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Speech Question- high pitched voice (x-posted from Childhood Years)

post #1 of 9
Thread Starter 
My oldest is almost 7. He started speech therapy for articulation when he was 3 and did it until almost 5. His articulation went from no one but me being able to understand him to incredible. He has a high pitched voice though and always has. It's the sweetest little voice though. If I remember correctly, it's prosody. When he was in kindergarten, they did a speech evaluation for all the kids and this was brought up along with his fluency because he had a lot of "um" and "un" fillers. We didn't want to do an IDP through the school, so we took him back to his speech therapist. He's been going every week for a year now. He was re-evaluated by her last month and met all of his goals for fluency, but the pitch isn't any better.

Per her and the pediatrician's suggestion, he's gone to a pediatric neurologist (he had some other things going on and they wanted to rule out cerebral palsy or some other thing like that because he stopped breathing right after birth) and she said it was idiopathic, no good reason. We went to an ear, nose and throat specialist and he went in with a scope to see if there were any cysts or anything on the vocal chords. There weren't. That doctor said we really want to help him get his pitch lower because he's stressing out his vocal chords. When he talks, you see all the little tendons in his neck stick out and his voice gets kind of raspy sometimes because of it.

The speech therapist has figured out a couple things. One, he doesn't breathe well when he speaks. It's as if he takes a giant breath and tries to get it all out. Two, when he's laying on his back, his pitch is great. He told her that maybe he could have a scooter to lay on to go through his day. She told him maybe we'd better find some ways for him to find that voice when he's standing up.

I feel like we're kind of at a loss here. It's a once a week appointment that costs us $80 a month. If we need to do it and he's improving, it's totally worth it though. It's just with the other issues, we were seeing some improvement and then he reached his goals and things were fine.

Is anyone aware of anything we can do at home to help him with the pitch? I love his speech therapist. She's great with him and we have a good relationship since he has seen her for half of his life. She told me when we started the second time though that she has lots of experience with the fluency but not with the pitch, but said she'd do some research on what to work on with him. She's kind of baffled right now too. There isn't anyone else in the area that has more experience than her and I really like her anyway. If there is something I can do at home to help out though, I'd like to do that. It may lessen how long we need to go. Thanks!
post #2 of 9
Thread Starter 
Bump. Just hoping someone has some advice. Thank you.
post #3 of 9
A good textbook I had from school is called Manual of Voice Treatment: Pediatrics through Geriatrics. It goes through different treatments for various voice disorders.

It sounds like your SLP is a good one. Just because she's new to this disorder doesn't mean the won't be helpful. I think it's great that she was honest with you about needing to do research on treatments. A fellow master's student had a voice disorder client during her on campus clinic, and she managed to help me significantly by the end of the semester, despite it being her first voice client.

If finances are an issue, can you talk to her about reducing the rate and maybe publishing/presenting the therapy sessions as a case study for other SLPs in her area/state?
post #4 of 9
How about someone trained in music? It's a pitch issue, right? So maybe regular old voice lessons can help? If he likes music at all, you can even tell him this will be good for singing too, and pursue it as long as you both like just for the fun aspect of it. I know I'd LOVE to have that kind of thing, and I talk fine!
post #5 of 9
Have you taken him to see a craniosacral oesteopath? As you mentioned he doesn't breath when he speaks, I wonder if he is a "mouth breather", this is often structural and can be helped with cranial manipulation. It sounds like he has some birth trauma [he had some other things going on and they wanted to rule out cerebral palsy or some other thing like that because he stopped breathing right after birth].
post #6 of 9
My first thought is that in addition to whatever else you do diaphragm breathing exercises could help. Since he pitches his voice lower when he lays on his back that makes me think he has better breath control when laying down and many people breathe from the diaphragm when laying on their backs. So it could be that diaphragm breathing = better speech/breathing balance for him.

I'd try things like having him put his hands on his belly and try to feel it expand while sucking in air as though through a straw. Google about breathing exercises for singers and musicians for more ideas.
post #7 of 9
Thread Starter 
Quote:
Originally Posted by uccomama View Post
Have you taken him to see a craniosacral oesteopath? As you mentioned he doesn't breath when he speaks, I wonder if he is a "mouth breather", this is often structural and can be helped with cranial manipulation. It sounds like he has some birth trauma [he had some other things going on and they wanted to rule out cerebral palsy or some other thing like that because he stopped breathing right after birth].
After I post this, I'm going to look up what a craniosacral oesteopath is. Thanks! I was induced at 41 weeks. My doctor did a non-stress test a couple times during the week between 40 and 41. The first one was fine so he didn't want to do anything, but the second test indicated that he was getting stressed. My doctor induced at 41 weeks exactly. He (my doctor...no longer) was in a hurry so had the nurse turn the pitocin up fairly high. The contractions were coming too fast, so she turned it down and said she was going to go up more gradually. Next time he came in to check me, he noticed the pitocin wasn't where he wanted it and told her to turn it back up where it was. So instead of gradually increasing, it went from fairly low to high immediately. I wasn't progressing very well and later developed a fever. He wasn't born for a little over 6 hours after the fever started and was extracted with a vacuum. I held him and my husband went out to let everyone know it was a boy. I was exhausted from the almost 18 hours there and held him and closed my eyes. The nurse was next to me putting things away and noticed he wasn't breathing. She called a code something and then a whole team was there to get him breathing again. He had to stay in the nursery for observation our entire time in the hospital but never had any other problems.

