Objectives. The purpose of this study was to examine the voice quality and voice-related quality of life of children choir singers, an understudied population despite the disjunction between the demanding vocal requirements and limited vocal education.

Methods. Forty-five children (mean age: 13 years, range 8-17 years) involved in choir singing were included. A multidimensional assessment was performed, including Patient Reported Outcome Measures (PROMs), instrumental and auditory-perceptual outcomes. Dysphonia Severity Index (DSI), Acoustic Voice Quality Index (AVQI), fundamental frequency (fo), Grade (assessed using GRBASI) and PROMs were selected as primary outcomes for the analyses. The PROMs contained the KIDSCREEN-10 and Children’s Voice Handicap Index-10 (CVHI-10).

Results. The instrumental analysis revealed a mean DSI of 6.4 (range: 0.9-9.7), indicating excellent voice capacities. In terms of acoustic voice quality, the mean AVQI score was 3.1 (range: 1.7-5.0), corresponding to mild dysphonia. Auditory-perceptually, the mean Grade score was 0.4 (range: 0-2) corresponding with a normal to mildly deviant voice quality. PROMs indicated that the majority of the subjects reported an average (84.4%) to high (6.7%) health-related quality of life and minimal impact on well-being. They reported some voice difficulties with a mean CVHI-10 score of 3.4 (range: 0-15) just below the cutoff score (3.5). Furthermore, 51.1% of the children reported frequent occurrence of voice complaints after a vocal performance on a questionnaire designed to gather voice-related data.

Conclusion. While choir singing appeared to contribute to the development of excellent voice capacities, the overall acoustic voice quality indicated a mild dysphonia in the children’s voices. Despite the children's generally good health, half of them reported vocal complaints after performances, underscoring the importance of further investigation into children's understanding of their vocal habits.