Pediatric Dysphonia: A Cross-Sectional Survey of Subspecialty and Primary Care Clinics

Objectives: Prevalence data for pediatric dysphonia are sparse and primarily collected either in the community or within pediatric otolaryngology clinics. The objectives were to determine the prevalence of dysphonia in children undergoing outpatient medical evaluation, and to ascertain whether the prevalence varies across pediatric subspecialty clinic populations in comparison to primary care. Study Design: Cross-sectional survey. Setting: Tertiary care military medical center. Subjects and methods: Five hundred sixteen surveys were administered to caregivers of children undergoing evaluation in pediatric primary care and subspecialty clinics consisting of the pediatric voice-related quality of life (PVRQOL) instrument and questions regarding previous voice-related symptoms and diagnoses. Survey responses and PVRQOL scores were stratified by clinic type and compared to general pediatrics. Results: A total of 492 surveys were analyzed. The overall prevalence of dysphonia in this cohort based on PVRQOL is 19.3%. Every clinic except endocrinology and ophthalmology individually had an elevated prevalence compared to the expected community prevalence (11%). Compared to general pediatrics, PVRQOL scores were lower in developmental pediatrics (P < 0.001), genetics (P < 0.001), and otolaryngology (P = 0.033) clinics. Children from genetics and developmental pediatrics were more likely to have had speech therapy. Conclusions: In this cohort of children seeking care within a medical center, overall prevalence of dysphonia was quite high in comparison to community-based prevalence data. Not surprisingly, patients of developmental pediatrics, genetics and pediatric otolaryngology have lower PVRQOL scores than primary care. These results emphasize that all practitioners caring for children should seek to identify voice disorders and reinforce that subspecialists who treat developmentally challenged children should exert particular vigilance.