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      Occurrence of vocal changes in preschoolers with no voice complaints: an auditory-perceptual and acoustic analysis Translated title: Ocorrência de alterações vocais em pré-escolares sem queixas de voz: análise perceptivo-auditiva e acústica

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          Abstract

          ABSTRACT Purpose: to verify, with the auditory-perceptual and acoustic parameters, the occurrence of voice changes in children with no voice complaints, per sex. Methods: the registers of 36 children with no voice complaints, aged 6 to 8 years, of whom 19 were males, were assessed. The databank consisted of the recordings of sustained vowels, sentences, and spontaneous speech. The auditory-perceptual analysis was conducted with the Consensus Auditory-Perceptual Evaluation of Voice, and the acoustic analysis, with VoxMetria. The fundamental frequency, jitter, shimmer, noise, and glottal-to-noise excitation ratio were analyzed. The Mann-Whitney test was applied for numerical variables, and the McNemar test, for the categorical ones, at the p < 0.05 significance level. Results: of the 5 children with mild voice changes, 4 were males. The most frequent resonance deviation was the laryngopharyngeal one. There was no difference between the sexes in the auditory-perceptual findings. The fundamental frequency in the group with changes was lower than that in the group without changes. There was a statistical association between the changes in the auditory-perceptual assessment and the acoustic parameters. Conclusion: voice changes occurred in 13.89% of the studied sample of children with no voice complaints, without differences between the sexes in the auditory-perceptual parameters. Vocal deviations were in a mild degree in all children who had them, the most frequent ones being roughness and breathiness. The fundamental frequency and shimmer were the acoustic parameters whose values most often occurred outside the reference limits, in both genders.

          Translated abstract

          RESUMO Objetivo: verificar a ocorrência de alterações vocais por seus respectivos parâmetros perceptivo-auditivos e acústicos em crianças sem queixas de voz, segundo o sexo. Métodos: foram avaliados os registros de 36 crianças sem queixas de voz, com idade entre seis e oito anos, sendo 19 do sexo masculino. O banco de dados consistiu de gravações de vogais sustentadas, frases e fala espontânea. A análise perceptivo-auditiva foi realizada por meio do Consensus Auditory-Perceptual Evaluation of Voice e a análise acústica por meio do VoxMetria. Foram analisados: frequência fundamental, jitter, shimmer, ruído e glottal to noise excitation ratio e aplicados os testes Mann-Whitney, para as variáveis numéricas, e McNemar, para as categóricas, com nível de significância de p<0,05. Resultados: das cinco crianças com alterações vocais leves, quatro eram do sexo masculino. O desvio de ressonância mais ocorrente foi o laringofaríngeo. Não houve diferença entre os sexos, nos achados perceptivo-auditivos. A frequência fundamental do grupo com alterações foi menor em relação ao grupo sem alterações. Houve associação estatística entre as alterações na avaliação perceptivo-auditiva e nos parâmetros acústicos. Conclusão: a ocorrência de alterações vocais na população de crianças estudadas sem queixa vocal foi de 13,89% e não diferiu entre os sexos nos parâmetros perceptivo-auditivos. Das crianças que apresentaram desvios vocais, todos foram em grau leve, com rugosidade e soprosidade mais ocorrentes. A frequência fundamental e o shimmer foram os parâmetros acústicos com maior ocorrência de valores fora dos limites referenciais, em ambos os sexos.

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          Dysphonia in children.

          Vocal symptoms are common among the pediatric population and are often caused by vocal abuse. Laryngoscopy is essential for their diagnosis because it helps differentiate several laryngeal lesions, leading to a decision for suitable treatments considering each case.
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            Epidemiological study of dysphonia in 4-12 year-old children

            Abstract Children dysphonia studies have reported an incidence of 4.4 to 30.3%. Goals To establish the prevalence of dysphonia in children, based on the opinion of the parents, acoustic and vocal-perceptual assessments, associated symptoms, risk factors and videolaryngoscopy findings. Materials and Methods The parents from 2,000 children answered a questionnaire about the vocal quality of their children, and these children were submitted to perceptual vocal, acoustic and videolaryngoscopy assessments. Results We had 1,007 boys and 993 girls; sporadic symptoms were reported by 206 parents and permanent symptoms were reported by 123. In the perceptual assessment, the G parameter (degree of dysphonia) had a score of 0 in 694 voices; 1 in 1,065 and 2 in 228. There was f0 reduction with age and the remaining acoustic parameters were high in children with a G score of 2. Nodules, thickening and inflammation were the most common in the videolaryngoscopy exams. Conclusions Parental judgment indicated a prevalence of dysphonia in 6.15%, and perceptual analysis yielded a value of 11.4%. Vocal symptoms were associated with a phonatory overload. sinonasal disorders, vocal abuse and noise were considered relevant risk factors. The acoustic analysis kept a direct association with the perceptual-auditory. Laryngeal lesions were found in the videolaryngoscopy exams, stressing nodules, thickening and inflammation.
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              Auditory-perceptual evaluation of the degree of vocal deviation: correlation between the Visual Analogue Scale and Numerical Scale

              PURPOSE: To analyze the intra- and inter-rater agreement for visual analog scale and numerical scale in task of sustained vowel and to determine numerical cutoff points to visual analog scale corresponding to the degrees of the numeric scale. METHODS: We selected 205 samples of the usual task of the sustained vowel /a/. Six voice specialists rated the overall degree of vocal deviation, first by visual analog scale and, after two days, by the numeric scale. The results obtained by both scales were compared and the intra- and inter-rater agreement, the correlation between the scales, and the estimated cutoff points using the intraclass correlation and concordance Kappa coefficients, the Spearman coefficient, and analysis of variance, and the values of sensitivity and specificity were analyzed. RESULTS: A strong correlation was observed between the scales. The following numerical cutoff values were found for visual analog scale corresponding to the numerical scale: neutral (degree zero) - 0 to 34 mm; mild (degree one) - 34.1 to 51 mm; moderate (degree two) - 51.1 to 63.5 mm; intense (degree three) - 63.6 to 77.5 mm; and extreme (degree four) - above 77.5 mm. CONCLUSION: The visual analog scale and numerical scale showed a strong correlation, being observed the greater intra- and inter-rater agreement in visual analog scale. Numerical cutoff values for visual analog scale were found. This correlation enables the comparison between the results found in the evaluation of the overall degree of vocal deviation by both scales, which are widely used in research and in the clinical speech therapy routine.
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                Author and article information

                Journal
                rcefac
                Revista CEFAC
                Rev. CEFAC
                ABRAMO Associação Brasileira de Motricidade Orofacial (São Paulo, SP, Brazil )
                1516-1846
                1982-0216
                2021
                : 23
                : 2
                : e11120
                Affiliations
                [1] Recife Pernambuco orgnameUniversidade Federal de Pernambuco Brazil
                Article
                S1516-18462021000200505 S1516-1846(21)02300200505
                10.1590/1982-0216/202123211120
                73337f9b-fdb7-4501-831e-92f7acc1e749

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 18 September 2020
                : 02 December 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 0
                Categories
                Original Articles

                Dysphonia,Child,Disfonia,Voice Disorders,Voice,Distúrbios da Voz,Criança,Voz

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