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Huang M, Yu L, Hu J, Ren J, Li Z, Pan Z, Yang H, Lu D. Adaptation and Validation of the Mandarin Chinese Version of the Pediatric Voice Handicap Index-10 (pVHI-10). J Voice 2024; 38:243.e31-243.e35. [PMID: 34470707 DOI: 10.1016/j.jvoice.2021.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/25/2021] [Accepted: 07/28/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The purpose of this study was to adapt and validate the Mandarin Chinese version of the pediatric Voice Handicap Index-10 (pVHI-10). METHODS A cross-sectional study was conducted from January 2018 to December 2019. A total of 422 parents completed the questionnaire, including 283 parents of children with voice disorders (dysphonic group) and 139 parents of children without voice disorders (control group). Internal consistency, test-retest reliability, clinical effectiveness, and cut-off value were evaluated. RESULTS In the dysphonic group, the internal consistency of the Mandarin Chinese version of pVHI-10 was excellent (Cronbach's α = 0.95). The test-retest reliability was excellent for the total score of the Mandarin Chinese version of pVHI-10 (interclass correlation coefficient = 0.916). The total scores as well as scores on individual items were significantly higher in the dyphonic group compared to those in the control group (P <0.001). In addition, the optimum cut-off value for the Mandarin Chinese version of pVHI-10 was 6.5 (87% sensitivity and 86.3% specificity, respectively). CONCLUSION The Mandarin Chinese version of the pVHI-10 is a valid tool that evaluates the quality of life of children with voice disorders from the parents' perspective.
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Affiliation(s)
- Mengjie Huang
- Department of Otolaryngology, Chengdu Women's and Children's Central Hospital,School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, P.R. China
| | - Lingyu Yu
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Juanjuan Hu
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Jia Ren
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Zhen Li
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Zhongjing Pan
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Hui Yang
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Dan Lu
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.
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Guimarães I, Almeida L, Quintal A, Batista AP, Teixeira A, Romeiro C, Ferreira DB, Fernandes IS, Saraiva M, Bom R, Almeida S, Freitas SV. Pediatric Voice Handicap Index (pVHI): Validation in European Portuguese Children. J Voice 2023; 37:804.e11-804.e19. [PMID: 34183214 DOI: 10.1016/j.jvoice.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To determine reliability and validity of the European Portuguese pVHI version (pVHI-EP). STUDY DESIGN Cross-sectional design. METHODS The pVHI-EP and the talkative and global voice assessment scales were administered to the caregivers of children aged from 3 to 16 years old with and without dysphonia. Reliability (internal consistency and test-retest) was analyzed. The validity analyses performed were: (1) content validity by analyzing the percentage of missing data; (2) construct validity with intraclass correlation coefficients among pVHI-EP domains and overall score; (3) concurrent validity was conducted between pVHI-EP, the caregivers' judgment of the child's voice severity on a visual analog scale and the Speech-Language Pathologist perceptual voice assessment; (4) known-groups validity between children with and without dysphonia, and (5) predictive validity by calculating receiver operating characteristics, sensitivity and specificity and determining cut-off points. RESULTS A total of 283 children (61.5% boys, mean age 8.3 years) participated in the study. The pVHI-EP showed an excellent internal consistency for the pVHI-EP total data. Strong to moderate test-retest reliability confirms pVHI-EP reproducibility. Excellent to good intraclass correlation coefficients between the pVHI-EP overall and the domains confirms its construct validity. Weak to moderate concurrent validity with visual analog scale and Speech-Language Pathologist perceptual voice assessment was confirmed. The pVHI-EP significantly distinguished two groups of different voice conditions. A cut-off point of 10.5 with 95.9% sensitivity and 92.5% specificity was determined for the overall score of the pVHI-EP. CONCLUSIONS The pVHI-EP is a reliable and valid caregiver voice outcome tool for EP children with dysphonia.
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Affiliation(s)
- Isabel Guimarães
- Speech and Language Pathologist (SLP), Speech Therapy Department, Alcoitão Health School of Sciences, Clinical and Therapeutics Pharmacological Unit, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal
| | - Lina Almeida
- SLP, ENT Department, Hospital dos Lusíadas, Lisboa, Portugal.
| | - Aldora Quintal
- SLP, MSc, ENT Department, Hospital Garcia de Orta, Almada, Portugal
| | - Ana Paula Batista
- SLP, MSc, ENT Department, Centro Hospitalar e Universitário do Algarve, Portimão, Portugal
| | - Ana Teixeira
- SLP, Physical Medicine and Rehabilitation, Hospital São João de Deus, Montemor-o-Novo, Portugal
| | - Cláudia Romeiro
- SLP, ENT Department, Hospital de Ponta Delgada-Hospital do Divino Espírito Santo de Ponta Delgada, EPE, São Miguel, Açores, Portugal
| | - Daniela Brás Ferreira
- SLP, ENT Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | | | - Madalena Saraiva
- SLP, ENT Department, Hospital de Ponta Delgada-Hospital do Divino Espírito Santo de Ponta Delgada, EPE, São Miguel, Açores, Portugal
| | - Rita Bom
- SLP, ENT Department, Hospital do Espírito Santo de Évora, EPE, Évora, Portugal
| | - Sancha Almeida
- SLP, MSc, ENT Department, Hospital da Luz, Lisboa, Portugal
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Lee JM, Roy N, Park A, Muntz H, Smith M. Emotional Adjustment in Children with Vocal Fold Nodules. J Voice 2022:S0892-1997(22)00346-0. [PMID: 36509581 DOI: 10.1016/j.jvoice.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/25/2022] [Accepted: 10/25/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Vocal fold nodules (VNs) in children are benign, bilateral, callous-like lesions at the junction of the anterior third and posterior two-thirds of the true vocal folds. Chronic, repetitive, and intense vocal behavior is often cited as the primary etiology; however, difficulties with emotional adjustment may predispose some children towards extreme and possibly phonotraumatic vocal activity, thereby contributing secondarily to the development of VNs. OBJECTIVES This case-control study examined the association between features of emotional adjustment and VNs in children. METHODS Parents of children with VNs (N = 40, Mage = 7.5, SDage = 2.03) and two medical control groups [ie, voice disordered, but not VNs (VDCs; N = 40, Mage= 7.09, SDage = 2.01) and vocally normal controls (VNCs; N = 40, Mage = 7.6, SDage = 1.54)] participated in the study. Features of emotional adjustment were assessed using two inventories: the Parent Rating scale for Reactive and Proactive Aggression and the Revised Child Anxiety and Depression Scale - Parent version. RESULTS As compared with the VNCs, children with VNs were significantly more aggressive (P = 0.042, Cohen's d = 0.47) whereas the VDCs were more depressed (P = 0.013, Cohen's d = 0.60). Furthermore, VDCs experienced more separation anxiety than VNs (P = 0.038, Cohen's d = 0.45) and VNCs (P = 0.021, Cohen's d = 0.55). No other significant between-group differences were identified between the VNs and VDCs. CONCLUSIONS When present, elevated aggression may represent a risk factor for VNs formation in children, and possibly influence treatment outcomes. Therefore, the current results highlight the importance of understanding the role of emotional adjustment in the evaluation and treatment of dysphonia in children.
