Treating voice disorders can be challenging because the patient has to "buy into" the changes that he/she has to make to their everyday life.  I was treating a drill sergeant for vocal nodules.  She yelled all the time, drank 3 monster drinks (full of caffeine) a day, and smoked.  She understood that those things were causing her to have vocal nodules and was causing her to lose her voice.  However, she couldn't make the leap to change her lifestyle.  Therefore, she stopped coming... and I assume she still has vocal nodules.  

Treating kids can be even harder.  You are asking them not to: scream on the playground, yell while playing, yell to get someone's attention when they are in the other room, drink caffeine, eat snacks with caffeine, etc.  To a kid, it's almost like you're asking them to give up their livelihood! 

Well, a good way to get them to understand that their voice can be delicate is to ask to go into a classroom and target all the kids at once (since we all know they yell on the playground).  Kids like visuals and so showing them how our vocal chords work by using common objects can help.  

1.  Vocal Folds (VFs).  For those of you who are not speech therapists, let me explain how your VFs work.  They are essentially two parallel pieces of tissue that come together and push apart in a wave like motion.  Here is a quick video on youtube if you would like to watch it.  To show the kids how our VFs work, blow up a balloon.  Let out a little bit of air and let the end of the balloon vibrate just a little bit.  Let them put their hands on their throats and quietly say their name (but not in a whisper).  They should be able to feel their vibrations in their own throat.  Now push out the air of the balloon as hard as you can.  It will make a farting noise, which they will probably think is hilarious.  However, they can also see that the "vfs" (or the end of the balloon) is now being abused.  That's what it's like when they are yelling on the playground.

2.  Vocal Nodules.  I usually explain vocal nodules as calluses for your vfs.  Have the students hold up their two pointer fingers.  Show them the motion the vfs should make during phonation (talking).  Let them mimic that motion.  Now, ask them what would happen if you were to rub too hard or bang your fingers together over and over and over for days and years on end.  They would probably hurt, be damaged, get calluses, be bruised, swell up, etc.  Is it as easy to use your fingers for everyday tasks if they are any of the aforementioned?  No!  Explain that when you yell, the same things can happen to your vfs:  nodules (calluses), swelling, hurt, etc.

3.  Caffeine.  Why is caffeine bad for your vfs?  Caffeine takes moisture from your body - including your vfs.  Your vfs need to be hydrated to make sure they are working well.  Ask the kids what happens when a hinge is dry?  It squeaks!!  What do you do for it?  Put on WD40 (which is like water for us).  To show what caffeine does, pour water in a glass.  You can ask them what it is (water) and ask if they drink water.  Tell them that the glass is like their body and the water is what they have consumed.  Now get a big sponge (preferably the large round sponges that are very thick) and place it in the cup and in the water.  Ask the students what is happening.  The sponge is acting like the caffeine - it is soaking up all the water.

4.  Non-caffeinated snacks.  Now talk about which snacks/drinks have caffeine and which snacks do not.  They will probably know that soda has caffeine, but you can show them non-caffeinated soda!!  They may not know about tea or coffee yet.  They also may not know that CHOCOLATE has caffeine!  Give them a sweet snack that is not caffeinated so that they can see their world won't be only fruits and veggies for snacks from now on.  :o)

I've also included a worksheet you can bring in to the classroom (or use in therapy).  It is under the "therapists" tab in the "voice" section.

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