Voice disorders (dysphonia) in children include persistent hoarseness, strained voice, or loss of voice. While occasional voice changes after yelling or during a cold are normal, persistent issues lasting more than 2-3 weeks should be evaluated by an ENT specialist. The good news is that most pediatric voice problems respond well to voice therapy without surgery.
Voice is produced when air from the lungs passes through the vocal folds (vocal cords) in the larynx (voice box), causing them to vibrate. The sound is then shaped by the throat, mouth, and nose. Voice quality depends on the health and coordination of the vocal folds.
In children, the vocal folds are smaller and more delicate than in adults, making them vulnerable to injury from misuse. The good news is that with healthy voice habits and, if needed, voice therapy, most childhood voice problems can be resolved.
Vocal hygiene refers to habits and practices that keep the voice healthy. Teaching children good vocal hygiene can prevent voice problems and help heal existing ones.
Voice therapy with a speech-language pathologist is the primary treatment for most pediatric voice disorders. For problems like vocal nodules, voice therapy often resolves the issue without surgery. Therapy teaches healthy voice use habits and techniques for reducing vocal strain.
Any hoarseness or voice change lasting more than 2-3 weeks—especially without a cold or other obvious cause—should be evaluated by an otolaryngologist (ENT). The ENT can visualize the vocal folds using a scope to identify structural problems.
Early evaluation is important because some voice changes have serious causes that need medical attention. However, most pediatric voice problems are benign and treatable.
Teach children alternatives to yelling for getting attention: clapping, waving, ringing a bell, moving closer to the person, or using a whistle. This is especially important for young athletes and cheerleaders.
Contrary to what many believe, whispering is not easier on the voice—it can actually cause more strain than soft speech. If the voice needs rest, silent rest is better than whispering.
Well-hydrated vocal folds vibrate more efficiently and are less prone to injury. Make sure your child drinks plenty of water throughout the day, not just when thirsty.
Articulation refers to how clearly your child produces speech sounds using their lips, tongue, teeth, and palate. While all children make speech errors as they develop, most naturally acquire all sounds by age 8. Speech sound disorders occur when errors persist beyond the expected age or significantly affect how well a child can be understood. With appropriate therapy and consistent practice, most children can achieve clear speech.
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