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Affiliation(s)
- Jeong Min Lee
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, Utah.
| | - Nelson Roy
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, Utah
| | - Albert Park
- Pediatric Otolaryngology Clinic, Primary Children's Medical Center, Salt Lake City, Utah; Division of Otolaryngology - Head and Neck Surgery, The University of Utah, School of Medicine, Salt Lake City, Utah
| | - Harlan Muntz
- Pediatric Otolaryngology Clinic, Primary Children's Medical Center, Salt Lake City, Utah; Division of Otolaryngology - Head and Neck Surgery, The University of Utah, School of Medicine, Salt Lake City, Utah
| | - Marshall Smith
- Pediatric Otolaryngology Clinic, Primary Children's Medical Center, Salt Lake City, Utah; Division of Otolaryngology - Head and Neck Surgery, The University of Utah, School of Medicine, Salt Lake City, Utah
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Biot T, Fieux M, Henaine R, Truy E, Coudert A, Ayari-Khalfallah S. Long term outcome of laryngeal mobility disorder and quality of life after pediatric cardiac surgery. Int J Pediatr Otorhinolaryngol 2022; 158:111142. [PMID: 35580383 DOI: 10.1016/j.ijporl.2022.111142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/15/2022] [Accepted: 04/11/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Laryngeal mobility disorder after a pediatric heart surgery is common (between 5 and 10% of cases), and has important consequences on swallowing, breathing and speaking. After reviewing the literature, the recovery rate is variable and the postoperative follow-up is often done on a short time frame. The primary objective of the study is to describe the recovery from laryngeal mobility disorder with a follow-up time of at least 5 years. The secondary objective is to describe of the quality of life of the child in terms of phonation and swallowing, and to identify potential risk factors for a lasting laryngeal mobility disorder. METHODS We collected data (morphological characteristics and details of the procedures and medical care) on children who had undergone a heart surgery with risks of complications, between 2010 and 2015, and with a laryngeal mobility disorder detected after the surgery through nasal flexible laryngoscopy. During a follow-up consultation, carried at least 5 years after the surgery, we performed a nasal flexible laryngoscopy to assess whether or not the patient had recovered a full mobility of the larynx. Two questionnaires were also given to the patients, the pVHI and the PEDI EAT-10, to assess respectively the quality of their speech and of their swallowing function. RESULTS The recovery rate for a laryngeal mobility disorder more than 5 years after surgery was found to be 65% (9 children out of the 14 included in the study). We identified a risk factor for the persistence of a laryngeal mobility disorder after surgery: the presence of an associated genetic syndrome, p = 0.025. Children with persistent laryngeal mobility disorder have an impaired quality of life score, using the pVHI scale, which correlates well with the flexible laryngoscopy findings, p = 0.033. CONCLUSION Children with a lasting laryngeal mobility disorder have disabling respiratory and vocal symptoms in their daily lives. Nasal flexible laryngoscopy should therefore be systematically performed postoperatively after a surgery carrying risks. For improved patient management, early detection of these disorders by pharyngolaryngeal nasal flexible laryngoscopy in the aftermath of high-risk cardiac surgery is strongly advised, with prolonged follow-up.
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Affiliation(s)
- Thomas Biot
- Hospices Civils de Lyon, Hopital Edouard Herriot, Service d'ORL et de chirurgie cervico-faciale, Lyon cedex, F-69003, France
| | - Maxime Fieux
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'ORL, d'otoneurochirurgie et de chirurgie cervico-faciale, Pierre Bénite cedex, F-69495, France; Université de Lyon, Université Lyon 1, F-69003, Lyon, France; Université Paris Est Creteil, INSERM, IMRB, F-94010, Créteil, France; CNRS ERL 7000, F-94010, Créteil, France.
| | - Roland Henaine
- Université de Lyon, Université Lyon 1, F-69003, Lyon, France; Department of Adult and Child Cardiovascular Surgery and Heart Transplantation, Louis Pradel Cardiologic Hospital, Bron, France
| | - Eric Truy
- Hospices Civils de Lyon, Hopital Edouard Herriot, Service d'ORL et de chirurgie cervico-faciale, Lyon cedex, F-69003, France; Université de Lyon, Université Lyon 1, F-69003, Lyon, France; Inserm U1028, Lyon Neuroscience Research Center, Equipe IMPACT, Lyon, France; Hospices Civils de Lyon, Service d'ORL Pédiatrique, Hôpital Femme Mère Enfants, Bron Cedex, F-69500, France
| | - Aurelie Coudert
- Hospices Civils de Lyon, Hopital Edouard Herriot, Service d'ORL et de chirurgie cervico-faciale, Lyon cedex, F-69003, France; Hospices Civils de Lyon, Service d'ORL Pédiatrique, Hôpital Femme Mère Enfants, Bron Cedex, F-69500, France
| | - Sonia Ayari-Khalfallah
- Hospices Civils de Lyon, Service d'ORL Pédiatrique, Hôpital Femme Mère Enfants, Bron Cedex, F-69500, France
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Simões-Zenari M, Santos Batista GK, de Oliveira Pagan-Neves L, Nemr K, Wertzner HF. Acoustic voice and spectrographic measures in children with the phonological process of devoicing. Int J Pediatr Otorhinolaryngol 2022; 157:111137. [PMID: 35427996 DOI: 10.1016/j.ijporl.2022.111137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 04/06/2022] [Accepted: 04/09/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Children with speech sound disorders (SSDs) who present the devoicing of plosive and/or fricative sounds may have difficulties with glottal respiratory control. OBJECTIVE To analyze acoustic vocal measures, spectrographic aspects and the risk of dysphonia among children with devoicing SDDs and compare the results with those of other groups of children. METHODS Twenty-five boys aged between six and 12 years participated. They were divided into four groups: the SSD-devoicing (PPDG), dysphonia (DG), SSDs other than devoicing (PPOG) and control groups (CG). The vocal tasks were recorded, and perceptual-auditory and acoustic voice analyses were performed. The children's parents answered questions about voice-related aspects (to determine a dysphonia risk score). All data were compared among the groups. RESULTS Due to the sample size, an effect size analysis was considered, and the results showed possible differences between the PPDG and the other groups in measures of fundamental frequency (F0), jitter, shimmer, harmonic-to-noise ratio, maximum frequency of harmonic definition and dysphonia risk score. CONCLUSIONS The PPDG showed a high F0 and abnormal jitter and shimmer values. Although the voices of the children in this group had more harmonics than noise, the maximum frequency for defining the harmonics was very restricted. The PPDG had the lowest dysphonia risk score among all of the groups. Variations in F0, jitter and shimmer may indicate difficulties with controlling vocal adjustments, which appear to be hyperfunctional and not to impact vocal projection or voicing.
