Behavioral management programs using positive reinforcement are most effective in eliminating abusive behaviors. Back to Top Abuses too difficult to be entirely eliminated must be modified. Such abuses are coughing, throat clearing, loud talking and speaking at inappropriately low pitch. All of these abusive activities involve closing the vocal folds too tightly and, with the exception of inappropriate pitch, too abruptly. The resulting voice is strained or tight, and sounds harsh.
Children often adapt their vocal behavior in response to the vocal patterning of an adult.
Upon elimination or modification of abusive vocal behaviors, the child's natural voice normally returns. After use of these intervention techniques, the referring physician, on reexamination of the child's vocal folds, usually reports reduction or elimination of the pathologic condition which necessitated the original referral. See Vocal Abuse in Children . Inc. All Rights Reserved.