Wondering if your child has a voice disorder? Read on for tips on diagnosis and treatment.
In this article we will discuss:
Did you know that children can experience voice disorders as well as adults? Voice disorders in children can manifest in a number of ways and need to be differentiated from speech disorders. While speech disorders affect the articulation or pronunciation of sounds, voice disorders affect the vocal and breathing mechanisms involved in sound production.
Keep reading to find out if your child struggles with a voice disorder and may benefit from online voice therapy for kids.
How to diagnose a voice disorder
First, it might be a good idea to see an ENT (Ear, Nose, and Throat Doctor, or Otolaryngologist) to rule out other issues. A speech language pathologist is able to diagnose and provide treatment for a range of voice disorders in children. This speech therapy includes preschool children as well as older children and adolescents. In addition to speech therapy, parents can also assist in the therapy process by using simple and practical tips that are provided in this article.
If your speech language pathologist diagnoses your child with a voice disorder, these are the next steps: identify the type of the voice disorder, then determine the possible cause, and finally develop strategies appropriate for the specific issue. Below we outline these steps for some common voice disorders in children.
Dysphonia
What is it?
This disorder is perceived as a raspy, strained, gurgly sounding voice.
What causes it?
Dysphonia could be caused by a discoordination and overuse of the vocal folds and the breathing mechanism.
Overuse can also affect muscle strain in the diaphragm, chest, neck, and shoulders, with dysphonia.
This disorder can occur in children who tend to use a high volume to speak instead of an “inside” voice. Children may feel the need to squeeze the muscles in order to achieve a higher volume.
Tips for Parents:
Remind your child that they do not need to use a high volume to get attention and to get their point across. When children want to be loud, they sometimes tend to squeeze their diaphragm instead of allowing it to expand. When they do this, they are not utilizing the breathing mechanism correctly, which causes further issues. Instead of pushing their volume high, they can breathe in through their nose which will expand and fill the diaphragm and lungs, allowing sufficient amount of air for resonance and volume.
Voice disorders can affect children.
Hypernasality
What is it?
This disorder causes the vowels and consonants in words to sound nasal. It can also be perceived as airflow distortion, affecting “breathy” sounds such as /t, s, z, sh, ch/. The air ends up circulating in the nose instead of flowing through and out the mouth.
What causes it?
Hypernasality can be caused by discoordination or weakness of the soft palate. A soft palate is like a little door that closes at the back of the mouth to prevent airflow and liquids from entering the nose.
Tips for Parents:
In order to strengthen the soft palate and control airflow, have your child work on sounds that are produced at the back of the mouth, such as the /j/ as in ‘yes’ and /-ing/ as in ‘walking’ by emphasising the sounds and making sure they come out clear and accurate.
Work on the /t/ sound at the end of words to teach the correct, forward-moving airflow (ie, bat, cat, sat, mat, etc.). Once the /t/ sound is mastered, you can move on to work on the breathy sounds.
The /s, z, sh/ sounds are produced with the tip of tongue behind the teeth and the rest of the tongue pressed against the roof of the mouth. The teeth should be locked together like a gate, preventing the tongue from escaping. Depending on the child’s age, some children may be missing some of the teeth in the top front row and would have difficulty keeping the teeth fully locked together. In this case, focus on keeping the tongue back and pressing it against the roof of the mouth. Try out some words that start and end with these three sounds to see how the child is producing them. As they are saying the words, have them feel out where their tongue is going. Since the child already mastered the /t/ sound at this point, he/she already has experience elevating the tongue and propelling the air forward. When practicing the /s, z, sh/ sounds, have the child sustain the air flow for five counts. You can turn this into a game by taking turns, counting on fingers, and using toys you already have at home (ie. moving cars forward for five counts).
Younger children may not even notice that air is flowing through their nasal cavity when it's not supposed to. As you practice different words point out when the sound comes out sounding nasal and have them try the word again pushing the air forward through the mouth a few times. Over time, they will start noticing the incorrect airflow on their own and will correct it independently.
Breathy voice
What is it?
Breathy voice is perceived as whispers or complete omission of the last consonants in words and other utterances. This can sound like the child is “swallowing the words”.
What causes it?
The breathy quality in the voice can be caused by a lack of awareness of their speech. The child also may not have either good awareness or coordination of the breathing mechanism and tends to squish their abdomen muscles in some way. The child can end up taking in too much air when beginning to speak and run out of air towards the end of the utterance.
Tips for parents:
Oftentimes, children are not aware of how they speak and therefore it is important to first bring it to their awareness. Provide models for words and sentences of increasing length showing steady voice throughout the utterance. Breathe in gently through the nose at the start of your utterance and utilize your abdomen allowing the muscles to naturally expand. This way there will be sufficient air to last the entire utterance.
Practice words that end in a consonant and words that have two to three syllables. Emphasize the sounds and demonstrate that these sounds and syllables need to remain when speaking.
Online voice therapy for kids can help
Self awareness and guidance from a knowledgeable instructor is key in resolving voice disorders in children. Whether your child is misusing the breathing and vocal mechanism or not enunciating the sounds in words, children often do not realize they are not sounding correctly and do not know how to fix it. Oftentimes they try to sound “better” when they are being corrected or notice how people are looking at them. However, in the effort of self-correcting, more issues could arise that can lead to further dysfunction. With proper intervention, children can learn strategies to reduce and prevent vocal dysfunction over time.
There are many treatments available to assist children who have been diagnosed with a voice disorder. Under the watchful eye of a speech-language pathologist, a child can learn exercises and strategies to assist them (i.e., Resonant Voice Therapy, relaxation exercises, breathing exercises, etc.)
At Better Speech, we know that you deserve online voice therapy that works for you and your child. We have experts in your child’s needs and assign the right therapist; not just the therapist that happens to be in your area. We offer online speech therapy services convenient for you and tailored to your child's individual needs. Our services are affordable and effective - get Better Speech now.
