You know that we love working collaboratively with other professionals, having a team to surround yourself with is critically important. I am reminded of how important it is for us to share our expertise and experience with other professionals as well, it’s a two-way street. Specifically, I have had quite a few parents come back and ask really good questions from appointments with their ENT providers. One mom went to see an ENT because her son seemed to be “running out of air” when he spoke and demonstrated a chronic raspy vocal quality. The ENT performed a scope, where he threaded a small camera through the child’s nose and looked down at the vocal folds, or the soft pieces of tissue inside of our throat that vibrate in order to make speech/voice possible. The ENT described his findings of vocal nodules on the boys vocal folds and nonchalantly told the mother “yep, you have a talker, he’s just going to have nodes”.
As a speech therapist, this was very disturbing information for a fellow professional to provide a mother, and I honestly am grieved that I didn’t have a chance to speak with this provider directly because there are SO MANY options for this child and so much knowledge that could be provided to the ENT, the mother, and the child in order to improve his quality of life. Allow me to put my small rant here.
Children do not develop vocal nodules because they talk a lot. Most of us talk, especially me, an insane amount, and if you are able to provide your vocal folds with appropriate vocal rest, vocal use and hydration, nodes should never be an issue. We have many different sets of muscles and tissues in our throat in our neck that help us to either project our voice or to clench and strain and use muscles in compensatory ways that caused damage. This young man was also having chronic pain in addition to him sounding like he was “running out of air” and constantly sounding like he was losing his voice. It was so noticeable that even his classroom teacher had brought it up to his mother during conferences.
I strongly encouraged this mother to seek out a speech and language pathologist who specialized in pediatric vocal therapy in order to do a few things with her son. I would love to see this child learn how to relax the muscles of his neck and throat and use them appropriately to project his voice instead of using vocal misuse and abuse, which is causing damage. I would like to see this child work on increasing diaphragmatic breathing, expanding his breath support and also increasing his hydration.
A pediatric speech language pathologist who works with kids on voice disorders would use pitch glides up and down with humming or sustained phonation. It also would be beneficial for this child to be able to have some episodes of vocal rest, especially after long days of speaking where he could have a chance to rest his voice and provide him with further education about how different activities such as screaming, or singing extremely loudly in the car, could exacerbate his pain and or symptoms.
I do not write this blog post to slam any of my fellow colleagues, I true desire is to have a place to be able to provide some more clarification for those families and professionals who are seeking more education, who didn’t feel heard, or who received an answer that just didn’t sit well with them. Please if I can encourage you in one way, never stop advocating and following your gut. Keep asking the hard questions, keep looking for more answers, and as always, never ever hesitate to reach out to us directly!
-Kasey