title: Voice disorders in children and its relationship with auditory, acoustic and vocal behavior parameters.
abstract: OBJECTIVE
  Parameters to distinguish normal from deviant voices in early childhood have not been established. The current study sought to auditorily and acoustically characterize voices of children, and to study the relationship between vocal behavior reported by teachers and the presence of vocal aberrations.
  
  
  METHODS
  One hundred children between four and 6 years and 11 months, who attended early childhood educational institutions, were included. The sample comprised 50 children with normal voices (NVG) and 50 with deviant voices (DVG) matched by gender and age. All participants were submitted to auditory and acoustic analysis of vocal quality and had their vocal behaviors assessed by teachers through a specific protocol.
  
  
  RESULTS
  DVG had a higher incidence of breathiness (p<0.001) and roughness (p<0.001), but not vocal strain (p=0.546), which was similar in both groups. The average F(0) was lower in the DVG and a higher noise component was observed in this group as well. Regarding the protocol used "Aspects Related to Phonotrauma - Children's Protocol", higher means were observed for children from DVG in all analyzed aspects and also on the overall means (DVG=2.15; NVG=1.12, p<0.001). In NVG, a higher incidence of vocal behavior without alterations or with discrete alterations was observed, whereas a higher incidence of moderate, severe or extreme alterations of vocal behavior was observed in DVG.
  
  
  CONCLUSIONS
  Perceptual assessment of voice, vocal acoustic parameters (F(0), noise and GNE), and aspects related to vocal trauma and vocal behavior differentiated the groups of children with normal voice and deviant voice.
authors.affiliation: Department of Physiotherapy, Speech-Language and Hearing Science and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea 51, São Paulo, SP, Brazil. marciasz@usp.br
authors.forename: Marcia
authors.initials: M
authors.lastname: Simões-Zenari
authors.forename: Katia
authors.initials: K
authors.lastname: Nemr
authors.forename: Mara
authors.initials: M
authors.lastname: Behlau
mesh_terms: D017677:Age Distribution; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D012016:Reference Values; D012307:Risk Factors; D017678:Sex Distribution; D013061:Speech Acoustics; D013068:Speech Production Measurement; D014832:Voice Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D014833:Voice Quality