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De Maio V, Mozzanica F, Cardella A, Schindler A, Murry T, Ricci-Maccarini A. Normative Values for the Children Voice Handicap Index-10 (CVHI-10) and for the Children Voice Handicap Index-10 for Parents (CVHI-10-P). J Voice 2024:S0892-1997(24)00222-4. [PMID: 39142923 DOI: 10.1016/j.jvoice.2024.07.011] [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: 01/19/2024] [Revised: 06/12/2024] [Accepted: 07/11/2024] [Indexed: 08/16/2024]
Abstract
OBJECTIVES The objective of this study was to establish normative data and cut-off scores for the Children Voice Handicap Index-10 (CVHI-10) and the Children Voice Handicap Index-10 for Parents (CVHI-10-P) METHODS: For normative data, CVHI-10 and CVHI-10-P questionnaires originally developed in the Italian language were completed by 201 children without dysphonia and with no history of voice disorders, and by 1 of their parents. The results were analyzed for mean, standard deviation (SD), and standard error of the mean (SEM) for both questionnaires. For cut-off values determination, data from 49 dysphonic children and from 1 of their parents were also used. This analysis was based on the sensitivity and specificity indicators of the questionnaires using the "receiver operating characteristic" (ROC) curve. RESULTS Analysis of the questionnaires related to healthy children revealed a mean of 0.26 (SD 0.74; SEM 0.06) for CVHI-10 and a mean of 0.15 (SD 0.49; SEM 0.04) for CVHI-10-P for the normative values. ROC curve analysis allowed us to establish the cut-off scores of 2.5 for CVHI-10 and 1.5 for CVHI-10-P. CONCLUSIONS This study offers normative data for CVHI-10 and CVHI-10-P and provides cut-off values for both questionnaires to distinguish healthy and pathologic responders.
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Affiliation(s)
- Vincenzo De Maio
- ORL Unit, Surgical Department, Santo Bono Pausillipon Hospital, Naples, Italy
| | - Francesco Mozzanica
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Department of Otorhinolaryngology, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
| | - Arianna Cardella
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Department of Otorhinolaryngology, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences, L. Sacco Hospital, University of Milan, Milan, Italy
| | - Thomas Murry
- Department of Otolaryngology Head and Neck Surgery, Loma Linda Health University, Loma Linda, California.
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Alons E, Brauner L, Luinge M, Terwee CB, van Ewijk L, Gerrits E. Identifying Relevant Concepts for the Development of a Communicative Participation Item Bank for Children and Adolescents: A Systematic Review of Existing Instruments. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1186-1205. [PMID: 38358947 DOI: 10.1044/2024_jslhr-23-00376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
PURPOSE This study aims to systematically identify items that measure communicative participation from measurement instruments that measure (aspects of) communication and/or participation in children and adolescents (5-18 years old) with communication disorders, for developing an item bank. METHOD A systematic literature search was performed in MEDLINE and Embase to search for patient-reported outcome measures (PROMs) or parent reports measuring aspects of communication and/or participation in children and adolescents. The individual items of the included measurement instruments were reviewed on whether they measure communicative participation. The items were then classified into one of the International Classification of Functioning, Disability and Health (ICF) for Children and Youth (World Health Organization, 2007) domains of activities and participation. RESULTS A total of 29 instruments were found, nine PROMs and 20 parent reports. One hundred forty-five items were identified that measure communicative participation. From these 145 items, 74 were retrieved from PROMs (51%), and 71 were retrieved from parent reports (49%). The majority of items were classified in ICF Domain 7, interpersonal interactions and relationships (73.8%), followed by Domain 8, major life areas (13.8%), and Domain 9, community, social, and civic life (8.3%). Only a few items were found in Domains 5 and 6, and none was found in Domains 1, 2, and 4. CONCLUSIONS We identified 145 items potentially useful for developing an item bank addressing communicative participation in children and adolescents with communication disorders. However, item development in collaboration with the target population is needed to ensure that these items fully reflect the construct.