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Affiliation(s)
- Marcia Simões-Zenari
- Speech Therapy, Physiotherapy and Occupational Therapy Departament, The Universidade de Sao Paulo Medical School, Rua Cipotanea, 51, CEP 05360-000, Sao Paulo, SP, Brazil.
| | - Giovana Kaila Santos Batista
- Speech Therapy, Physiotherapy and Occupational Therapy Departament, The Universidade de Sao Paulo Medical School, Rua Cipotanea, 51, CEP 05360-000, Sao Paulo, SP, Brazil
| | - Luciana de Oliveira Pagan-Neves
- Speech Therapy, Physiotherapy and Occupational Therapy Departament, The Universidade de Sao Paulo Medical School, Rua Cipotanea, 51, CEP 05360-000, Sao Paulo, SP, Brazil
| | - Katia Nemr
- Speech Therapy, Physiotherapy and Occupational Therapy Departament, The Universidade de Sao Paulo Medical School, Rua Cipotanea, 51, CEP 05360-000, Sao Paulo, SP, Brazil
| | - Haydée Fiszbein Wertzner
- Speech Therapy, Physiotherapy and Occupational Therapy Departament, The Universidade de Sao Paulo Medical School, Rua Cipotanea, 51, CEP 05360-000, Sao Paulo, SP, Brazil
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Lee JM, Roy N, Park A, Muntz H, Redmond SM, Smith M. Self-regulation in children with vocal fold nodules: A multilevel analysis. JOURNAL OF COMMUNICATION DISORDERS 2022; 97:106203. [PMID: 35272152 DOI: 10.1016/j.jcomdis.2022.106203] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 02/09/2022] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Vocal fold nodules (VNs) represent the most common cause of voice disorders in children. Phonotrauma related to chronic, repetitive, intense vocal activity is often cited as the proximate cause of VNs. However, diminished self-regulation (SR) may predispose some children toward extreme phonotraumatic voice use, thereby contributing secondarily to their development. This case-control study examined the association between features of SR and VNs in children. METHOD Parents of children with VNs (N = 40, Age Mean = 7.5, SD = 2.03 years) and vocally normal, medical controls (VNCs; N = 40, Age Mean = 7.6, SD = 1.54 years) completed the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2; Gioia, Isquith, Guy & Kenworthy, 2015), an inventory that evaluates components of SR in children. RESULTS Children with VNs, as compared with the vocally normal control group, were described as (i) impulsive (i.e., scoring significantly worse on the Behavior Regulation Index, BRI; P < 0.001, Cohen's d = 0.86), and (ii) emotionally dysregulated (i.e., scoring significantly worse on the Emotional Regulation Index, ERI; P < 0.001, Cohen's d = 0.81). CONCLUSIONS Diminished SR in some children with VNs may contribute to phonotraumatic vocal behaviors and potentially attenuate the effectiveness of voice therapy.
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Affiliation(s)
- Jeong Min Lee
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, UT, United States.
| | - Nelson Roy
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, UT, United States
| | - Albert Park
- Pediatric Otolaryngology Clinic, Primary Children's Medical Center, Salt Lake City, UT, United States; Division of Otolaryngology, Head and Neck Surgery, The University of Utah, School of Medicine, Salt Lake City, UT, United States
| | - Harlan Muntz
- Pediatric Otolaryngology Clinic, Primary Children's Medical Center, Salt Lake City, UT, United States; Division of Otolaryngology, Head and Neck Surgery, The University of Utah, School of Medicine, Salt Lake City, UT, United States
| | - Sean M Redmond
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, UT, United States
| | - Marshall Smith
- Pediatric Otolaryngology Clinic, Primary Children's Medical Center, Salt Lake City, UT, United States; Division of Otolaryngology, Head and Neck Surgery, The University of Utah, School of Medicine, Salt Lake City, UT, United States
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Šimkienė R, Šiupšinskienė N, Purlys P, Žvirblis T, Lesinskas E. Adaptation and Validation of the Lithuanian Version of the Pediatric Voice Handicap Index. J Voice 2022:S0892-1997(22)00041-8. [PMID: 35361515 DOI: 10.1016/j.jvoice.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to develop the Lithuanian version of the Pediatric Voice Handicap Index (pVHI) and to assess its psychometric characteristics. METHODS The Lithuanian version of the pVHI was prepared according to the standard requirements for the questionnaire translation and adaptation procedure. It also included forward and backward translations of the original questionnaire, as well as a committee review and psychometric testing of the final version of the pVHI. A total of 126 children between 4 and 13 years of age were included in the study. Two study groups were formed: a group consisting of children with dysphonia (n = 70) and a control group of children without any alterations in their voice (n = 56). The questionnaire was always completed by their parents. The results were statistically analysed to assess the reliability, validity, sensitivity and specificity of the Lithuanian version of the pVHI. RESULTS High internal consistency of the Lithuanian version of the pVHI was determined (Cronbach's α = 0.938). The test-retest analysis also showed a high correlation between the two tests (r = 0.949) for both the dysphonic and control groups. The mean overall pVHI score was significantly higher (P < 0.001) in the dysphonic group than in the control group: 26.16 ± 11.84 and 2.43 ± 2.61, respectively. Similar results were obtained for all domains of pVHI. The most sensitive and specific limiting value for discrimination between the clinical and control groups was the sum of 8 points. CONCLUSIONS The Lithuanian version of the pVHI is a reliable and valid instrument for the evaluation of the Voice Handicap Index in the pediatric population and can be easily applied in daily clinical practice.
