Preparing for Your Appointment with the Voice Program

Because we want to ensure the best care for your child, and because your child will be seen by several members of the Voice Program team in order to provide a comprehensive treatment plan, please be prepared for your first appointment to last between two to three hours.

The following information can help make your appointment go as smoothly as possible and keep your child comfortable.

• It is very likely your child will need to undergo a laryngoscopy, which is the placement of a spaghetti-like camera in the nose and down the throat. This allows our team to look at your child’s voice box, or larynx. This procedure does not require sedation. It may be helpful to let your child know this test may happen in advance. We will review the process with you and your child during the visit and have your child feel the camera, in attempt to put him or her at ease. We’ll also record the exam and take pictures, which you can keep for your records (some children enjoy sharing the photos with their friends and classmates!).
• Let us know if there is anything we can do to help ease any fears or concerns you or your child may have before the day of your appointment. Please also let us know if there are any special circumstances we should be aware of.
• Please bring some of your child’s favorite toys, books or activities. We will also have some age-appropriate activities related to the voice (such as word puzzles and drawings) to help pass the time during the wait period.
• Your child should have a small meal prior to coming to the Voice Clinic. We also encourage you to bring water for your child.
• If your child’s appointment is on a school day, please let your child’s school know he or she will be out for most of the day. We will be happy to give you school and work excuse note forms when checking out after your visit, so please be sure to ask for one.

Our services

Because your child’s vocal folds are still developing, we believe in finding nonsurgical solutions for voice issues whenever possible.

During your child’s initial evaluation, you will meet with voice therapists who will evaluate your child’s voice and try several forms of vocal exercises. If your child responds well, we may recommend a course of voice therapy to see if his condition improves.

We measure improvement using objective data. You will be asked to fill out a survey about your child’s quality of life. You can do this while waiting to be seen in the office. We use this survey, called a Pediatric Voice Handicap Index (pVHI), to monitor the progress of your child’s voice over time.

Our voice therapists will also collect acoustic information, which is a way to monitor certain parameters of your child’s voice over time. To do this, your child will play games on a computer with the voice therapist. Most children look forward to this part of the exam. It’s possible your child may also be asked to blow air into a mask so that pressure and flow through the vocal tract can be measured.

If no improvement is seen or your child isn’t a candidate for voice therapy, our team will discuss other options, including:

• Laryngeal electromyography (EMG)
• Vocal fold injections (aka injection laryngoplasty)
• Recurrent laryngeal nerve (RLN) reinnervation
• Phonomicrosurgery

Getting involved in our research

The Voice Program is involved in a number of research projects and our team has presented at numerous national and international conferences.

You may be asked to sign a consent form if there is an ongoing project for which your child may be eligible. You are NOT obligated to participate if you are approached about a possible project, and please feel comfortable in deciding not to participate. This will not affect your child’s care in our practice.