Indirect voice therapy: 10 practical things to do to help your child

Seeing your child suffer because of a voice disorder is awful. But, for many common voice problems, you can help:

1. Dial it down: when chatting, turn down the car radio, television and/or the Minecraft (or, better yet, turn them off). When there’s a lot of background noise, we automatically speak more loudly – it’s called the Lombard effect. Reduce the noise, and your child won’t need to shout to be heard.

2. Sip and swallow – don’t cough – to clear your throat: When your child coughs, he or she bangs their vocal cords together. Two much coughing can lead to nodules, a common cause of voice disorders in kids. Sipping and swallowing is a far less damaging way of clearing your throat.

3. Give in to the flu: tell your child not to talk too much or sing when sick, especially if their throat hurts. Belting or talking through the pain will only make things worse.

4. Discourage silly voices: monster croaks and anime squeals have their time and place – every now and then. But do it too often and it can hurt the voice box.

5. Drink lots of water: a healthy voice box needs lots of moisture. Unsurprisingly, water is generally accepted to be the best maker of things wet. It’s certainly the most freely available. So drink up!

6. Spice DOWN meals and de-caffeinate drinks: foods like curries, chocolate, and nuts can dry out and/or irritate the voice box. So can caffeinated soft-drinks and energy drinks. On the other hand, ice-cream and full cream milk and yoghurts can cause too many mucous secretions on the vocal cords and increase the temptation to clear your throat.

7. Bag the fags: as Yul Brynner used to say before he died a horrible death, “Just Don’t Smoke”. If you can’t quit altogether, at least don’t smoke in the house or near your child.

8. Spot training has its limits: you can tell a lot about how healthy someone is by their voice – that’s why sick people are often sound said to sound sickly. The best way to have a healthy voice box is to be healthy. So general health tips – get lots of regular sleep, eat a balanced diet, exercise regularly – can also help the voice box. You don’t need to change everything. Lots of little changes can make a big difference (and won’t defeat your willpower as easily).

9. Watch out for acid reflux and get it checked out if in doubt: If your child reports too much mucous in the throat, heart (or throat) burn, mucous dripping down the back of the nose into the throat, a “lump” in the throat, the need to clear the throat a lot, he or she might have reflux. Reflux can damage the tissue of your voice-box and contribute to a voice disorder. Your GP can arrange a reflux check. If your child has reflux, manage it carefully – e.g. avoid eating and drinking 2 hours before bedtime, use medications prescribed or recommended by your GP to control it, raise the head of the bed 15 centimetres, and eliminate foods and drinks that seem to set it off.

10. Spring clean: reduce dust, smoke and chemical fumes (glues, sprays, etc) that can irritate the voice box.

Common sense suggestions like these are sometimes called “indirect voice therapy” – because we are helping the voice box indirectly (rather than by working directly on the voice). There is good evidence that indirect voice therapy helps. But we also know that indirect therapy may not be enough for some children with voice disorders; and that a combination of indirect therapy and direct voice therapy (working on voice production) is more effective than just following tips like these (e.g. Behrman et al., 2008).

So direct therapy for children who like to talk a lot is where we will head next.

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.