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Affiliation(s)
- Rita Šimkienė
- Vilnius University Hospital Santaros Klinikos Center for Ear, Nose and Throat Diseases, Vilnius, Lithuania.
| | - Nora Šiupšinskienė
- Lithuanian University of Health Sciences, Medicine Academy, Department of Otorhinolaryngology, Kaunas, Lithuania; Klaipeda University, Faculty of Health Sciences, Klaipeda, Lithuania
| | | | - Tadas Žvirblis
- Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Eugenijus Lesinskas
- Vilnius University Hospital Santaros Klinikos Center for Ear, Nose and Throat Diseases, Vilnius, Lithuania
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Yağcıoğlu D, Aydınlı FE, Aslan G, Kirazlı MÇ, Köse A, Doğan N, Akbulut S, Yılmaz T, Özcebe E. Development, Validation, and Reliability of the Teacher-Reported Pediatric Voice Handicap Index. Lang Speech Hear Serv Sch 2021; 53:69-87. [PMID: 34762816 DOI: 10.1044/2021_lshss-21-00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to develop a novel teacher-reported pediatric voice outcome measure and to investigate its psychometric properties. METHOD In the first stage, a new instrument, the Teacher-Reported Pediatric Voice Handicap Index (TRPVHI), was developed. After item generation, a panel of experts evaluated the items to assess the content validity. Subsequently, the final version of the preliminary instrument was applied to teachers of 306 children (57 dysphonic and 249 vocally healthy) between the ages of 4 and 11 years. Eventually, the construct validity, criterion-related validity, test-retest reliability, and internal consistency of the developed instrument were examined. RESULTS The items with a content validity ratio less than .8 were modified or removed, and accordingly, the preliminary version of the index was finalized. After the application of the preliminary version, item reduction was made based on the factor analysis. The index is composed of 27 questions and three subscales: Functional, Physical, and Emotional. A significant difference was observed between the dysphonic and vocally healthy children for the TRPVHI scores (p < .001). A positive moderate correlation was determined between the Pediatric Voice Handicap Index and TRPVHI scores. Correlation coefficients between the test and retest scores of the TRPVHI were in the range of .92-.98. Cronbach's alpha values computed to assess the internal consistency were in the range of .94-.98. CONCLUSIONS The TRPVHI is the only valid and reliable teacher-reported outcome measure of the effects of voice disorders on children. It is anticipated that the deployment of the TRPVHI in conjunction with other subjective tools, both in the initial evaluation and the follow-up of the treatment results, will allow a better understanding of the physical, functional, and emotional effects of voice disorders on children. Furthermore, it can potentially lead further research to enable the use of the TRPVHI for screening purposes.
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Affiliation(s)
- Damlasu Yağcıoğlu
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Fatma Esen Aydınlı
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Gizem Aslan
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Meltem Ç Kirazlı
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Ayşen Köse
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Nuri Doğan
- Department of Education, Hacettepe University, Ankara, Turkey
| | - Sevtap Akbulut
- Department of Otolaryngology, Demiroglu Bilim University, İstanbul, Turkey
| | - Taner Yılmaz
- Department of Ear-Nose-Throat, Hacettepe University, Ankara, Turkey
| | - Esra Özcebe
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
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Lee JM, Roy N, Park A, Muntz H, Meier J, Skirko J, Smith M. Personality in Children With Vocal Fold Nodules: A Multitrait Analysis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:3742-3758. [PMID: 34525315 DOI: 10.1044/2021_jslhr-21-00144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose Vocal fold nodules (VNs) are bilateral, symmetrical, callous-like lesions secondary to phonotrauma and possibly related to specific personality traits. This case-control study examined the relation between personality and VNs in children within the context of the Trait Theory of VNs. Method Parents of children with VNs (N = 39, M = 7.43, SD = 2.01 years) and two medical control groups (i.e., voice disordered controls, but not VNs [VDCs; N = 40, M = 7.09, SD = 2.01 years] and vocally normal controls [VNCs; N = 40, M = 7.6, SD = 1.54 years]) completed the Inventory of Child Individual Differences, a personality instrument that describes the Big Five superfactors as well as 15 lower order personality traits. Results Children with VNs, as compared with VNCs, were (a) emotionally reactive (i.e., higher N-Neuroticism, p < .005, Cohen's d = 0.53), (b) Antagonistic, Strong-Willed, and less Compliant (i.e., lower A-Agreeableness, p < .014, Cohen's d = 0.59), and (c) Distractible and Disorganized (i.e., lower C-Conscientiousness, p < .009, Cohen's d = 0.62). Both voice disordered groups displayed elevated scores on the personality superfactor of Neuroticism (N; and the "Negative Emotions" lower order trait). Conclusions The combination of personality traits identified in this study (i.e., high N, low A and C) may play a central role in VNs development and possibly attenuate voice therapy success. Children with VNs displayed a similar personality typology as women with VNs, with the exception of elevated Extraversion (E), thereby providing support for the relevance of the Trait Theory of VNs in both children and adults. Clinicians treating children with voice disorders, including VNs, should consider their underlying personality traits in assessment and management.
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Affiliation(s)
- Jeong Min Lee
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City
| | - Nelson Roy
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City
| | - Albert Park
- Pediatric Otolaryngology Clinic, Primary Children's Medical Center, Salt Lake City, UT
- Division of Otolaryngology-Head and Neck Surgery, School of Medicine, The University of Utah, Salt Lake City
| | - Harlan Muntz
- Pediatric Otolaryngology Clinic, Primary Children's Medical Center, Salt Lake City, UT
- Division of Otolaryngology-Head and Neck Surgery, School of Medicine, The University of Utah, Salt Lake City
| | - Jeremy Meier
- Pediatric Otolaryngology Clinic, Primary Children's Medical Center, Salt Lake City, UT
- Division of Otolaryngology-Head and Neck Surgery, School of Medicine, The University of Utah, Salt Lake City
| | - Jonathan Skirko
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The University of Arizona, Tucson
| | - Marshall Smith
- Pediatric Otolaryngology Clinic, Primary Children's Medical Center, Salt Lake City, UT
- Division of Otolaryngology-Head and Neck Surgery, School of Medicine, The University of Utah, Salt Lake City
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Elders BBLJ, Hakkesteegt MM, Ciet P, Tiddens HAWM, Wielopolski P, Pullens B. Structure and Function of the Vocal Cords after Airway Reconstruction on Magnetic Resonance Imaging. Laryngoscope 2021; 131:E2402-E2408. [PMID: 33459361 PMCID: PMC8247893 DOI: 10.1002/lary.29399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/22/2020] [Accepted: 01/04/2021] [Indexed: 11/10/2022]
Abstract
