The most common cause of hoarseness in children is related to colds or flu's causing inflammation of this area. This type of hoarseness typically resolves once the cold symptoms have resolved.

Another common cause of hoarseness in children are vocal cord nodules. These occur as a result of constant shouting, screaming, or singing. These nodules can be likened to calluses that form on the vocal cords from vigorous vocal usage. Once the otolaryngologist has confirmed the presence of these vocal nodules, the mainstay of therapy is through a speech therapist. The therapist will train the child to use vocalization techniques that will not strain the voice. On occasion, nodules do not respond to this conservative therapy and surgical intervention is required.

Less common causes of hoarseness include immobility of the vocal cord, polyps or cysts on the vocal cords, foreign bodies in the airway and tumors. A complete examination by the otolaryngologist will rule out these conditions