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Pediatrician approach to dysphonia
Mirabelle Sajisevi1, Seth Cohen1, Eileen Raynor1
1Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
Insights
Pediatricians face challenges assessing pediatric voice disorders, with many not routinely screening for dysphonia. They are interested in more training to improve patient care and quality of life.
Area of Science:
- Pediatric Medicine
- Otolaryngology
- Speech-Language Pathology
Background:
- Voice disorders affect up to 23.4% of children, impacting their quality of life.
- Pediatricians play a crucial role in identifying and managing these conditions.
Purpose of the Study:
- To investigate how pediatricians assess and manage pediatric voice disorders.
- To identify barriers faced by pediatricians in evaluating patients with dysphonia.
Main Methods:
- A cross-sectional survey was distributed to pediatricians affiliated with the North Carolina Pediatric Society and Duke University.
- The questionnaire assessed comfort levels, assessment frequency, barriers, referral reasons, and treatments for pediatric voice problems.
Main Results:
- Only 16.7% of responding pediatricians routinely assess for voice problems.
- Common barriers include lack of patient/parent concern and uncertainty about assessment/treatment.
- Referrals are typically made for unintelligible speech or concurrent neurological symptoms; allergy/reflux medications are often trialed first.
Conclusions:
- Pediatricians encounter significant barriers in assessing pediatric voice disorders.
- There is a strong interest among pediatricians in receiving more information and training on dysphonia.
- Enhanced outreach from otolaryngologists is needed to improve pediatrician screening and management of pediatric voice disorders.
Objective:
The prevalence of voice disorders reaches up to 23.4% in the pediatric population and has a negative impact on quality of life. The objective of this study is to examine how pediatricians assess and manage patients with voice disorders and barriers they face when evaluating patients with dysphonia.
Subjects And Methods:
The study was designed as a cross-sectional survey. Pediatricians who are members of the North Carolina Pediatric Society or Duke University affiliated physicians were selected to participate in the study. They were emailed a description of the study with a link to a questionnaire regarding comfort level in recognizing an abnormal voice, how often they assess for dysphonia, barriers to evaluation of voice problems, reasons for referral, and common treatments employed.
Results:
A total of 1125 physicians were sent a questionnaire and 72 replied for a response rate of 6.4%. Of those who responded, only 16.7% routinely assess patients for voice problems. The most common reasons for not assessing patients for dysphonia include patients not complaining of voice problems or parents not concerned, and being unsure of the best method or available treatment options. Referrals were most commonly made when speech could not be understood or when the voice problem coincided with other neurological symptoms. Allergy and reflux medications were often trialed prior to referral. The majority of responders felt that voice problems impacted quality of life and 84.7% were interested in more information regarding pediatric voice problems.
Conclusion:
Pediatricians encounter barriers in the assessment of voice problems in their patients. There is evidence from our study that they have interest in learning more about dysphonia. Otolaryngologists must continue to provide outreach to pediatricians to enhance the screening and management of patients with voice disorders.
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