Does your child have a “raspy” voice?


Recently, I have had quite a few kids on my caseload who have a “horse” or “raspy” voice. When I bring this up to parents, many of them respond “oh she’s always just had a raspy voice!”. But did you know that this “raspy” vocal quality is often a sign of vocal abuse? Vocal strain and nodules are caused by stress to the larynx. This stress is generally referred to as “vocal abuse” or misuse, and can eventually lead to the development of vocal nodules.

Usually children develop nodules or strain due to the interaction of two or more of the following done in excess:

  • Talking and singing excessively without quiet “recovery time”
  • crying, laughing, and loud prolonged outburst of emotion
  • throat clearing
  • forcefully using their voice
  • Excessive coughing or loud forceful sneezing
  • Shouting
  • restricted fluid intake

Vocal nodules and strain are diagnosed by an Ear, Nose and Throat provider (ENT). Once the child has an ENT examination, speech therapy for the voice is usually recommended. The goal of voice therapy is to teach a healthy, non-abusive voice production patterns so the vocal cords can heal, allowing a return to a normal voice.

A typical vocal hygiene program will consist of:

  • isolating medical conditions (like GERD) that aggravate vocal problems, then undergoing treatment
  • modifying behaviors that cause distress to the vocal cords, like yelling
  • learning how to take deep breaths and relax the muscles in the throat
  • taking time to speak slowly and clearly
  • staying properly hydrated throughout the day
  • avoiding caffeinated beverages, like soda, which dry out the vocal cords

If your child presents with a hoarse, breathy or rough voice, consult with a speech pathologist and learn more about the benefits of voice therapy!


Information for Families: Vocal Nodules in Children

Melanie Yovino, MA. CF-SLP




How to use sign language to foster your child’s Speech and Language development


Did you know that sign language can be beneficial to not only individuals with hearing impairments, but also to babies who are first learning to communicate?  In fact, babies actually develop the ability to point and gesture before they even use words to express their wants and needs! Many parents may be skeptical to introduce sign language to their babies out of fear that it may actually delay the development of spoken language. However, research as shown that sign language often provides a bridge to support a child’s spoken language development.

So what exactly are some of these benefits to using sign language?

  • Sign language can reduce frustration by providing children a way to express their wants and needs. Research has shown that having an alternate way to communicate often decreases behavior issues, such as screaming and crying, because the child can more effectively communicate their wants and needs
  • Sign Language can improve language, vocabulary and reading skills.  When a child hears a word paired with a visual sign, the child is actually receiving two repetitions of the word through two different modalities. These repetitions can actually strengthen a child’s ability to recall and and enhance the development of oral language for reading comprehension. “The benefit of using this system is the representation of information through seeing, hearing, and movement. The more pathways created in the brain, the stronger the memory.”
  • Sign language can also help children to expand the length of their utterances. Studies have shown that when children are exposed to sign language, they have a better understanding of the grammatical structure of English, and use language in a more productive manner. If a child is only using one word utterances to communicate wants and needs, such as milk, parents can model that word and pair it with a sign, for example “more milk.

Now that you know about some of the benefits to using sign language with your child, your probably wondering, how do I choose which words to introduce first? When choosing words to target, you need to keep in mind what is going to be the most functional and beneficial for your child, in order to help them effecitvely communicate in a wide variety of situations. Some common early signs include:

  • More
  • eat
  • drink
  • play
  • stop
  • finished/ all done
  • help
  • my/mine

Remember that all children are different and some may require more assistance than others, such as hand-over-hand assistance, in order to use sign language to communicate.  If you are considering introducing sign language to your child, consult with a speech language pathologist for tips on how to appropriately teach and chose sign language targets that are individualized to meet the needs of your specific child


Vroom, J. (2004) Encouraging Spoken Language through Signs. Super Duper Publications.




Melanie Yovino M.A CF-SLP 




Can Speech and Language Therapy Help Improve Literacy Skills?

decoding-x-language-comp-reading-comp Did you know that a child’s speech and language development can actually have a significant impact on their development of literacy skills? Many people may not know that literacy skills, such as reading and writing, are actually language based skills.  Research has shown that there is a strong relationship between language impairment in early childhood and reading and spelling difficulties in school age children. Since there is a significant relationship between spoken and written language, and SLP’s are the experts when it comes to language development, it makes sense that speech and language therapy can actually impact literacy skills, such as reading and writing! So how exactly can a Speech Language pathologist help improve these skills?

Research has shown that reading can be broken down into two component parts, decoding and language comprehension.

  • Decoding is defined as efficient word recognition and the ability to sound out words based on phonics rules. Difficulties with decoding words typically involve deficits in the area of phonological awareness, or the ability to hear and identify the sounds that make up words.
  • Language Comprehension is defined as the ability to derive meaning from spoken words, when they are part of sentences or other discourse. Language comprehension encompasses receptive vocabulary, grammatical understanding, and discourse comprehension.

Based on this criteria for reading, children can fall into one of three general categories. Each category requires a specific type of intervention.

  • Poor Language Comprehension – Children with poor language comprehension have adequate decoding skills and weak language comprehension skills. Speech-Language pathologist can work with children with language comprehension difficulties to improve their vocabulary, increase their understanding of syntactical and morphological structures, and improve their overall discourse comprehension.
  • Poor at Decoding – Children with poor decoding skills have adequate language comprehension and weak decoding skills. Children that fall into this category also often receive a diagnosis of  dyslexia.  Speech-language pathologists can work with children with deficits in decoding to improve their phonological awareness skills. SLP’s help boost their ability to identify, recall, and retrieve these sounds and link them to written language.
  • Weaknesses in Both Areas – These children require intervention in both the areas of decoding and reading comprehension.

If you think your child fits into any of the categories mentioned above, contact a Speech-Language Pathologist and schedule a full evaluation!


Catts, H.W. & Weismer, S.E. (2006). Language Deficits in Poor Comprehenders: A Case for the Simple View of Reading. Journal of Speech, Language, and Hearing Research, 49, 278-293.  

Hoover, W.A. & Gough, P.B. (1990). The Simple View of Reading. Reading and Writing, 2,  127–160

Melanie Yovino MA CF-SLP