Dysphonia in Preschool-Aged Children: Efficacy of Voice Therapy.

Introduction: Pediatric dysphonia is common, with a prevalence as high as 38% in school-aged children. Previous studies have shown the benefits of therapy in treating pediatric dysphonia; however, much of the literature that discusses these benefits address older school-aged children (6-18 years) and not those who are younger. The objective of this study is to examine the efficacy of voice therapy for preschool-aged patients, between ages 2 and 5 years old.

Methods: An IRB-approved retrospective review was conducted of pediatric patients (age range 2-5 years) seen at multi-disciplinary voice clinics within Boston Children's Hospital, Department of Otolaryngology, between January 2015 and March 2023. Data including dates of presentation, demographics, co-morbidities, presenting symptoms, number of therapy sessions, Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) ratings, and Pediatric Voice Handicap Index (pVHI) scores were collected and analyzed.

Results: 77 patients who were recommended voice therapy for dysphonia were reviewed. 51 (66.2%) were male and 26 (33.8%) were female. The mean age at first evaluation was 4.49 years old. Each patient underwent, on average, 5.29 sessions (SD = 2.16) and 1.87 months (SD = 2.79) of therapy. Patients experienced a 36.4% decrease in their CAPE-V Overall Severity score from pretherapy to post therapy. Patients diagnosed with vocal cord nodules experienced greater decrease in CAPE-V ratings than those with other etiologies for hoarseness (-18.18, P = 0.016). Age, schooling status, number of siblings, history of speech delay, and other medical co-morbidities had no significant effect on patients' overall CAPE-V ratings. pVHI parental rating of severity decreased 43.9% from pretherapy to post therapy. Total pVHI scores also decreased after treatment.

Conclusion: Voice therapy in younger preschool age children can be efficacious and result in improved vocal quality.