title: Effect of MP4 Therapy Videos on Adherence to Voice Therapy Home Practice in Children With Dysphonia.
abstract: OBJECTIVE
  Voice disorders in children are often treated with behavioral voice therapy, which requires home practice of exercises. Previous studies with adults demonstrated increased practice frequency when patients were given videos of a clinician and patient performing therapy tasks. The purpose of this study was to determine whether videos of practice exercises would increase adherence to therapy in children.
  
  
  METHODS
  The study used a randomized double crossover research design.
  
  
  METHODS
  Twenty-eight patients, aged 6-18, referred for voice therapy were included in the study. Two conditions were alternated on a weekly basis: standard-of-care therapy and standard-of-care therapy with video models added. Participants recorded practice frequency and participated in semi-structured interviews, which were analyzed for themes.
  
  
  RESULTS
  Participants practiced an average of 1.79 times per day without videos and 1.72 with videos (P = 0.743), indicating no significant difference between conditions. There was also no age group effect (P = 0.314). Qualitative analysis of interview responses established the following themes: (1) I knew how to do my exercises, (2) I didn't like seeing/hearing myself, (3) Videos helped me remember to practice, (4) I didn't like the video player itself, (5) The videos didn't make a difference with practice, and (6) Practicing was no fun.
  
  
  CONCLUSIONS
  Video models of therapy tasks do not appear to influence adherence to home practice frequency in children with voice disorders, in contrast to findings in adults. Videos were found useful by several participants as reminders to practice.
authors.affiliation: Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin. Electronic address: braden@surgery.wisc.edu.
authors.forename: Maia N
authors.initials: MN
authors.lastname: Braden
authors.affiliation: Program of Communication Disorders, Georgia State University, Atlanta, Georgia.
authors.forename: Eva
authors.initials: E
authors.lastname: van Leer
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D001296:Audiovisual Aids; D002648:Child; D002652:Child Behavior; D018592:Cross-Over Studies; D055154:Dysphonia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010349:Patient Compliance; D013997:Time Factors; D016896:Treatment Outcome; D014741:Video Recording / Q000295:instrumentation*; D014831:Voice; D014834:Voice Training
keywords: adherence; dysphonia; pediatric; therapy; voice