Paradoxical vocal fold motion in children and adolescents

Paradoxical vocal fold motion (PVFM) is a complex adductory disorder of the vocal folds that frequently is mistaken for asthma. PVFM typically requires behavioral intervention by a trained speech-language pathologist for complete resolution of the symptoms. Once thought to be limited to adults, PVFM has been increasingly documented and successfully treated in the child and adolescent population. Understanding PVFM requires thorough knowledge of the differential diagnoses, the clinical features of PVFM, the differentiation of PVFM from asthma, the medical professionals involved in the diagnosis and treatment, and the behavioral interventions that are commonly prescribed. Teachers, school nurses, and coaches may be the first professionals to see the symptoms in children and assume that they have asthma. Successful referral, diagnosis, and behavioral treatment requires a team of individuals in the child's community, including the school speech-language pathologist, who can work together to ensure identification and resolution of the symptoms. This article discusses etiologies, differential diagnosis, referral, medical management, evaluation, and behavioral treatment of the child or adolescent with PVFM.