Moya Andrews

Clinical Implications for the Voice of Children

Moya Andrews

Clinicians tailor voice treatment to the needs of each individual child with whom they work, but also must mesh intervention approaches with information concerning child and adolescent development. Voice use is an integral part of the adaptive behaviors children use to meet their needs, interact with others, explore their physical and emotional realities and rehearse and refine their communication repertoires. In this presentation the implications of developmental issues on the design and application of voice treatment techniques, protocols, tests and programs will be explored. Although children are referred for evaluation and treatment because they exhibit atypical vocal patterns, clinicians must also focus on all aspects of each child’s development that may impact on diagnosis and remediation. Vocal signs and symptoms are just the tip of the iceberg that draws the listeners’ attention, but other relevant developmental issues precipitate and maintain voice disorders and are salient in terms of both differential diagnosis and amelioration. These include developmental issues related to the anatomical, physiologic, environmental, cognitive and social domains. These aspects may often seem less obvious initially, though they are frequently extremely relevant to clinical outcomes. Emotional factors are particularly significant when children sound different from their peers, and psychosocial as well as physiological compensations need to be specifically addressed in treatment programs.