Signs and symptoms of voice disorders

If your child has a voice disorder, their voice may sound:

• harsh or hoarse
• too high or too low
• too loud or too quiet, or they may have 'lost' their voice entirely
• as though they are speaking through a blocked nose or with too much air coming down through the nose during speech. 

Children with voice disorders often have voices that tire easily or they have difficulty projecting their voice.
Poor voice quality may make it hard for your child to communicate effectively, and may make them lose self-confidence or affect the way other people see them. Infants with voice disorders may have a cry that is weak/harsh or hoarse in quality, or they may have noisy breathing. 

When to seek medical advice?

If your child has a hoarse voice that is getting worse or if you are concerned about your child's voice for any reason, see your GP for advice. Your child may be referred to a speech and language therapist, specialist doctor - Paediatrician or Ear, Nose and Throat (ENT) Specialist.

What causes voice disorders?

Voice disorders in children are usually caused by:

• excessive shouting or loud talking
• excessive use of harsh voice 'sound effects' during play
• common childhood infections.
• Hoarse voice
• Vocal nodules : these occur with excessive use of force when vocalising such as shouting,screaming or prolonged loud talking or crying. Encourage your child to rest their voice by not talking loudly or shouting. In some instances, lesions may need surgical removal.
• Infections: a hoarse voice often happens when a child has a viral infection, such as a cold or laryngitis (inflammation of the voice box). This hoarseness will be temporary and usually disappears when the infection clears. Encourage your child to frequently sip fluids and rest their voice until they get better.
• Less common causes of hoarseness in children include Recurrent Respiratory Papillomatosis (a viral infection in the vocal folds caused by the human papillomavirus) or, in extremely rare cases, tumours or cancers.
• An ENT specialist will manage treatment of these conditions.

• Encourage your child to get closer to the person they want to speak to instead of yelling at a distance.
• Schedule short periods of voice rest or quiet time during the day.
• Play around with different voices with your child so as you child becomes more aware of different levels of loudness, pitch and clarity. E.G. (a) start speaking very softly then build up gradually to louder voicing (b) talk about voice sounds being very soft, a bit louder and then loud, (c ) discuss what level of loudness is the best to use for talking in different situations e.g. at home / in the playground.(d)  also talk about gentle and harsh/rough voices.
• Praise your child when you hear them using their gentle voice.
• Discourage yelling, screaming, excessive shouting, talking over people or background noise (e.g. the TV), speaking in a screechy and harsh manner and whispering. 
• Avoid smoky, dusty and polluted environments
• Encourage your child to have regular, small sips of water, throughout the day, eating fleshy fruits e.g. strawberries can also help,
• Discourage excessive coughing and throat clearing
• If you have any concern regarding your child's wellbeing or they are showing signs of upset/distress/anxiety, seek advice from your Doctor and local Child Psychologist.