Voice, Resonance, and Swallowing Center Tests and Treatments

We offer various tests and treatments to diagnose and treat children with voice, resonance, or swallowing conditions.

Your child's care team at UPMC Children's Hospital of Pittsburgh will outline each test and treatment in detail. We're also here for you to answer any questions you may have.

Contact the Voice, Resonance, and Swallowing Center

Most kids visit our center after their doctors refer them to us.

Your doctor can refer your child to us for diagnosis, a second opinion, or treatment. Or you can call us to learn more about our services and book your child's appointment.

To refer a child or make your child's appointment, call 412-692-5460.

Voice and Swallowing Tests

Your child's doctor and speech therapist will use the safest and best tests to diagnose their condition.

Acoustic voice analysis

For this test, the speech pathologist engages your child in conversation and asks them to repeat sounds.

A computer assesses your child's voice:

  • Pitch
  • Loudness
  • Range

This test also shows how the voice quality changes with certain consonant or vowel sounds.

Clinical feeding assessment

Dynamic x-ray studies (fluoroscopy)

A dynamic x-ray takes a steady series of images, which shows movement inside the body.

It differs from normal x-rays, which only take one image at a time and use more radiation per image.

Your child's team may order this test to see how the bony palate closes against the throat during speech.

Functional endoscopic evaluation of swallowing (FEES)

During a FEES test, the doctor:

  • Passes a flexible scope with a video camera on it to the back of the throat.
  • Asks your child to swallow various textures and amounts of food.
  • May also ask your child to move the head and neck in different positions when swallowing.

By seeing how your child swallows in real-time, the doctor can learn what foods are safe to swallow.

They can also tell you the best positions that improve your child's swallowing.

High-speed kymography

Laryngeal electromyography

This test measures nerve signals in the vocal cords.

Your child's doctor may use it to diagnose speech problems due to nerve damage.

Modified barium swallows

Barium is a liquid that passes through the body and shows up well on x-rays. The body doesn't absorb it.

For this test, your child consumes barium mixed with a food or drink they like. An X-ray takes pictures as your child swallows.

The test lets doctors and speech therapists see swallowing issues that FEES may not show.

Nasal endoscopy

A nasal endoscope has a camera that allows doctors to see the nasal cavity, throat, and voice box.

The scope is wide enough that a doctor can pass very small surgical tools through it.

Your child's doctor may use this test to take a sample of a lesion (biopsy).

Videostroboscopy of the larynx

In this test, the doctor passes a thin, flexible scope down your child's nasal passage. The scope has a video camera and light on it.

It takes pictures of the vocal cords as your child speaks and can show:

  • Lesions, growths, or scar tissue.
  • Swelling or damage to the vocal cords
  • Issues with vocal cord movement.

Treatments for Voice and Swallowing Problems

Your child's care team will suggest one or more treatments for their vocal or swallowing disorder.

BOTOX® shots

Doctors have used BOTOX for decades to treat voice and swallowing conditions.

Your child's doctor may inject BOTOX to stop involuntary spasms of the vocal muscles. Or if your child has too much saliva, the doctor may give them a shot in the salivary glands.

Laryngeal framework surgery

A structure of cartilage and muscles support the vocal cords.

In this surgery, the doctor repositions part of this structure or adds an implant, to better support the vocal cords.

Laryngeal reconstruction

Lesions, infections, and other health issues can damage muscles in your child's voice box, or larynx.

With this treatment, your child's surgeon will reconstruct the damaged part of the larynx.

Medicines for voice disorders

Medicines can improve some voice problems, such as hoarseness. These include drugs that reduce swelling or treat acid reflux.

In most cases, your child will take it by mouth until the problem resolves.


These advanced surgeries involve tiny surgical tools that doctors can pass down the throat to avoid external incisions.

Doctors use microsurgery to remove lesions and inject a filler in a vocal cord that's too thin (due to vocal cord paralysis).

Pharyngeal flap and other soft palate surgeries

These treatments stop air from getting into the nose during speech.

The surgeon will remove or reposition tissue in the back of the throat to improve your child's voice.

Vocal hygiene therapy

Your speech therapist will teach your child vocal hygiene practices and how to use them in everyday life.

To improve voice hygiene, your child should avoid:

  • Shouting
  • Whispering
  • Throat clearing
  • Irritants

Voice therapy

The speech therapist will teach your child:

  • Techniques to speak without straining the vocal cords.
  • Breathing exercises to relax the vocal cords.

Your child will have one or many sessions of voice therapy, depending on their diagnosis and needs.