Pediatric Dysphonia and the Access to Voice Therapy: A Study in Speech Therapy Services Available in a Capital City in the Northeast of Brazil.

OBJECTIVES: Defining the laryngeal and vocal alterations in the pediatric group studied in private speech therapy facilities; and estimating the time period between the problem being identified by the parents and the access to the proper provided services. METHODS: A cross-sectional analytical observational research with data collected from medical records by the speech therapist of each private facility. A written form was prepared and sent to the speech therapists of the 40 existing facilities. We received 124 of them from the pediatric group being assisted in 15 of the facilities. The form included questions about gender, age, vocal complaints; general degree of dysphonia; otorhinolaryngological diagnosis of vocal fold alterations; the age that the problem was identified by the parents and the beginning of speech therapy. The larynx was examined by videonasopharyngolaryngoscopy, and voice quality by auditory-perceptual assessment. RESULTS: The time period between the identification of the participant's dysphonia by the parents and the start of speech therapy was considered long (3.5years). The group showed variance in the proportion of nodule and cyst between genders. The highest prevalence of nodules occurred in boys; and the cyst in girls. Moderate general dysphonia occurred between 4 and 17years old, average age of 7years and 7months, with greater distribution between 5 and 10years of age. CONCLUSIONS: The average time delay until the start of speech therapy was 3.5years, more frequently in the 5-10years group and due to nodules in boys and cysts in girls.

Vocal function and vocal discomfort in sheltered and non-sheltered 7- to 10-year-old school children in Aracaju, Brazil.

OBJECTIVE: To compare vocal function, school performance, and vocal discomfort between sheltered and nonsheltered school children in Aracaju, Brazil. METHODS: A controlled cross-sectional study was carried out on 7- to 10-year-old children who attended school regularly. Two groups of children were studied: the study group (SG), with children who lived in a shelter, and the control group (CG) containing children who lived with their families. We interviewed 44 children for the SG and 15 (34%) revealed vocal discomfort (SG = 15). Concomitantly, we interviewed 400 regular school children from the same geographical area and 45 (11.25%) were selected for the control group (CG). They were paired by sex and age with the sheltered children using a 3:1 ratio. Both groups were interviewed about school performance and vocal discomfort and were evaluated using perceptual and acoustic measurements for the voice and larynx. RESULTS: Children from both groups had started public school late. There were more individuals with vocal discomfort in the SG and individuals in this group also had a slower speech rate and inadequate pneumophonic coordination compared with the CG. The Dysphonia Severity Index (DSI) revealed mild-moderate deviation for both groups. Upper harmonics and palatal tonsil hypertrophy were higher in the CG, whereas laryngeal constriction was more common in the SG. CONCLUSION: All the SG children revealed mild-moderate deviance on the DSI, a higher level of vocal discomfort, a slow speech rate, inadequate pneumophonic coordination, and laryngeal constriction. The results here presented suggest that social conditions are important for voice behavior in children.

Voice performance evaluation of street children from Aracaju, Brazil using perceptual-auditory and acoustic analyses.

OBJECTIVE: To compare the voice performance of children involved in street labor with regular children using perceptual-auditory and acoustic analyses. METHODS: A controlled cross-sectional study was carried out on 7- to 10-year-old children of both genders. Children from both groups lived with their families and attended school regularly; however, child labor was evident in one group and not the other. A total of 200 potentially eligible street children, assisted by the Child Labor Elimination Programme (PETI), and 400 regular children were interviewed. Those with any vocal discomfort (106, 53% and 90, 22.5%) had their voices assessed for resonance, pitch, loudness, speech rate, maximum phonation time, and other acoustic measurements. RESULTS: A total of 106 street children (study group [SG]) and 90 regular children (control group [CG]) were evaluated. The SG group demonstrated higher oral and nasal resonance, reduced loudness, a lower pitch, and a slower speech rate than the CG. The maximum phonation time, fundamental frequency, and upper harmonics were higher in the SG than the CG. Jitter and shimmer were higher in the CG than the SG. CONCLUSION: Using perceptual-auditory and acoustic analyses, we determined that there were differences in voice performance between the two groups, with street children having better quality perceptual and acoustic vocal parameters than regular children. We believe that this is due to the procedures and activities performed by the Child Labor Elimination Program (PETI), which helps children to cope with their living conditions.