getting you back to baseline

5 Tips on Treating Vocal Nodules in Kids & Teens

It's always a challenge to find fun and creative materials to help children and young adults want to take care of their voices. With recent research backing a behavioral approach to treating vocal nodules, versus surgical excision, it's even more important we keep these clients engaged.

1. Start Simple: You don't want to overwhelm your young client with too much information at first, because there's a possibility of being "tuned out." Try bubbles in a cup at first to get them interested. This is a very inexpensive way to make voice rehabilitation very fun. First take a cup filled with 1-2 inches of water and put a narrow-diameter straw in it. Make sure no air comes out the nose, and blow bubbles in the water. Slowly add voice until you have the client vocalizing and making bubbles at the same time. This creates inertive reactance (back pressure at the level of the vocal folds) and helps re-educate the muscles during voice production. Need ideas? Try these easy to print interactive products:

Straw Phonation characters for decreasing phonotrauma

Bubbles in Hot Chocolate!

Bubbles in a Cup for introducing Semi-occluded vocal tract exercises.

2. Remember Breathing and Hygiene: It is important once your client is engaged, that you stress the importance of no stress! Two ways you can do this are by teaching diaphragmatic/abdominal breathing and good vocal hygiene. Breaths supported from the abdomen are much more likely to decrease upper body tension than breaths from the chest and shoulders. You're fighting gravity when you breathe from your upper body. Staying hydrated by drinking enough water and avoiding caffeine, ceasing yelling at sporting events or on the playground, and resting your voice are all easy ways to keep good vocal health. Get started with these fun additions to your toolkit:

Elephants Don't Forget Good Vocal Hygiene

Voice-O-Poly: Challenge your Vocal Health Knoweldge

3. Vocal Resonance: Humming at the front of your face is a type of semi-occluded vocal tract exercise, but it can get boring quickly. To keep kids engaged find materials that are applicable to lesson plans that they are already doing in the regular classroom. You might also find that sending home fun "hum" activities to try during meal times can help the child remember to practice. Yummy! The following materials can dovetail humming into fun games during your sessions:

Halloween Themed Resonance for Voice

My Mom Makes Lemon Muffins: Vocal Resonance

For the boys! Resonance Football

4. Use Flow Voice when the laryngeal squeezing is intense. Some clients have struggles with producing sound with "humming" in a healthy way after developing a voice disorder. Flow voice, with roots with Casper, Stone and Casteel, can help break the habit of vocal overcompensation. Kleenex tissue can also be used as great visual feedback to let the client know if the airflow is coming out at the same time as the voice. Find out more and use the following products to teach this type of voicing.

Stretch your vowels and flow with Frogs and leaping!

Flow phonation with tissues!

5. Straw phonation is the newest craze! Cheap, easy, fun and full of benefit. Ingo Titze has done an amazing job with researching benefits that come from phonating or making noise through a narrow straw. This is so perfect for children because they can take their straws anywhere and improve their voicing while letting their friends join in. This is even great for your whole classroom, and for teachers to share on the vocal benefits. I take straw phonation breaks all the time. Keep kids interested with these:

Climb mountains with straw phonation

Fly your airplanes with straw phonation

Kristie Knickerbocker, MS, CCC-SLP, is a speech-language pathologist and singing voice specialist in Fort Worth, Texas. She rehabilitates voice and swallowing at her private practice, a tempo Voice Center, and lectures on vocal health to area choirs and students. She also owns and runs a mobile videostroboscopy and FEES company, Voice Diagnostix. She is an affiliate of ASHA Special Interest Group 3, Voice and Voice Disorders, and a member of the National Association of Teachers of Singing and the Pan-American Vocology Association. Knickerbocker blogs on her website at www.atempovoicecenter.com. She has developed a line of kid and adult-friendly therapy materials specifically for voice on TPT or her website. Follow her on Pinterest, on Twitter and Instagram or like her on Facebook.

Now, we all know that family and home carryover is one of the the most important things for successful outcomes in therapy (right @speechythings?) So what could be more appropriate than digging deep into how kids with voice disorders do character voices? Do they watch tv and act out the roles? Do they play make-believe in the yard? Do they okay video games and have vocal outbursts that might be phonotraumatic (bad for the vocal folds)? Pictured is part of Voice Detectives Vocal Hygiene Edition! It’s a card game with good and bad vocal habit suggestions. Kids have to decide which pile each card belongs in. http://www.atempovoicecenter.com/all-products/voicetherapydetectives⠀⠀⠀⠀⠀⠀⠀⠀⠀
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#slp #slpeeps #instaslp #ashaigers #slpmaterials #specialEdonTPT #slpa #slpsontpt #speechpathology #speechies #slpsfollowslps #speechtherapy #speechtherapist #tpt #teacherspayteachers #slp2b #slplife #medslp #snfslp #slpgradstudent #slpcfy #voice #thisisvocology #voicetherapy #voicerehab

