What is it?

Voice is the sound that we hear when someone talks. It is produced by air coming from the diaphragm and lungs passing through the voice box, or vocal folds, causing them to vibrate and make a sound which is then shaped by the movement of the articulators (tongue, lips, jaw, cheeks, etc.) to make speech sounds. Each person has a unique voice which distinguishes them from other people. Without voice we would be unable to make all the speech sounds necessary to be understood by others.

Why is it important?

Voice is important in order to be understood by others and to get messages across. Hence it is important in everyday communication from the moment that we are born.

You can tell there are problems with voice if the child has:

• A harsh, hoarse, croaky, strained or rough voice quality.
• A high or low pitch of voice.
• A loud or whispery voice.
• A nasal (too much air coming through the nose) or hypo-nasal (like they have a blocked nose) voice quality.
• Loss of voice during production of specific sounds.
• Periods of time when voice is lost completely.

Voice difficulties can range from mild to severe and may occur in isolation or alongside a speech and/or language delay or disorder.

Common challenges for a child with a voice difficulty:

• It may have significant impact on the intelligibility of a child's speech.
• It may have an effect on the child's confidence in speaking situations and affect their social skills and how they relate to others.
• It may lead to adult voice difficulties as most adult voice difficulties begin in childhood.

What can be done to improve voice difficulties?

• Speech Pathologists will generally refer to a child presenting with a voice disorder to an Ear Nose and Throat (ENT) Specialist to determine whether the voice box has any medical reason for the voice difficulties (e.g. nodules, polyps, etc.).
• Following an ENT assessment, a detailed speech pathology assessment can take place and information from this and the report from the ENT Specialist will be used to determine the type of therapy that will be recommended.
• The family and educational setting can be provided with information about the nature of the voice difficulty.
• The family and child can be taught how voice is produced and how damage can occur to the voice box.
• Specific exercises, techniques and strategies can be taught to the child on how to use the voice box effectively.
• The therapist will liaise with pre-school and school staff to implement strategies and ideas into the educational setting.
• Activities and treatment is tailored to the individual child so that it is meaningful and fun.

Activities that can improve voice difficulties?:

The activities recommended vary depending on the individual nature of the voice difficulties. Here are some general activities:

• Make sure the vocal folds/cords are hydrated by drinking water regularly.
• Avoiding noisy environments so that your child does not have to tall over the top of noise (ie background noise like loud music).
• Have a quiet time each day where your child does not have to use his/her voice a lot, and if he/she does it is quiet (i.e. looking at books, quiet play, and television time).
• Introduce the concept of "big voice" vs. "little voice" and encouraging use of the "little voice" most of the time. Praise your child when they use their "little voice".
• Use visuals to remind children to talk in their "little voice" (e.g. picture of child shouting in red and picture of child talking in blue etc)
• Demonstrate a relaxed nature and normal speaking voice for your child. You are the best model for your child.
• Relaxation activities are useful to relieve tension in the neck and shoulders when talking.
• Try teaching and practicing breathing activities to aid breathing.
• Look at resonance and practice using the voice in the most effective and easy way.