Summary: Objective. Engaging children with voice therapy is a commonly reported clinical challenge. It is unknown whether this is because children cannot perceive dysphonia, or whether clinicians do not discuss it in age-appropriate terms. This research aimed to analyze whether children can identify the presence of dysphonia in other children’s voices and understand how they describe dysphonic and non-dysphonic voices.
Study design. The research was carried out using a multimethod design combining quantitative and qualitative approaches.
Methods. Thirty children aged 5-10 (17 male, 13 female) listened to 5 dysphonic and 5 normophonic pediatric voice samples. They were asked whether the voices sounded “OK” or ”Not-OK”. Relationship between sex and age on the percentage of correct responses was analyzed using Mann-Whitney U and Spearman’s correlation. Participants were asked to describe one normophonic and one dysphonic voice sample in their own words. Descriptions were analyzed using Content Analysis to thematically categorize responses.
Results. Median correct answers for identifying dysphonia presence was 70% (IQR=20). No statistically significant difference between sexes was found (p=0.432). Results showed no correlation between age and percentage of correct answers (p=0.751). Content analysis identified three categories: (a) Words describing voices, featuring adjectives related to voice quality, (b) Extra information, concerning speech and voice but not voice quality, (c) Unrelated information, irrelevant to communication.
Conclusions. Children are capable of correctly identifying dysphonia presence in other children’s voices with a high degree of accuracy, unrelated to their sex or age. However, lack of universal appreciation of dysphonia means that clinicians should examine pediatric clients’ perceptual abilities before commencing voice therapy. Children sometimes mistake voice quality for other concepts, both communication-related and not. The findings of the present study provide some age-appropriate descriptive terms that could facilitate education of pediatric clients about the concept of voice quality.
Keywords: Pediatric dysphonia, Awareness, Children, Voice disorders