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Affiliation(s)
- Eline Alons
- Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
- Department of Languages, Literature and Communication, Institute for Language Sciences, Utrecht University, the Netherlands
| | - Laurien Brauner
- Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
- Department of Languages, Literature and Communication, Institute for Language Sciences, Utrecht University, the Netherlands
| | - Margreet Luinge
- Centre of Expertise Healthy Ageing and Youth, Education and Society, Hanze University of Applied Sciences, Groningen, the Netherlands
| | - Caroline B Terwee
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit, the Netherlands
- Methodology Program, Amsterdam Public Health Research Institute, the Netherlands
| | - Lizet van Ewijk
- Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
| | - Ellen Gerrits
- Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
- Department of Languages, Literature and Communication, Institute for Language Sciences, Utrecht University, the Netherlands
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Reynolds V, Demarco J, Steinberg K. Better Breathing, Tougher Speaking? A Scoping Review of the Effects of Inhaled Corticosteroids on the Voice Quality of Asthmatic Children. J Voice 2024:S0892-1997(24)00003-1. [PMID: 38331703 DOI: 10.1016/j.jvoice.2024.01.005] [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: 11/14/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Inhaled corticosteroids (ICS) are a common treatment for certain lung diseases, including chronic obstructive pulmonary disorder in adults, and asthma across the lifespan. There is a link between the use of ICS and dysphonia in adults. This scoping review aims to investigate the incidence of dysphonia, in children aged under 12, who use ICS to treat asthma. METHODS A scoping review was conducted, in accordance with the guidelines prescribed by Arksey and O'Malley (2005). ASHAWire, Science Direct, PubMed, and ProQuest databases were searched. Out of the total yield of 1471 articles, four articles met the inclusion criteria, that is, were primary studies reporting on voice quality in children who use ICS, who present with asthma and/or allergy. RESULTS The majority of papers yielded from the initial search were retrieved because of the use of the term "dysphonia" in the basic definitions of asthma and descriptors of its side effects. Only four studies presented primary data about the presence of dysphonia in asthmatic children (with or without comorbid allergic conditions). None specifically investigated the relationship between ICS and dysphonia. Research questions focused on side effects associated with allergies and asthma, which included some information about medication. Only three of the four studies conducted a comprehensive review of the voice and utilized video laryngoscopy. DISCUSSION The evidence of a relationship, between ICS and dysphonia in children, is not conclusive, and is complicated by the connection between asthma, and breath support for phonation. There is a need for more thorough and focused investigation of the relationship between ICS, with or without bronchodilator use, and any resultant effects on children's vocal quality.
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Affiliation(s)
| | - Jenalee Demarco
- Lewis University, Romeoville, Illinois; Advanced Therapy and Wellness Clinic, Crest Hill, Illinois
| | - Katie Steinberg
- Lewis University, Romeoville, Illinois; Downers Grove Grade School District 58, Downers Grove, Illinois
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Balakrishnan S, Santhi T, Afsal EM. Dysphonia in Children; Clinical Profile, Conservative Treatment Modalities and Outcomes: An Institutional Experience. Indian J Otolaryngol Head Neck Surg 2023; 75:3248-3255. [PMID: 37974702 PMCID: PMC10646136 DOI: 10.1007/s12070-023-03952-6] [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: 05/26/2023] [Accepted: 06/08/2023] [Indexed: 11/19/2023] Open
Abstract
Dysphonia in children represents broad-spectrum voice problems. Global prevalence of hoarseness in school-aged children is 6-23%. It impairs communication of child, thus affects social life. This study shows importance of appropriate preventive measures for paediatric dysphonia and diagnosis of voice problems in early stages. Continuous voice abuse in children can cause recurrent voice disorders as well as speech problems. This prospective study included 104 patients(78 males and 26 females) of 6-15 years, with voice problems, in a tertiary care centre, North Kerala, during June 2022-March 2023. Chief complaints and risk factors evaluated. Voice analysis using maximum phonation time (MPT), Child Voice Handicap Index for Parents (CVHI-10-P), Reflux Symptom Index (RSI) and clinical examination including indirect laryngoscopy (IDL) and 70degree scopy were done. Treatment given for a maximum of 2 weeks. Advised voice rest and voice therapy throughout. All patients followed up after 2 weeks and up to 3 months. Voice abuse was the commonest risk factor and voice change, the commonest symptom. MPT reduced in 23% males and 14% females. According to CVHI-10-P, screaming was present in 52% children and symptoms present mostly in afternoon. RSI identified the role of LPRD in dysphonia. IDL and 70 scopy identified most common diagnosis as vocal nodule. Treatment given and follow-up period noted. All except vocal polyp had complete relief. Most common diagnosis was vocal nodule which resulted from chronic voice abuse. Appropriate preventive measures, early diagnosis and adequate treatment of voice problems should be considered. Conservative management in early stages is recommended.
