The psychosomatic aspects of children with vocal nodules

Psychological and emotional aspects of voice disorders have long received attention from otolaryngologits and speech clinicians. The literature contains frequent reports of such problems, but there are few studies on the full importance of these aspects. The cause of vocal nodules in children has been attributed to vocal abuse, and therapy has consisted of the elimination of this abuse. Reports of long-term follow-up are few, lending suspicion to both the proposed causes and the therapeutic approaches. Seventy-seven prepuberal children with vocal nodules are studies from the social, medical, and physical aspects. The incidence of vocal nodules approaches 1% of all children. Boys predominate this amount by ratios greater than 3:1, with incidence peaks between ages 5 and 10. Conventional modes of therapy have been unsuccessful because of the lack of recognition of psychosomatic factors. New approaches for therapy are suggested including parental involvement, counseling, group therapy, and drug therapy. Though emotional problems may persist, the somatic aspect of this disease disappears at puberty.