In this section
disorders are fairly common in children. About 4-6
children out of every 100 have a voice disorder.
Children can have many
types of voice disorders. Most of them are harmless and are caused
by excessive shouting and loud talking, excessive use
of certain harsh voice 'sound effects' during play, or they
can be caused by common childhood infections.
Your child's voice may
sound harsh, hoarse or they may have 'lost' their voice entirely.
If you are concerned about your child's voice, please see your
Voice is the sound produced
by the vocalfolds in the larynx (voice
box). The vocal folds are thin muscle bands which open to let the
air in and out of the lungs during breathing. They close to produce
vibrations (sound) used for speaking. You can feel the sound
vibrations if you gently rest your hand at the front of your neck
and say the sound 'aaaaaah'. This sound is then modified by
the movement of the lips, tongue, jaw and palate to produce
The human voice has a
number of features:
Generally, the human voice
conveys a lot of information about how a person is feeling. For
example, when a child is angry their voice might sound louder and
more strained than when he or she is calm.
A voice disorder is when
the quality of a person's voice is noticeably different to that of
others their age and sex. People with voice disorders often
complain that their voices tire easily or that they have difficulty
projecting their voice.
Children with voice
disorders may have harsh or hoarse voices or voices which are too
high or low, too loud or too nasal.
A poor voice quality may
make it hard for a child to communicate effectively, and may make
them lose self confidence or affect the way other people see
There are some rare medical
conditions which may cause a child's voice to change in quality.
Please see your local doctor if you have concerns about your
child's voice or refer to www.voiceproblem.org for
further information about medical conditions which affect
children's voices (follow the prompts: 'voice disorders',
'paediatric voice disorders').
Hoarseness is quite common
in children. It is usually related to the way children use
their voices rather than a serious or life threatening illness.
There are some rare medical conditions however, which need
prompt medical attention by an Otolaryngologist (Ear, Nose and
Throat specialist), especially if the hoarseness persists or if
there is a marked deterioration in voice quality. A joint
assessment by an Otolaryngologist and a Speech Pathologist in a
specialist voice clinic may be needed for your
Vocal Nodules / Cysts /
Recurrent Respiratory Papillomatosis (RRP)
A weak voice is often the
result of poor vocal fold movement or incomplete closure of the
vocal folds during speech.Neurological
causessuch as vocal fold
paralysis or non-neurological causes such as laryngeal
stenosis (narrowing of the larynx) are associated with a weak
voice. For example, children who are born very premature and have
long term intubation (breathing tube) through the larynx (throat)
to help them breathe are at risk of long term voice problems.
Children with poor vocal fold movement generally have difficulty
raising their voices and being heard over background noise. This
can be quite frustrating for the child and adolescent.
There are some surgical
procedures which are used to correct vocal fold paralysis in adults
but these are not commonly done for children. Voice therapy is
sometimes used for children with weak voices and may help your
child achieve optimum voice volume and quality. It teaches your
child different ways to communicate effectively with others without
straining their voice.
When an infant's cry is
weak or has a harsh or hoarse quality it needs to be assessed by an
Otolaryngologist (ear, nose and throat doctor). Certain medical
conditions can be associated with noisy breathing (stridor) in
larynx) is a common cause of noisy breathing in infants. It
generally resolves by itself by the second year of life without any
long term voice problems. Your child will be closely monitored
by doctors to make sure they are breathing well. If the condition
is severe an operation may be necessary.
Developed by RCH Speech Pathology. First
published January 2008. Updated November 2010