title: Dysphonia in preterm children: assessing incidence and response to treatment.
abstract: BACKGROUND
  Mild dysphonia in childhood is surprisingly common, yet moderate to severe dysphonia is rare. The latter has been associated with complex medical conditions and congenital abnormalities. Intubation injury has also been documented as a cause of childhood dysphonia. Children born very preterm may be intubated as part of the intensive care administered in the perinatal and neonatal periods, yet there are few studies investigating dysphonia in this population. This study will be the first to: use an objective acoustic voice assessment in a paediatric study, document the incidence of dysphonia in very preterm children at school age, and conduct a controlled trial of behavioural voice therapy in this population.
  
  
  METHODS
  This study will consist of three phases: assessment of voice quality and its impact on quality of life in up to 200 children born at less than 32 weeks' gestation: assessment of the nature and extent of laryngeal pathology in children with moderate to severe dysphonia; and a non-blinded, randomised controlled trial of behavioural voice therapy in children with moderate to severe dysphonia.
  
  
  CONCLUSIONS
  This study will be the first to use clinical assessment to examine the voice quality of very preterm children, and to use fibre optic endoscopic evaluation of laryngeal function to determine the nature and extent of any laryngeal pathology in such children. Those participants with significant voice difficulties will be randomised to receive treatment immediately or after the eight week assessment.
  
  
  BACKGROUND
  This study is registered on the Australian New Zealand Clinical Trials Registry (ACTRN12613001015730/ACTRN12613001012763).
authors.affiliation: School of Paediatrics and Child Health, University of Western Australia, Australia; Speech Pathology Department, Princess Margaret Hospital for Children, Western Australia, Australia. Electronic address: victoria.reynolds@uwa.edu.au.
authors.forename: Victoria
authors.initials: V
authors.lastname: Reynolds
authors.affiliation: School of Paediatrics and Child Health, University of Western Australia, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Meldrum
authors.affiliation: School of Paediatrics and Child Health, University of Western Australia, Australia; Centre for Neonatal Research and Education, University of Western Australia, Australia; Neonatal Clinical Care Unit, King Edward Memorial Hospital, Western Australia, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Simmer
authors.affiliation: School of Paediatrics and Child Health, University of Western Australia, Australia; Department of Paediatric Otorhinolaryngology and Head and Neck Surgery, Princess Margaret Hospital for Children, Western Australia, Australia; School of Surgery, University of Western Australia, Australia; Perth ENT Centre, Western Australia, Australia.
authors.forename: Shyan
authors.initials: S
authors.lastname: Vijayasekaran
authors.affiliation: Centre for Neonatal Research and Education, University of Western Australia, Australia; Neonatal Clinical Care Unit, King Edward Memorial Hospital, Western Australia, Australia; State Child Development Centre, Western Australia, Australia.
authors.forename: Noel P
authors.initials: NP
authors.lastname: French
mesh_terms: D002648:Child; D002675:Child, Preschool; D055154:Dysphonia / Q000453:epidemiology* / Q000534:rehabilitation*; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D062071:Infant, Extremely Premature; D007234:Infant, Premature; D007442:Intubation, Intratracheal; D008297:Male; D011788:Quality of Life; D012107:Research Design; D012720:Severity of Illness Index; D014833:Voice Quality; D014834:Voice Training
keywords: Dysphonia; Intervention; Paediatric; Preterm; Trial; Voice