pediatric voice disorders

Understanding Pediatric Voice Disorders

Has your child ever had a strained or hoarse voice? Does your child use a loud voice ALL the time? While a strained or hoarse voice does not always indicate a voice disorder, it may be a sign of phonotraumatic behaviors. Phonotraumatic behaviors can then lead to a voice disorder.

Voice disorders do not only occur in adults. In fact, children are also at risk for voice disorders. There are different kinds of voice disorders, but the most common voice disorder found in children is vocal nodules.

Voice disorder? Phonotrauma? Phonotraumatic behaviors? Vocal nodules? What? Let’s take a closer look at what these different terms mean.

Voice disorder 2kids-with-voice-bubbles

The American Speech and Hearing Association defines a voice disorder as being “characterized by the abnormal production and/or absences of vocal quality, pitch, loudness, resonance, and/or duration, which is inappropriate for an individual’s age and/or sex.”


Phonotrauma (previously termed misuse and abuse) is defined as trauma to the vocal cords due to vocal (phonotraumatic) behaviors that may include yelling, screaming, throat-clearing, and excessive and inappropriate use of the voice. Phonotraumatic behaviors cause the vocal cords to come together with greater force, which can lead to growths known as nodules.

Vocal Nodules

Vocal nodules are growths that occur on the vocal cords as a result of forceful collision of the vocal cords secondary to the continued use of phonotraumatic behaviors.  The nodules will continue to grow until the phonotraumatic behaviors are discontinued.

Phonotraumatic behaviors include the following:

  •             Screaming
  •             Whispering
  •             Excessive Talking
  •             Throat Clearing
  •             Coughing
  •             Inappropriate pitch
  •             Inappropriate volume

What can I do to decrease and eliminate phonotrauma? Read the following vocal hygiene techniques below.

  • Avoid yelling
  • Avoid whispering
  • Drink lots of water
  • Take a vocal break each day

There are also additional types of voice disorders that may be present in children. At times, it is difficult to determine the type of voice disorder present because many of the signs and symptoms are similar among disorders. If you think your child may have a voice disorder, consult an otolaryngologist for a formal diagnosis. A speech and language pathologist can then provide appropriate voice therapy based upon the diagnosis given.


Vocal Cords Nodules and Polyps. Retrieved from

American Speech-Language-Hearing Association. (1993). Definitions of communication disorders and variations [Relevant Paper]. Available from

NPST offers Speech Therapy services in Bucktown, Evanston, Highland Park, Lincolnwood (coming soon), Glenview and the Neuropsychology Diagnostic and Testing Center in Des Plaines. If you have questions, or concerns, about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!