Objective
Speech-Language Pathologists infrequently assess pediatric performers. Many performers may already have an established voice teacher or vocal coach when they seek medical care. This study examines assessment and management of a large group of singers vs. non-singers.
Methods/Design
This retrospective study examines the 10 most effective therapy probes used among 100 pediatric singers and 100 pediatric non-singers who were referred to Voice Clinic with voice complaint.
Results
The most common and effective therapy exercises were examined across the two groups of pediatric patients. Groups were similar for incidence of previous voice therapy, but non-singers were significantly more likely to have had speech/language therapy. Most singers (78%) had a voice teacher or vocal coach. Athletic involvement was similar amongst both groups. Age for singer subjects was significantly older than non-singer subjects (singer mean age 15 years, non-singer mean age 9 years).
While therapy probes addressing posture, breath management, vocal glides, resonant voice, semi-occluded vocal tract exercises, tonal placement and tension management strategies were present in both groups, there was a difference in the hierarchy of most beneficial probes to reduce dysphonia complaints. Further, there were differences between groups for further management and therapy needs.

Conclusions
Management of dysphonia in pediatric singers focused on posture, breath support, and use of semi-occluded vocal tract exercises to allow for reduced strain and tension at the level of the larynx as well as increased use of a forward tonal placement for vocal positioning. While dysphonia was the chief complaint, most of the singers did not have a complaint of hoarseness but rather tension and an inability to reach their normal vocal range. Frequency of voice use is also a determinant in service provision. In contrast, management of dysphonia in non-singers focused on resonant voice, tonal placement, and breath support with hoarseness as the most common factor. Both are managed in conjunction with medical recommendations from the laryngologist. Coordination of care with the voice teacher/coach was common as part of management plan for singers. Coordination of care with the local Speech-Language Pathologist was common for management plan for non-singers.