Pediatric Dysphonia: A Cross-sectional Survey of Subspecialty Care Clinics

Abstract

Objectives:

1) Determine the prevalence of caretaker reported dysphonia in children undergoing medical evaluation. 2) Determine whether subspecialty pediatric clinics are associated with variable patterns of pediatric dysphonia compared to primary care.

Methods:

Cross-sectional survey recording demographic data, caretaker perception of their child’s voice, and the validated pediatric voice related quality of life (PVRQOL) instrument administered to caregivers of children undergoing evaluation in primary care and subspecialty clinics. Survey responses and PVRQOL scores were stratified by clinic type and compared to general pediatrics using Fisher’s exact test for categorical data and the Wilcoxon Mann Whitney test for interval data.

Results:

A total of 406 complete surveys were analyzed. The mean PVRQOL score for all children was 90.6 (95%CI:88.7, 92.4). Compared to general pediatrics, PVRQOL scores were lower in developmental pediatrics (P = .0004), genetics (P = .0240), and otolaryngology (P = .0332) clinics. Children in developmental pediatrics also were more likely to have a prior speech evaluation (P < .001) and speech therapy (P = .001). Otolaryngology patients were more likely to have undergone speech evaluation (P = .030). Of note, no difference was found comparing PVRQOL scores in general pediatrics to gastroenterology (P = .2086) or pulmonology (P = .6633).

Conclusions:

Children undergoing evaluation in developmental pediatrics, genetics, and otolaryngology have lower PVRQOL scores than children evaluated in primary care. No other significant differences between subspecialty clinics were identified. These data reinforce that all practitioners caring for children should seek to identify voice disorders and highlight the importance of subspecialists who treat developmentally challenged children to exert particular vigilance.