Cognitive and Biological Mechanisms in Pediatric Voice Therapy

项目摘要/摘要。 本研究的目的是探讨可能影响儿童心理健康的发展因素。 对患有常见的良性声音创伤病变的儿童进行经过审查的标准护理嗓音疗法的结果， 声带小结。具体目标1将调查对儿童认知发展能力的影响 关于他们在发声治疗中的学习反应，就他们获得治疗性发声模式而言， “共鸣的声音”，在经过审查的治疗计划中，声音中的冒险(AIV)。《特定目标2》将调查 儿童身体发育阶段对其语音冒险生物反应的影响 作为声带组织弹性基线估计的函数的小结缩小的术语，这是 已知随着年龄的变化而变化。具体目标3是探索性的，评估了一个更全面、更完整的发声因果模型 随着认知和身体的成熟，通过对结节进行发声治疗，喉咙得到了改善。 具体目标3还将在探索性水平上解决可能影响治疗结果的其他因素。 例如医疗合并症、报告的儿童依从性和报告的父母参与 通过心理治疗。我们将在AIMS的单一队列中使用纵向观察性研究设计， 采用了对这类研究来说是新颖的，但在实验室科学中经过良好审查的技术，包括高 快速视频成像和带有激光投影的视频频闪检查，后者用于获得精确的测量结果 治疗前后的结节大小。这些技术将与更传统的技术集成，包括 声音和喉部的声学和知觉评估。 长期目标是改进和推进数百万儿童的干预模式，他们的生活质量是 受这些良性声带病变的影响。研究结果将为语音治疗中新兴的行为策略提供参考 对于数百万受这些疾病影响的儿童来说，他们目前正遭受着巨大的健康- 由此产生的相关后果。

Project Summary/Abstract. The objective of this research is to investigate the influence of developmental factors that may influence the outcome of a vetted, standard of care voice therapy for children with common, benign phonotraumatic lesions, vocal fold nodules. Specific Aim 1 will investigate the influence of children's cognitive developmental abilities on their learning response in voice therapy, in terms of their acquisition of a therapeutic phonation pattern, “resonant voice,” in the vetted therapy program, Adventures in Voice (AIV). Specific Aim 2 will investigate the influence of children's physical development stage on their biological response to Adventures in Voice, in terms of reduction in nodule size, as a function of baseline estimates of vocal fold tissue elasticity, which is known to vary with age. Specific Aim 3 is exploratory, and assesses a fuller, integrated causal model of vocal and laryngeal improvements with voice therapy for nodules, as a function of cognitive and physical maturation. Specific Aim 3 will also address at an exploratory level other factors that may contribute to therapy outcome such as medical co-morbidities, reported child compliance with therapy, and reported parental involvement with therapy. We will use a longitudinal observational study design in a single cohort across aims, incorporating technologies that are novel for such studies but well vetted in bench science, including high- speed video imaging and videostroboscopy with laser projection, this latter to obtain precise measures of nodule size pre and post therapy. These technologies will be integrated with more traditional ones including acoustic and perceptual evaluation of voice and larynx. The long-term goal is to refine and advance intervention models for millions of children whose quality of life is affected by these benign vocal fold lesions. Results will inform emerging behavioral strategies in voice therapy for the millions of children who are affected by these conditions, and who currently suffer substantial health- related consequences as a result.