Family-Involved Hybrid Voice Therapy for Pediatric Vocal Fold Nodules in School-Aged Children: Clinical Outcomes and Socioeconomic Associations
Laryngoscope Investigative Otolaryngology, cilt.11, sa.3, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 11 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.1002/lio2.70422
- Dergi Adı: Laryngoscope Investigative Otolaryngology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Anahtar Kelimeler: hybrid care, pediatric, socioeconomic factors, telepractice, vocal fold nodules, voice therapy
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective(s): To evaluate the effectiveness of a family-involved hybrid voice therapy program in children with vocal fold nodules using multidimensional voice outcomes (objective acoustic, auditory-perceptual, and parent-reported measures) and to examine whether family socioeconomic opportunity is associated with baseline burden or posttreatment outcomes. Methods: This prospective single-arm pre–post observational study included children with vocal fold nodules confirmed by fiberoptic or videolaryngoscopic examination. Participants completed a 12-week hybrid voice therapy program consisting of 12 weekly sessions alternating face-to-face and synchronous online delivery (six in-person, six online). Caregivers received structured vocal hygiene education and were trained to support standardized Vocal Function Exercises with daily home practice (5–10 min/day) monitored using an exercise diary. Pre- and posttreatment assessments included acoustic measures (jitter, shimmer, cepstral peak prominence smoothed [CPPs], maximum phonation time [MPT], noise-to-harmonics ratio [NHR]), auditory-perceptual evaluation (CAPE-V), and parent-reported impact (pVHI-10). Family socioeconomic opportunity was assessed using the 20-item Family Socioeconomic Opportunity Questionnaire (FSOQ; score range 0–60). Results: Thirty-nine children completed the program (mean age, 8.36 years). Significant pre- to posttreatment improvements were observed across outcomes, including increased CPPs and MPT and decreased NHR, jitter, and shimmer. CAPE-V scores decreased from 34.46 ± 10.12 to 7.64 ± 4.76 (p < 0.001), and parent-reported pVHI-10 scores decreased from 27.62 ± 4.45 to 6.54 ± 3.07 (p < 0.001). At baseline, FSOQ showed a strong positive correlation with pVHI-10 (r = 0.700, p < 0.001), indicating that higher FSOQ scores were associated with higher parent-reported voice handicap. Posttreatment, FSOQ was not significantly correlated with CAPE-V or pVHI-10. Conclusion: A 12-week family-involved hybrid voice therapy program was associated with substantial improvements in acoustic, perceptual, and parent-reported outcomes in children with vocal fold nodules. Family socioeconomic opportunity was associated with baseline subjective burden but not with posttreatment outcomes. Controlled studies with longer follow-up are warranted. Level of Evidence: Level 3.