Research Article| Volume 37, ISSUE 2, P299.e9-299.e14, March 2023

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Cross-cultural Adaptation and Validation of the Hong Kong-Chinese version of Children's Voice Handicap Index-10 for Parents (CVHI-10-P(HK))

  • Elaine Kwong
    Address correspondence and reprint requests to Elaine Kwong, Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, EF 701, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
    Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Published:December 28, 2020DOI:



      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)).


      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).


      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).


      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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      Elaine Kwong, PhD. is currently an Assistant Professor in the Department of Chinese and Bilingual Studies, Hong Kong Polytechnic University. She is also an experienced speech-language pathologist (SLP) who specializes in managing both adult and pediatric voice disorders. Dr Kwong had delivered courses on clinical management for voice disorders to student SLPs from various institutes in Hong Kong. She also regularly supervises student SLPs in voice clinics. Her research interests include, but not limit to, complementary and alternative medicines for voice disorders, physiology of voice production and vocal fatigue, and prevention of voice disorders in occupational voice users etc.