Most people are somewhat familiar with speech therapy in the areas of articulation, stuttering, and language, and have at least a vague idea of ​​what happens in speech therapy in these areas. Voice therapy, however, is an area of ​​which many people are unaware.

A voice disorder is an “abnormal pitch, loudness, and / or vocal quality resulting from disordered laryngeal, respiratory and / or vocal tract functioning.” (Ramig & Verdolini, 1998) This definition can cover a variety of abnormal qualities of the voice, but the most common voice disorder seen in children is hoarseness caused by vocal abuse, or misuse of the voice. Misuse of the voice, such as excessive yelling or hard vocal tilt can cause swelling of the vocal cords or vocal nodules, resulting in a chronically breathy, harsh, or hoarse voice. In adults, vocal cord swelling and nodules are often seen in singers who overuse or abuse their voices. Many of us probably know someone with a consistently hoarse or breath voice, but may not have considered this as a voice disorder.

Any child with a suspected vocal disorder should be seen by an ENT because often medical / surgical treatment may be needed. However, speech (voice) therapy is often prescribed either instead of or in addition to medical treatment. In voice therapy, the child will learn how to use his voice in a healthy manner. This will help to reduce the occurrence of medically managed disorders and can even allow damaged vocals cords to heal without surgery.

Voice therapy is likely to include:

1. Education about the speech mechanism and how it works – lungs, breath control, the role of the larynx and vocal cords in sound production.

2. Education about the correct ways to use the speech mechanism, including practice and experimentation with both positive and negative behaviors. The child's specific habits will be discussed.

3. Practice in using the voice and breath in a relaxed manner. The child will often be taught to use a quieter and more breath voice and an easy sunset of speech utterances. These practices reduce trauma to the vocal cords and allow them to heal.

4. Environmental impacts will be addressed, such as changes that might be made in the home or school to minimize the need for shouting or other vocal abuse.

More information about voice disorders and treatment, as well as references to certified speech-language-pathologists can be found at the American Speech-Language-Hearing Association (ASHA) website. ( )