Q: My preschool client uses a whisper instead of a “real voice” when he talks. We are using PECS with him, and he can build sentences up to 5 words. Do you have suggestions for developing his voice?

First, he needs to be seen by a physician – an ENT – to determine if there is a medical reason for his lack of voice: nodules, polyps, paralysis, malformation, etc.. You need this so you know what you are working with.

Assuming that there is no medial reason, I would take the focus away from speech for communication purposes, and focus instead on playing with the voice for fun. Teach him to play with his voice in many ways: sing, shout, growl, laugh, giggle, intone, pretend to be various animals, play with pitch, and so forth. Teach your client to play with his voice so he has more control of it and he produces more of it. Then teach him to use these voices on words. Teach him to be dramatic. I would use the following toys and tools:

• Kazoo: Use a kazoo to build vocal production. The kazoo can only be played when voice is “on”. Use it to make voice, sing songs, count to ten, etc..
• Sound-activated toys: Use toys that move in response to voice. This will encourage him to make voice for some other purpose than communication.
• Natural amplifiers: Use bowl, boxes, stairwells, closets, and cabinets. Kids love to make sounds into these echo chambers.
• Tubes, funnels, megaphones, toy telephones: Use these toys and tools to make a wide variety of sounds. These are great toys to use in groups. The kids can talk to one another with them.
• Echo Microphone: A great toy for sound exploration. Kids make voice into the chamber and it echoes back to them.

My book Becoming Verbal With Childhood Apraxia has a lot about this.