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Updated: May 16, 2026

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
Severity of voice disorders in children: correlations between perceptual and acoustic data
Leonardo Wanderley Lopes1, Ivonaldo Leidson Barbosa Lima, Larissa Nadjara Alves Almeida
1Department of Speech and Language Pathology, Universidade Federal da Paraíba, João Pessoa, Brazil. lwlopes@hotmail.com
Objectives:
The aims of this study were to verify whether there is correlation between perceptual and acoustic data and to verify which measures are useful to identify the severity of voice deviation in children.
Methods:
The participants were 71 children aged 3-9 years. The severity of voice deviation, roughness, breathiness, strain, and instability was evaluated by three speech therapists, experts on perceptual voice evaluation. A visual analog scale was used; speech material consisted of a sustained vowel sound /ε/ and the counting of numbers from one to 10. The means and standard deviations of fundamental frequency (F(0)), jitter, shimmer, and glottal-to-noise excitation (GNE) ratio were extracted from the sustained vowel, and the mean and variability of F(0) were extracted from automatic speech (counting). Perceptual and acoustic data were correlated.
Results:
Most children had mild voice deviation, with strain, instability, and breathiness as predominant voice qualities. F(0) measures correlate with strain to phonate. Shimmer and GNE correlate with general degree of voice deviation and with the roughness, breathiness, and instability parameters. GNE and F(0) mean in connected speech were the only measures that distinguished voices regarding severity of voice deviation.
Conclusions:
There was a correlation between perceptual and acoustic measures from these children's voices. Children with high-pitched voices had higher voice deviations. GNE is a measure that reliably distinguishes the severity of voice deviation and may be useful in the screening and evaluation of children's voices.
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