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Affiliation(s)
- Sreelakshmi Balakrishnan
- Department of Otorhinolaryngology, Government Medical College, Manjeri, Malappuram, Kerala 676121 India
| | - T. Santhi
- Department of Otorhinolaryngology, Government Medical College, Manjeri, Malappuram, Kerala 676121 India
| | - E. Muhammed Afsal
- Department of Otorhinolaryngology, Government Medical College, Manjeri, Malappuram, Kerala 676121 India
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Kaya T, Yılmaz G, Zraick RI, Konrot A, Cangi ME. Reliability and validity of the Turkish voice handicap index-partner (VHI-P-TR). JOURNAL OF COMMUNICATION DISORDERS 2023; 106:106380. [PMID: 37738707 DOI: 10.1016/j.jcomdis.2023.106380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE This study examines the Turkish validity, reliability and diagnostic performance of the Voice Handicap Index-Partner (VHI-P-TR), which is used to obtain the perceptions of communication partners of individuals with dysphonia about the functional, physical and emotional handicap resulting from the patient experiencing dysphonia. METHOD The study included 160 individuals with dysphonia and their communication partners. First, translation, back translation, expert validity and pilot study were performed in the scale adaptation process. Then, a confirmatory factor analysis (CFA) was conducted to assess the construct validity of the VHI-P-TR. Correlations between the VHI-P-TR and Voice Handicap Index (VHI-TR) scores of dysphonic individuals were examined to evaluate the concurrent validity of the VHI-P-TR. To assess the reliability of the VHI-P-TR, a test-retest analysis was performed, and internal consistency coefficients (α) were calculated. A receiver operating characteristic (ROC) analysis was conducted to determine the cut-off point for the VHI-P scores. RESULTS A high positive correlation was found between the participants' VHI-P-TR and VHI-TR total and subscales mean scores (r's > 0.782; p < 0.01). The VHI-P-TR had high internal consistency regarding for its subscales and total score (α's > 0.94; p < 0.01). Factor loadings of all VHI-P-TR items were higher than 0.30 and their error variances were lower than 0.90. In addition, factor loadings were statistically significant for all the items (p < 0.05). The data fit the model well according to all CFA indices except for GFI (scale = 0.69). An adequate sensitivity and specificity were achieved for the VHI-P-TR, and the cut-off point was found as 11.50 for the total score and ranged from 2.50 to 5.50 for the subscales. CONCLUSION The VHI-P-TR is a valid and reliable measurement tool with high diagnostic performance in all subscales and total score, and has high levels of agreement with the VHI-TR.
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Affiliation(s)
- Tuğba Kaya
- University of Health Sciences, Speech and Language Deparment, İstanbul, Türkiye.
| | - Göksu Yılmaz
- Uskudar University, Speech and Language Deparment, İstanbul, Türkiye
| | - Richard I Zraick
- University of Central Florida, School of Communication Sciences and Disorders, Orlando, United States of America
| | - Ahmet Konrot
- Uskudar University, Speech and Language Deparment, İstanbul, Türkiye
| | - Mehmet Emrah Cangi
- University of Health Sciences, Speech and Language Deparment, İstanbul, Türkiye
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Yi S, Yang H. Update on the pediatric adverse vocal behavior voice disorders: a clinical practice review. Eur J Pediatr 2023:10.1007/s00431-023-04879-4. [PMID: 36973568 DOI: 10.1007/s00431-023-04879-4] [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: 11/26/2022] [Revised: 01/16/2023] [Accepted: 02/14/2023] [Indexed: 03/29/2023]
Abstract
The main causes of voice disorders in children with adverse vocal behavior include benign lesions of the vocal folds caused by voice abuse or misuses, such as vocal fold nodules, vocal fold polyps, and laryngitis. Long-term voice disorders can affect the physical and mental health of children. Reviewing the literature of the last two decades on "Vocal Fold Nodules," "Vocal Fold Polyp," "Voice disorder," "Voice Abuse," "Voice Misuse," "Pediatrics," and "Children" with the appropriate Boolean operators. Conclusion: A total of 315 results were returned on an initial PubMed search. All articles from 2000 to 2022 written in English or Chinese were screened. Duplicate articles, those relating to adults only or concerned with the malignant lesion of the vocal cord, were excluded, resulting in 196 articles of interest. Relevant references and books have also been consulted, and we provide a review of the pathogenesis, diagnosis, and treatment of these maladaptive vocal behavioral voice disorders. What is Known: • Hoarseness is the most common voice symptom in children, and there are various causes of hoarseness in children. However, there is a lack of reviews on voice disorders caused by adverse vocal habits in children. • Voice training is a conservative treatment method for children with voice disorders , and it is important to clarify the factors that influence the effectiveness of voice training for children. What is New: • This review of the personality and family characteristics of children with adverse vocal behavioural voice disorders provides a valuable guide to the clinical planning of subsequent treatment. • This article discusses and summarises some of the factors that may influence the effectiveness of voice training in children and collates some of the scales and questionnaires currently used in children that are important in predicting the effectiveness of voice training.
