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Voice is most closely related to the emotional tone of communication. Several other occupations also require a sustained voice because they require sustained speech. Unfortunately, the occupations that depend on a pleasant and capable voice also are the ones that pose the greatest threat to a healthy voice. These physical problems can get worse if the voice problem is not treated. Voice disorders are more common in people who hold such occupations, compared to those in other occupations. Many voice disorders may be just unpleasant to the listeners, but the person who has a voice problem usually has to contend with many kinds of personal, social, and often medical complications. Voice is a complex phenomenon made possible by a highly sophisticated and extremely sensitive structure called the phonatory mechanism, the main structure of which is the larynx that includes the vocal folds. With a few exceptions, voice disorders do not necessarily create communication barriers of the kind experienced by a person with extremely limited language skills. The estimates of the number of children who exhibit voice problems varies from 3% to 10%. An early response a newborn baby learns is to recognize the mother's voice, perhaps because of this vocal individuality. Most children who are treated for voice disorders have a hoarse voice due to vocal abuse. The voice can hide messages or give message that are different from the ones conveyed by the words. The vocal folds vibrate and approximate to produce sound. In a survey study, speech-language pathologists in schools reported that 2% to 4% of children on their caseload had voice problems. Another survey of older individuals found voice disorders in 29% of them, suggesting a higher prevalence of voice problems in older people. Anyone who needs to speak or sing for relatively long periods needs to sustain his or her voice. Voice can reveal whether someone is angry or happy, so the speaker does not have to say it. Physical problems such as vocal nodules and the resulting voice problems create a vicious circle. Several voice disorders have associated physical problems. Nonetheless, a voice problem is no less handicapping to the person who has it. Adults can recognize a person by just listening to his or her voice. Voice helps communicate more than what the words say. In many occupational situations, employees with unpleasant voices may not last long. A speaker's voice may be judged pleasant or unpleasant. Voice also is unique, so voice marks a speaker's individuality. For the same reason, listeners also are attuned to the emotional message hinted at by the voice. Generally, voice disorders are more common among women than men.
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