Pediatric Voice Clinic

Voice evaluation

This is when we listen to your child’s voice and assess problems with voice quality. They’ll be asked to do various voice and speech tasks. If they’re old enough (around 3 or 4 years old), we will record and analyze these interactions using a microphone and special computer software. A comprehensive voice evaluation helps inform the best possible treatment approach.

Ear, nose, and throat exam

During your child’s visit, they’ll meet with the otolaryngologist, who will perform a general ear, nose, and throat exam. This is a non-invasive process where they’ll look in your child’s ears, nose, and mouth, and may gently touch their neck to examine for abnormalities.

Videolaryngoscopy

To diagnose voice box problems, the otolaryngologist will perform a videolaryngoscopy to examine your child’s vocal cords. For many children, this process can feel daunting. It’s important to remember that this is a quick procedure that typically lasts less than one minute. 

During the procedure, the doctor will use a nasal numbing spray to help reduce any discomfort. Then, they’ll gently feed a thin, flexible tube (about the width of a spaghetti noodle) into your child’s nose and to the back of their throat. At the end of the cord is a camera the doctor will use to photograph the larynx to help identify irregularities in the vocal cords and surrounding tissues.

Voice therapy

Voice therapy is generally focused on teaching efficient voice production and behaviors to support a healthy voice. Therapy is customized for each patient based on diagnosis and specific voice concerns. Speech-language pathologists also provide home-practice activities and guidance to help transition newly learned skills into the home environment for lasting voice improvement. With young children, parents or caregivers are directly involved in the therapy process.

The frequency of therapy sessions may vary, though they usually start with weekly one-hour appointments. Time between therapy sessions may increase over the duration of therapy, which is typically a total of six to eight treatment sessions.

Surgical care

Some pediatric voice disorders require surgical intervention to achieve the best possible outcome. For children who may benefit from surgery, our team develops a customized treatment plan that includes surgical care when appropriate. Decisions are made collaboratively by pediatric otolaryngologists, speech-language pathologists, and other specialists to ensure the safest and most effective approach.

We offer a full range of surgical options, including:

• Airway evaluation under anesthesia with excision of lesions for conditions affecting the vocal cords
• Specialized surgeries for vocal cord paralysis, including reinnervation procedures
• Advanced procedures for more complex situations, such as after previous airway or voice box reconstruction

Surgical recommendations are made in the context of the child’s diagnosis, overall health, and therapy progress. Surgery is often paired with voice therapy, either before or after the procedure, to ensure the best possible outcomes and smooth recovery.

Our approach focuses not only on addressing the immediate medical concern but also on preserving healthy vocal anatomy. This helps ensure that a child’s voice improves now and remains strong and functional into adulthood, even as voice use changes over time.