University Hospital of Mont-Godinne, Yvoir, Belgium.
J Voice. 2011 May;25(3):373-80. doi: 10.1016/j.jvoice.2009.11.008. Epub 2010 Apr 1.
Subjective evaluation of the voice by the patient is routinely assessed in the adult dysphonic population; this is, however, not the case in the pediatric population. There were three objectives of this study: the first goal was to study the ability of children aged 5-13 years to express themselves about physical, emotional, and sociofunctional aspects of their voice. The second goal was to explore if specific voice-related complaints were expressed by dysphonic children as compared with normophonic children. The third goal was to compare the dysphonic children's voice-related complaints with those of their mothers. The overall objective was to set the grounds for the elaboration of a standardized questionnaire in French concerning subjective evaluation of voice in children. Twenty-five dysphonic children with vocal complaint (15 nodules, one polyp, one microweb, eight unspecified) and 55 normophonic children aged 5-13 years were interviewed. The interviews were semistructured based on a canvas of voice-related questions. The dysphonic children's mothers were interviewed with the mean of a written questionnaire and were invited to discuss their answers orally with the examiner. The results were analyzed qualitatively and statistically. A Chi-square test and the Fisher's test were used to analyze the differences between the complaints expressed by the dysphonic and the normophonic children, and a binomial test was used to compare the children's answers with their mothers' answers. The qualitative analysis of the interviews suggests that children are capable of reflecting over their own voice and of giving autonomous information about different aspects of their voice. It also appeared that voice is a complex phenomenon and that it needs to be clearly and cautiously defined to the children. We identified 27 different complaints related to the voice, out of which 17 were significantly more expressed by dysphonic than by normophonic children (P<0.05). Three of the 27 identified complaints show significant discordances between the mothers and the dysphonic children. The results suggest that children are capable of making a subjective and autonomous evaluation of their voice and that dysphonic children experience significantly more voice-related discomfort than nondysphonic children. The complaints expressed by the dysphonic children and their mothers are not all in concordance. The main conclusion is that a standardized subjective evaluation of the voice, not only by the parents but also by the child him/herself, would be relevant in the assessment of pediatric dysphonia.
患者对声音的主观评估在成年发音障碍人群中通常会进行评估；然而，在儿科人群中并非如此。本研究有三个目的：第一个目标是研究 5-13 岁儿童表达自己声音的身体、情感和社会功能方面的能力。第二个目标是探索发音障碍儿童是否会表达特定的与声音相关的抱怨，与发音正常的儿童相比。第三个目标是比较发音障碍儿童与他们母亲的声音相关抱怨。总体目标是为制定法语儿童声音主观评估的标准化问卷奠定基础。对 25 名有声音抱怨的发音障碍儿童（15 名声带小结，1 名息肉，1 名微小结，8 名未特指）和 55 名 5-13 岁的发音正常儿童进行了访谈。访谈基于一系列与声音相关的问题进行半结构化。对发音障碍儿童的母亲进行了书面问卷访谈，并邀请她们与检查者口头讨论答案。结果进行了定性和统计学分析。使用卡方检验和 Fisher 检验分析发音障碍儿童和发音正常儿童表达的抱怨之间的差异，使用二项式检验比较儿童和母亲的答案。访谈的定性分析表明，儿童能够反思自己的声音，并能自主提供有关声音不同方面的信息。研究还表明，声音是一个复杂的现象，需要向儿童清楚且谨慎地定义。我们确定了 27 种不同的与声音相关的抱怨，其中 17 种在发音障碍儿童中比在发音正常儿童中表达得更明显（P<0.05）。27 种确定的抱怨中有 3 种在母亲和发音障碍儿童之间存在显著差异。结果表明，儿童能够对自己的声音进行主观和自主评估，发音障碍儿童比发音正常儿童经历更多与声音相关的不适。发音障碍儿童及其母亲表达的抱怨并非完全一致。主要结论是，对儿童声音的主观评估（不仅是父母，还有儿童自己）标准化将与儿科发音障碍的评估相关。
