Purpose: The aim of this study was to investigate children's processing of dysphonic speech in a realistic classroom setting, under the influence of added classroom noise. Method: Typically developing 6-year-old primary school children performed two listening tasks in their regular classrooms--a phoneme discrimination task to assess speech perception and a sentence-picture matching task to assess listening comprehension. Speech stimuli were played back in either a typical or an impaired voice quality. Children performed the tasks in the presence of induced classroom noise at signal-to-noise ratios between +2 and +9 dB. Results: Children's performance in the phoneme discrimination task decreased significantly when the speaker's voice was impaired. The effect of voice quality on sentence-picture matching depended on task demands: Easy sentences were processed more accurately in the impaired-voice condition than in the typical-voice condition. Signal-to-noise ratio effects are discussed in light of methodological constraints. Conclusions: Listening to a dysphonic teacher in a noisy classroom may impede children's perception of speech, particularly when phonological discrimination is needed to disambiguate the speech input. Future research regarding the interaction of voice quality and task demands is necessary.