Evil's raspy voice might be from: Vocal nodules
http://www.britishvoiceassociation.org. ... odules.htm
When a child develops a hoarse/husky voice it is usually associated with inflammation of the vocal folds from an infection (laryngitis) and the voice is back to normal within two weeks. If your child's voice does not return to normal after two weeks you need to consult your GP for advice... Sometimes inflammation of the vocal folds (laryngitis) can develop as a result of allergies or occasionally, from asthma inhalers, especially when they are not properly administered. Along with nodules, children can also develop cysts in their vocal folds or a small scar (known as a sulcus)... Children can be born with or develop a paralysed vocal fold for example, and even more rarely the human papilloma virus can cause warty growths to develop on the vocal folds. Finally, although it must be stressed that it is extremely rare, vocal fold cancer in a child has been reported... Some children are born with obvious voice problems. Their cries at birth and during babyhood are not normal and they are therefore usually diagnosed early as the problem is easy to spot. Perhaps the most common problem with this sort of history would be paralysed vocal fold or some other developmental vocal fold abnormality... The more serious problems, such as papilloma, start with a mild but unvarying hoarseness which becomes steadily worse with time. The child is likely to develop difficulties breathing, becoming short of breath or breathing noisily as the papilloma begins to reduce the available space in the airway. These symptoms should be reported to your doctor and investigated immediately.
Vocal nodules develop as the result of trauma to the vocal folds. When the vocal folds collide violently swelling can develop around the site of the collision. A single episode of trauma, such as shouting, usually recovers over several days of voice rest, but unfortunately, these episodes are often repeated so the swelling becomes more persistent and requires treatment. These swellings are often described as "soft nodules". If soft nodules are ignored and allowed to progress, the persistent damage may begin to produce fibrous scar tissue. This makes the affected area stiffer and therefore less able to vibrate effectively. When this happens we refer to them as "hard nodules". They are more difficult to treat as they do not resolve with voice therapy and may require surgery to restore the voice... Sometimes vocal nodules in children do become hard and fibrous and voice therapy is unable to resolve the voice problem fully. Adults with hard nodules may be offered surgery; however, many surgeons prefer not to offer surgery to children until they have reached adolescence. The reason for this is partly to do with the layered structure of the vocal fold, which develops during childhood but is not fully mature until approx 10 years old.
https://en.m.wikipedia.org/wiki/Vocal_fold_nodule
Vocal fold nodules are thought to be the result of vocal fold tissue trauma caused by excessive mechanical stress... Vocal overuse (speaking for long periods), abuse (yelling), or misuse (hyperfunction) may produce excessive amounts of mechanical stress by increasing the rate and/or force with which the vocal folds collide. This may lead to trauma that is focalized to the mid-membranous vocal fold and subsequent wound formation. Repeated or chronic mechanical stress is thought to lead to the remodeling of the superficial layer of the lamina propria. It is this process of tissue remodeling that results in the formation of benign lesions of the vocal folds such as nodules... The presence of dehydration, respiratory infection, and inflammatory factors may also act as predisposing or aggravating factors. Inflammatory factors may include allergies, tobacco and alcohol use, laryngopharyngeal reflux, and other environmental influences.
Behaviours such as frequent throat clearing, shouting, speaking over background noise, and hard crying are associated with an increased risk of developing nodules and other vocal pathologies... Behavioural voice therapy with a speech-language pathologist is recommended...
https://www.speech-language-therapy.com ... Itemid=117
Some children are more vulnerable to developing vocal nodules and vocal strain than others. Children who are more at risk may have one or more of the following:
a family with loud voice habits such as yelling around the house and calling from room to room in constant background noise. Some children with vocal problems have developed habitually loud voices simply in order to “get the message across” in a constantly loud household.
chronic asthma and/or allergies (including post nasal drip and allergic rhinitis); and incorrect use of some puffers (i.e., no spacer and/or drink of water when they are recommended)
recurrent and frequent upper respiratory tract infections including infected tonsils, sinuses, adenoids and throat
gastric reflux
affective disorders such as attention deficit disorder and hyperactivity, or a “temperamental personality”
behaviour problems
excessive stress or tension in the child’s life, due to internal factors (within the child), external factors (within the environment) or interpersonal factors (e.g., conflict or competition)
a loud, outgoing, enthusiastic, competitive personality with a tendency to “act out” emotionally (their parents can often remember them as terrible “terrible two’s” who tantrumed loud and long and who could whinge endlessly). Some babies just seem to be born loud and lovable, and grow into loud and lovable toddlers and children, some of whom are, unfortunately, 'at risk' for voice problems.
