- Loud and long emotional outbursts or tantrums.
- Glottal attack (when vocal folds slam quickly and forcefully).
- Persistent throat clearing
Voice misuse can lead to Vocal Nodules
Vocal nodules are noncancerous growths on the vocal cords. They are formed due to a thickening of the lining of the vocal fold due to repeated pressure (stress) on the same area of the vocal cords. Vocal nodules affects the voice resulting in hoarseness or decreased volume.
Caring For Your Voice
Voice Tips for Children with a Hoarse Voice or Vocal Nodules
Sometimes, people hurt their vocal cords and they get bumps on them.
These make your voice sound harsh because the air cannot go past the bumps smoothly. Others may get sore swollen vocal cords or blisters on them.
In caring for children’s voices, we aim to do Three Things:
- Keep the voice box healthy
- Reduce the strain on the voice
- Help your child to monitor his or her own voice.
Ten Tips For a Healthy Voice
- Drink plenty of water each day, 6 to 8 glasses (1.5 - 2 litres) and take frequent sips throughout the day.
- Rest your throat if you have a cold or a sore throat.
- Avoid things like smoke and haze as they will irritate your vocal cords.
- Use a quiet voice to talk to your friends.
- Avoid yelling or shouting or crying loudly. Using a loud voice forces your vocal cords together hard. This can strain the vocal cords and hurt your voice.
- Give your voice a rest, for example: by reading a book or drawing.
- Sip and swallow – don’t cough – to clear your throat: When you cough, your vocal cords bang together. Prolonged throat clears and coughing can lead to nodules, a common cause of voice disorders in kids. Sipping and swallowing is a far less damaging way of clearing your throat.
- Reduce background noise: Turn down the television or music level. Reduce the noise level so your child won’t need to shout to be heard.
- Discourage silly voices: Monster noises, Darth Vader impersonations or speaking in a squeaky Donald Duck voice are fun. However, doing it too often may hurt your voice box.
- Monitor for Gastroesophageal Reflux. Acid reflux happens when stomach contents flow back up (reflux) into the food pipe (oesophagus). Reflux can hurt the tissues in your voice-box and contribute to a voice disorder. If you suspect that your child might have reflux, do visit your pediatrician or ENT.
Some signs include:
- A burning sensation in the throat, neck or chest or the feeling of stomach acid coming up into the back of the throat.
- Mucous dripping down the back of the nose into the throat.
- Frequent hiccups or spitting after meals.
- A “lump” in the throat.
- Frequent throat clearing.
- Bad breath.
Positive Reinforcement for Voice Management in Children
- Provide positive reinforcement. When your child uses her or his “indoor” or “inside” voice, provide lots of praise.
- Be specific with praise. “Well done using your inside voice when speaking!”
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Praise your child 5 times for every 1 criticism. Aim for a 5:1 ratio of praise to correction as this more attainable and backed by research in creating happy, healthy environments.
Provide feedback in an environment where your child feels safe and secure. Refrain from providing negative criticism publicly, especially if your child is sensitive or self-conscious.
- Control the general volume in your house. That means no loud music and MOST IMPORTANTLY, no screaming at your child to stop screaming.
- Set Voice Rules together. Have everyone gather around the table at home. Each person takes turns contributing one rule. As a family, agree on weekly rewards for keeping Voice Rules.
- Lower your voice. Maintain your composure by looking at your child in the eye and speaking in a quiet voice. That may catch your child’s attention and may make her/him curious enough to self-monitor and self-correct.
Voice Treatment for a Hoarse or Strained Voice
Voice therapy aims to help your child learn a healthy and safe way to use a loud voice without hurting his or her vocal cords, squeezing or tensing the “false vocal cords”, or allowing too much air pressure to build up beneath the vocal cords when speaking.
We work together with you to help motivate your child in voice therapy using evidence-based treatment approaches.
Voice therapy strategies may include:
- Yawn Sign or Gentle Onsets: Bringing your vocal cords together lightly without slamming them shut when your child speaks or shouts.
- Resonant Voice Therapy
- Diaphragmatic Breathing (Deep breathing): Place one hand on your chest and one hand on your tummy (above the belly button). Breathe in through your nose and feel your belly rise. As your belly expands out, your bottom hand rises. Count slowly backwards 5-4-3-2-1 as you breathe out.
Watch this Diaphragmatic Breathing video here:
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