Summary
Background
The most common etiologies of dysphonia in the pediatric population are vocal fold
nodules and muscle tension dysphonia. Vocal therapy is the first line treatment for
these disorders in children. Despite this, not all children undergo therapy. The goal
of this study is to examine how factors such as patient demographics and parental
perceptions differ between children that choose to undergo or not to undergo voice
therapy.
Methods
A retrospective review was conducted of all pediatric patients seen at a tertiary
voice clinic between January 2014 and December 2017. Patients were included if diagnosed
with vocal fold nodules and/or muscle tension dysphonia. Patients were divided into
groups of children that received voice therapy at our institution and those that did
not. Data include demographics, Consensus Auditory-Perceptual Evaluation of Voice
(CAPE-V) scores and pediatric Voice Handicap Index (pVHI) scores. Distance to therapy
site was approximated using patient zip codes.
Results
Three hundred and forty-six children were included, 224 (65%) boys and 122 (35%) girls.
In the 2 years following initial diagnosis, 74 (21%) children participated in voice
therapy at our institution. Patients who underwent voice therapy were older than those
who did not (mean age: 9.1 [SD 3.5] vs 7.6 [SD 3.8] years; P = 0.004). Patients who received voice therapy were more likely to live closer to
the therapy site (mean distance: 15.5 [SD 13.0] vs 24.3 [SD 23.9] miles; P< 0.001). Likelihood of receiving voice therapy did not differ by gender or health
insurance status (private vs public). Patients who underwent voice therapy had significantly
greater CAPE-V Overall Severity scores than those who did not (mean score: 44.6 [SD
19.4] vs 37.4 [SD 18.0]; P = 0.003). Higher CAPE-V Strain scores were associated with increased likelihood of
voice therapy. pVHI scores did not differ between the two groups.
Conclusion
Older age, shorter distance to therapy site, and increased CAPE-V Overall Severity
and Strain scores were associated with higher likelihood of receiving voice therapy.
Gender, insurance status, and pVHI scores did not affect likelihood of receiving voice
therapy. Patients may primarily consider ease of access and necessity of treatment
when considering voice therapy.
Key Words
Abbreviations:
MTD (Muscle Tension Dysphonia), CAPE-V (Consensus Auditory-Perceptual Evaluation of Voice), pVHI (Pediatric Voice Handicap Index)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 23, 2021
Accepted:
January 8,
2021
Footnotes
Declaration of interest: none
Role of the funding source: no funding to disclose.
Identification
Copyright
© 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
