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Assessing the Coherence of Parents' Short Narratives Regarding their Child Using the Five-Minute Speech Sample Procedure

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Published on: September 19, 2019

Socioeconomic Status, Voice Disorder Risk, and Voice-Related Handicap Across Childhood.

Robert Brinton Fujiki^1,2, Susan L Thibeault²

¹Department of Otolaryngology-Head & Neck Surgery, Indiana University School of Medicine, Indianapolis.

JAMA Otolaryngology-- Head & Neck Surgery

|September 4, 2025

Summary

Children from lower socioeconomic status (SES) homes have a higher prevalence of voice disorders and experience greater voice-related handicap. This highlights a significant disparity in pediatric vocal health linked to economic background.

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Area of Science:

Pediatric Health
Speech and Hearing Sciences
Social Determinants of Health

Background:

Voice disorders and socioeconomic deprivation negatively impact children's quality of life.
The relationship between socioeconomic status (SES), voice disorder prevalence, and voice-related handicap in pediatric populations remains underexplored.

Purpose of the Study:

To investigate the association between SES and voice disorder prevalence in children and adolescents.
To examine the relationship between SES and voice-related handicap in pediatric populations.

Main Methods:

Cross-sectional study surveying 1656 US children (4-12 years, via proxy) and adolescents (13-17 years).
SES proxies included household income, parental education, race/ethnicity, and residence.
Voice disorder prevalence, Voice Handicap Index (VHI), and Pediatric Voice Handicap Index (P-VHI) were assessed.

Main Results:

Children from households earning <$30,000 annually were 82% more likely to report a voice disorder than those earning >$100,000.
Participants with voice disorders reported significantly higher VHI/P-VHI scores compared to those with healthy voices.
Lower SES was associated with worse VHI/P-VHI scores in both adolescents and children with voice disorders.

Conclusions:

Children and adolescents from lower-SES backgrounds exhibit higher voice disorder prevalence and greater voice-related handicap.
Findings underscore the impact of socioeconomic factors on pediatric vocal health.
Further research is needed to understand the underlying mechanisms and clarify the SES-voice disorder association.