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Affiliation(s)
- Sixi Yi
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, 610044, China
| | - Hui Yang
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, 610044, China.
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Kwong E. Cross-cultural Adaptation and Validation of the Hong Kong-Chinese version of Children's Voice Handicap Index-10 for Parents (CVHI-10-P(HK)). J Voice 2023; 37:299.e9-299.e14. [PMID: 33384249 DOI: 10.1016/j.jvoice.2020.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/06/2020] [Accepted: 12/09/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The purpose of this study was to cross-culturally adapt and validate the Hong Kong Chinese version of the Children's Voice Handicap Index-10 for Parents (CVHI-10-P(HK)), a parent-proxied quality of life (QOL) questionnaire that pairs with the Children's Voice Handicap Index-10 (CVHI-10(HK)). METHOD The English version of the (CVHI-10-P(HK)) underwent forward-backward translation and pretesting. Content validity was computed from an expert panel rating on relevance and test-retest reliability was obtained from parents and/or guardians of six dysphonic and five vocally-healthy children. Other validity and reliability measures were analyzed from CVHI-10-P(HK) completed by parents and/or guardians of 28 dysphonic and 35 vocally-healthy children who had completed CVHI-10(HK). RESULTS The CVHI-10-P(HK) demonstrated excellent internal consistency (α = 0.091), excellent content validity (item- and scale-level content validity indices = 1.00), good construct validity (between group difference in total CVHI-10-P(HK) score: t(30.904) = -6.449, P < 0.001, Cohen's d = 1.709) and excellent test-retest reliability (r = 0.966, P < 0.001). Criterion validity analysis showed a moderate correlation between the total CVHI-10-P(HK) score and auditory-perceptual ratings on overall severity (r = 0.515, P < 0.001). Area under the curve of the receiver operating characteristic plot was found to be 0.855. The CVHI-10-P(HK) has excellent intrinsic accuracy. A cutoff of score of four may be adopted for the optimal sensitivity and specificity match. A moderate correlation was found between the total scores of CVHI-10-P(HK) and CVHI-10(HK) (r = 0.684, P < 0.001). CONCLUSION The CVHI-10-P(HK) is a valid tool that measures QOL of dysphonic children from the parents' perspective. It is recommended to be used in parallel to the CVHI-10(HK) as part of a comprehensive voice assessment for children in Hong Kong.
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Affiliation(s)
- Elaine Kwong
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
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Adriaansen A, Van Lierde K, Meerschman I, Everaert C, D'haeseleer E. Validity and Reliability of the Dutch Children's Voice Handicap Index-10. J Voice 2022:S0892-1997(22)00131-X. [PMID: 35641381 DOI: 10.1016/j.jvoice.2022.04.020] [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: 02/22/2022] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Voice-related quality of life (Qol) questionnaires provide the clinician with information regarding the impact of voice disorders on the patient's well-being. The available voice-related QoL tools for Dutch-speaking children are parent-proxy in nature. However, the use of proxy measurements has been debated in the literature. The Children's Voice Handicap Index-10 (CVHI-10) is a self-reported QoL tool for dysphonic children. Therefore, the aim of this study is to develop and validate a Dutch version of the CVHI-10. STUDY DESIGN Observational, prospective, cross-sectional study. METHODS The original version of the CVHI-10 was translated and adapted to Dutch according to the recommendations of the Quality of Life Special Interest Group - Translation and Cultural Adaptation group. Subsequently, the questionnaire was individually completed by 77 children (dysphonic group: n = 30, control group: n = 47) between eight and 14 years. In order to investigate test-retest reliability, 50% of the participants were asked to complete the questionnaire twice with an interval of 2 weeks. Internal consistency, test-retest reliability and construct validity were calculated. A receiver operating characteristic (ROC) analysis was conducted to check the sensitivity and specificity levels of the instrument. RESULTS Internal consistency measured with Cronbach's alpha coefficient was 0.745. Test-retest reliability measured with intraclass correlation coefficients was 0.718. Mean total CVHI-10 score was 6.17 ± 2.7 in the dysphonic group and 2.68 ± 2.6 in the control group. The difference in total score between the groups was statistically significant (P < 0.001), suggesting that the tool has good construct validity. ROC analysis demonstrated moderate diagnostic accuracy (area under the curve = 0.869) and suggested a cut-off score of 3.5. CONCLUSIONS The Dutch CVHI-10 is the first self-reported voice-related QoL tool for dysphonic Dutch-speaking children. It is a valid, reliable and sensitive tool to assess the impact of a voice disorder on the child's well-being.
