Like adults, child voice problems (dysphonia) can occur because of illness or misuse. Illness aside, children may not be using their voice correctly or over using and straining it. This may cause a lost voice, a hoarse voice, or a croaky or breathy voice.
Voice is created by air from the lungs passing through the larynx which contains the vocal folds (often called the vocal chords). The vocal folds are 2 folds of muscle that meet together many times per second, and this creates the voice which is then shaped into words by the speech apparatus, the tongue, lips, facial muscles etc.
What causes voice problems in children
Many things can go wrong with the 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. Once a nodule has formed and the child is struggling to keep a normal sounding voice, they may work harder to maintain that voice and in doing so, strain their voice further.
Voice misuse and abuse:
- The personality of the child can give them a predisposition to voice problems. If your child is outgoing and loud, they may be more prone to using their voice to bring attention to themselves.
- If the child is prone to getting angry or upset and shouting, screaming, crying and having tantrums, they may also be prone to voice difficulties.
- The social activities of the child can stress the voice, 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.
- If the child is extremely stressed this can lead to voice difficulties.
- Medical reasons such as frequent throat infections, tonsillitis, coughs and dehydration.
- Certain medications such as inhalers can also have an effect on the voice.
- Injury to the vocal folds, larynx, a brain injury or intubation in hospital, disease, can lead to voice problems.
Therapy and treatment for voice problems
Sometimes all that is needed to improve a child voice problem is to change the behaviour and lifestyle of the child. If the problem persists or if there is a nodule, 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 may 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.
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