Risk factors in the development of dysphonia in childhood

Aim: Childhood dysphonia has an estimated incidence of 6–24%. Dysphonia may adversely impact the child’s communicative effectiveness, social and educational development, self-esteem and participation in school group activities. It is commonly believed that children become dysphonic due to vocal misuse behaviors, however there are no consistent data in the few studies published on this topic. Our aim was to evaluate the influence of some potential risk factors on the development of childhood dysphonia. Sources and methods: 33 consecutive dysphonic children with vocal folds nodules underwent a phoniatric examination in the Phoniatric Unit of the “Azienda Policlinico Umberto I Hospital” of Rome. The mean age was 10 years (Ds ± 2 ys). Several risk factor were examined, such as temperament, ENT pathologies, number of siblings, sport practices, scouting, extended school, singing activities, environmental noise in classrooms. Data were compared with a control group of 33 matched children without voice pathologies. Results: the incidence of allergy, sport practices and extended school was found significantly higher in the group of dysphonic children compared with the control group. Furthermore also a prevalence of extrovert and anxious personality in dysphonic children was found. Conclusions: data from our study on risk factors, that act in the development of dysphonia in childhood, stress the relevance of both personality and behavioral factors. It would be useful to encourage the diffusion of information to show the risks related to voice abuse in children, in order to prevent the development of pediatric dysphonia. It would also be necessary to develop instruments specifically designed to examine personality dispositions in dysphonic children