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The Egyptian Journal of Otolaryngology
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Formulation of a program for treatment of childhood dysphonia

The Egyptian Journal of Otolaryngology volume 35, pages 189–194 (2019)Cite this article

Abstract

Background

Dysphonia is a disorder characterized by change in voice quality, pitch, loudness, or vocal effort that impairs communication or reduces voice-related quality of life. Childhood dysphonia has several adverse educational and psychosocial implications. Dysphonic children are not aware or not bothered by their voice disorder. Although dysphonia might, in some cases, improve by itself in adulthood, it can be of important value to treat the dysphonic voice already during childhood.

Aim

The aim of this study was to adapt and formulate a program of voice intervention for childhood dysphonia and apply it on Egyptian children to explore its effectiveness as a therapeutic tool.

Patients and methods

This study was conducted on 20 children of both sexes attending the Phoniatrics Unit in Alexandria Main University Hospital complaining of dysphonia. The remediation program aims to improve dysphonia in children using a combination of indirect and direct treatment techniques. It is a modification of The Boone Voice Program for Children combined with new technologies such as the voice games by Kay Elementrics. It is designed to provide the clinician with step-by-step procedures and materials to remediate voice disorders in school-aged children. The program was translated to Arabic and a number of modifications were done in order to adapt it to the Egyptian children.

Results

The study showed effectiveness of the remediation program for childhood dysphonia regarding some of the auditory perceptual assessment and acoustic analysis values. Some of the laryngeal examination findings also showed improvement post-therapy. The study showed significant relation between the children’s age, sex, diagnosis, and some pretherapy and post-therapy findings.

Conclusion

Data from the current study suggests that voice therapy may prove to be a valid alternative to just planned follow-up.

References

  1. Schwartz SR, Cohen SM, Dailey SH, Rosenfeld RM, Deutsch ES, Gilespie MB, et al. Clinical practice guideline:hoarseness (dysphonia). Otolaryngol Head Neck Surg 2009; 141:1–31.

    Article  Google Scholar 

  2. Connor NP, Cohen SB, Theis SM, Thibeault SL, Heatley DG, Bless DM. Attitudes of children with dysphonia. J Voice 2008; 22:197–209.

    Article  Google Scholar 

  3. Fuchs M, Meuret S, Stuhrmann NC, Schade G. Tune in children and adolescents. HNO 2009; 57:603–614.

    Article  CAS  Google Scholar 

  4. Verduyckt I, Remacle M, Jamart J, Benderitter C, Morsomme D. Voice related complaints in the pediatric population. J Voice 2011a;25:373–380.

    Article  Google Scholar 

  5. Duff MC, Proctor A, Yairi E. Prevalence of voice disorders in African American and European American preschoolers. J Voice 2004; 18:348–353.

    Article  Google Scholar 

  6. Nicollas R, Giovanni A, Triglia J-M. Les dysphonies de l’enfant. Arch Pediatr 2008; 15:1133–1138.

    Article  CAS  Google Scholar 

  7. Mortensen M, Schaberg M, Woo P. Diagnostic contributions of videolaryngostroboscopy in the pediatric population. Arch Otolaryngol Head Neck Surg 2010; 136:75–79.

    Article  Google Scholar 

  8. Carding PN, Roulstone S, Northstone K, ALSPAC Study Team. The prevalence of childhood dysphonia: a cross-sectional study. J Voice 2006; 20:623–630.

    Article  Google Scholar 

  9. Connelly A, Clement WA, Kubba H. Management of dysphonia in children. J Laryngol Otol 2009; 123:642–647.

    Article  CAS  Google Scholar 

  10. Lecoq M, Drape F. Epidemiological survey of dysphonia in children at primaryschool entry. Rev Laryngol Otol Rhinol (Bord) 1996; 117:323–325.

    CAS  Google Scholar 

  11. Arias Marsal C, Estapé i Vilà M. Childhood dysphonia: diagnosis and treatment. Barcelona: Ars Médica 2005; 230.

    Google Scholar 

  12. Cornut G, Trolliet-Cornut A. Les dysphonies de l’enfant : aspects cliniques et thérapeutiques. Rééducation orthophonique : les pathologies vocales chezl’enfant, 194. Paris: Fédération Nationale des Orthophonistes (FNO); 1998. 9–17

    Google Scholar 

  13. Connor NP, Cohen SB, Theis SM, Thibeault SL, Heatley DG, Bless DM. Attitudes of children with dysphonia. J Voice 2008; 22:197–209.

    Article  Google Scholar 

  14. Sderholm E, McAllister A. Group therapy for dysphonic children. In: White P. (ed) Child voice. ISBN 91-7170-512-0. USA: KTH Voice Center; 2000; 143–147.

  15. Truong MT, Messner AH, Kerschner JE, Scholes M, Wong-Dominguez J, Milczuk A, et al. Pediatric vocal fold paralysisafter cardiac surgery: rate of recovery and sequelae. Otolaryngol Head Neck Surg 2007; 137:780–784.

    Article  Google Scholar 

  16. Miyamoto RC, Parikh SR, Gelad W, Licameli GR. Bilateral con-genital vocal cord paralysis: a 16-year institutional review. Otolaryngol Head Neck Surg 2005; 133:241–245.

