title: Pediatrician approach to dysphonia.
abstract: OBJECTIVE
  The prevalence of voice disorders reaches up to 23.4% in the pediatric population and has a negative impact on quality of life. The objective of this study is to examine how pediatricians assess and manage patients with voice disorders and barriers they face when evaluating patients with dysphonia.
  
  
  METHODS
  The study was designed as a cross-sectional survey. Pediatricians who are members of the North Carolina Pediatric Society or Duke University affiliated physicians were selected to participate in the study. They were emailed a description of the study with a link to a questionnaire regarding comfort level in recognizing an abnormal voice, how often they assess for dysphonia, barriers to evaluation of voice problems, reasons for referral, and common treatments employed.
  
  
  RESULTS
  A total of 1125 physicians were sent a questionnaire and 72 replied for a response rate of 6.4%. Of those who responded, only 16.7% routinely assess patients for voice problems. The most common reasons for not assessing patients for dysphonia include patients not complaining of voice problems or parents not concerned, and being unsure of the best method or available treatment options. Referrals were most commonly made when speech could not be understood or when the voice problem coincided with other neurological symptoms. Allergy and reflux medications were often trialed prior to referral. The majority of responders felt that voice problems impacted quality of life and 84.7% were interested in more information regarding pediatric voice problems.
  
  
  CONCLUSIONS
  Pediatricians encounter barriers in the assessment of voice problems in their patients. There is evidence from our study that they have interest in learning more about dysphonia. Otolaryngologists must continue to provide outreach to pediatricians to enhance the screening and management of patients with voice disorders.
authors: Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA. Electronic address: Mirabelle.sajisevi@dm.duke.edu.
authors: Mirabelle
authors: M
authors: Sajisevi
authors: Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
authors: Seth
authors: S
authors: Cohen
authors: Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
authors: Eileen
authors: E
authors: Raynor
mesh_terms: D018926:Anti-Allergic Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D055154:Dysphonia; D005260:Female; D006801:Humans; D008297:Male; D009657:North Carolina; D010372:Pediatrics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
chemical_list: D018926:Anti-Allergic Agents; D000897:Anti-Ulcer Agents
keywords: Dysphonia; Pediatric; Voice