Voice and Resonance

What is voice?

Voice is the sound made when your child speaks. A normal voice sounds free of strain, with a pitch that sounds like that of peers and a volume that suits the situation. A child with voice problems may have a hoarse or harsh voice quality and/or a pitch that is too high or low. Sometimes, a child may sound as if he/she is “losing” their voice.

What are the typical assessment procedures for voice?

A speech-language pathologist (S-LP) will ask questions about the child’s medical history, history of the voice problem, voice symptoms and the child’s voice behaviour throughout a typical day. With this information, careful listening during play and specific voice activities, the S-LP will determine if your child has a voice problem.

Assessment by an Ear, Nose and Throat (ENT) specialist must occur before the S-LP can provide direct therapy. Counselling regarding appropriate voice care will occur once referral to an ENT has been made by your family doctor.

What is a resonance disorder?

The palate (roof of the mouth) and the muscles at the back of the throat control the amount of air that comes out of the nose. If the palate and these muscles are not working correctly, this is called velopharyngeal inadequacy, and problems with the resonance of a child’s speech can result. If your child’s speech sounds “hypernasal”, this means that there is too much sound coming out the nose when your child is talking. Or, if your child’s speech sounds “hyponasal”, this means that not enough sound is coming out of your child’s nose when he or she is talking. Sometimes parents think that their child sounds “nasal” or sounds like they have a cold all the time.

What are the typical assessment procedures for resonance?

A speech-language pathologist (S-LP) will ask questions about the child’s medical history, history of the problem and when the symptoms are noticeable throughout a typical day. The S-LP will also use play-based assessments, standardized tests and/or informal checklists to assess your child’s overall speech and language skills. With this information, careful listening during play and specific activities, the S-LP will determine if your child has a resonance problem. Referral for assessment by an Ear, Nose and Throat (ENT) specialist, or at the Velopharyngeal Inadequacy (VPI) Clinic may be recommended to further investigate the problem and what should be done about it.

Who can be referred?

Any child from early infancy (birth) up to the age at which they are eligible to start primary school can be referred.

Who can refer?

Nova Scotia Hearing and Speech Centres has an open referral policy whereby parents/caregivers, teachers, doctors and related professionals with parental consent may refer a child for assessment.

Click here to download the NSHSC referral form.

How do I make a referral?

Referrals and questions may be directed to your local NSHSC site.

Upon receipt of referral, NSHSC will send you a case history form to fill out. It is important to fill out and return the case history form as soon as possible. An appointment cannot be booked until the case history form is returned. Please inform the centre if you need help filling the form out. We would be happy to assist you.