Okul Çağı Disfonili Çocuklarda 'Grup Ses Terapisi' ve 'Bireysel Ses Terapisi' Bulgularının Karşılaştırılması

Abstract

The aim of this study was to investigate the effectiveness of group voice therapy in children diagnosed with vocal fold nodules (VFN). Eighteen children aged 7.00–11.11 years (15 males, 3 females) were assigned by stratified randomization to control group (n=6), individual voice therapy group (n=6), or group voice therapy group (n=6). The control group received one session of vocal hygiene education, while the intervention groups received eight sessions of holistic voice therapy. Auditory-perceptual evaluation included overall voice quality (G), roughness (R), and breathiness (B). Self-assessment measures were the Pediatric Voice Handicap Index (pVHI) and the Pediatric Voice-Related Quality of Life Questionnaire (PVRQOL). Aerodynamic measures included maximum phonation time (MPT) and the s/z ratio. Acoustic data were analyzed using the Multi-Dimensional Voice Program and Analysis of Dysphonia Speech and Voice. In pre- and post-intervention comparisons (T1–T2), both individual and group voice therapy resulted in significantly greater improvements in pVHI-total and pVHI-physical scores compared to the control group (individual: p=0,015 and p=0,003; group: p=0,005 and p=0,001). A significant reduction in the pVHI-emotional score was observed only in the group voice therapy group (p=0,041). Long-term comparisons across four time points (T1, T2, 3- and 6-month follow-ups) showed statistically significant and comparable improvements in self-assessment (pVHI, PVRQOL), acoustic (cepstral peak prominence and cepstral peak prominence standard deviation), and aerodynamic (MPT) measures in both intervention groups, with effects maintained over time. Group voice therapy was found to be an effective and feasible intervention, particularly in clinical settings with limited access to services.