Research On Evaluation Of Pediatric Voice Disorders And Design Of Treatment Software With Visual And Audio Feedback

Voice disorders negatively affect the physical and psychological health of children.The evaluation and treatment methods in clinic now are mostly applied to adults,not to children.There are no standard and effective methods for treatment of voice disorders in children yet,and the evaluation methods are also insufficient.According to the characteristics of children,this study developed some evaluation and treatment methods for children with voice disorders.In this study,there are two parts which are pediatric voice evaluation and therapy in sequence.Part ?.Evaluation of pediatric voice disorders.Objective:1.Evaluation voice disorders using objective acoustic parameters in dysphonia Children.2.Developed the subjective evaluation methods of pediatric voice disorders.Methods:Fifty-two children with voice disorders with vocal fold nodules?age range 4-12 years,40 males and 12 females?and forty-three children with no history or symptoms of voice problems?age range 5-11 years,27 males and 16 females?as well as their parents or legal guardians were involved in this study.The voice of every child were recorded and documented.Voice samples were measured and analyzed by objective acoustic and auditory perceptual analysis.All parents of every child completed the Chinese version-pVHI?Pediatric voice handicap index?.For validity and reliability analysis,statistical analysis were used as following:1.The differences between patients and control group were tested using the t-test.2.The reliability of Chinese version-pVHI were tested using the internal consistency and test-retest reliability methods,and the validity of Chinese version-pVHI were tested using content validity,criterion validity and discriminant validity.3.The correlations between objective parameters and Chinese version-pVHI were tested using Pearson correlation test.Results:1.There were significant differences in Jitter,Shimmer,HNR?harmonics-to-noise ratio?and MPT?maximum phonation time??P<0.05?.2.The Chinese version-pVHI has a good internal consistency?Cronbach?>0.7?,test-retest reliability?Pearson correlation r=0.631⁰.887,P<0.01?,content validity?r=0.373⁰.946,P<0.01?,criterion validity?r=0.309⁰.540,P<0.01?and discriminant validity?P=0.000 or P=0.001?.3.For all participants,there were significant correlations between objective parameters?except F₀?and Chinese version-pVHI?||=0.374⁰.436,P<0.01?.Conclusions:1.Jitter,Shimmer,HNR and MPT can be used as voice evaluation indexes of children with vocal fold nodules.2.The Chinese version-pVHI has a good reliability and validity for evaluating pediatric voice disorders.Part ?.Voice training software with video games for pediatric dysphonia.The correlative theories of speech signal processing were the theoretical basis of the part.First,the correlative theories of speech signal processing were analysed.Then,we developed video carton games with visual and auditory feedback in the voice training software.Children can use their voice to control animates in the software to achieve the purpose of voice training through autonomous control and visual auditory feedback.Based on the methods of evaluation and traditional voice training,three programs including pitch training,intensity training and duration training were designed in the software.In the light of the concept of modularized programming,there were four modules in the software,including audio recording module,speech feature parameter extracting module,graphic processing module and user interface designing module.The programming of software was implemented by the graphic and audio API?Application Programming Interface?of DirectX,as well as the digital speech processing technology.Then,two important performances of the software were tested.The results showed that the software can run as expected function and has good performances.The proposing and implementing of this software made an exploratory study for treatment of pediatric voice disorders.At the end of this paper,the limitations of this study and the prospects of further studies were illustrated.