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Affiliation(s)
- Anke Adriaansen
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Kristiane Van Lierde
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South-Africa
| | - Iris Meerschman
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Charlot Everaert
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Evelien D'haeseleer
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
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Alrahim A, Alshaibani AK, Algarni S, Alsaied A, Alghamdi AA, Alsharhan S, Al-Bar M. Prevalence and Determinants of Hoarseness in School-Aged Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5468. [PMID: 35564863 PMCID: PMC9103237 DOI: 10.3390/ijerph19095468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 11/23/2022]
Abstract
Hoarseness in school-aged children may affect their educational achievement and interfere with their communication and social skills development. The global prevalence of hoarseness in school-aged children ranges between 6% and 23%. To the best of our knowledge, there is a scarcity of studies describing the prevalence or determinates of hoarseness in Saudi school-aged children. Our aim was to measure the prevalence of hoarseness among school-aged children and to identify its determinants. A cross-sectional questionnaire-based survey was used that included randomly selected primary and early childhood schools from private and governmental sectors in Saudi Arabia. The data were collected using a questionnaire which was self-completed by the children's parents and covered the following aspects: sociodemographic features, health and its related comorbidities about children and their families, attendance and performance in school, child's voice tone, past history of frequent crying during infancy, history of letter pronunciation problems and stuttering, the Reflux Symptom Index (RSI) and the Children's Voice Handicap Index-10 for parents (CVHI-10-P). Determinants of hoarseness were investigated using the SPSS software (version 20). The mean age of the study children (n = 428) was 9.05 years (SD = 2.15), and 69.40% of them were male. The rate of hoarseness in the participants was 7.5%. Hoarseness was significantly common in children with a history of excessive infancy crying (p = 0.006), letter pronunciation issues (especially 'R' and 'S'; p = 0.003), and stuttering (p = 0.004) and in those with a previous history of hoarseness (p = 0.023). In addition, having the symptoms of gastrointestinal reflux increased the risk of hoarseness by four times (OR = 4.77, 95% CI = 2.171, 10.51). In summary, hoarseness in children may be dangerously underestimated, as it may reflect the presence of speech problems, in addition to the presence of laryngopharyngeal reflux (LPR). Hoarseness was assumed on the basis of parental complaints. Therefore, further research with diagnoses based on a clinical assessment is needed to understand the magnitude of the hoarseness problem and its consequences in children.
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Affiliation(s)
- Ahmed Alrahim
- ENT Department, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.A.); (S.A.); (M.A.-B.)
| | - Askar K. Alshaibani
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.K.A.); (S.A.)
| | - Saad Algarni
- College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.K.A.); (S.A.)
| | - Abdulmalik Alsaied
- ENT Department, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.A.); (S.A.); (M.A.-B.)
| | - Amal A. Alghamdi
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia;
| | - Salma Alsharhan
- ENT Department, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.A.); (S.A.); (M.A.-B.)
| | - Mohammad Al-Bar
- ENT Department, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.A.); (S.A.); (M.A.-B.)
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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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Surgical and therapeutic advances in the management of voice problems in children and young people. Curr Opin Otolaryngol Head Neck Surg 2019; 27:178-184. [PMID: 30920984 DOI: 10.1097/moo.0000000000000533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The current article reviews advances in both the assessment of paediatric voice disorders, as well as surgical, medical and therapeutic treatments. RECENT FINDINGS It is important to evaluate the impact of a voice disorder from both the parent and child perspective. Outpatient laryngoscopy with stroboscopy is very possible even in young children; however, high-speed ultrasound is a plausible alternative. High-speed videolaryngoscopy, videokymography and dynamic computed tomography, offer potential for augmenting the assessment of vocal fold vibratory characteristics in children. The evidence to support the efficacy of both indirect and direct voice therapy interventions is growing. The management of vocal fold palsy has advanced to include laryngeal reinnervation. Intubation injury with/without surgical intervention offers challenge and gives rise to voice disorders that may be lifelong. SUMMARY Although assessment and management practices of paediatric voice disorders closely follow those applied to adults, there are important differences and a developmental approach is required when considering both surgical and therapeutic management. Children can benefit from both indirect and direct therapy treatments following an ear, nose and throat assessment which utilizes paediatric instrumentation and considers the health of the entire airway. Underlying medical contributory factors should be explored and treated. Voice disorders due to congenital and acquired changes of the vocal tract may be amenable to surgery.
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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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