An estimated range of 41%–73% of children were identified with vocal nodules, indicating vocal nodules as a predominant cause of pediatric dysphonia (Martins et al., 2015) however, there can be a variety of causes other than vocal fold nodules that result in dysphonia in the pediatric population. Longer stays in the neonatal intensive care unit and prolonged intubation (more than 28 days) were associated with more severe dysphonia in premature infants (Hseu et al., 2018). In the pediatric population, the reported prevalence of a voice disorder has ranged from 1.4% to 6.0% (Black et al., 2015 Carding et al., 2006). Prevalence refers to the number of individuals who are living with voice disorders in a given time period.Įstimates of incidence and prevalence vary due to a number of factors, including etiology, age, gender, and occupation. Incidence of voice disorders refers to the number of new cases identified in a specific time period. EILO may go by other names such as supraglottic airway obstruction during exercise (Murry & Milstein, 2016).įor further information, see ASHA’s Practice Portal page on Aerodigestive Disorders. Exercise-induced laryngeal obstruction (EILO)-EILO is most often diagnosed in adolescence and is typically due to obstruction at the laryngeal level due to inappropriate glottic closure or adduction/collapse of supraglottic structures (Maat et al., 2011).When this is suspected, SLPs may be consulted to help identify abnormal laryngeal and respiratory function and to teach various techniques (e.g., vocal exercises, relaxation techniques, quick-release breathing techniques, and proper breath management) to improve laryngeal and respiratory control (Mathers-Schmidt, 2001 Patel et al., 2015 Traister et al., 2016). Paradoxical vocal fold movement (PVFM)-a condition in which there is intermittent adduction of the vocal folds that interferes with breathing. SLPs may also be involved in the assessment and treatment of disorders that affect the laryngeal mechanism (i.e., the aerodigestive tract) and that are not classified as voice disorders, such as the following: However, the voice misuse results in repeated trauma to the vocal folds, which may then lead to structural (organic) changes to the vocal fold tissue. For example, vocal fold nodules may result from behavioral voice misuse (functional etiology). The complementary relationships among these organic, functional, and psychogenic influences ensure that many voice disorders will have contributions from more than one etiologic factor (Stemple et al., 2014 Verdolini et al., 2006). Speech-language pathologists (SLPs) may refer individuals suspected of having a psychogenic voice disorder to other appropriate professionals (e.g., psychologist and/or psychiatrist) for diagnosis and may collaborate in subsequent behavioral treatment. The resulting voice disorders are referred to as psychogenic voice disorders or psychogenic conversion aphonia/dysphonia (Stemple et al., 2010). Voice quality can also be affected when psychological stressors lead to habitual, maladaptive aphonia or dysphonia. Functional-voice disorders that result from inefficient use of the vocal mechanism when the physical structure is normal, such as.Neurogenic-organic voice disorders that result from problems with the central or peripheral nervous system innervation to the larynx that affect functioning of the vocal mechanism, such as.structural changes in the larynx due to aging.
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