When he walked, he often walked on his toes. I would tell him to put his feet flat and he would. Finally when he was three, he said "Mommy, do you know why I walk like that?" I told him no and he said it's because it doesn't hurt then. I took him to the pediatrician and she said he was really tight. We did physical therapy for a couple years, a few sets of serial casting, and home exercises. The casting would help in the short term, but soon after they were off, he was right back where he started. We were referred to a neurologist to rule out cerebral palsy because of the tight heel cords as well as the speech issues. The neurologist said it was idiopathic and just the way he is. We did the ENT and he also found nothing. We finally went to the pediatric orthopedic doctor and we've got the incline box to gain some stretch and some AFO's that he wears at night to maintain the stretch. Everyone says that both things are just the way he is, but unrelated to each other.

I really like his speech therapist and I do appreciate her honesty. But I also would like to start seeing some improvement if we're going to pay for therapy weekly and take an hour and a half of our time to go there. I'll also google the breathing exercises for some tips.

Thanks everyone.
post #8 of 9
I'm an SLP and had a random thought...when he is lying on his back and is using proper pitch, does he do this just for the SLP, or for you at home as well?
It sounds like he is pretty self aware of the "desired" pitch if he could talk with her about the difference and talked about wanting to lay on a scooter all day to use it.
If he can lay on his back at home and use it, perhaps you can start there...work on talking with good pitch on his back flat, and then have him lay on a pillow or something to slightly increase the incline, but still have him mostly lying down. Then if he can still replicate the good pitch, continue to increase the incline bit by bit with pillows or towels or something, as long as he continues to use/find the good pitch. Stop when he begins to have difficulty and go back to the most recent level at which he had success.

*In my very limited opinion (since I haven't actually seen him) it sounds like you guys think there is an issue with the level of tension in his vocal output. If you could at least provide lots of opportunity to practice speech at an appropriate level of vocal tension, it seems like that should help.

BTW, you should feel free to be honest with your SLP about the $ thing. Has she given you good advice for what you should be doing at home? Ask her if you can decrease visits and instead work on a home program.

Good luck!
** He sounds like a sweet kiddo!!
post #9 of 9
Thread Starter 
Quote:
Originally Posted by lovetobemama View Post
I'm an SLP and had a random thought...when he is lying on his back and is using proper pitch, does he do this just for the SLP, or for you at home as well?
It sounds like he is pretty self aware of the "desired" pitch if he could talk with her about the difference and talked about wanting to lay on a scooter all day to use it.
Thank you for responding. Yes, he is aware of his pitch. I'm able to tap my throat with my fingers and it's like a sign for him to lower the pitch. I feel bad to do that ALL the time though. Plus, he is very particular about things being done/said in the correct order, so if he needs to stop to think about his pitch and lower it, he won't resume his story at the same place. He'll say he has to start all over again and it's usually a whole lot of information he's telling again. I get concerned about correcting it too much during his normal speaking too because he's starting to say "Then I just won't talk at all." That's not what I want at all. I know he knows that too, I think he just gets frustrated. Which, to be honest, if lots of times when I said something, someone pointed out the way I said it, I would get pretty aggravated too.

Quote:
Originally Posted by lovetobemama View Post
If he can lay on his back at home and use it, perhaps you can start there...work on talking with good pitch on his back flat, and then have him lay on a pillow or something to slightly increase the incline, but still have him mostly lying down. Then if he can still replicate the good pitch, continue to increase the incline bit by bit with pillows or towels or something, as long as he continues to use/find the good pitch. Stop when he begins to have difficulty and go back to the most recent level at which he had success.
This is a really good idea and one I'll definitely try.

Quote:
Originally Posted by lovetobemama View Post
BTW, you should feel free to be honest with your SLP about the $ thing. Has she given you good advice for what you should be doing at home? Ask her if you can decrease visits and instead work on a home program.
We see her again tomorrow and I'll ask her about this. I also emailed the school speech therapist to see if she has any thoughts.

Quote:
Originally Posted by lovetobemama View Post
** He sounds like a sweet kiddo!!
Thanks! He definitely is a sweet one. And his voice is actually incredibly sweet too, pitch and all. Almost everyone that hears him speak comments on what a sweet voice he has. His kindergarten teacher said it's not a huge deal now, but she's concerned if it doesn't change as he gets into second or third grade, that he may be teased. Our main concern is what the ENT said- about not wanting him to strain his vocal cords. Thanks again for your thoughts.
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