Objectives/Hypothesis Dysphonia is a common problem at long‐term follow‐up after airway surgery for laryngotracheal stenosis (LTS) with major impact on quality of life. Dysphonia after LTS can be caused by scar tissue from initial stenosis along with anatomical alterations after surgery. There is need for a modality to noninvasively image structure and function of the reconstructed upper airways including the vocal cords to assess voice outcome and possible treatment after LTS. Our objective was to correlate vocal cord structure and function of patients after airway reconstruction for LTS on static and dynamic magnetic resonance imaging (MRI) to voice outcome. Study Design Prospective cohort study. Methods Voice outcome was assessed by voice questionnaires ((pediatric) Voice Handicap Index (p)VHI)) and the Dysphonia Severity Index (DSI). Postsurgical anatomy, airway lumen, and vocal cord thickness and movement on multiplanar static high‐resolution MRI and dynamic acquisitions during phonation was correlated to voice outcome. Results Forty‐eight patients (age 14.4 (range 7.5–30.7) years) and 11 healthy volunteers (15.9 (8.2–28.8) years) were included. Static MRI demonstrated vocal cord thickening in 80.9% of patients, correlated to a decrease in DSI (expected odds 0.75 [C.I. 0.58–0.96] P = .02). Dynamic MRI showed impaired vocal cord adduction during phonation in 61.7% of patients, associated with a lower DSI score (0.65 [C.I. 0.48–0.88] P = .006). Conclusions In LTS patients, after airway reconstruction MRI can safely provide excellent structural and functional detail of the vocal cords correlating to DSI, with further usefulness expected from technical refinements. We therefore suggest MRI as a tool for extensive imaging during LTS follow‐up. Level of evidence 3 Laryngoscope, 131:E2402–E2408, 2021
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Affiliation(s)
- Bernadette B L J Elders
- Department of Pediatric Pulmonology and Allergology, Erasmus Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Marieke M Hakkesteegt
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Pierluigi Ciet
- Department of Pediatric Pulmonology and Allergology, Erasmus Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Harm A W M Tiddens
- Department of Pediatric Pulmonology and Allergology, Erasmus Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Piotr Wielopolski
- Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Bas Pullens
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands
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11
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Krasnodębska P, Szkiełkowska A, Rosińska A, Skarżynski H. Polish version of the pediatric Voice Handicap Index (pVHI). Int J Pediatr Otorhinolaryngol 2020; 138:110278. [PMID: 32805495 DOI: 10.1016/j.ijporl.2020.110278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/26/2020] [Accepted: 07/25/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The modern standard of voice diagnostics in both the adult and pediatric populations is based on perceptual, acoustic and videolaryngoscopic assessment, as well as self-assessment of voice quality. Currently, only two tools for assessing the voice in the pediatric population were translated into Polish: pVHI and its abbreviated version - cVHI (Children Voice Handicap Index). Thanks to the use of pVHI, the therapist and the patient, as well as his family and relatives, become aware of what functional zones are disturbed as a result of voice problems. AIM The aim of the study was to analyze various methods of assessing children's voice, including the pVHI voice disability questionnaire in children with various voice disorders. In addition, the authors wanted to develop a classification of the degree of disability of children's voice expressed by the sum of points obtained in pVHI. MATERIAL AND METHOD The study included a group of 89 children aged 5-12. Each child underwent a standard otolaryngological and phoniatric examination procedure with hearing assessment and fiberoscopic laryngeal evaluation. The voice of the dysphonic children was assessed with a spectrogram and the GRBAS scale. The children's guardians completed the Pediatric Voice Handicap Index (pVHI). RESULTS Polish children without voice disorders obtained an average of 1.9 points as a total result of the pVHI questionnaire. The results of the questionnaire obtained from children with voice disorders were on average 24.7 (SD 13.9). Total and individual domain scores were significantly higher in children with dysphonia than in asymptomatic children. Children with voice disorders were rated an average of 1.95 (SD 0.6) degree of hoarseness in Yanagihara's scale, and obtained an average overall score of 4.8 on the GRBAS scale (SD 2). A common upward trend in all types of evaluation is evident, along with an increase in the handicap expressed in pVHI score. Statistical analysis showed significant dependence between the overall pVHI score and other voice rating indicators. The result correlated to a moderate degree with the sum of points obtained from GRBAS and the severity of hoarseness assessed subjectively (G) and objectively according to Yanagihara's scale. In addition, weak correlations of the functional part of the questionnaire with the presence of learning problems, and the emotional part with the presence of problems with socialization were noticed. Analyzing the results of the questionnaire depending on the GRBAS results and the Yanagihara scale, a better fit of the exponential trend line than the linear one was observed. The point of inflection of the exponential curve, and thus a significant deterioration in voice assessment indicators, was observed in children who obtained over 32 points, which is 33% of the maximum value that can be obtained from the questionnaire. CONCLUSIONS A new voice assessment tool for the pediatric population has been developed that complements the diagnostic facilities of the otolaryngologist, phoniatrician and speech therapist. Adaptation of the Polish version of the Voice Handicap Index (pVHI) allows the introduction of a new diagnostic indicator into medical and speech therapy practice. The pVHI questionnaire result differentiates children with voice and speech disorders from healthy children. The analysis of children's voice using various methods allows the clinician to further characterize the disturbance of voice quality. It is possible to assess the scale of the severity and type of problem, as well as the spheres of life it concerns most. There is a correlation between the severity of voice disorders and the severity of voice disability expressed in the pVHI question.
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Affiliation(s)
- P Krasnodębska
- Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland.
| | - A Szkiełkowska
- Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland; Audiology and Phoniatrics Faculty, Fryderyk Chopin University of Music, Warsaw, Poland
| | - A Rosińska
- Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - H Skarżynski
- Audiology and Phoniatrics Faculty, Fryderyk Chopin University of Music, Warsaw, Poland; Otorhinolaryngologic Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
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Khoshhal Z, ShahMahmood TM, Ghayoumi-Anaraki Z, Jahan A, Haresabadi F. Adaptation and validation of the Persian version of pediatric Voice Handicap Index (pVHI). Int J Pediatr Otorhinolaryngol 2020; 137:110204. [PMID: 32682167 DOI: 10.1016/j.ijporl.2020.110204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/14/2020] [Accepted: 06/14/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES This study aimed to assess the reliability and validity of the Persian version of the Pediatric Voice Handicap Index (pVHI). MATERIALS AND METHODS The questionnaire was translated into Persian and then administrated to the parents of 45 dysphonic children and parents of 135 normal children. The content validity of the questionnaire was confirmed by eight speech-language pathologists. Internal consistency and test-retest reliability were measured via Cronbach's alpha and intra-class correlation coefficient, respectively. Independent-samples t-test was used to evaluate the discriminative and clinical validity of Persian pVHI. RESULTS Cronbach's coefficient values were excellent for the total score (α = 0.94) and physical subcomponent (α = 0.91). Moreover, these corresponding values were satisfactory for functional (α = 0.82) and emotional (α = 0.79) subcomponents. Test-retest reliability for the total score was high in both dysphonic and control groups (intra-class correlation coefficient> 0.92). There were significant differences between the control and dysphonic groups in terms of the total score and all subcomponents scores of Persian pVHI. However, no significant difference was observed in the mean total score of the Persian pVHI between the control and dysphonic group regarding gender (P < 0.001). DISCUSSION Persian version of pVHI is a valid and reliable tool to evaluate the severity of voice disorder and its negative effects on the daily life of Persian children with voice disorder from the Parents' viewpoint.
