Vocal Health for Young People

Why do we need to think about children’s voices?

If a child has a voice problem, it will affect many aspects of their life. The child will be less able to project their voice – socially, in class, in sports, or in singing/acting. This can have a negative impact on self-esteem and a greater effect on overall development.

How common are voice problems in children?

• Surprisingly common in children. They mostly resolve with time, and the changes of circumstance that are part of growing up.
• The habits that lead to voice problems tend to be most common in young people with higher levels of anxiety, these are not necessarily the ‘shouters’, they are often those who are dealing with other emotional issues.

What about teenagers?

• Vocal identity can become much  more important and often less certain.
• Psychological uncertainty occurs alongside physical instability as the vocal system grows and changes.
• During this time, healthy voices can sound unhealthy.

What is different about children’s voices?

• Different physical proportions, qualities and stamina.
• Less able to sustain loud, high, fast or long.
• May have a different awareness of their own voice.
• Children who are singing and acting will have a range of advice from their teachers, parents and peers; often with conflicting information.
• The child who is compliant and eager to please will be the most vulnerable in these situations.

What can go wrong?

Three factors can increase the stress on our voices:

Amount of use: The number of hours spent speaking or singing.

Level of use: Louder voicing requires the vocal folds to collide harder.

Emotional stress: This is often less easy to identify or deal with. Anxiety creates holding patterns in the vocal system; voice use is therefore less efficient and takes greater effort.

• Temporary vocal stress leads to inflammation which rapidly subsides and heals if the impact is reduced.
• If it continues, the swollen vocal folds are more difficult to vibrate, and voicing becomes a struggle.
• This struggle leads to more pushing and squeezing, making the problem worse

Some solutions:

• Reduce unnecessary background noise. Turn the TV off, turn the music down, face the person you are speaking to.
• Use amplification: If you can’t reduce background noise, using amplification is not a sign of failure – it is common sense. The use of amplification can be a real help for children performing in poor acoustic conditions.
• Notice voice use during sport; team sports can involve shouting, martial arts can involve impactful voicing.
• You can also use cupped hands to create a simple megaphone effect.
• Value the vocal rest that can come with time spent alone.
• Reduce voice use by splitting it into small units. Have lots of short periods of voice rest in a lesson or rehearsal.
• Give positive instruction and expectations. If the young person is confident that you are going to help them, they will learn faster.
• Flexibility and resilience can be fostered in their voice use by incorporating variety into their activities.

Resilience isn’t ‘being tough’, it’s being bouncy! Young people can be amazingly receptive, adaptable and sensible if they can understand the reasoning and feel the differences.

What might this sound like?

• Breathiness, huskiness, hoarseness, roughness, weakness, strain, instability/cracks, or pitch range limitations.
• Nearly all vocal instabilities are temporary, either from over-use, misuse, new use, or from illness.
• Nearly every young person will have one or more of these qualities in their voice, understanding more about the variety
  of possible causes will help you to know what might be significant.

What else might be contributing to this?

• Noisy environments:  playground, school cafeteria or dining hall, swimming pool, sports stadium, or even an unsupervised or poorly supervised classroom.
• Hours spent per day in large groups, competing for attention.
• Anxiety from neurodiversity, or unrealistic ambition and competition.

What is the best way to help?

If there is no change for more than three weeks, and the issue is causing concern or struggle for the young person, then it is advisable to seek help from a specialist voice clinic via their primary healthcare provider (GP).

• When voice problems occur, it is important to remove any sense of guilt or blame.
• It may be the result of a series of unfortunate situations, often outside the direct control of the child.
• Reassure them that they are not alone and that all voice problems can be helped, if not removed altogether.
• The solutions will be in a number of small changes, not in a single significant one.