title: Objective vocal quality in children using cochlear implants: a multiparameter approach.
abstract: OBJECTIVE
  The purpose of this study was to determine the objective vocal quality in 36 prelingually deaf children using cochlear implant (CI) with a mean age of 9 years. An additional purpose was to compare the objective vocal quality of these 36 CI users with 25 age-matched children with prelingual severe hearing loss using conventional hearing aids (HAs) and 25 normal hearing (NH) children.
  
  
  METHODS
  The design for this cross-sectional study was a multigroup posttest-only design.
  
  
  METHODS
  The objective vocal quality was measured by means of the dysphonia severity index (DSI). Moreover, perceptual voice assessment using the GRBASI scale was performed.
  
  
  RESULTS
  CI children have a vocal quality by means of the DSI of +1.8, corresponding with a DSI% of 68%, indicating a borderline vocal quality situated 2% above the limit of normality. The voice was perceptually characterized by the presence of a very slight grade of hoarseness, roughness, strained phonation, and higher pitch and intensity levels. No significant objective vocal quality differences were measured between the voices of the CI children, HA users, and NH children.
  
  
  CONCLUSIONS
  According to the results, one aspect of the vocal approach in children with CI and using HAs must be focused on the improvement of the strained vocal characteristic and the use of a lower pitch and intensity level.
authors.affiliation: Department of Otorhinolaryngology, Audiologic and Logopaedic Sciences, Ghent University, Ghent, Belgium. nele.baudonck@ugent.be
authors.forename: Nele
authors.initials: N
authors.lastname: Baudonck
authors.forename: Evelien
authors.initials: E
authors.lastname: D'haeseleer
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Dhooge
authors.forename: Kristiane
authors.initials: K
authors.lastname: Van Lierde
mesh_terms: D002648:Child; D003054:Cochlear Implants; D003430:Cross-Sectional Studies; D003638:Deafness / Q000503:physiopathology* / Q000628:therapy; D055154:Dysphonia / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D013061:Speech Acoustics; D014833:Voice Quality