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Childhood Voice Disorders

Childhood Voice Disorders. Hyperfunctional Disorders vocal nodules and vocal strain By: Mary Beth Dehn. Prevalence. Boone & McFarlane stated that about 7% of school-aged children experience continuing voice disorders.

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Childhood Voice Disorders

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  1. Childhood Voice Disorders Hyperfunctional Disorders vocal nodules and vocal strain By: Mary Beth Dehn

  2. Prevalence • Boone & McFarlane stated that about 7% of school-aged children experience continuing voice disorders. • Lecoq & Drape (1996) looked at primary school children and found that 10% of them at the time of examination had dysphonic voices related to laryngeal or resonance disorders.

  3. Signs & symptoms to look for in children who may have voice disorders: • Dysphonia, a hoarse, breathy, or rough voice, may have excessive glottal fry • Intermittent aphonia, recurring temporary loss of voice (first thing in the morning, end of the day, or after a specific event, for example a sports event) • Voice breaks, fleeting interruptions in voice during singing or speech. • Pitch breaks, abrupt changes in pitch of voice, usually when going from lower to higher pitch.

  4. Signs and symptoms cont. • An excessively loud voice for no reason • An inability to sustain a note when singing • An effortful or strained voice, voice sounds as if it takes special effort to produce and is not efficient.

  5. Causes of childhood voice disorders:(Voice strain and nodules) • Stress to the larynx, specifically the vocal folds • This is referred to as vocal abuse. • ‘Hyperfunctional’ means ‘overused’ • Rare to find just “one” abusive behavior. • Most common habits – Talking too long, too loudly, and with too much effort.

  6. Activities in children that may cause development of vocal nodules or vocal strain: • Talking and singing in excess, for example in a school play, concert, choir; shouting in the playground against background noise; overusing the voice when sick; cheerleading; overusing voice when emotionally upset or tired. • Glottal attack, use of forceful voice can really damage vocal folds. • Coughing, an loud forceful sneezing, children who do not rest voice when they have sore throat, asthma, or post nasal drip. • Crying, laughing, loud and long outbursts of emotions, tantrums, inability to cope properly with negative emotions, related to loud, forceful use of voice. • Shouting, cheering, and screaming

  7. Causes cont. • Grunting, during sports activity or weight training,this puts a sudden shock to the vocal folds. • Throat clearing, vocal folds are slammed together every time the throat is cleared. • Making sound effects or character voices, especially when breathing IN, this puts more strain on the vocal folds. • Dryness, caused by overuse of certain medicines (cough drops and antihistamines), allergies, caffeine, and mouth breathing. • Restricted fluid intake, for healthy vocal system good hydration is necessary.

  8. Children at risk for voice disorders may have one or more of the following: • Families with loud voice habits • Chronic asthma or allergies • Frequent upper respiratory tract infections • Gastric reflux • Affective disorders, ADD, hyperactivity, “temperamental personality” • Behavioral problems • Excessive stress or tension in child’s life (internal, external, or interpersonal factors) • Loud, outgoing competitive personality with tendency to act out emotionally

  9. Treatment for voice disorders • Child must first see an ENT, to determine if voice therapy is recommended. • Record detailed case history (child’s early development, family relationships, ways disputes are resolved, behavior management, peer relationships, health history, child’s personality) • Aim for therapy is to teach a healthy, non-abusive voice production pattern • Educate child and family about nature of problem, symptoms, causes, and risk factors • Explain normal anatomy and physiology of larynx in relation to child’s pathology

  10. Treatment cont. • Identify abusive behaviors and reduce or eliminate them • Teach child about voice production: phonation (how sound is produced by vocal folds), respiration (breathing), resonance (loudness) • Teach child about correct breathing style • Explain how to recognize excessive neck tension around the larynx • Provide a foundation for learning to produce the best voice with the least effort • Resonance training teaches child to “project” voice to achieve loudness , rather than straining voice • Teach voice exercises and relaxation techniques

  11. Boone Voice Program for Children • Designed to give children insights into why they may have voice problems related to vocal abuse. • Provides guidelines and materials for evaluation and remediation of voice disorders • Based on philosophy and procedures in “The Voice and Voice Therapy” • http://www.psycan.com • “Video Voice Speech Training”- comprehensive computerized speech therapy tool to aid in speech therapy. • http://www.videovoice.com

  12. Resources • Boone, D.R. & McFarlane, S.C. (2000). The voice and voice therapy (6th ed.). Boston: Allyn and Bacon. • http://members.tripod.com/~Caroline_Bowen • http://www.psycan.com • http://www.videovoice.com • http://www.unc.edu/~chooper/clinprog/childvoice/treatment.html • http://www.superduperinc.com/P_Pages/pe9878.htm

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