title: Vocal fold nodules in school age children: attention deficit hyperactivity disorder as a potential risk factor.
abstract: OBJECTIVE
  To evaluate the presence of symptoms of inattention and hyperactivity/impulsivity in a population of school age children affected by vocal fold nodules.
  
  
  METHODS
  Parents and teachers of 18 children with vocal fold nodules (10 males, eight females; aged between 6 and 12 years) and 20 matched controls without dysphonia and/or vocal fold diseases (11 males, nine females; aged between 6 and 12 years) completed Attention-Deficit/Hyperactivity Disorder (ADHD) rating scale for parents (SDAG [Scala per i Disturbi di Attenzione/Iperattività per Genitori]) and teachers (SDAI [Scala per i Disturbi di Attenzione/Iperattività per Insegnanti) rating scales containing in two subscales items that specifically evaluate the symptoms of ADHD according to the DSM-IV. All children were subjected to videolaryngoscopy.
  
  
  RESULTS
  The group with vocal fold nodules scored significantly higher than the controls; the difference between the two groups was statistically significant for both the subscales of both questionnaires (SDAG and SDAI) (P < 0.05). Four children in the group with vocal fold nodules who scored higher than 14 in at least one subscale were referred for psychiatric evaluation. For two of the children, both male, a diagnosis of combined ADHD was formulated.
  
  
  CONCLUSIONS
  ADHD is a possible risk factor for the development of vocal fold nodules in childhood. SDAG and SDAI rating scales may supplement the diagnostic assessment of children with vocal fold nodules.
authors.affiliation: ENT and Ophthalmology Department, Institute of Otorhinolaryngology, Policlinico "A. Gemelli", Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: D'Alatri
authors.affiliation: ENT and Ophthalmology Department, Institute of Otorhinolaryngology, Policlinico "A. Gemelli", Catholic University of Sacred Heart, Rome, Italy. Electronic address: livia83@hotmail.it.
authors.forename: Livia
authors.initials: L
authors.lastname: Petrelli
authors.affiliation: ENT and Ophthalmology Department, Institute of Otorhinolaryngology, Policlinico "A. Gemelli", Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Lea
authors.initials: L
authors.lastname: Calò
authors.affiliation: ENT and Ophthalmology Department, Institute of Otorhinolaryngology, Policlinico "A. Gemelli", Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Pasqualina Maria
authors.initials: PM
authors.lastname: Picciotti
authors.affiliation: ENT and Ophthalmology Department, Institute of Otorhinolaryngology, Policlinico "A. Gemelli", Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Maria Raffaella
authors.initials: MR
authors.lastname: Marchese
authors.affiliation: ENT and Ophthalmology Department, Institute of Otorhinolaryngology, Policlinico "A. Gemelli", Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bussu
mesh_terms: D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D016022:Case-Control Studies; D002648:Child; D055154:Dysphonia / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D011237:Predictive Value of Tests; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014741:Video Recording; D014827:Vocal Cords / Q000473:pathology*
keywords: ADHD; Attention deficit hyperactivity disorder; Childhood dysphonia; Vocal fold nodules