    Article  Google Scholar 

  17. Kaufmann I, Lina-Granade G, Truy E, et al. La dysphonie chronique de l’enfant.Mise au point à la lumière d’une série personnelle de 54 cas (france). Pediatrie 1992; 47:313–319.

    Google Scholar 

  18. Dejonckere PH, Bradley P, Clemente P, Cornut G, Crevier-Buchman L, Friedrich G, et al. A basic protocol for func-tional assessment of voice pathology, especially for investigating the efficacyof (phonosurgical) treatments and evaluating new assessment techniques.Guideline elaborated by the Committee on Phoniatrics of the European Laryngological Society (ELS). Eur Arch Otorhinolaryngol 2001; 258:77–82.

    Article  CAS  Google Scholar 

  19. Boone D, McFarlane S. The voice and voice therapy, 8th edition. 1988.

  20. Nygren M, Tyboni M, Lindström F, McAllister A, Doorn JV. Gender differences in children’s voice use in a day care environment. J Voice 2012; 26:817.e15–e18.

    Article  Google Scholar 

  21. Trani M, Ghidini A, Bergamini G, Presutti L. Voice therapy in pediatric functional dysphonia. Int J Pediatr Otorhinolaryngol 2007; 71:379–384.

    Article  Google Scholar 

  22. Colton R, Casper JK, Leonard R. Understanding voice problems. a physiological perspective for diagnosis and treatment. 3rd ed. Baltimore, MD: Lippincott Williams & Wilkins; 2006.

    Google Scholar 

  23. Sederholm E, McAllister A, Dalkvist J. Aetiological factors associated with hoarseness in ten year old children. Folia Phoniatr Logop 1995; 47:262–278.

    Article  CAS  Google Scholar 

  24. Tezcaner CZ, Karatayli Ozgursoy S, Sati I, Dursun G. Changes after voice therapy in objective and subjective voice measurements of pediatric patients with vocal nodules. Eur Arch Otorhinolaryngol 2009; 266:1923–1927.

    Article  Google Scholar 

  25. Lee EK, Son YI. Muscle tension dysphonia in children: voice characteristics outcome of voice therapy. Int J Pediatr Otorhinolaryngol 2005; 69:911–917.

    Article  Google Scholar 

  26. Oates J. Auditory perceptual evaluation of disordered voice quality: pros, cons and future directions. Folia Phoniatr Logop 2009; 61:49–56.

    Article  Google Scholar 

  27. Tavares ELM, Brasolotto A, Santana MF, Padovan CA, Martins RHG. Epidemiological study of dysphonia in 4–12 year-old children. Braz J Otorhinolaryngol 2011; 77:736–746.

    Article  Google Scholar 

  28. Speyer R, Wieneke GH, Dejonckere PH. Documentation of progress in voice therapy: perceptual, acoustic, and laryngostroboscopic findings pretherapy and posttherapy. J Voice 2004; 18:325–340.

    Article  CAS  Google Scholar 

  29. AboRas YA, El-Maghraby RM, Abdou RM. The normative study of acoustic parameters in normal Egyptian children aged 4–12 years. Alex J Med 2013; 49:211–214.

    Article  Google Scholar 

  30. Campisi P, Tewfik TL, Manoukian JJ, Schloss MD, Pelland-Blais E, Sadeghi N. Computer-assisted voice analysis. Arch Otolaryngol Head Neck Surg 2002; 128:156–160.

    Article  Google Scholar 

  31. Niedzielska GY, Glijer EB, Niedzielski A. Acoustic analysis of voice in children with noduli vocales. Int J Pediatr Otolaryngol 2001; 60:119–122.

    Article  CAS  Google Scholar 

  32. Wuyts FL, De Bodt MS, Molenberghs G, Remacle M, Heylen L, Millet B, et al. The Dysphonia Severity Index an objective measure of vocal quality based on a multiparameter approach. J Speech Lang Hear Res 2000; 43:796–809.

    Article  CAS  Google Scholar 

  33. Behlau M, Azevedo R, Pontes P. Concept of normal voice and classification of dysphonias, in: M Behlau (Ed.), Voice - the specialist’s book, vol. I, Revinter, Rio de Janeiro 2001.

  34. Tavares ELM, Brasolotto AG, Rodrigues SA, Benito Pessin AB, Garcia RH. Martins, maximum phonation time and s/z ratio in a large child cohort. J Voice 2012; 26:675.e1–675.e4.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Phoniatrics, Faculty of Medicine, University of Alexandria, 12 Street El Nahda Roushdy, Alexandria, Egypt

    Riham M. Elmaghraby Msc, Phd (Assist aprof. of phoniatrics)

  2. Unit of Phoniatrics, Department of Phoniatrics, Faculty of Medicine, University of Alexandria, Alexandria, Egypt

    Yehia A. A. Ras

  3. Department of otorhinolaryngology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt

    Maha M. Elkaraksy

Authors
  1. Riham M. Elmaghraby Msc, Phd
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  2. Yehia A. A. Ras
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Correspondence to Riham M. Elmaghraby Msc, Phd.

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Elmaghraby, R.M., Ras, Y.A.A. & Elkaraksy, M.M. Formulation of a program for treatment of childhood dysphonia. Egypt J Otolaryngol 35, 189–194 (2019). https://doi.org/10.4103/ejo.ejo_7_18

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  • DOI: https://doi.org/10.4103/ejo.ejo_7_18

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