Systematization of the voice therapy program for children with vocal nodules

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For the treatment of vocal nodules, educational programs for vocal hygiene and voice training for acquisition of correct phonation aide essential. In the case of children, special considerations are necessary as some of their vocal behaviors and reaction to voice disorders are different from those of adults. In this study, we developed a voice therapy program for child vocal nodules and good results were obtained for 6 children. They were 4 boys and 2 girls (Age; 4y -11y) and bilateral nodules were found for all of them. In addition to a conventional vocal hygiene program for children, correct production of loud voice (so-called "Belting") was the major focus of the voice therapy as the visual inspection of the larynges and perceptual evaluations of the voice revealed inappropriate loud voice production with laryngeal constriction in all children. After 5 to 24 voice therapy sessions, disappearance of the nodules was found in 5 children and the reduction of the nodule sizes was found in 1 child. Improvement of the GRBAS scores, longer maximum phonation time, extension of vocal ranges were found after the completion of the therapy programs. It was implicated that our voice therapy program was effective for the 6 children with vocal nodules.