Deborah Ruth, Samayan Kala
Department of Audiology and Speech Language Pathology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu District 603203, Tamil Nadu, India.
J Voice. 2024 Apr 26. doi: 10.1016/j.jvoice.2024.03.019.
Dysphonia in school-aged children is attributed primarily to hyperfunctional use of voice. These can be identified through effective protocols using both acoustic and auditory-perceptual analyses.
The current study aimed to investigate voice characteristics in school children aged 4-17 years using auditory-perceptual rating and cepstral measures of voice.
This is a descriptive cross-sectional observational study.
Four hundred and fifty-seven recordings of sustained phonation of /a/ in children and adolescents obtained in a quiet room using Zoom h1 voice recorder were analyzed using auditory-perceptual evaluation by three speech-language pathologists using Grade of overall dysphonia, Roughness, Breathiness, Asthenia, and Strain(GRBAS) rating scale. The samples were classified based on age into five groups: 1) 4 to 6; 11 years 2) 7-8; 11 years, 3) 9-11; 11years 4) 12-13; 11years and 5) 14-16; 11 years. PRAAT software was used to extract Cepstral Peak Prominence (CPP) and Cepstral Peak Prominence Smoothed (CPPS). Inter-rater reliability was assessed for both auditory-perceptual and acoustic analysis.
Auditory-perceptual analysis revealed dysphonia in 7.8% of samples with higher rate in males than females. Inter-rater reliability for auditory-perceptual rating was found to be good (Intraclass Corelation Coefficient-0.83). Independent t test revealed statistically significant difference (P < 0.001) in both cepstral measures and mean values were lower in dysphonic than normal group. Gender effect was present for CPP in group 5(14-16;11 years) and CPPS in group 4 (12-13; 11 years). One-way analysis of variance within groups in males (P < 0.005) revealed statistical difference in both cepstral measures but not in females. Statistically significant difference was not found between ratings of both speech language pathologists for both CPP (P = 0.929) and CPPS (P = 0.965) values indicating the ratings to be reliable.
Pediatric dysphonia has received less attention when compared to adults. Assessing school-aged children for dysphonia using both auditory-perceptual and acoustic measures would aid in identifying those at risk to make appropriate referrals and plan further intervention.
学龄儿童的发声障碍主要归因于发声的过度功能化使用。这些可以通过使用声学和听觉感知分析的有效方案来识别。
本研究旨在通过听觉感知评分和嗓音的谐波峰值频率测量来调查4至17岁学龄儿童的嗓音特征。
这是一项描述性横断面观察研究。
使用Zoom h1录音机在安静房间中获取457名儿童和青少年发/a/音的持续发声记录，由三名言语治疗师使用总体发声障碍分级、粗糙程度、气息声、虚弱程度和紧张程度（GRBAS）评分量表进行听觉感知评估。样本按年龄分为五组：1）4至6岁；2）7至8岁；3）9至11岁；4）12至13岁；5）14至16岁。使用PRAAT软件提取谐波峰值突出度（CPP）和平滑谐波峰值突出度（CPPS）。对听觉感知和声学分析的评分者间信度进行评估。
听觉感知分析显示7.8%的样本存在发声障碍，男性发生率高于女性。发现听觉感知评分的评分者间信度良好（组内相关系数-0.83）。独立t检验显示，在谐波峰值频率测量中均存在统计学显著差异（P<0.001），发声障碍组的平均值低于正常组。在第5组（14至16岁）的CPP和第4组（12至13岁）的CPPS中存在性别效应。男性组内的单因素方差分析（P<0.005）显示在谐波峰值频率测量中均存在统计学差异，而女性中未发现。对于CPP（P=0.929）和CPPS（P=0.965）值而言，两名言语治疗师的评分之间未发现统计学显著差异，表明评分可靠。
与成人相比，儿童发声障碍受到的关注较少。使用听觉感知和声学测量方法对学龄儿童进行发声障碍评估，将有助于识别有风险的儿童，以便进行适当的转诊并制定进一步的干预计划。
