What Are Vocal Nodules?
- Vocal nodules, often called singer’s nodules, are callus-like bumps on the vocal folds.
- Caused by repeated misuse or overuse of the voice, they prevent the vocal folds from closing completely when producing sound.
- Unlike vocal polyps (blister-like growths that can form from a single event, e.g., yelling), nodules develop gradually over time.
- Their size can range from a pinhead to a split pea and, if untreated, can lead to further vocal strain and damage.
Common Causes of Vocal Nodules
- Vocal Abuse Behaviors in Children:
- Excessive talking for extended periods.
- Loud vocalizations like shouting, screaming, whining, cheering, or crying
- Frequent coughing or throat clearing
- Strained vocal sounds (e.g., imitating vehicles, animals, or superheroes)
- Vocal Misuse and Other Contributing Factors:
- Poor breath support during speaking or singing.
- Straining the voice or using incorrect pitch or volume outside of one’s natural range
- Environmental and health factors:
- Chronic upper respiratory infections or allergies
- Acid reflux
- Exposure to second-hand smoke or air pollution, which exacerbates swelling and inflammation
Healthy Vocal Practices and Alternatives
To reduce strain and help nodules heal, children should follow these guidelines:
- Avoid loud talking
- Family members should take turns speaking so that the child does not need to talk over other members in the family to be heard. Also, the child should walk closer to the listener instead of yelling from a distance.
- No screaming when angry
- Offer alternatives like punching a pillow or tearing paper.
- Stop imitating loud sounds (e.g., animals, motors, superheroes)
- Use a gentle humming sound instead.
- Refrain from talking over background noise
- Turn off TVs or radios during conversations to avoid shouting.
- Replace throat clearing with a hard swallow
- This clears secretions without damaging the vocal folds.
- Pause singing for now
- Encourage playing a musical instrument or using a whistle instead.
- Stay hydrated
- Drink plenty of water and avoid caffeinated drinks. Caffeine causes dehydration, making vocal folds more prone to injury.
Encouraging Compliance
- Positive reinforcement works best. Use tools like sticker charts to track progress.
- Offer gentle reminders rather than nagging if rules are broken.
By adopting these practices with consistent effort and patience, vocal nodules will typically heal over time. Your speech-language pathologist can assist your child in regaining healthy vocal habits and preventing future issues.
By Kathleen Winger, M.S., CCC-SLP