Children's ability to identify and describe dysphonia: A multimethod study

Abstract

Background: While some studies have demonstrated that children can express opinions about their voice, and that they are conscious of and affected by their voice disorders, knowledge about age-related understanding of paediatric dysphonia is still incomplete. To date, no study has investigated children’s accuracy in their ability to identify dysphonia and the language they use when describing voice quality. Aims: This research aims to improve our knowledge of how children perceive and describe dysphonic and non-dysphonic voices. The objectives are to analyse whether children can identify the presence of dysphonia in other children’s voices and understand how they describe dysphonic and non-dysphonic voices. Methods and Procedures: The research was carried out using a multimethod design combining quantitative and qualitative approaches. Thirty children listened to 5 dysphonic and 5 normophonic paediatric voice samples, and were then asked to decide whether the voices sounded ’OK’ or ’not-OK’. Correct answers were calculated as percentages. The relationships between sex and age on the percentage of correct guesses were analysed with descriptive statistics and by using Mann-Whitney U and Spearman’s Correlation. Participants were also asked to describe one normophonic and one dysphonic voice sample. Children’s descriptions of the voices were analysed using Content Analysis. Results: The median correct answers for identifying dysphonia presence was 70% (IQR=20). No statistically significant difference in correct answers between sexes were found (U=91.0, p=0.432). Results showed no correlation between age and the percentage of correct answers (rs(28)=-0.060, p=0.751). Content analysis identified three themes: (a) Words describing voices, which featured adjectives related to voice quality, (b) Extra information, which concerned speech and voice but not voice quality, (c) Unrelated information, irrelevant to voice quality. Conclusions: Children were capable of correctly identifying whether other children’s voices were or were not dysphonic with a high degree of accuracy. Their perceptual abilities were unrelated to their sex or age. Perceptual awareness of dysphonia is a necessary prerequisite for successful voice intervention in dysphonic children. Clinicians should therefore ensure that dysphonic children can adequately discriminate dysphonia presence before starting therapy. Children can express themselves about how voices sound, but sometimes mistake voice quality for other concepts. Clinicians should therefore be aware of this tendency and could inform and teach their paediatric clients about voice quality. This study provides some age-appropriate descriptive terms to facilitate that process.