Prospective Study of Voice Therapy in Children: A Pilot Study

Inclusion Criteria: * Diagnosis of vocal fold nodules. * Age 4-11 yr. * Informed Consent. * English comprehension and production sufficient to participate in the protocol and in voice therapy. * Considered behaviorally and cognitively appropriate by the ear, nose, and throat physician and speech-language pathologist for voice therapy. * Parent and child willingness to participate in all aspects of the protocol and voice therapy. Exclusion Criteria: * Co-morbid medical conditions or medications that would mask or amplify the outcome of voice therapy, including (a) developmental or other neuromuscular conditions, (b) major illness, chronic or acute, with the exception of laryngopharyngeal reflux disease (LPR) or allergies and their treatments, which are common in both children and adults with voice disorders, thus their exclusion would severely restrict the participant pool and, moreover, threaten external validity. * Hearing loss: \> 20 dB hearing loss at 1000, 2000, 4000 Hz in at least one ear.