Voice

Voice - what to look for

Some strategies

Volume, pitch and quality are all aspects of speaking related to the voice. Some possible problems include:

• A voice which is frequently or constantly hoarse (even when the child doesn't have a cold)
• A voice which is excessively loud or quiet
• Any other voice quality which sounds particularly unusual eg, very nasal.

If the child has a hoarse voice

A hoarse voice is often a result of the child giving their voice box `a hard time'; for example, by yelling a lot, making a lot of `growly' or animal noises, using a pitch which is much higher or lower than their natural pitch. Although these types of voice can cause some damage to the vocal cords this is usually temporary. Encourage these strategies to reduce the behaviour and monitor for 2-3 months before referring:

• Encourage the child to take regular drinks of water. This helps to `oil' the vocal cords and help them to work together smoothly
• Discourage the child from making a lot of animal or `growly' noises such as roaring like a lion, making machine noises, high pitched squeaking etc. This type of voice use can strain the vocal cords
• Discourage the child from yelling or screaming during play. Suggest alternative activities which do not involve the use of a loud voice
• Praise the child for using a quiet voice
• Instead of calling out across a room, encourage the child to come closer
• Reduce the background noise (TV, radio, open window) when you are listening to the child so that there is no need for raised voices
• Model good voice use. Demonstrate the way to care for a voice by doing the things listed yourself.

If the child speaks too loudly

• Praise the child for using a quiet voice eg, "I really like it when you use that quiet voice"
• Give your full attention when the child is talking to you so that voices do not have to be raised
• Encourage the child to come closer to the person s/he wants to speak to instead of calling out across a room. Praise the child for doing this
• Reduce background noise (TV, radio, open window) when you are listening to the child so that voices do not have to be raised
• Model a quiet voice.

If the child speaks very quietly

• Praise the child for using a louder voice eg, "I really like the way you used a bigger voice that time - It was really easy to hear what you were saying"
• Respond to the meaning of what the child is saying more than to how it is said
• Encourage and praise the child for non-speaking activities - build his/her confidence as much as possible.

If the child has a very unusual voice quality

• Encourage the parents/caregivers to discuss the child's voice quality with their doctor
• If you are unsure about the child's voice and whether you should refer, contact GSE and discuss whether referral is appropriate.

Voice - what to do and when to refer

(Please note, this diagram can be viewed more clearly in the attachments at the end of this web page).