Dysphonia in Preschool-Aged Children: Efficacy of Voice Therapy
Anne F Hseu1, Stacy Jo2, Roseanne Clark2
1Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115; Department of Otolaryngology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115.
Insights
Voice therapy effectively improves vocal quality in preschool children aged 2-5 years. This study shows significant reductions in both perceptual (CAPE-V) and functional (pVHI) measures of dysphonia severity.
Area of Science:
- Pediatric Otolaryngology
- Speech-Language Pathology
- Voice Science
Background:
- Pediatric dysphonia affects up to 38% of school-aged children.
- Existing research often focuses on older children (6-18 years), with less data on younger populations.
- Early intervention is crucial for managing childhood voice disorders.
Purpose of the Study:
- To evaluate the efficacy of voice therapy for preschool-aged children (2-5 years) with dysphonia.
- To assess changes in voice quality using standardized perceptual and functional measures.
- To identify factors influencing treatment outcomes in young children.
Main Methods:
- Retrospective review of 77 pediatric patients (ages 2-5) diagnosed with dysphonia.
- Data collected included demographics, clinical assessments (CAPE-V), and patient-reported outcomes (pVHI).
- Analysis of pre- and post-therapy scores to determine treatment effectiveness.
Main Results:
- Voice therapy led to a 36.4% decrease in Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) overall severity scores.
- Pediatric Voice Handicap Index (pVHI) scores decreased by 43.9%, indicating improved vocal function.
- Patients with vocal cord nodules showed significant improvement in CAPE-V ratings.
Conclusions:
- Voice therapy is an effective treatment for improving vocal quality in preschool-aged children.
- Early intervention with voice therapy can yield positive outcomes for young children with dysphonia.
- The findings support the use of voice therapy for even the youngest patients with voice concerns.
Introduction:
Pediatric dysphonia is common, with a prevalence as high as 38% in school-aged children. Previous studies have shown the benefits of therapy in treating pediatric dysphonia; however, much of the literature that discusses these benefits address older school-aged children (6-18 years) and not those who are younger. The objective of this study is to examine the efficacy of voice therapy for preschool-aged patients, between ages 2 and 5 years old.
Methods:
An IRB-approved retrospective review was conducted of pediatric patients (age range 2-5 years) seen at multi-disciplinary voice clinics within Boston Children's Hospital, Department of Otolaryngology, between January 2015 and March 2023. Data including dates of presentation, demographics, co-morbidities, presenting symptoms, number of therapy sessions, Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) ratings, and Pediatric Voice Handicap Index (pVHI) scores were collected and analyzed.
Results:
77 patients who were recommended voice therapy for dysphonia were reviewed. 51 (66.2%) were male and 26 (33.8%) were female. The mean age at first evaluation was 4.49 years old. Each patient underwent, on average, 5.29 sessions (SD = 2.16) and 1.87 months (SD = 2.79) of therapy. Patients experienced a 36.4% decrease in their CAPE-V Overall Severity score from pretherapy to post therapy. Patients diagnosed with vocal cord nodules experienced greater decrease in CAPE-V ratings than those with other etiologies for hoarseness (-18.18, P = 0.016). Age, schooling status, number of siblings, history of speech delay, and other medical co-morbidities had no significant effect on patients' overall CAPE-V ratings. pVHI parental rating of severity decreased 43.9% from pretherapy to post therapy. Total pVHI scores also decreased after treatment.
Conclusion:
Voice therapy in younger preschool age children can be efficacious and result in improved vocal quality.