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Affiliation(s)
- Zeynab Khoshhal
- Department of Speech Therapy, Tabriz University of Medical Science, Tabriz, Iran.
| | - Toktam Maleki ShahMahmood
- Department of Speech Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Zahra Ghayoumi-Anaraki
- Department of Speech Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ali Jahan
- Department of Speech Therapy, Tabriz University of Medical Science, Tabriz, Iran. https://
| | - Fatemeh Haresabadi
- Department of Speech Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
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Batista GKS, Simões-Zenari M, Nemr K. Cut-off point for high dysphonia risk in children based on the Child Dysphonia Risk Screening Protocol: preliminary findings. Clinics (Sao Paulo) 2020; 75:e1682. [PMID: 32876106 PMCID: PMC7442376 DOI: 10.6061/clinics/2020/e1682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/17/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The objective of the study was to establish a cut-off point for high dysphonia risk in children using the Child Dysphonia Risk Screening Protocol (DRSP-C). METHODS Through a preliminary study, voice recordings of 59 children (4-12 years of age) were collected during an auditory-perceptual analysis using the Consensus Auditory-Perceptual Evaluation of Voice protocol. Thirty of the patients had voice disorders (patient group), and 29 did not (control group). A risk score for dysphonia was then calculated, and data were compared between groups. The relationship between overall degrees of deviation and questionnaire scores was analysed. The questionnaire's validity was verified from the area under the Receiver Operating Characteristic (ROC) curve, and cut-off points were obtained based on diagnostic criteria for screening procedures. RESULTS The DRSP-C score was found to be higher for the patient group, as was the partial score for vocal behaviour. No correlation was found between overall degrees of dysphonia and questionnaire scores. The area under the ROC curve was measured as 0.678, denoting limited diagnostic capacity. The cut-off point was set at 16.50. Thus, above this value, dysphonia risk is higher. CONCLUSION A cut-off point for high dysphonia risk was calculated. The DRSP-C proved to be a promising tool for children's clinical vocal and health promotion and should be used in conjunction with General Dysphonia Risk Screening.
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Carrera Fernández SM, Massé PG, Wilder F, Preciado D, Rodriguez HA. Index of pediatric voice handicap: Translation, transculturalization and validation to Argentinian Spanish. Int J Pediatr Otorhinolaryngol 2019; 127:109663. [PMID: 31526934 DOI: 10.1016/j.ijporl.2019.109663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/26/2019] [Accepted: 08/28/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Voice disorders are very common in the pediatric population, with 6% and 23% of all children presenting with some form of dysphonia [1,2]. For many years, these patients have been underdiagnosed. There has been increasing awareness and interest in the study of voice alterations in children, and, most importantly, their impact in their quality of life. To do this, an instrument capable of measuring the quality of life in pediatric patients with vocal pathology is required, which can be used extensively in the scientific community. The objective of our study is to carry out the translation, transculturalization and validation of pVHI (Pediatric Voice Handicap Index) to Argentinian Spanish-speakers. MATERIAL AND METHODS A study was carried out in the Hospital de Pediatria Dr. JP Garrahan in the city of Buenos Aires, Argentina. It included patients between 3 and 18 years old. The pVHI was translated and transculturalized for said population and for its validation, a survey was carried out in two groups of patients: one group being children with a background of both reconstructive larynx surgery, and dysphonia (n = 35) and the other group being control patients, without any voice pathology (n = 35). The survey was conducted among either parents or caregivers of the children in question. RESULTS A significant difference was found between both groups, for both overall pVHI score and survey subgroups score (p < 0.001) with an optimal internal confidence and a good Alpha Cronbach for each of the subgroups (functional 0,92; organic 0,87 and emotional 0,88). Test-retest for reliability revealed "p-values" without any significant difference (p > 0.05) for each of all subgroups (functional 0,68; organic 0,32 and emotional 0,72). CONCLUSION The validation and transculturalization of the rate of pediatric vocal impairment to Argentinian Spanish population presented an adequate validity and reliability. The rate of pediatric vocal impairment was identified through this simple and practical survey, offering additional information on the child's own vocal perception by part of the caregiver. We recommend this survey being included as a valuable tool in the evaluation of pediatric dysphonia in Spanish-speaking families.
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Affiliation(s)
| | | | - Fabiana Wilder
- Hospital de Clinicas José de San Martín, Buenos Aires, Argentina
| | - Diego Preciado
- Department of Otolaryngology, Children's National Medical Center, Washington, D.C, USA
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Schneider K, Mehlum CS, Grønhøj C, Kjærgaard T, Møller CL, von Buchwald C, Hjuler T. Reliability and validity of The Danish pediatric voice handicap index. Int J Pediatr Otorhinolaryngol 2019; 125:11-14. [PMID: 31229853 DOI: 10.1016/j.ijporl.2019.06.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 06/14/2019] [Accepted: 06/16/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The pediatric voice handicap index (pVHI) questionnaire was developed in 2006 to provide parental information regarding the impact of a voice disorder on their child's life. OBJECTIVES The aim of this study was to make a Danish version of the original American pVHI and to validate the Danish pVHI by evaluating its internal consistency and reliability. MATERIALS AND METHODS The original version of the pVHI was translated into Danish. Nineteen parents of dysphonic children, diagnosed in a tertiary otolaryngology hospital department, and 43 parents of children without known voice disorder (control group) completed the questionnaire. The internal consistency, content validity including comparisons of the scores in the two groups and the test-retest reliability were assessed through statistical analysis. RESULTS The total pVHI scores significantly differed between the group of parents with dysphonic children and the group of parents with children without known voice disorder (p < 0.001). The internal consistency showed an excellent consistency (Chronbach's α > 0.9) of the three subdomains score and the total pVHI score. The test-re-test reliability of the total pVHI score was "strong" with a Pearson's correlation coefficient of 0.97. CONCLUSIONS AND SIGNIFICANCE The Danish pVHI is a valid and reliable instrument to assess the parents' perception of the impact of a voice disorder on a child's physical, social and emotional well-being.
