Thursday, April 3, 2025
4/3/2025
Intelligibility and dysphonia in children with vocal fold nodules - Voice disorders occur in 6–17% of children, resulting in dysphonia (i.e., altered vocal quality) which has significant negative health, social, emotional, and educational consequences if left untreated. The most common cause of dysphonia in children is vocal fold nodules (VFN), callus-like growths on the vocal folds. Although voice therapy is the preferred treatment, over one-third of children do not show clinically meaningful improvements from therapy. Two critical issues contribute to this lack of impactful therapeutic changes: 1) children are not mini- adults, and 2) dysphonia reduction may not be a salient and motivating goal for all children. To maximize treatment effectiveness for the dynamic pediatric system, we propose shifting from a narrow focus on dysphonia to a broader focus on improving speech intelligibility. This proposal will examine previously collected speech samples from children with VFN between 3 – 9 years, a critical developmental period. Speech samples will be compiled from clinical databases from three top pediatric voice centers, Children’s Hospital of Philadelphia, Boston Children’s Hospital, and Cincinnati Children’s Hospital Medical Center. Aim 1 will define the relationship between dysphonia and measures of intelligibility (e.g., speech intelligibility, speech naturalness). As intelligible speech production requires coordination of the vocal and articulatory systems, we hypothesize that the significant developmental changes in these systems will impact the relationship between dysphonia and intelligibility. Aim 2 will determine the extent that acoustic measures of the developing vocal system, developing articulatory system, and dysphonia severity contribute to the relationship between dysphonia and intelligibility. The acoustic measures with the largest contribution to the relationship between dysphonia and intelligibility will be examined in a subsequent R01 grant to determine which therapy tasks elicit the largest change in these measures. These therapy tasks will then be examined in a randomized controlled trial to test their efficacy and effectiveness in improving intelligibility in children with VFN. This research program is designed to address multiple priority areas of the NIDCD, with an overall emphasis on improving human communication (Priority Area 4). The current grant focuses on understanding diseases and disorders (Priority Area 2), with outcomes indicating which acoustic measures are the ideal method of predicting intelligibility in this population. This R21 lays the groundwork for the subsequent R01, a randomized clinical trial designed to test the effectiveness of therapy tasks at different developmental stages. This research program will therefore optimize treatment for children with VFN (Priority Area 3), providing information on developmentally appropriate therapy tasks for this underserved and vulnerable population. The research will be completed at Temple University (R1 university), which maintains a robust research environment with exceptional dedication and support to early-career faculty. Outcomes from this proposal will lay the foundation for a paradigm shift in how we conceptualize and treat children with voice disorders, an understudied and underserved clinical population.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).