Auditory-perceptual evaluation of voice: comparing different speech tasks to identify children with and without laryngeal lesions
Avaliação perceptivo-auditiva da voz: comparação de diferentes tarefas de fala na identificação de crianças com e sem lesões laríngeas
Cintia Conceição Costa; Ana Paula Dassie Leite; Glaucya Madazio; Mara Behlau
Abstract
Purpose
To compare the vowel emission and number counting tasks in perceptual-auditory differentiation among children with and without laryngeal lesions.
Methods
Observational, analytical, and cross-sectional methods were used. Medical records of 44 children were selected from a database of an otorhinolaryngology service at a University Hospital and they were divided into groups: without laryngeal lesion (WOLL), and with laryngeal lesion (WLL), with 33 and 11 children. For the auditory-perceptual evaluation, the vocal samples were separated according to the type of task. They were analyzed separately by a judge who analyzed the general degree of vocal deviation and assessed whether the child would pass or fail in the face of a screening situation.
Results
There was a difference between the WOLL and WLL groups in terms of the overall degree of vocal deviation for the task of number counting, with a predominance of mild deviations in WOLL and moderate in WLL. In the screening, there was a difference between the groups during the number counting task, with more failures in the WLL. The groups were similar in the sustained vowel task, both in terms of the overall degree of vocal deviation and the vocal screening. Most children in the WLL failed in both tasks during vocal screening compared to the children in the WOLL who, in general, failed in only one task.
Conclusion
The task of number counting contributes to the auditory differentiation in children with and without laryngeal lesion, by identifying deviations of greater intensity in children with laryngeal lesion.
Keywords
Resumo
Objetivo
comparar as tarefas de emissão de vogal e de contagem de números na diferenciação perceptivo-auditiva de crianças com e sem lesão laríngea.
Método
Estudo observacional, analítico, transversal. Utilizou-se banco de dados de uma pesquisa de doutorado, com resultados de avaliações laringológicas e gravação de amostras vocais de 44 crianças que se dividiram em: Grupo sem lesão laríngea (GSLL), com 33 crianças; e grupo com lesão laríngea (GCLL), com 11 crianças. Para a avaliação perceptivo-auditiva, as amostras vocais foram separadas de acordo com o tipo de tarefa e analisadas separadamente por uma juíza, que analisou o grau geral do desvio vocal e informou se, diante de uma situação de triagem, a criança passaria ou falharia.
Resultados
Houve diferença entre os grupos GSLL e GCLL quanto ao grau geral do desvio vocal para tarefa de emissão de números, com predomínio de desvios discretos no GSLL e moderados no GCLL. Quanto à triagem, houve diferença entre os grupos para a tarefa de contagem, com mais falhas no GCLL. Os grupos foram semelhantes na tarefa de vogal, tanto no que se refere à intensidade do desvio quanto ao resultado da triagem. A maior parte das crianças do GCLL falhou em ambas as tarefas na situação de triagem vocal, com diferença em relação às crianças do GSLL que, em geral, falharam em apenas uma tarefa.
Conclusão
A tarefa de contagem de números contribui para a diferenciação auditiva de crianças com e sem lesão laríngea, por identificar desvios de maior intensidade em crianças com lesão.
Palavras-chave
Referências
- Connor NP, Cohen SB, Theis SM, Thibeault SL, Heatley DG, Bless DM. Attitudes of children with dysphonia. J Voice. 2008;22(2):197-209. http://dx.doi.org/10.1016/j.jvoice.2006.09.005 PMid:17512168.
- Oliveira RC, Teixeira LC, Gama ACC, Medeiros AM. Análise perceptivo-auditiva, acústica e autopercepção vocal em crianças. J Soc Bras Fonoaudiol. 2011;23(2):158-63. http://dx.doi.org/10.1590/S2179-64912011000200013 PMid:21829932.
- Souza BO, Nunes RB, Friche AAL, Gama ACC. Análise da qualidade de vida relacionada a voz na população infantil. CoDAS. 2017;29(2):e20160009. http://dx.doi.org/10.1590/2317-1782/20172016009 PMid:28300937.
- Paixão CLB, Silvério KCA, Berberian AP, Mourão LF, Marques JM. Disfonia infantil: hábitos prejudiciais à voz dos pais interferem na saúde vocal de seus filhos? Rev CEFAC. 2012;14(4):705-13. http://dx.doi.org/10.1590/S1516-18462011005000116
- Stathopoulos ET, Sapienza C. Respiratory and laryngeal measures of children during vocal intensity variation. J Acoust Soc Am. 1993;94(5):2531-43. http://dx.doi.org/10.1121/1.407365 PMid:8270731.
- Lopes LW, Barbosa Lima IL, Alves Almeida LN, Cavalcante DP, de Almeida AA. Severity of voice disorders in children: correlations between perceptual and acoustic data. J Voice. 2012;26(6):819.e7-12. http://dx.doi.org/10.1016/j.jvoice.2012.05.008 PMid:23177753.
- McAllister A, Sjölander P. Children’s voice and voice disorders. Semin Speech Lang. 2013;34(2):71-9. http://dx.doi.org/10.1055/s-0033-1342978 PMid:23633171.
- Lopes LW, Lima ILB, Almeida LNA, Azevedo EHM, Silva MFBL, Silva POC. Análise acústica de vozes infantis: contribuições do diagrama de desvio fonatório. Rev CEFAC. 2015;17(4):1173-83. http://dx.doi.org/10.1590/1982-0216201517415514
- Tavares EL, Brasolotto A, Santana MF, Padovan CA, Martins RH. Epidemiological study of dysphonia in 4-12 year-old children. Braz J Otorhinolaryngol. 2011;77(6):736-46. http://dx.doi.org/10.1590/S1808-86942011000600010 PMid:22183280.
