Pediatric Voice Handicap Index (pVHI): Validation in European Portuguese Children

Isabel Guimarães; Lina Almeida; Aldora Quintal; Ana Paula Batista; Ana Teixeira; Cláudia Romeiro; Daniela Brás Ferreira; Inês Sofia Fernandes; Madalena Saraiva; Rita Bom; Sancha Almeida; Susana Vaz Freitas

doi:10.1016/j.jvoice.2021.05.004

Pediatric Voice Handicap Index (pVHI): Validation in European Portuguese Children

J Voice. 2023 Sep;37(5):804.e11-804.e19. doi: 10.1016/j.jvoice.2021.05.004. Epub 2021 Jun 26.

Authors

Affiliations

¹ Speech and Language Pathologist (SLP), Speech Therapy Department, Alcoitão Health School of Sciences, Clinical and Therapeutics Pharmacological Unit, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal.
² SLP, ENT Department, Hospital dos Lusíadas, Lisboa, Portugal. Electronic address: linalmeida@gmail.com.
³ SLP, MSc, ENT Department, Hospital Garcia de Orta, Almada, Portugal.
⁴ SLP, MSc, ENT Department, Centro Hospitalar e Universitário do Algarve, Portimão, Portugal.
⁵ SLP, Physical Medicine and Rehabilitation, Hospital São João de Deus, Montemor-o-Novo, Portugal.
⁶ SLP, ENT Department, Hospital de Ponta Delgada-Hospital do Divino Espírito Santo de Ponta Delgada, EPE, São Miguel, Açores, Portugal.
⁷ SLP, ENT Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal.
⁸ SLP, MSc, Music Conservatorium Calouste Gulbenkian, Braga, Portugal.
⁹ SLP, ENT Department, Hospital do Espírito Santo de Évora, EPE, Évora, Portugal.
¹⁰ SLP, MSc, ENT Department, Hospital da Luz, Lisboa, Portugal.
¹¹ SLP, PhD, ENT Department, Hospital Santo António, Porto, Portugal.

PMID: 34183214
DOI: 10.1016/j.jvoice.2021.05.004

Abstract

Objectives: To determine reliability and validity of the European Portuguese pVHI version (pVHI-EP).

Study design: Cross-sectional design.

Methods: The pVHI-EP and the talkative and global voice assessment scales were administered to the caregivers of children aged from 3 to 16 years old with and without dysphonia. Reliability (internal consistency and test-retest) was analyzed. The validity analyses performed were: (1) content validity by analyzing the percentage of missing data; (2) construct validity with intraclass correlation coefficients among pVHI-EP domains and overall score; (3) concurrent validity was conducted between pVHI-EP, the caregivers' judgment of the child's voice severity on a visual analog scale and the Speech-Language Pathologist perceptual voice assessment; (4) known-groups validity between children with and without dysphonia, and (5) predictive validity by calculating receiver operating characteristics, sensitivity and specificity and determining cut-off points.

Results: A total of 283 children (61.5% boys, mean age 8.3 years) participated in the study. The pVHI-EP showed an excellent internal consistency for the pVHI-EP total data. Strong to moderate test-retest reliability confirms pVHI-EP reproducibility. Excellent to good intraclass correlation coefficients between the pVHI-EP overall and the domains confirms its construct validity. Weak to moderate concurrent validity with visual analog scale and Speech-Language Pathologist perceptual voice assessment was confirmed. The pVHI-EP significantly distinguished two groups of different voice conditions. A cut-off point of 10.5 with 95.9% sensitivity and 92.5% specificity was determined for the overall score of the pVHI-EP.

Conclusions: The pVHI-EP is a reliable and valid caregiver voice outcome tool for EP children with dysphonia.

Keywords: Childhood dysphonia; European Portuguese children; Pediatric voice disorder; Pediatric voice handicap index.

MeSH terms

Adolescent
Child
Child, Preschool
Cross-Sectional Studies
Dysphonia* / diagnosis
Female
Humans
Male
Parents
Portugal
Reproducibility of Results
Severity of Illness Index
Surveys and Questionnaires
Voice Disorders*