Barriers to Voice Therapy in Dysphonic Children

Area of Science:

• Pediatric Otolaryngology
• Speech-Language Pathology
• Voice Disorders

Background:

• Pediatric dysphonia commonly stems from vocal fold nodules or muscle tension dysphonia.
• Voice therapy is the primary treatment, yet not all children receive it.
• Understanding factors influencing therapy uptake is crucial for improving pediatric voice care.

Purpose of the Study:

• To investigate demographic and parental perception differences between children who do and do not undergo voice therapy.
• To identify predictors of voice therapy participation in pediatric patients.

Main Methods:

• Retrospective review of pediatric patients (vocal fold nodules/muscle tension dysphonia) at a tertiary voice clinic (2014-2017).
• Comparison of patients who received voice therapy versus those who did not.
• Data collected included demographics, Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) scores, and pediatric Voice Handicap Index (pVHI) scores.

Main Results:

• 21% of 346 children received voice therapy within 2 years of diagnosis.
• Therapy recipients were older (9.1 vs 7.6 years) and lived closer to the clinic (15.5 vs 24.3 miles).
• Higher CAPE-V Overall Severity and Strain scores predicted therapy uptake; gender, insurance, and pVHI scores did not.

Conclusions:

• Older age, proximity to the clinic, and greater voice disorder severity increase the likelihood of pediatric voice therapy participation.
• Ease of access and perceived treatment necessity appear to be key factors in treatment decisions.
• These findings can inform strategies to enhance voice therapy access for children.