Effects of Voice Therapy in School-Age Children

Objectives. To assess the overall efficacy of voice therapy for dysphonia in school-age children in two different cities in Turkey. Study Design. Retrospective cohort study. Methods. Ninety-nine outpatients aged 7-15 years with persistent hoarseness for at least 2 months as a primary symptom. Ratings of the Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale, s/z ratio, and maximum phonation time (MPT). Voice therapy outcome data collected on three types of voice therapy (physiological, hygienic, and symptomatic). Setting. Outpatient clinics in university hospitals in two different cities in Turkey. Results. Voice therapy improved voice quality as assessed by an observer according to GRBAS rating system (P < 0.0001). All the subjects demonstrated varying degrees of hoarseness (G1-G3) and strained (S1-S3) voices. Varying degrees of roughness (R1-R3) and breathiness (B1-B3) were also noted. In general, changes to the value of the grade (the measure of the overall degree of voice deviance) were statistically significant (t = -8.3; P < 0.0001) before and after therapy. Significant changes were found in the s/z ratio when the values were compared before and after therapy sessions (t = 11.08; P < 0.0001). Changes in MPT were statistically significant for all types of voice therapy (P < 0.0001). Conclusions. Vocal nodules were the main cause of the school-age children's voice problems, accounting for 62.6% of the cases. Different types of voice therapy techniques could be used in school-age children. Many of these techniques can successfully restore the normal voice. However, in this study, all subjective voice ratings such as GRBAS, s/z ratio, and MPT statistically changed by symptomatic voice therapy techniques. Symptomatic voice therapy was found to be a successful method of therapy.