A Randomized, Controlled Trial of Behavioral Voice Therapy for Dysphonia Related to Prematurity of Birth.
OBJECTIVE
Dysphonia is a potential complication of prematurity. Preterm children may sustain iatrogenic laryngeal damage from medical intervention in the neonatal period, and further, adopt compensatory, maladaptive voicing behaviors. This pilot study aimed to evaluate the effects of a voice therapy protocol on voice quality in school-aged, very preterm (VP) children.


METHODS
Twenty-seven VP children with dysphonia were randomized to an immediate intervention group (n = 7) or a delayed-intervention, waiting list control group (n = 14). Following analysis of these data, a secondary analysis was conducted on the pooled intervention data (n = 21). Six participants did not complete the trial.


RESULTS
Change to voice quality was measured via pre- and posttreatment assessments using the Consensus Auditory Perceptual Evaluation of Voice. The intervention group did not demonstrate statistically significant improvements in voice quality, whereas this was observed in the control group (P = 0.026). However, when intervention data were pooled including both the immediate and delayed groups following intervention, dysphonia severity was significantly lower (P = 0.026) in the treatment group.


CONCLUSIONS
Dysphonia in most VP children in this cohort was persistent. These pilot data indicate that some participants experienced acceptable voice outcomes on spontaneous recovery, whereas others demonstrated a response to behavioral intervention. Further research is needed to identify the facilitators of and barriers to intervention success, and to predict those who may experience spontaneous recovery.
Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia; School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia. Electronic address: victoria.reynolds@uwa.edu.au.
Victoria
V
Reynolds
Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia; School of Psychology and Social Science, Faculty of Health, Engineering and Science, Edith Cowan University, Perth, Western Australia, Australia.
Suzanne
S
Meldrum
Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia; Department of Neonatal Paediatrics, King Edward Memorial Hospital and Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia.
Karen
K
Simmer
Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia; Department of Otolaryngology and Head and Neck Surgery, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia; School of Surgery, University of Western Australia, Perth, Western Australia, Australia.
Shyan
S
Vijayasekaran
Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia; Department of Neonatal Paediatrics, King Edward Memorial Hospital and Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia; State Child Development Centre, Health Department of Western Australia, Perth, Western Australia, Australia.
Noel
N
French
D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D002652:Child Behavior; D004185:Disability Evaluation; D055154:Dysphonia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007600:Judgment; D007828:Laryngoscopy; D008297:Male; D010865:Pilot Projects; D047928:Premature Birth; D020127:Recovery of Function; D012307:Risk Factors; D012720:Severity of Illness Index; D013061:Speech Acoustics; D013065:Speech Intelligibility; D013067:Speech Perception; D013997:Time Factors; D016896:Treatment Outcome; D014833:Voice Quality; D014834:Voice Training; D014904:Western Australia
Dysphonia; Pediatric; Preterm; Treatment; Voice