Can Students Qualify for Voice Treatment? Yes, and speech-language services can boost their academic performance and self-esteem. School Matters
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School Matters  |   February 01, 2016
Can Students Qualify for Voice Treatment?
Author Notes
  • Amy W. Piper, PhD, CCC-SLP, is an assistant clinical professor at Indiana University in Bloomington and is externship coordinator for the speech-language pathology graduate program. She is an affiliate of ASHA Special Interest Group 9, Hearing and Hearing Disorders in Childhood; 11, Administration and Supervision; and 16, School-Based Issues. awpiper@indiana.edu
    Amy W. Piper, PhD, CCC-SLP, is an assistant clinical professor at Indiana University in Bloomington and is externship coordinator for the speech-language pathology graduate program. She is an affiliate of ASHA Special Interest Group 9, Hearing and Hearing Disorders in Childhood; 11, Administration and Supervision; and 16, School-Based Issues. awpiper@indiana.edu×
  • Rita Patel, PhD, CCC-SLP, is an assistant professor in Indiana University’s Department of Speech and Hearing Sciences. She is the coordinator of ASHA Special Interest Group 3, Voice and Voice Disorders. patelrir@indiana.edu
    Rita Patel, PhD, CCC-SLP, is an assistant professor in Indiana University’s Department of Speech and Hearing Sciences. She is the coordinator of ASHA Special Interest Group 3, Voice and Voice Disorders. patelrir@indiana.edu×
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / School-Based Settings / School Matters
School Matters   |   February 01, 2016
Can Students Qualify for Voice Treatment?
The ASHA Leader, February 2016, Vol. 21, 32-33. doi:10.1044/leader.SCM.21022016.32
The ASHA Leader, February 2016, Vol. 21, 32-33. doi:10.1044/leader.SCM.21022016.32
A person’s voice is unique, just like fingerprints. So problems with the voice can make people—especially children—highly self-conscious. A voice disorder occurs when the pitch, loudness or quality of the voice become abnormal or inappropriate, resulting in a voice that draws attention.
Many triggers can cause an abnormal voice quality, also known as dysphonia or hoarseness, including anatomical, physiological or psychological issues. In the United States, experts estimate more than 1 million children have been diagnosed with dysphonia.
If asked whether a child with a voice disorder qualifies for school services, many educators and school-based speech-language pathologists believe that a child qualifies only if a communication disorder negatively affects the child’s academics. However, regulations actually use the term “educational performance.” In 2007, ASHA sought clarification on the eligibility criteria from the U.S. Department of Education.
The response from the Office of Special Education Programs (OSEP) states that “educational performance is not limited to academic performance.” OSEP encourages professionals to determine a child’s eligibility for services on a case-by-case basis and to use a variety of assessment tools to gather information regarding functional and developmental performance—as well as academic achievement.
Academic impact
Given these guidelines, children with voice disorders can receive services in the schools. Whether it results in a child being too loud, not loud enough or having an unusual vocal quality, a voice disorder likely draws negative attention from teachers and peers. Difficulty being heard in and out of the classroom—particularly in classes such as musical education and physical education—may lead to the child’s withdrawal from activities and to the development of a negative self-image.

Whether it results in a child being too loud, not loud enough or having an unusual vocal quality, a voice disorder likely draws negative attention.

A child with a voice disorder may attempt to conceal his or her differences, affecting interaction with teachers and classmates. With limited classroom participation, the student experiences fewer chances to practice academic skills or receive feedback.
Over time, the additive effect of fewer opportunities may have a negative impact on the child’s education. The child’s quality of oral presentations, oral reading and involvement in class discussion might also decline. Dysphonia might hinder children both psychologically and academically. So early identification and restoration of optimal vocal health is critical.
Steps for services
If a parent, teacher or SLP has concerns about vocal quality, the SLP can refer the child to a laryngologist for a full examination. Following medical evaluation and demonstrated school-related distress, a student qualifies for school-based voice treatment. When treating a voice disorder, SLPs work on modifying the voice through techniques like resonant voice therapy, vocal function exercises and abdominal breathing. The SLP determines the amount of treatment and model for intervention based on individual needs.
If school systems pose obstacles to such services, SLPs can overcome them. An SLP can remedy the misconception that academic performance remains the sole qualifier by more clearly defining educational performance for parents, teachers and administrators. Voice treatment isn’t just a medical issue—it can impair a child’s school experience and self-esteem.
School-based SLPs can build their expertise in recognizing and treating voice disorders through professional development. They can collaborate with other SLPs, as well as laryngologists, music teachers, physical education teachers or drama teachers to develop prevention programs that teach children and other faculty good vocal hygiene and habits.
It’s worth the effort for school-based SLPs to learn IDEA guidelines and work with the administration to help these students qualify for services and better access the curriculum.
Sources
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Coyle, S. M., Weinrich, B. D., & Stemple, J. C. (2001). Shifts in relative prevalence of laryngeal pathology in a treatment-seeking population. Journal of Voice, 15(3), 424–440. [Article] [PubMed]
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February 2016
Volume 21, Issue 2