It’s really exciting when you open up the#journalofvoice and you find your colleague Maria Dietrich and Nelson Roy have collaborated with other individuals to further explore the neural basis of primary muscle tension dysphonia (pMTD). They used MRI technology to further assess the brain. Primary muscle tension dysphonia is a voice disorder where there is no explanation by structures or pathology present. We know that there are some good ideas out there about why pMTD develops but truly we don’t know. Common associated things include emotions, anxiety & conflict. Also, functional neurological disorder A.K.A “conversion disorder” which is a psychological factor. Findings were after one successful voice therapy session, there is a shift in activations of the brain in the voice and speech area. Findings also were very similar to dysfunctional limbic motor interactions observed in people who have conversion disorders. So this will direct future studies in this area. Limitations are single case study, but just such great information. 🔥 .
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#slp #slpeeps #instaslp #ashaigers #slpmaterials #specialEdonTPT #slpa #slpsontpt #speechpathology #speechies #slpsfollowslps #speechtherapy #speechtherapist #tpt #teacherspayteachers #slp2b #slplife #medslp #snfslp #slpgradstudent #slpcfy #voice #thisisvocology #voicetherapy #voicerehab

Monday’s come fast most weeks. But I’m hoping to help you get through today. If you help one person find happiness today, you’ve had purpose. If you’ve given one person an answer to a question they’ve been struggling with, you’ve had purpose. If you bring a smile to a person’s face whose struggle you have no idea about, you’ve had purpose today. Let’s have a great Monday helping out patients. My clinic and heart are both full today. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
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#coach #vocalcoach #sing #singer #vocalathlete #music #instaslp #ashaigers #slpmaterials #slp2be #slp2b #slplife #medslp #snfslp #snfspeech #voice #thisisvocology #voicetherapy #voicerehab #atempovoicecenter #slpeeps

Let us help you bring some extra LUCK to your classroom this year! 🍀 One super lucky winner will win a complete kit for Braidy the Storybraid! Plus a $15 gift card to Barnes & Noble for #allthebooks to use with your Braidy kit!
To Enter:
1️⃣ Follow me @kristie_voice
2️⃣ Like this post ❤️
3️⃣ Comment below with the first chapter book you remember reading 📚
4️⃣ Go to @thespeechspace to continue the loop!
🍀Tag a friend for an extra entry!
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Be sure to ENTER before 8:00 pm EST on Thursday, March 21st. All entries after that time will not be eligible to win. The winner will be contacted by DM on Friday, March 22nd. This giveaway is in no way affiliated with the MindWing Concepts, Instagram or Barnes & Noble. Open to U.S. residents only. Good LUCK!🍀
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#slp #slpeeps #instaslp #ashaigers #slpmaterials #specialEdonTPT #slpa #slpsontpt #speechpathology #spedsquad #weteachsped #speechies #slpsfollowslps #speechtherap #tpt #teacherspayteachers #slp2b #slplife #teachersoftpt #thisisvocology #voicetherapy

Let us help you bring some extra LUCK to your classroom this year! 🍀 One super lucky winner will win a complete kit for Braidy the Storybraid! Plus a $15 gift card to Barnes & Noble for #allthebooks to use with your Braidy kit!⠀⠀⠀⠀⠀⠀⠀⠀⠀
To Enter:⠀⠀⠀⠀⠀⠀⠀⠀⠀
1️⃣ Follow me @kristie_voice⠀⠀⠀⠀⠀⠀⠀⠀⠀
2️⃣ Like this post ❤️⠀⠀⠀⠀⠀⠀⠀⠀⠀
3️⃣ Comment below with the first chapter book you remember reading 📚 ⠀⠀⠀⠀⠀⠀⠀⠀⠀
4️⃣ Go to @thespeechspace to continue the loop!⠀⠀⠀⠀⠀⠀⠀⠀⠀
🍀Tag a friend for an extra entry!⠀⠀⠀⠀⠀⠀⠀⠀⠀
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Be sure to ENTER before 8:00 pm EST on Thursday, March 21st. All entries after that time will not be eligible to win. The winner will be contacted by DM on Friday, March 22nd. This giveaway is in no way affiliated with the MindWing Concepts, Instagram or Barnes & Noble. Open to U.S. residents only. Good LUCK!🍀⠀⠀⠀⠀⠀⠀⠀⠀⠀
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#slp #slpeeps #instaslp #ashaigers #slpmaterials #specialEdonTPT #slpa #slpsontpt #speechpathology #spedsquad #weteachsped #speechies #slpsfollowslps #speechtherap #tpt #teacherspayteachers #slp2b #slplife #teachersoftpt #thisisvocology #voicetherapy

Now you have no excuse! Haha. I'm only kidding slightly. You want to know that there is a difference here. And we also use the word cord interchangeably with fold when describing the tissue in your larynx that phonates when you speak or sing. Chords are part of my life too, however, because they are #music and we create Chords with our Cords. Say that 5 times fast! Hope your Sunday is rolling right along. Happy Monday tomorrow.
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#slp #slpeeps #medical #music #singer #musician #ashaigers #sing #speechpathology #speechies #slpsfollowslps #speechtherapy #slp2Be #slplife #medslp #perform #larynx #fellowshipofthelarynx #thisisvocology #vocology #atempovoicecenter #voicetherapy #voicerehab

