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Voice disorders are fairly common in children, with about five per cent of children experiencing a chronic (long-lasting) voice disorder.
A voice disorder is when the quality of a person's voice is noticeably different to the voices of others who are the same age and sex. Children with voice disorders may have harsh or hoarse voices, or voices that are too high or low, too loud or too nasal.
Most voice disorders are harmless and disappear on their own, though some require the help of a specialist.
If your child has a voice disorder, their voice may sound:
Children with voice disorders often have voices that tire easily or they have difficulty projecting their voice.
Poor voice quality may make it hard for your child to communicate effectively, and may make them lose self-confidence or affect the way other people see them.
Infants with voice disorders may have a cry that is weak or has a harsh or hoarse quality, or they may have noisy breathing.
If your child has a hoarse voice that is getting worse or not getting better, or if you are concerned about your child's voice for any reason, see your GP for advice. Your child may be referred to a speech pathologist or specialist doctor, such as a paediatrician or ear, nose and
throat (ENT) specialist.
A person’s voice is the sound produced by the vocal folds in their larynx (voice box). The vocal folds are thin muscle bands that produce vibrations (sound) used for speaking. Voice disorders often involve problems with the vocal folds.
Voice disorders in children are usually caused by:
There are also some rare medical conditions that may cause voice disorders in children.
Hoarseness is quite common in children. If your child has a hoarse voice, a joint assessment by an ENT specialist and a speech pathologist in a voice clinic may be needed.
Hoarseness is usually related to the way children use their voices, rather than a serious illness. Other common causes of hoarseness in children include:
Less common causes of hoarseness in children include Recurrent Respiratory Papillomatosis (a viral infection in the vocal folds caused by the human papillomavirus) or, in extremely rare cases, tumours or cancers. An ENT specialist will manage treatment of these conditions.
A weak voice is often the result of poor vocal fold movement or incomplete closure of the vocal folds during speech. Causes may include vocal fold paralysis or narrowing of the larynx. Children who have had a breathing tube during a period of illness (or due to prematurity) are at higher
risk of weak voice, and may experience long-term voice problems.
There are some surgical procedures that 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.
If your infant's cry is weak or has a harsh or hoarse quality, they need to be assessed by a paediatrician or ENT specialist.
Laryngomalacia (larin-go-mah-lay-shia), or floppy larynx, is a common cause of noisy breathing in infants. It generally resolves by itself by the time your child is two years old, and your child will not experience any long-term voice problems. If your child has laryngomalacia, they will be
closely monitored by doctors to make sure they are breathing well. If the condition is severe, an operation may be necessary.
These suggestions can help your child take good care of their voice:
There are a number of other things that may have a negative effect on the voice:
Will my child grow out of his voice disorder or will he have
it for life?
Most voice disorders either get better by themselves over
time, or get better with the help of a specialist, such as a speech therapist
or ENT specialist. It will depend on the cause of the disorder. It is very rare
for adults to have voice disorders.
Do I need a referral to a speech pathologist or can I
contact one directly?
Your GP can give you a referral for a speech pathologist, or
you can contact one directly and make a private appointment for your child. You
can find a speech pathologist at the Speech Pathology Australia website.
Higher fees will apply if you see a speech pathologist privately, but you may
be able to get an appointment sooner. If your child is school-aged, you may be
able to access a speech pathologist through your child’s school.
If my baby has an abnormal cry, does that mean they are
seriously ill or have a genetic disorder?
No, but an abnormal cry in a baby should always be
investigated by a doctor. If the abnormal cry is a sudden change (that is, it
was not that way from birth), then your baby should be seen more urgently.
Developed by The Royal Children's Hospital Speech Pathology department. We acknowledge the input of RCH consumers and carers.
Reviewed March 2018.
Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit
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