Voice


Children present with voice problems for a variety of reasons. Children can have voice problems due to illness, infection, trauma, surgery, shouting, screaming or talking too much. Voice problems can present as  –

  • Changes in pitch
  • Changes in loudness when speaking
  • Changes in the overall quality of voice production

The most common cause of voice problems in children is that of vocal abuse – shouting and screaming. This can lead to vocal nodules – a swelling on the vocal cords – which in turn lead to deterioration in the quality of the voice.

Not all children with poor voice quality have vocal nodules but if shouting and screaming persists then nodules may develop.

It is usual to have ENT involvement if a child has poor voice quality. This is always the case if there is serious illness, trauma or surgery involved. In such cases, Speech and Language Therapists will be part of a multi-disciplinary team.

Once direct multi-disciplinary involvement has finished, parents may still feel it would be beneficial to have speech and language therapy input.

In cases such as vocal abuse and mis-use, some parents may choose not to have ENT involvement in the first instance and seek the advice and involvement of a Speech and language Therapist.


Speech and Language Therapists can help a child with these difficulties by –

  • Assessing general health, voice history, medical issues and a child’s awareness of the problem
  • Advising parents and children on how the voice is produced
  • Advising on how voice behaviour affects voice quality
  • Giving strategies and exercises to children and parents to help improve voice quality
  • Advising children and parents on how to look after the voice
  • Working with and /or liaising with ENT specialists
  • Referring on to specialist teams if necessary

Last updated: January 26th, 2018