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Voice Program

Ear, Nose and Throat (Otolaryngology) | 202-476-2159

The Division of Otolaryngology (Ear, Nose, and Throat) and Division of Hearing and Speech coordinate the monthly Voice Program for evaluation and management of voice disorders in children. If your child has tension or swelling of the voice box, they may have a more complex condition that requires advanced care from our specialists in the Voice Program. 

In addition, we offer a monthly clinic specializing in paradoxical vocal fold mobility, a disorder of the vocal cords that can lead to trouble breathing, especially during activity. This is coordinated with Otolaryngology, Speech and Psychology in the neurosciences clinic space.   

How the Voice Program Helps

In the Voice Program our pediatric otolaryngologists and speech pathologists treat a wide variety of functional and structural voice conditions. The strength of the program is the close coordination between ENT and speech pathology, which allows children to receive a full evaluation and treatment recommendation during one office visit.

Once we diagnose and identify the reason for your child's voice problem, we can develop a treatment plan that addresses the cause as well as long-term management of the condition. We also monitor your child's progress at 6-month intervals.

During your child's clinic visit, we perform a full otolaryngologic examination including videolaryngoscopy with stroboscopy and complete voice evaluation — we see, hear and record what happens to the vocal cords when your child makes a sound.

Symptoms we treat:

  • Rough or hoarse voice quality
  • Noisy breathing, especially during exercise/activity
  • Vocal cord movement problems
  • Vocal cord paralysis
  • Voice changes related to heart conditions
  • Voice concerns related to other medical problems
  • Growths on vocal cords
  • Changes in singing or talking voice 
  • Tension disorders that affect voice, cough and swallow

Conditions commonly treated in the Voice Program include:

  • Voice and resonance disorders, such as vocal nodules and cysts
  • Difficulty in professional voice use including for actors and singers
  • Vocal cord paralysis that may cause a weak breathy voice and possible aspiration
  • Chronic cough not related to lung problem alone
  • Suspected laryngopharyngeal reflux (gastroesophageal reflux disease involving the upper and/or lower airway)
  • Suspected paradoxical vocal cord motion or vocal cord paralysis

Hoarseness (dysphonia) and vocal nodules are the most common problems we see in the clinic. Nodules, like a callus, can cause severe hoarseness and even complete loss of voice. Voice therapy to treat the problem and the cause involves conducting a vocal quality assessment, learning behaviors to avoid straining the voice (vocal abuse) and other habits to preserve your child's voice.

Contact Us

If you would like more information about the Voice Program, please call 202-476-2159 or email us.

Voice Program Team

  • Pamela Mudd

    Pamela Mudd
    Director, Pediatric Voice Program
    Otolaryngologist

  • Nancy Bauman

    Nancy Bauman
    Director, Aerodigestive Clinic
    Director, Vascular Anomalies Clinic
    Otolaryngologist

  • Lilia Mucka Andrew

    Lilia Mucka Andrew
    Director, Research in Anxiety Disorders Program
    Psychologist

  • Children's National Hospital

    Courtney Long
    Speech-Language Pathologist