- Ribeiro LL, Paula KMP, Behlau M. Voice-related quality of life in the pediatric population: validation of the Brazilian version of the Pediatric Voice-Related Quality-of-Life Survey. CoDAS. 2014;26(1):87-95. http://dx.doi.org/10.1590/s2317-17822014000100013 PMid:24714864.
- Krohling LL, Behlau M, Verduyckt I. Equivalência cultural da versão brasileira do Questionnaire des Symptômes Vocaux. CoDAS. 2016;28(4):454-8. http://dx.doi.org/10.1590/2317-1782/20162015124 PMid:27409418.
- Simões-Zenari M, Nemr K, Behlau M. Voice disorders in children and its relationship with auditory, acoustic and vocal behavior parameters. Int J Pediatr Otorhinolaryngol. 2012;76(6):896-900. http://dx.doi.org/10.1016/j.ijporl.2012.02.067 PMid:22444740.
- Mortensen M, Schaberg M, Woo P. Diagnostic contributions of videolaryngostroboscopy in the pediatric population. Arch Otolaryngol Head Neck Surg. 2010;136(1):75-9. http://dx.doi.org/10.1001/archoto.2009.209 PMid:20083783.
- Wuyts FL, De Bodt MS, Molenberghs G, Remacle M, Heylen L, Millet B, et al. The dysphonia severity index: an objective measure of vocal quality based on a multiparameter approach. J Speech Lang Hear Res. 2000;43(3):796-809. http://dx.doi.org/10.1044/jslhr.4303.796 PMid:10877446.
- Nardone HC, Recko T, Huang L, Nuss RC. A retrospective review of the progression of pediatric vocal fold nodules. JAMA Otolaryngol Head Neck Surg. 2014;140(3):233-6. http://dx.doi.org/10.1001/jamaoto.2013.6378 PMid:24435469.
- Martins RH, Ribeiro CB, Fernandes de Mello BM, Branco A, Tavares EL. Dysphonia in children. J Voice. 2012;26(5):674e.17-674.e20. http://dx.doi.org/10.1016/j.jvoice.2012.03.004 PMid: 22801244.
- Dassie-Leite AP, Behlau M, Nesi-França S, Lima MN, De Lacerda L. Vocal evaluation of children with congenital hypothyroidism. J Voice. 2018;32(6):770.e11-9. http://dx.doi.org/10.1016/j.jvoice.2017.08.006 PMid:28986152.
- Gramuglia ACJ, Tavares ELM, Rodrigues SA, Martins RHG. Perceptual and acoustic parameters of vocal nodules in children. Int J Pediatr Otorhinolaryngol. 2014;78(2):312-6. http://dx.doi.org/10.1016/j.ijporl.2013.11.032 PMid:24370465.
- Behlau M, Madazio G, Feijó D, Pontes P. Avaliação de voz. In: Behlau M, organizador. Voz: o livro do especialista. Rio de Janeiro: Revinter; 2004. Vol. 1, p. 96-104.
- Maryn Y, Roy N. Sustained vowels and continuous speech in the auditory-perceptual evaluation of dysphonia severity. J Soc Bras Fonoaudiol. 2012;24(2):107-12. http://dx.doi.org/10.1590/S2179-64912012000200003 PMid:22832675.
- Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-74. http://dx.doi.org/10.2307/2529310 PMid:843571.
- Devadas U, Dhanya M, Gunjawate D. Adaptation and validation of the Malayalam pediatric voice handicap index. Int J Pediatr Otorhinolaryngol. 2015;79(9):1425-8. http://dx.doi.org/10.1016/j.ijporl.2015.06.018 PMid:26143127.
- Guerrero Lopez HA, Mondain M, Amy de la Bretèque B, Serrafero P, Trottier C, Barkat-Defradas M. Acoustic, aerodynamic, and perceptual analyses of the voice of cochlear-implanted children. J Voice. 2013;27(4):523.e1-17. http://dx.doi.org/10.1016/j.jvoice.2013.03.005 PMid:23809572.
- Kreiman J, Gerratt BR, Precoda K, Berke GS. Individual differences in voice quality perception. J Speech Hear Res. 1992;35(3):512-20. http://dx.doi.org/10.1044/jshr.3503.512 PMid:1608242.
- Patel S, Shrivastav R. Perception of dysphonic vocal quality: some thoughts and research updates. Perspectives on Voice and Voice Disorders. ASHA Division 3. 2007;17(2):3-6. https://doi.org/10.1044/vvd17.2.3
- Possamai V, Hartley B. Voice disorders in children. Pediatr Clin North Am. 2013;60(4):879-92. http://dx.doi.org/10.1016/j.pcl.2013.04.012 PMid:23905825.
- Guimaraes MF, Behlau MS, Panhoca I. Análise perceptivo-auditiva da estabilidade vocal de adolescentes em diferentes tarefas fonatórias. Pro Fono. 2010;22(4):455-68. http://dx.doi.org/10.1590/S0104-56872010000400016 PMid:21271099.
- Lu FL, Matteson S. Speech tasks and interrater reliability in perceptual voice evaluation. J Voice. 2014;28(6):725-32. http://dx.doi.org/10.1016/j.jvoice.2014.01.018 PMid:24841668.