Perceptual Evaluation of Voice and Parental Reports of Vocal Behaviors in Primary School Children in Chennai, India: A Cross-Sectional Observational Study.

INTRODUCTION

The human voice plays a pivotal role in communication, influencing social interactions and overall development. Voice disorders among children, ranging from 6% to 9%, can hinder communication, academic, and social performance. Despite the prevalence, limited research examines parental observations alongside professional evaluations. This study bridges this gap, integrating parental perspectives with speech-language pathologist (SLP) assessments to provide a comprehensive understanding of children's vocal health.

AIM AND OBJECTIVES OF THE STUDY: The aim of the study was to investigate vocal and non-vocal behaviors of primary school children as reported by parents, compare these with SLPs' auditory-perceptual analyses, and profile family, environmental, and personality factors within the sample.

RESEARCH

DESIGN

A cross-sectional observational study METHOD: A total of 162 primary school children aged 5-10 years were included. Participants were recruited from three schools in Chennai. Inclusion criteria required parental consent and the absence of prediagnosed vocal pathologies. A 38-item questionnaire was developed and used to document parental observations. Auditory perceptual analysis was carried out using the GRBAS (grade, roughness, breathiness, asthenia, and strain) rating scale for sustained phonation of /a/ samples, and inter-rater reliability was measured. Statistical analyses, including Chi-square tests, were performed using SPSS.

RESULTS

Participants included 82 females (mean age = 7.49 years) and 80 males (mean age = 7.43 years). Dysphonia prevalence was higher among males (40%) compared to females (29.2%). Parental reports revealed frequent vocal misuse during outdoor activities (45.68%) and limited awareness of vocal abnormalities, with only 2.47% seeking medical advice. Using the GRBAS scale, 34.6% of children were identified as dysphonic. Among these, 24.7% exhibited mild, 8% moderate, and 1.9% severe abnormalities. Significant associations were observed between non-vocal habits (hydration, vocal misuse) and GRBAS Grade scores (χ², P < 0.01).

DISCUSSION: This study emphasizes the integral role of parents in identifying vocal issues and highlights the discrepancies between parental awareness and clinical findings. Educating parents on vocal hygiene can enhance early identification and intervention for voice disorders.

CONCLUSION

This study reveals a gap between parental awareness and clinical findings in pediatric voice disorders, emphasizing the need for targeted education on vocal hygiene. Integrating parental training into clinical practice can enhance early detection, support timely intervention, and foster meaningful family involvement in voice care.