Cognitive and Biological Mechanisms in Pediatric Voice Therapy

项目概要/摘要。 本研究的目的是探讨可能影响儿童智力发展的发展因素对儿童智力发展的影响。 对患有常见良性声音创伤性病变的儿童进行经过审查的标准护理声音治疗的结果， 声带小结具体目标1将研究儿童认知发展能力的影响 他们在声音治疗中的学习反应，在他们获得治疗发声模式方面， “共鸣的声音，”在审查治疗计划，在声音冒险（AIV）。具体目标2将调查 儿童生理发育阶段对语音冒险生物反应影响 根据声带组织弹性的基线估计， 已知随年龄变化。具体目标3是探索性的，并评估了一个更全面的，综合的因果模型的声乐 和喉部改善与语音治疗结节，作为一个功能的认知和身体成熟。 具体目标3还将在探索性水平上讨论可能影响治疗结局的其他因素 如医学共病、报告的儿童治疗依从性和报告的父母参与 接受治疗我们将在单个队列中使用纵向观察性研究设计， 结合这些研究的新技术，但在实验室科学中得到了很好的审查，包括高- 快速视频成像和视频频闪镜与激光投影，后者获得精确的措施， 治疗前后的结节大小。这些技术将与更传统的技术相结合，包括 声音和喉的声学和感知评估。 长期目标是为数百万生活质量受到严重影响的儿童完善和推进干预模式。 受到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信息 对于数百万受这些疾病影响的儿童，以及目前遭受严重健康问题的儿童， 相关的后果。

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.