Abstract
Background
Vocal fold nodules are the most common etiology of chronic dysphonia in the pediatric
population. Voice therapy is an effective first line of treatment, with increasing
evidence supporting the use of telepractice in speech pathology. Despite this, there
is limited data on its effectiveness in the pediatric population. The aim of this
retrospective study was to investigate the feasibility and efficacy of telepractice
in delivering voice therapy to children diagnosed with vocal fold nodules.
Methods
A retrospective review was conducted of patients treated with virtual voice therapy
from April 2020 to June 2021. Patients were included if diagnosed with vocal fold
nodules, 2-18 years of age, and completed therapy in a virtual format. Data includes
demographics, Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) scores and
pediatric Voice Handicap Index (pVHI) scores.
Results
Twenty-three children were included, 17 (74%) male and six (26%) female (with an age
range of 2.4-9.9 years at the start of therapy). Prior to treatment, the average CAPE-V
Overall Severity score was 37.9 (SD 13.8); the average posttreatment score was 22.4
(SD 10.2). The average pVHI total score prior to treatment was 26.3 (SD 12.1), with
an average posttreatment score of 20.2 (SD 11.7). Patients who underwent virtual voice
therapy had improved posttreatment CAPE-V severity scores than those prior to treatment
(average difference = -15.5 points; 95% CI: -8.3 to -22.7; P < 0.001). An increased number of therapy sessions was associated with both higher
initial CAPE-V severity scores (r = 0.72; P < 0.01) and a greater decrease in posttreatment CAPE-V scores (r = -0.55; P < 0.01).
Conclusion
Virtual voice therapy may be feasible and efficacious in treating dysphonic children
diagnosed with vocal fold nodules. Significant improvements were found in perceptual
CAPE-V scores in overall severity; positive changes were also seen in parental measures
of quality of life. Delivery of voice therapy in a telehealth format may increase
access of care and should be considered as a treatment option.
Key Words
Abbreviations:
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: December 27, 2021
Accepted:
November 8,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