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Affiliation(s)
- Katrine Schneider
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Blegdamsvej 9, University of Copenhagen, Denmark.
| | - Camilla Slot Mehlum
- Department of Otorhinolaryngology - Head & Neck Surgery and Audiology, Odense University Hospital, J.B. Winsløwsvej 4, University of Southern Denmark, Denmark
| | - Christian Grønhøj
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Blegdamsvej 9, University of Copenhagen, Denmark
| | - Thomas Kjærgaard
- Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, Denmark
| | | | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Blegdamsvej 9, University of Copenhagen, Denmark
| | - Thomas Hjuler
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Blegdamsvej 9, University of Copenhagen, Denmark
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Glottal function index questionnaire for screening of pediatric dysphonia. Int J Pediatr Otorhinolaryngol 2019; 123:97-101. [PMID: 31085464 DOI: 10.1016/j.ijporl.2019.04.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/21/2019] [Accepted: 04/30/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE to assess the diagnostic value of Lithuanian version of Glottal Function Index (GFI-LT) questionnaire in pediatric dysphonia screening. METHODS The GFI-LT was completed by 82 children (7-16 years old): 41 patients with voice disorders (patients group) and 41 healthy subjects (control group). Auditory-perceptual evaluation of voice was performed using the Grade Roughness Breathiness (GRB) protocol. Acoustic voice analysis was accomplished for F0, SDF0, jitter, shimmer and NNE using Dr. Speech, Tiger Elemetrics software. To evaluate the diagnostic accuracy differentiating normal and dysphonic voice, the receiver operating characteristic statistics were used. RESULTS Perceptually dysphonia was revealed in all children of the patients group. Grade I (65.9%) was the most prevalent (p > 0.05). No dysphonia was detected in the control group. Acoustic voice analysis revealed statistically significantly (p < 0.001) deteriorated all acoustic voice parameters in patients' group comparing to control group. Statistically significant (p < 0.05) strong or moderate correlations were found between the GFI-LT, auditory-perceptual rating and all acoustic voice parameters of the patients group. The strongest correlations were observed between GFI-LT and G (r = 0.70), R (r = 0.69), jitter (r = 0.56) and SDF0 (r = 0.56). No statistically significant correlations between GFI-LT and children' age or gender were found (p > 0.05). The GFI-LT cut-off score of ≥3.0 was associated with excellent test accuracy (AUC = 0.961) distinguishing children with voice disorders from healthy controls, resulting in a balance between sensitivity and specificity (95.1% vs 85.4%). CONCLUSION GFI-LT is considered to be a valid and reliable tool for self-assessment and screening of voice disorders in children.
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Moodley DT, Swanepoel C, van Lierde K, Abdoola S, van der Linde J. Vocal Characteristics of School-Aged Children With and Without Attention Deficit Hyperactivity Disorder. J Voice 2018; 33:945.e37-945.e45. [PMID: 30115579 DOI: 10.1016/j.jvoice.2018.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/20/2018] [Accepted: 06/22/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The aim of this study was to describe the laryngeal anatomy, perceptual, acoustic, and aerodynamic vocal characteristics of school-aged children with and without Attention Deficit Hyperactivity Disorder (ADHD). The predisposition that children with ADHD have for laryngeal injuries are recurrent in nature and are more often than not overlooked as laryngitis. Previous studies have reported varied results on the prevalence rates of pediatric vocal fold nodules within the school-aged ADHD population. STUDY DESIGN A static, two-group comparison was used in the study to investigate the clinical, perceptual, acoustic, and aerodynamic vocal characteristics of children between 7 and 9 years old with and without ADHD. METHODS The study replicated the protocol as executed by Barona-Lleo and Fernandez (2016) with additions. The Multidimensional Voice Program and the Voice Range Profile as additions to the assessment of vocal parameters were used with which comparable dysphonia severity index scores were calculated. Once-off clinical, perceptual, acoustic, and aerodynamic voice assessments were conducted on 20 age-gender matched participants (Control group mean age [months] = 98.80, standard deviation = 10.379; ADHD group mean age [months] = 108.00, standard deviation = 10.873). It was hypothesized that children with ADHD would have more hyperfunctional vocal characteristics; leading to laryngeal injuries, than their control group peers. RESULTS Forty-five percent (n = 9) of the total sample population (both groups combined) had laryngeal pathology. Similar parent reported etiological voice symptoms and vocal habits were seen across both groups. Both groups performed similarly across both perceptual and aerodynamic voice assessments. Acoustically, the control group achieved significantly higher producible pitches than the ADHD group (P = 0.028) and were found to have more dysphonic dysphonia severity index scores than their ADHD group peers (P = 0.034). CONCLUSION Prepubertal, school-aged children with or without ADHD may have similar vocal characteristics than previously thought. This is in support of the null hypothesis. The authors of the current study recommend that vocal screening in all school-aged children be carried out as an effective measure to monitor voice disorders in the pediatric population. Future research into larger sample sizes with this population with a special focus on the effect that central nervous system stimulants may have on the voice is recommended.
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Liu K, Liu S, Zhou Z, Ren Q, Zhong J, Luo R, Qin H, Zhang S, Ge P. Reliability and validity of the Chinese pediatric voice handicap index. Int J Pediatr Otorhinolaryngol 2018; 105:127-131. [PMID: 29447800 DOI: 10.1016/j.ijporl.2017.12.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To evaluate the reliability and validity of the Chinese version of pediatric voice handicap index (pVHI). MATERIAL AND METHODS The original English version-pVHI was translated into Chinese. Parents of 52 children with voice dysphonia and 43 children with no history or symptoms of voice problems were asked to fill the Chinese pVHI questionnaires twice with an interval of 2 weeks. GRB (Grade, Roughness, Breathiness) scale was used for perceptual assessment by two otolaryngologists and one speech pathologist for each child's voice. The internal consistency was assessed using Cronbach's alpha coefficient. Pearson's correlation coefficient was used to evaluate the test-retest reliability. The Kendall's coefficient of concordance W was used to assess the consistency of GRB scores of 3 voice specialists. The nonparametric Mann-Whitney test was used to assess the differences between the dysphonia group and controls. The correlation between pVHI and GRB scores were assessed using Pearson's correlation coefficient. RESULTS The internal consistency of total score and three subscales scores of Chinese pVHI were 0.788-0.944. The test-retest reliability was 0.631-0.887(P < .001). The pVHI scores of control group significantly were lower than the pathological group (P = .000). The GRB scores of 3 voice specialists have an excellent consistency (W = 0.694-0.807, P = .000). The pVHI scores positively correlated with GRB assessment (P < .01). CONCLUSIONS The Chinese version of pVHI had a good reliability and validity. It can be applicable and useful supplementary tool for evaluating parents' perception of their children's dysphonia.
