Voice Disorders in School-Age Populations: Identification and Treatment
Voice disorders in children can affect their ability to communicate effectively, impacting both performance in the classroom and social interactions. These disorders can result from a variety of causes, including vocal misuse, medical conditions, or structural issues with the vocal cords. Identifying and treating voice disorders early is important to prevent long-term effects on communication.
Assessing a child’s voice involves a comprehensive evaluation of vocal quality, pitch, loudness, and resonance. According to ASHA, this process should begin with a detailed case history, focusing on factors such as vocal habits, medical history, and family concerns. The use of tools like the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) can help SLPs measure the severity of vocal quality issues (ASHA, 2023).
In addition, SLPs may refer the child to an otolaryngologist (ENT) for a laryngeal examination using endoscopy or stroboscopy. This ensures that there are no structural abnormalities like vocal nodules or polyps affecting the child’s voice.
Treatment for voice disorders among children focuses on improving vocal function while reducing strain and vocal misuse. ASHA recommends various exercises depending on the underlying issue. For children with vocal strain, exercises like vocal rest and resonant voice therapy (RVT) can be effective. Resonant voice therapy involves producing sounds with minimal vocal fold pressure, which reduces strain and improves vocal quality. A typical RVT exercise might be to practice humming softly, while focusing on vibrations specifically in the nose and lips (instead of further back, which may be a strain on the vocal system). In this exercise, the child would progress from humming on a single pitch to adding simple sounds such as "mmm" before moving on to words, phrases and conversational speech using resonant voicing.
SLPs may also use vocal hygiene education, teaching children how to protect their voices by staying hydrated, avoiding excessive yelling, and resting their voice when able (ASHA, 2023).
Referral to additional specialists may be necessary. ASHA suggests that SLPs collaborate with ENT specialists, pediatricians, and teachers to create a comprehensive care plan. Regular follow-ups and adjustments to treatment ensure long-term success.
Identifying and treating pediatric voice disorders early can make a significant difference in a child's communication skills. With a combination of comprehensive assessment, targeted treatment, and collaborative care, SLPs can help children overcome voice disorders and improve their vocal health.
References:
American Speech-Language-Hearing Association. (2023). Voice Disorders.