The 411 on Childhood Voice Disorders

Image via Mindi Stavish
Image via Mindi Stavish

Ask any parent with a child under the age of five years old and they will agree: children scream- A LOT!  According to Boone, D.R. & McFarlane, S.C (2000), approximately 7% of school-aged children suffer from a voice disorder.  Voice disorders affect the quality of sound, specifically abnormal pitch or loudness.  

If a child's voice sounds hoarse, froggy, or squeaky, he or she may have a voice disorder.  

Causes of Voice Disorders

There are several different causes of voice problems in children, with the most common being vocal nodules.  Vocal nodules are small callous growths, typically found on both vocal folds (cords).  Nodules form due to long-term irritation to the vocal folds, which is referred to as vocal hyperfunction (overuse).  The most common hyperfunction behaviors are talking too long, too loudly, or with too much force.  Here are the most common activities that may lead to a voice disorder:  

*  Excessive talking and singing (singing in choir, shouting at the playground or over background noise, cheerleading)

*  Excessive coughing and loud sneezing

*  Long and loud crying and yelling outbursts, such as during tantrums or extreme emotional outbursts   

*  Excessive throat clearing

Voice disorders may also be impacted by medical conditions, including allergies, reflux, affective disorders, ADD, and hyperactivity.  In a common case of laryngitis, vocal strain is expected to last one to two weeks.  

Diagnosis of a Voice Disorder

If a child's voice sounds abnormal for a longer period of time, he or she should be evaluated by a otolaryngologist, also known as a ear, nose, and throat doctor (ENT).  An ENT will perform a case history examination and assess the vocal folds using a fiberoptic camera fed through the nose and down to the vocal cords.

Treatment of a Voice Disorder

Unlike the treatment of a vocal nodules in adults, surgical intervention is rarely performed on children.  Instead, a child will work with a Speech-Language Pathologist.  Speech therapy will focus on teaching appropriate vocal patterns and decreasing negative vocal behaviors.  The Speech-Language Pathologist will also teach the child vocal function exercises, which have been shown to be very effective in treatment of vocal nodules.  

Prevention of a Voice Disorder

There are several steps you can take to encourage good vocal health in your child.  Most specifically, you can create an enviorment that decreases vocal hyperfunction.  

1.  Reduce the overall loudness of your household.  Turn the volume on the TV, radio, and other electronic devices down or off when speaking with your child.  Instead of shouting from one room in the house to another, walk over to your child to have a conversation and encourage all family members to do the same.   

2.  Teach your children other ways to cheer at sporting events, or other places where cheering and yelling is common.  Help your child make support signs, or encourage your child to clap.  

3.  Dedicate a certain time during the day for quiet time, where all family members rest their voices.  Quiet time can be used for reading, watching TV, or participating in any other low-key activity that does not require talking.  

4.  Encourage your child to use a normal speaking voice and avoid whispering.  Whispering for long periods of time can cause stress on the vocal cords.  

For more information about voice therapy, please visit the American Speech-Hearing Language Association. 


What do you think?

The 411 on Childhood Voice Disorders

Mindi is a working mom with three boys ages 4, 2, and an infant (born June 2013). She spent her first 8 years of her career in Speech-Language Pathology at a Children's Hospital. She currently works with adults and children in home health. The real fun for her happens when she is at home with her boys, chasing them around and pretending to be a super hero. She blogs about life as a working mom at Simply Stavish. Her weekly feature, Words in the Sand, teaches parents how to grow their child's s ... More

Tell us what you think!


  1. april says:

    Wow interesting article.

  2. Phammom says:

    Never heard of this glad I read this article.


Send this to a friend