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Affiliation(s)
- Kena Liu
- School of Medicine, South China University of Technology, China
| | - Shaofeng Liu
- Department of Otolaryngology, Guangzhou Women and Children's Medical Center, China
| | - Zhou Zhou
- Department of Otolaryngology, Shenzhen People's Hospital, China
| | - Qinyi Ren
- Department of Otolaryngology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Southern Medical University, China
| | - Jie Zhong
- Department of Otolaryngology, Guangzhou Women and Children's Medical Center, China
| | - Renzhong Luo
- Department of Otolaryngology, Guangzhou Women and Children's Medical Center, China
| | - Huabiao Qin
- School of Electronic and Information Engineering, South China University of Technology, China
| | - Siyi Zhang
- School of Medicine, South China University of Technology, China; Department of Otolaryngology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Southern Medical University, China
| | - Pingjiang Ge
- School of Medicine, South China University of Technology, China; Department of Otolaryngology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Southern Medical University, China.
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Lu D, Huang M, Li Z, Yiu EML, Cheng IKY, Yang H, Ma EPM. Adaptation and validation of Mandarin Chinese version of the pediatric Voice Handicap Index (pVHI). Int J Pediatr Otorhinolaryngol 2018; 104:19-24. [PMID: 29287865 DOI: 10.1016/j.ijporl.2017.10.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/15/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of this study was to adapt and validate the English version of pediatric voice handicap index (pVHI) into Mandarin Chinese.
METHODS: A cross-sectional study was performed from May 2016 to April 2017. A total of 367 parents participated in this study, and 338 parents completed the translated questionnaire without missing data, including 213 parents of children with voice disorders (patients group), and 125 parents of children without voice disorders (control group). The internal consistency, test-retest reliability, contents validity, construct validity, clinical validity, and cutoff point were calculated. RESULTS The most common voice disorder in the patients group was vocal fold nodules (77.9%), followed by chronic laryngitis (18.8%), and vocal fold polyps (3.3%). The prevalence for voice disorders was higher in boys (67.1%) than girls (32.9%). The most common vocal misuse and abuse habit was shouting loudly (n = 186, 87.3%), followed by speaking for a long time (n = 158, 74.2%), and crying loudly (n = 99, 46.5%). The internal consistency for the Mandarin Chinese version of pVHI was excellent in patients group (Cronbach α = 0.95). The inter-class correlation coefficient indicated strong test-retest reliability (ICC = 0.99). The principal-component analysis demonstrated three-factor eigenvalues greater than 1, and the cumulative proportion was 66.23%. The mean total scores and mean subscales scores were significantly higher in the patients group than the control group (p < 0.05). The physical domain had the highest mean score among the three subscales (functional, physical and emotional) in the patients group. The optimal cutoff point of the Mandarin Chinese version of pVHI was 9.5 points with a sensitivity of 80.3% and a specificity of 84.8%. CONCLUSION The Mandarin Chinese version of pVHI was a reliable and valid tool to assess the parents' perception about their children's voice disorders. It is recommended that it can be used as a screening tool for discriminating between children with and without dysphonia.
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Affiliation(s)
- Dan Lu
- Department of Otorhinolaryngology, Head & Neck Surgery, West China Hospital, Sichuan University, Sichuan, China.
| | - Mengjie Huang
- Department of Otorhinolaryngology, Women's & Children's Central Hospital, Chengdu, Sichuan, China.
| | - Zhen Li
- Department of Otorhinolaryngology, Head & Neck Surgery, West China Hospital, Sichuan University, Sichuan, China.
| | - Edwin M-L Yiu
- Division of Speech and Hearing Sciences, Voice Research Laboratory, The University of Hong Kong, Pokfulam, Hong Kong.
| | - Ivy K-Y Cheng
- Division of Speech and Hearing Sciences, Voice Research Laboratory, The University of Hong Kong, Pokfulam, Hong Kong.
| | - Hui Yang
- Department of Otorhinolaryngology, Head & Neck Surgery, West China Hospital, Sichuan University, Sichuan, China.
| | - Estella P-M Ma
- Division of Speech and Hearing Sciences, Voice Research Laboratory, The University of Hong Kong, Pokfulam, Hong Kong.
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Oddon PA, Boucekine M, Boyer L, Triglia JM, Nicollas R. Health-related quality of life in children with dysphonia and validation of the French Pediatric Voice Handicap Index. Int J Pediatr Otorhinolaryngol 2018; 104:205-209. [PMID: 29287869 DOI: 10.1016/j.ijporl.2017.09.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/21/2017] [Accepted: 09/22/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE voice disorders are common in the pediatric population and can negatively affect children's quality of life. The pediatric voice handicap Index (pVHI) is a valid instrument to assess parental perception of their children voice but it is not translated into French language. The aim of the present study was to adapt a French version of the pVHI and to evaluate its psychometric properties including construct validity, reliability, and some aspects of external validity. PATIENTS AND METHOD we performed a cross sectional study including 32 dysphonic children and 60 children with no history of voice problems between 3 and 12 years of age. The original pVHI was translated into French language according to forward-backward rules and then administered to parents or caregivers. Construct validity and internal consistency were explored using confirmatory factor analysis and Cronbach's alpha. The questionnaire was filled twice to assess test-retest reliability using the intra-class correlation coefficient. The external validity was explored by comparing the French pVHI total and subscales scores between dysphonic and asymptomatic children. Correlations between the French pVHI and both the perceptual GRBAS scale and the health-related quality of life (HRQOL) survey "Vécu et Santé Perçu de l'Adolescent et de l'Enfant" (VSP-Ap) were also performed. RESULTS the structure of the French pVHI showed a good fit with excellent reliability (α = 0.929) and high test-retest reliability. Significant differences were found between the group of dysphonic children and the control group (p < 0.001). The French pVHI scores were positively correlated to all parameters of the GRBAS scale (p < 0.05). Significant negative correlations were found between the Functional domain of the pVHI and various domains of the VSP-Ap as Leisure Activities, Schooling and Sentimental Relationship (p < 0.05). CONCLUSION the French pVHI is considered to be a valid and reliable instrument to assess voice-related quality of life in children with voice disorder. We recommend its use in the multidimensional protocols for assessing voice disorder in the pediatric population.
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Affiliation(s)
- P A Oddon
- APHM, Department of Pediatric Otorhinolaryngology Head and Neck Surgery, La Timone Children's Hospital, 13385, Marseille, France.
| | - M Boucekine
- Aix-Marseille University, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Marseille, France
| | - L Boyer
- Aix-Marseille University, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, Marseille, France
| | - J M Triglia
- APHM, Department of Pediatric Otorhinolaryngology Head and Neck Surgery, La Timone Children's Hospital, 13385, Marseille, France
| | - R Nicollas
- APHM, Department of Pediatric Otorhinolaryngology Head and Neck Surgery, La Timone Children's Hospital, 13385, Marseille, France
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