What causes voice problems in children

Many things can go wrong with voice, but with children the most likely cause is some form of vocal abuse or misuse. These factors can sometimes cause a small growth to appear on the vocal folds (a nodule, cyst or polyp etc). These are not initially harmful to your health but if you do not address the problems via therapy or surgery they can lead to further deterioration of voice over time and possibly long term damage. Unfortunately, once a nodule has formed the child may work harder to maintain their normal voice and strain their voice further.

Voice problems through misuse or abuse are probably the most common and can occur for several reasons:

• The personality of the child can give them a predisposition to voice problems. If your child is outgoing, loud and shows off, they may be more prone to using their voice to bring attention to themselves. If they are behaviourally challenging, get very angry or upset and shout, scream, cry and have tantrums, they may be prone to voice difficulties.
• The social activities of the child such as singing or cheering at a sports match, or any activity that over exerts the voice.
• Living in a “loud” household where it is often noisy and the child has to shout to be heard.
• Medical reasons such as frequent throat infections, tonsillitis, coughs and dehydration. Certain medications such as inhalers can also have an effect on the voice.
• If the child is extremely stressed this can lead to voice difficulties.
• Other, rarer reasons for voice difficulties include injury to the larynx, a brain injury or intubation in hospital.

Therapy and treatment for voice problems

Following a growth on the vocal folds (chords) there are generally 2 options, surgery and or therapy treatment. Although surgery can be successful in removing the growth, if the underlying behaviour that caused the growth is not dealt with, the problem is likely to recur. Surgery combined with therapy is often a good option, but therapy alone can also have a positive outcome. However, it is often difficult to provide successful speech therapy to some younger children with voice problems because they do not always see it as a problem and lack awareness. It is also difficult to change the habits of some younger children especially if they have a personality which causes them to talk or shout a lot. For this reason it is important that parents and teachers are aware of the problem and are there to give subtle reminders to the child.

Creating an environment at home that is more communication friendly is also a good idea and being aware of simple things such as talking to your child face to face rather than shouting back and forth between rooms. It is also important to check your child’s hearing as this could inadvertently be causing a voice problem if the child is not getting sufficient feedback from their own speech.

An unhealthy voice is often a symptom of an unhealthy person, so look after your child’s health. While your child’s voice is healing encourage them to avoid activities that may strain their voice. Make sure your child drinks plenty of liquids and stays hydrated (very important). Find time to have one to one time in a quiet environment with your child.