Voice Disorders

Children's Service Areas

Treating stuttering (dysfluency), kids playing together

If your child’s voice quality does not align with their age, gender, or culture, they may have a voice disorder. Hoarse voice quality, voice breaks, vocal fatigue, difficulties with volume, and pain when speaking are some of the signs and symptoms of voice disorders.

Most voice issues are treatable – the vocal cords are a muscle and can be trained and strengthened like every other muscle in the body. Voice disorders can typically be described as:

Functional: problems caused by the way the vocal cords are moving. For example,

  • Vocal fatigue
  • Muscle tension dysphonia
  • Functional aphonia (voice loss)
  • Puberphonia
  • Resonance or pitch that does not align with one’s age or gender
  • Irritable larynx

Structural: difficulties caused by changes to the structure or nervous system control of the vocal cords. For example,

    • Laryngitis or swelling of the vocal cords (as may be caused by vocal
      abuse or acid reflux)
    • Vocal nodules
    • Polyps
    • Vocal tremor
    • Spasmodic dysphonia
    • Paralysed vocal cords

Some voice issues are more common in childhood, including vocal nodules, due to the volume and intensity of voice use at certain ages.

While voice issues can be categorized as functional or structural, structure can impact function and vice-versa. For instance, as a body tries to compensate for vocal nodules, your child may struggle with vocal fatigue and vocal strain. Similarly, pushing through vocal fatigue and strain can lead to the development of vocal nodules.

If your child is struggling with a functional voice disorder, an SLP can help them change the movement patterns of their vocal cords. The movement of the vocal cords is driven by breath and the quality of the sound is further shaped by the vocal tract and resonant spaces. An SLP can help your child find a more clear, effortless  voice by training the breathing, resonance, and laryngeal systems (vocal cords) to work together. 

If your child is struggling with a structural voice disorder, an SLP can help them optimize vocal function and teach them compensatory strategies as needed. Some structural changes may require surgery – for instance, polyps are not expected to improve with voice therapy alone. In these situations, an SLP can help your child manage their voice while awaiting other treatment and help them return to normal voice activities afterwards. Other structural  changes, such as vocal nodules, can be expected to heal with appropriate voice therapy and time.

In the case of gender affirming voice care, the structure of the vocal cords and size of the voice box may mean that certain vocal ranges are easier to produce. However, upper and lower vocal ranges can be trained, and managing resonance and prosodic features can further alter how feminine or masculine a voice is perceived to be.

If it is possible that your child’s voice issue may be due to a structural disorder, we will recommend an Ear Nose and Throat doctor (ENT) assessment before starting therapy. Visual assessment of the vocal cords by an ENT can provide us with  important information.

At Speech Pathways, we have SLPs who can support your child in meeting their voice goals. Whether they are working to feel more  confident with their sound, or resolve a structural/functional voice issue, we welcome the opportunity to help them find their voice.