Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, UT, United States.
Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, UT, United States.
J Commun Disord. 2022 May-Jun;97:106203. doi: 10.1016/j.jcomdis.2022.106203. Epub 2022 Feb 25.
Vocal fold nodules (VNs) represent the most common cause of voice disorders in children. Phonotrauma related to chronic, repetitive, intense vocal activity is often cited as the proximate cause of VNs. However, diminished self-regulation (SR) may predispose some children toward extreme phonotraumatic voice use, thereby contributing secondarily to their development. This case-control study examined the association between features of SR and VNs in children.
Parents of children with VNs (N = 40, Age Mean = 7.5, SD = 2.03 years) and vocally normal, medical controls (VNCs; N = 40, Age Mean = 7.6, SD = 1.54 years) completed the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2; Gioia, Isquith, Guy & Kenworthy, 2015), an inventory that evaluates components of SR in children.
Children with VNs, as compared with the vocally normal control group, were described as (i) impulsive (i.e., scoring significantly worse on the Behavior Regulation Index, BRI; P < 0.001, Cohen's d = 0.86), and (ii) emotionally dysregulated (i.e., scoring significantly worse on the Emotional Regulation Index, ERI; P < 0.001, Cohen's d = 0.81).
Diminished SR in some children with VNs may contribute to phonotraumatic vocal behaviors and potentially attenuate the effectiveness of voice therapy.
声带小结（VN）是儿童嗓音障碍最常见的原因。与慢性、反复、剧烈的发声活动相关的发声创伤常被认为是 VN 的直接原因。然而，自我调节能力下降（SR）可能使一些儿童倾向于过度使用创伤性声音，从而间接地促成其发展。本病例对照研究探讨了儿童 SR 特征与 VN 之间的关联。
VN 患儿的父母（VN 组，N=40，年龄均值=7.5，标准差=2.03 岁）和嗓音正常的医学对照组（VNC 组，N=40，年龄均值=7.6，标准差=1.54 岁）完成了行为评定量表第二版（BRIEF2；Gioia、Isquith、Guy 和 Kenworthy，2015），该量表评估了儿童的 SR 成分。
与嗓音正常的对照组相比，VN 患儿被描述为（i）冲动（即，行为调节指数 BRI 得分显著更差，P<0.001，Cohen's d=0.86），以及（ii）情绪失调（即，情绪调节指数 ERI 得分显著更差，P<0.001，Cohen's d=0.81）。
一些 VN 患儿的 SR 下降可能导致创伤性发声行为，并可能降低语音治疗的效果。
