Effectiveness of vocal hygiene education with resonant voice therapy on school-aged children with vocal nodules: A randomized controlled trial

Abstract

BACKGROUND: Voice disorders are prevalent among school-aged children. The majority of voice problems in children are phonotraumatic in nature. Previous studies reported that resonant voice therapy, with the aim of reducing phonotraumatic behaviors, is effective in improving children’s voice quality. However, there was a paucity of randomized controlled trial evidence for long-term efficacy of resonant voice therapy n children. OBJECTIVE: The aim of this study was to investigate the effectiveness of resonant voice therapy on school-aged children with vocal nodules, compared to placebo control group and no treatment control group. METHODS: 39 children aged between 6 to 12 years old were recruited. All participants were diagnosed by otolaryngologists as having phonotrauma associated with vocal nodules. They were randomly assigned into resonant voice therapy group, placebo group, or no treatment control group. Participants in the resonant voice therapy group received six one-hour sessions on vocal hygiene and resonant voice therapy. Participants in the placebo group received six one-hour therapy on reading exercise to enhance their presentation skills. Participants in the control group did not receive any treatment. The outcome of resonant voice therapy was assessed by quality of life measures (Pediatric Voice Handicap Index and Children’s Voice Handicap Index), acoustic and perceptual voice evaluations. Voice assessments were performed before treatment, immediately after treatment and two-months after treatment. RESULTS AND DISCUSSION: This RCT study would provide evidence on the effectiveness of resonant voice therapy for school-aged children with vocal nodules. Learning Outcome: 1. Discuss the effectiveness of resonant voice therapy on treating phonotrauma associated with vocal nodules. 2. Discuss the importance of providing early treatment to children with vocal nodules.