Resonant Voice Therapy shouldn't be boring for your pediatric patients. In fact, they should be excited to do voice rehabilitation with you because of your awesome voice games. Boys love football, girls do too! You can get some real motivation in your therapy sessions and at home with the child's family with Football Resonant Voice. It comes complete with single sound cards to give lots of chances to find the perfect, forward-focused hum, it has single words with M at the beginning. Advance to sentences and then create your own with the "blank" football cards so you can facilitate utterances that are appropriate for your kid. http://www.atempovoicecenter.com/all-products/footballresonantvoice .
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#slp #slpeeps #instaslp #ashaigers #slpmaterials #resonantvoice #sped #atempovoicecenter #specialEdonTPT #slpa #slpsontpt #speechpathology #speechies #slpsfollowslps #speechtherapy #speechtherapist #tpt #teacherspayteachers #slp2b #slplife #medslp #snfslp #slpgradstudent #slpcfy #voice #thisisvocology #voicetherapy #voicerehab

This is something I use in my clinic every day. I don't always use every single approach with every patient, but I have multiple activities created in one place for ease of use. If you haven't had a voice client in a while, this is a great start for behavioral voice therapy. I even have the research studies listed in the back of the resource so you can read up on your own to make sure you really know your stuff. Here is what some folks say about this resource...
"Easy to use, evidence-based materials. Always trust A Tempo resources" "Perfect crash course in voice therapy" "This is so helpful for those who don't have the most experience with voice. It was easy to follow and easy to use."
"I used it and was told that I'm doing such a great job with my patient by her otolaryngologist."
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Thanks for your support. I'll keep the materials coming.
Bit.ly/atempoSTORE or bit.ly/atempoTPT to get your very own.
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#slp #slpeeps #instaslp #ashaigers #slpmaterials #specialEdonTPT #slpa #slpsontpt #speechpathology #speechies #slpsfollowslps #speechtherapy #speechtherapist #tpt #teacherspayteachers #slp2b #slplife #medslp #snfslp #slpgradstudent #slpcfy #voice #thisisvocology #voicetherapy #voicerehab

Oh vocal paralysis...What do you look like? I see few of these each month. It is usually unilateral, meaning only "one" side of the voice box is paralyzed. It ranges from midline fixation, paramedian fixation or lateral fixation. This means the midline paralysis is right in the middle, allowing for the working vocal fold to have a good chance at adequate closure pattern during vocalization, meaning a probable good voice. Paramedian seems to be the most common in my clinic, and it's a toss up on whether the patient will have a good voice quality. This position is when we would consider voice therapy and injection of a filler into the fold, or a medialization procedure. Lateral paralysis is likely going to cause the most grief, because the patient usually has little to no voice, it is very breathy and aphonic. Aphonic means "no sound." This patient will more than likely require a surgical consult before beginning any voice therapy because the anatomy will not lend itself to any improvement with voice therapy alone. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
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#singer #vocalparalysis #injectionlaryngoplasty #ent #slp #slpeeps #instaslp #ashaigers #slpmaterials #specialEdonTPT #slpa #slpsontpt #speechpathology #speechies #slpsfollowslps #speechtherapy #speechtherapist #tpt #teacherspayteachers #slp2b #slplife #medslp #snfslp #slpgradstudent #slpcfy #voice #thisisvocology #voicetherapy #voicerehab

I want to take today to say thank you for following my account because it’s really what I enjoy. I love being able to share applicable vocal knowledge with you. I never dreamed I would have this many people in what I consider to be an #ATempoVoiceTribe ❤️❤️ I feel so enveloped in a community of singers, SLPs, students, teachers, and musicians! You ask questions, you do better, you know more now and benefit from what I feel is really fun on Instagram. I love that you are involved in this voice tribe and community. Keep asking the questions! Keep helping others. From the bottom of my voice box, thank you. -Sincerely, just a girl with a 🔥 for voice and science ⠀⠀⠀⠀⠀⠀⠀⠀⠀
Artwork by @lovelylittlecommunicators She is truly the most talented! She really captured me how I see me. She can capture you too in her Etsy store ⠀⠀⠀⠀⠀⠀⠀⠀⠀
#slp #slpeeps #instaslp #ashaigers #slpmaterials #specialEdonTPT #slpa #slpsontpt #speechpathology #speechies #slpsfollowslps #speechtherapy #speechtherapist #tpt #teacherspayteachers #slp2b #slplife #medslp #snfslp #slpgradstudent #slpcfy #voice #thisisvocology #voicetherapy #voicerehab

How often should you be hydrating?

Get in the habit of drinking half of your body weight in ounces of water each day. I label my water bottles with times I must drink a certain amount by. Get a nifty looking reusable bottle to help keep you motivated.

Cough Drops?

Try Breezers by Halls. They do not contain menthol or eucalyptus. Those ingredients can contribute to chronic cough.

Vocal Abuse Tip

Instead of yelling from room to room at home, bring the communication partner closer to you when communicating.

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No portion of this website is intended to diagnose or treat any medical problem. It is meant to help further understanding of voice and swallow related issues. Please make an appointment with a licensed Speech Language Pathologist or Physician for assessment.