A Randomized, Controlled Trial of Behavioral Voice Therapy for Dysphonia Related to Prematurity of Birth

  • Victoria Reynolds
    Correspondence
    Address correspondence and reprint requests to Victoria Reynolds, School of Paediatrics and Child Health, University of Western Australia, M561 35 Stirling Highway, Crawley, WA 6009, Australia.
    Affiliations
    Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia

    School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
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  • Suzanne Meldrum
    Affiliations
    Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia

    School of Psychology and Social Science, Faculty of Health, Engineering and Science, Edith Cowan University, Perth, Western Australia, Australia
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  • Karen Simmer
    Affiliations
    Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia

    Department of Neonatal Paediatrics, King Edward Memorial Hospital and Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia
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  • Shyan Vijayasekaran
    Affiliations
    Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia

    Department of Otolaryngology and Head and Neck Surgery, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia

    School of Surgery, University of Western Australia, Perth, Western Australia, Australia
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  • Noel French
    Affiliations
    Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia

    Department of Neonatal Paediatrics, King Edward Memorial Hospital and Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia

    State Child Development Centre, Health Department of Western Australia, Perth, Western Australia, Australia
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Published:September 08, 2016DOI:https://doi.org/10.1016/j.jvoice.2016.08.004

      Summary

      Objectives

      Dysphonia is a potential complication of prematurity. Preterm children may sustain iatrogenic laryngeal damage from medical intervention in the neonatal period, and further, adopt compensatory, maladaptive voicing behaviors. This pilot study aimed to evaluate the effects of a voice therapy protocol on voice quality in school-aged, very preterm (VP) children.

      Methods

      Twenty-seven VP children with dysphonia were randomized to an immediate intervention group (n = 7) or a delayed-intervention, waiting list control group (n = 14). Following analysis of these data, a secondary analysis was conducted on the pooled intervention data (n = 21). Six participants did not complete the trial.

      Results

      Change to voice quality was measured via pre- and posttreatment assessments using the Consensus Auditory Perceptual Evaluation of Voice. The intervention group did not demonstrate statistically significant improvements in voice quality, whereas this was observed in the control group (P = 0.026). However, when intervention data were pooled including both the immediate and delayed groups following intervention, dysphonia severity was significantly lower (P = 0.026) in the treatment group.

      Conclusions

      Dysphonia in most VP children in this cohort was persistent. These pilot data indicate that some participants experienced acceptable voice outcomes on spontaneous recovery, whereas others demonstrated a response to behavioral intervention. Further research is needed to identify the facilitators of and barriers to intervention success, and to predict those who may experience spontaneous recovery.

      Key Words

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