What is it?

This is where a child has difficulty with the pitch, volume or quality of their voice which distracts a listener from what is being said and their voice quality is noticeably different from those of their peers. A child with a voice disorder may have difficulties projecting their voice and also may experience pain or discomfort in the throat region.

A child's voice has a number of features including pitch, volume, quality of voice and resonance which are used to convey information about how the child is feeling. For example: a child who is excited will use a louder, more high-pitched voice than when they are calm.

Characteristics of a Voice Disorder:

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

Common challenges experienced by children who have a voice difficulty

• A voice disorder can range from mild to severe and may occur in isolation or alongside a speech and/or language delay or disorder. It may have significant impact on the intelligibility of a child's speech.
• May have an effect on the child's confidence in speaking situations and affect their social skills and how they relate to others.
• May lead to adult voice difficulties, as most adult voice difficulties begin in childhood.

Causes of voice disorders in children:

• Talking or shouting loudly.
• Talking and shouting all of the time.
• Lack of water and hydration and talking all of the time.
• Common childhood infections.
• Emotional and Psychological reasons (e.g. a very shy child may only talk in a whispered voice).
• There are some very rare medical condition that may affect the quality of a child's voice and it is important to see a doctor if you are concerned.

Management Strategies that help support a child at home and school:

• Speech Pathologists will refer to a child presenting with a voice disorder to an Ear, Nose and Throat (E.N.T.) Specialist to determine whether the voice box has any medical reason for the voice difficulties (e.g. nodules, polyps etc.).
• Following an E.N.T. Assessment, a detailed Speech Pathology Assessment will take place and information from this and the report from the E.N.T. Specialist will be used to determine the type of therapy that will be recommended.
• The family and educational setting will be provided with information about the nature of the voice difficulty.
• The family and child will be taught how voice is produced and how damage can occur to the voice box.
• Specific exercises, techniques and strategies will be taught to the child on how to use the voice box effectively.
• Speech Pathology approaches and activities that can support the child and their carers include:
• Providing information on vocal hygiene and hydration and implemented that into the child's daily life.
• Teaching and practicing breathing activities to aid breathing.
• Activities which focus on reducing tension within the body and neck when talking and/or shouting.
• Looking at resonance and practicing using the voice in the most effective and easy way.
• Liaising with pre-school and school staff to implement strategies and ideas into the educational setting.