Effects of voice therapy in school-age children

Abstract

Objectives: To assess the overall efficacy of voice therapy for dysphonia in school-age children in two different cities in Turkey.

Study design: Retrospective cohort study.

Methods: Ninety-nine outpatients aged 7-15 years with persistent hoarseness for at least 2 months as a primary symptom. Ratings of the Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale, s/z ratio, and maximum phonation time (MPT). Voice therapy outcome data collected on three types of voice therapy (physiological, hygienic, and symptomatic).

Setting: Outpatient clinics in university hospitals in two different cities in Turkey.

Results: Voice therapy improved voice quality as assessed by an observer according to GRBAS rating system (P<0.0001). All the subjects demonstrated varying degrees of hoarseness (G1-G3) and strained (S1-S3) voices. Varying degrees of roughness (R1-R3) and breathiness (B1-B3) were also noted. In general, changes to the value of the grade (the measure of the overall degree of voice deviance) were statistically significant (t = -8.3; P<0.0001) before and after therapy. Significant changes were found in the s/z ratio when the values were compared before and after therapy sessions (t=11.08; P<0.0001). Changes in MPT were statistically significant for all types of voice therapy (P<0.0001).

Conclusions: Vocal nodules were the main cause of the school-age children's voice problems, accounting for 62.6% of the cases. Different types of voice therapy techniques could be used in school-age children. Many of these techniques can successfully restore the normal voice. However, in this study, all subjective voice ratings such as GRBAS, s/z ratio, and MPT statistically changed by symptomatic voice therapy techniques. Symptomatic voice therapy was found to be a successful method of therapy.

Keywords: Child; Evidence-based practice; Voice; Voice therapy.