A Randomized, Controlled Trial of Behavioral Voice Therapy for Dysphonia Related to Prematurity of Birth

Victoria Reynolds, Suzanne Meldrum, Karen Simmer, Shyan Vijayasekaran, Noel French

    Research output: Contribution to journalArticle

    2 Citations (Scopus)

    Abstract

    Objectives 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.

    Original languageEnglish
    Pages (from-to)247.e9-247.e17
    Number of pages9
    JournalJournal of Voice
    Volume31
    Issue number2
    DOIs
    Publication statusPublished - 1 Mar 2017

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    Dysphonia
    Voice Quality
    Randomized Controlled Trials
    Parturition
    Control Groups
    Waiting Lists
    Therapeutics
    Research

    Cite this

    Reynolds, Victoria ; Meldrum, Suzanne ; Simmer, Karen ; Vijayasekaran, Shyan ; French, Noel. / A Randomized, Controlled Trial of Behavioral Voice Therapy for Dysphonia Related to Prematurity of Birth. In: Journal of Voice. 2017 ; Vol. 31, No. 2. pp. 247.e9-247.e17.
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    A Randomized, Controlled Trial of Behavioral Voice Therapy for Dysphonia Related to Prematurity of Birth. / Reynolds, Victoria; Meldrum, Suzanne; Simmer, Karen; Vijayasekaran, Shyan; French, Noel.

    In: Journal of Voice, Vol. 31, No. 2, 01.03.2017, p. 247.e9-247.e17.

    Research output: Contribution to journalArticle

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    AU - Reynolds, Victoria

    AU - Meldrum, Suzanne

    AU - Simmer, Karen

    AU - Vijayasekaran, Shyan

    AU - French, Noel

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    N2 - Objectives 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.

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