Voice or Speech Problems

Voice problems are called as dysphonia. These problems may be congenital or acquired. Voice problems occur in children due to shouting, screaming, and excessive talking in order to seek attention of playmates, parents, and siblings which will later result in serious voice problems. Children who constantly talk more will experience inadequate air supply which may have a great impact or more pressure on vocal cords.

Voice problems can occur due to various reasons such as formation of nodules or polyps in vocal cords, infections, chronic laryngitis, vocal cord ulcers, and inflammation of vocal cords. Other medical conditions that affect the vocal cords are allergies, neurological problems, papilloma, laryngomalacia, subglottic stenosis, and glottis web which lead to breathing and swallowing problems.

Children with voice problems may have weak cry, frequent coughing, voice changes throughout the day, hoarseness, scratchy throat, and airy speech.

The most common voice problems are misuse of voice (speaking too loudly, speaking with a high pitch, not drinking enough of water), vocal abuse (shouting or screaming with exerting too much of pressure, constant cough or clearing the voice, straining voice to imitate), medical and emotional problems.

Treatment

The effective treatment includes vocal hygiene programs and surgery. Hygiene program educates your child on how to keep vocal cords moist and not to shout or stress the vocal cords. Voice therapy teaches how to use the voice correctly by using different techniques.

Treating the underlying condition will also help your child to get rid of voice problems. Treating polyps by surgery may treat the associated voice problems. Surgery alone may not treat the condition and prevent recurrence therefore combined approach of surgery and voice therapy offer better results.

How can parents help?

• Create a communicating friendly environment at home. Your child will respond or learn to talk by imitating you. Avoid talking from near distances rather than shouting from large distances
  
• Notice your child's feedback in response to your voice when you talk
• Encourage your child to play and watch television which will allow your child's voice to rest
  
• Keep the outside noise minimum which may necessitate the child to shout or speak loud
  
• Talk to your child everyday which will reduce the attention seeking behavior
  
• Promote sharing and listening environment at home between siblings
  
• Discourage speaking in higher tone at home
  
• If your child has hoarseness in voice, then suggest quiet playing activities
• Avoid giving caffeine containing products such as coffee or other beverages

Speech problems

Phonology is referred to as study of sounds of language. Pronunciation errors are common in children when they are learning to talk. During the child's development stage, phonological disorders can affect children's ability to learn read or spell. Speech problems are temporary or can be overcome.

Your child should listen before it begins to speak. If not, then there may be chances of speech problems and you may have to consult your doctor. Some of the common speech problems are

• Mispronunciation - Your child may often substitute 'f' or 'd' for 'th', or mix up words. For example your child may say I am taking baf, instead of I am taking bath
  
• Lisping - Your child may pronounce "s" as "th". For an instance, sister will become thithter, seven may be pronounced as theven. During this condition, your child will push the tongue out while pronouncing these letters where as in normal children, the tongue will touch the upper teeth while speaking or pronouncing these letters
• Stuttering - It is the repetition of certain words, sounds, or phrases. In children it is common to stutter until the age of 7 years, but sometimes it may become a permanent speech disorder. One of the causes for stuttering is genetic predisposition
  
• Flow - This is the condition where your child is learning the new speech skills and struggles to speak the sentences
• Hoarseness - It is the change in the voice or sound because of laryngitis or upper respiratory tract infection
  
• Slurred speech and difficulty in speaking - It develops from nerve and muscle disorders such as multiple sclerosis and Parkinson's disease

Some of the common speech disorders are apraxia and dysarthria.

• Apraxia - It is caused due to the disorder of the nervous system which affects the child's ability to pronounce words and produce sounds. In this condition the brain does not send signals to the body parts that are involved in speech. For example your child may pronounce 'sut' for 'sat'
• Dysarthria - It is a dysfunction or impairment of the neuromotor or neuro muscular systems

Infection of the upper respiratory tract may cause inflammation of the larynx, which leads to temporary loss of voice. Also some of the brain disorders affect the organs involved in speech and these disorders include include Parkinson's disease, cerebral palsy, nerve and muscle disorder, and Alzheimer's disease. Speech problems may also be caused because of hearing loss, mental retardation, cancer, mutisim, deafness, vocal cord problems, and nodules or polyps. These conditions may interfere in the child's ability to speak.

Treatment

The best way to treat your child and improve the speech ability is by treating the underlying disease conditions.

Speech therapy helps to overcome the problems of stuttering and lisping. In this therapy, your child will be given speech and language test which will help the therapist to diagnose, understand, and treat the problem. Speech therapist will try to sing some rhymes or poems and read repetitive books which will improve the vocabulary speech. Sign language is taught which supports the child to say few words to avoid frustration.

• Speech therapy helps children who have trouble in pronouncing letters, syllables. It includes coordination exercises which enable the speech muscles to strengthen and speech therapist will guide your child showing them the proper placement of lips and tongue
  
• For stuttering there is no treatment, speech therapist will teach your child to talk in such as way that your child will feel easy and relaxes while speaking

Other ways to overcome speech problems in your child include

• Your child will learn how to speak by imitating you. You must speak in front of your child rather than speaking behind your child or shouting from some corner
• Check if your child can breathe properly through nose. If your child has allergy or cold or sinus problems, then work on nose blowing and clear the blockage by using nasal sprays which will help the child to breathe through the nose with lips together