Murali Mridhula, Cleland Joanne, Taylor Lauren, Young David, Stuart-Smith Jane, Kuschmann Anja
Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.
Department of Mathematics and Statistics, Univerisity of Strathcylde, Glasgow, UK.
Folia Phoniatr Logop. 2025 Jun 9:1-14. doi: 10.1159/000546421.
Voice disorders, or dysphonia, in children impact communication, social interactions, and quality of life, emphasizing the need for effective assessment tools with accurate reference norms. Acoustic measures taken during sound prolongation are widely used to evaluate voice quality, but variability in children's performance and limited norms from children from diverse backgrounds pose challenges for clinicians. This study investigated voice quality and variability in sound prolongation tasks among 5-12-year-old school children, contributing to the development of acoustic reference data.
A total of 275 primary school-aged children in Scotland participated, producing sustained phonations of [a], [s], and [z] to evaluate respiratory and phonatory performance. Durations and acoustic measures, including jitter, shimmer, harmonics-to-noise ratio (HNR), cepstral peak prominence (CPP), and s/z ratio, were analyzed to capture variability in performance.
Analysis indicated significant age-related increases in sound prolongation durations, with older children (7-12 years) outperforming younger children (5-6 years), reflecting enhanced respiratory capacity and vocal fold control. While jitter, shimmer, and HNR did not differ significantly across age groups, CPP values were higher in older children, indicating improved vocal stability and harmonic richness. Median s/z ratios also showed significant age-related changes, highlighting developmental changes in phonatory and respiratory coordination. Notably, children exhibited longer average sound prolongation durations than previously reported norms, with considerable variability in performance. No significant sex differences were found, except for the s/z ratio, where females had higher values.
These findings contribute and advance the growing body of reference data for assessing voice quality in children and emphasize the importance of factors such as age and sex in large, diverse samples. The study highlights the need to account for developmental variability and robust, comprehensive methodologies to contextualize voice quality issues in children.
儿童嗓音障碍或发声困难会影响沟通、社交互动和生活质量，这凸显了对具有准确参考标准的有效评估工具的需求。在声音延长过程中采取的声学测量方法被广泛用于评估嗓音质量，但儿童表现的变异性以及来自不同背景儿童的标准有限给临床医生带来了挑战。本研究调查了5至12岁学龄儿童在声音延长任务中的嗓音质量和变异性，为声学参考数据的发展做出了贡献。
苏格兰共有275名小学适龄儿童参与，发出[a]、[s]和[z]的持续发声以评估呼吸和发声表现。分析了持续时间和声学测量指标，包括抖动、闪烁、谐波噪声比（HNR）、谐波峰值突出度（CPP）和s/z比，以捕捉表现的变异性。
分析表明，声音延长持续时间与年龄显著相关，年龄较大的儿童（7至12岁）表现优于年龄较小的儿童（5至6岁），这反映了呼吸能力和声带控制的增强。虽然抖动、闪烁和HNR在不同年龄组之间没有显著差异，但年龄较大的儿童CPP值较高，表明嗓音稳定性和谐波丰富度有所改善。s/z比的中位数也显示出与年龄显著相关的变化，突出了发声和呼吸协调的发育变化。值得注意的是，儿童的平均声音延长持续时间比先前报告的标准更长，表现存在相当大的变异性。除了s/z比（女性的值较高）外，未发现显著的性别差异。
这些发现为评估儿童嗓音质量的参考数据的不断增长做出了贡献并有所推进，并强调了年龄和性别等因素在大型多样样本中的重要性。该研究强调需要考虑发育变异性以及采用稳健、全面的方法来将儿童嗓音质量问题置于具体情境中。
