Approximately 4-6 out of every 100 children have a voice disorder.  Of the various disorders, vocal nodules is the most commonly cited in children.  By building healthy habits from the start, you can help keep your child’s voice healthy.  Read on to learn more about vocal nodules and how to keep your child’s voice healthy.

What are vocal nodules?

Vocal cord nodules are small (noncancerous) growths that develop on the vocal cords as a result of vocal abuse.  “Vocal abuse” refers toany behaviors that overwork or harm the vocal cords, such as yelling, dehydration, or frequent coughing.  An isolated instance of vocal abuse might result in a soft swollen spot on the vocal cords, which can impact the sound quality of your voice.  For example, you might have a horse voice after an afternoon of cheering at a football game.  However, excessive and repeated instances of vocal abuse can eventually cause the swelling to become callous-like growths called nodules.

How do I know if my child has vocal nodules?

There are several indicators that your child may have vocal nodules.  Vocal nodules will likely impact the sound of your child’s voice.  Indicators might include:

• Voice may sound hoarse, harsh or scratchy
• Child may have frequent voice breaks, or difficulty sustaining notes
  
• Child may have pitch breaks during speech or singing
• Voice may sound effortful or strained
• Child may use an excessively loud voice
• Child may strain their neck and shoulder muscles during speech
• Child may experience pain in their neck or throat

What causes vocal nodules?

Vocal cord nodules are typically caused by behaviors that are harmful to the voice, such as:

• Using an excessively loud voice
• Emotional outbursts that include loud laughing, yelling, or crying
• Frequent yelling, cheering or shouting
• Dehydration or reduced fluid intake
• Dryness, which may result from certain medications
• Coughing, loud forceful sneezing, or throat clearing
• Loud busts of voice or strained sounds.  This might occur when children make sound effects (e.g. explosion, bear growl, dinosaur roar, etc)
• Insufficient breathing patterns

6 Tips to Promote a Healthy Voice

If you suspect that your child has vocal nodules, seek help from a license professional as soon as possible.  An evaluation will likely include an otolaryngologist (ear nose and throat doctor) and a speech-language pathologist.   Whether or not your child has vocal nodules, it’s important to promote a healthy voice from the start.  Here are 5 ways to encourage a healthy voice:

1. Encourage your child to stay hydrated and drink lots of water.  Avoid caffeinated beverages as much as possible.
2. Talk to your child about appropriate speaking volume.  Discuss appropriate times to use a loud voice, and appropriate times to use a quiet voice.  Give your child feedback and praise about their own speaking volume (“Wow, I like the way you used your inside voice when you told me that story.”)
3. Encourage your child to find constructive ways to express their emotions.  For example, your child can clap their hands instead of yelling at a ballgame.  Or your child can verbalize how they feel, instead of screaming or shouting.
4. Build in daily quiet time for your child to rest their voice.  Especially if your child is engaging in prolonged periods of talking or singing, encourage them to rest their voice.
5. Avoid excessive whispering, coughing or throat-clearing.  Sometimes throat-clearing can become habitual, and may result from the throat feeling dry and sticky.  If this is the case, encourage your child to take sips of water.  Whispering can tire and dry out the vocal cords, so it’s best to limit whispering.
6. Finally, be a role-model.  Children learn by watching others around them.  Model the behaviors you want your child to exhibit, such as appropriate speaking volume and expressing emotions in a constructive way.