• Meike Brockmann-Bauser, Denis Beyer, and Jörg Edgar Bohlender.
• Department of Phoniatrics and Speech Pathology, Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland. Electronic address: meike.brockmann-bauser@usz.ch.
• Int. J. Pediatr. Otorhinolaryngol. 2015 Dec 1; 79 (12): 2035-42.

BackgroundCurrent pediatric voice assessment guidelines include instrumental measurements of fundamental frequency (F0) and the perturbation indices jitter and shimmer. In children below 10 years, gender, age, height and weight effects on these parameters have been inconsistently characterized. Recent research in healthy children showed, that differences in habitual speaking voice intensity (voice SPL) under the usual assessment procedure significantly affect jitter and shimmer. These effects were reduced in phonations with controlled voice SPL >80dBA. Reliable measurement methods and description of physiologic influencing factors are essential to identify pathologic voices.ObjectiveThis cross-sectional single cohort study investigates in children between 5;0 and 9;11 years how gender, age, height and weight affect voice F0, jitter and shimmer in phonations at individually "medium" voice intensity (modeling the usual clinical practice) and with controlled voice SPL >80dBA.Subjects And Methods68 vocally healthy children (39 f/29 m) aged 5;0-9;11 years provided 3 prolonged phonations of/a/at individually "medium" and controlled voice intensity at ">80dBA" (visual feedback, 10cm distance). F0 (Hz), jitter (%), shimmer (%) and voice SPL (dBA) were determined with PRAAT. Gender, age, height and weight effects without and with controlled voice SPL were assessed by descriptive statistics, Analysis of Variance and Linear Mixed Models.ResultsF0 (Hz), jitter (%), shimmer (%) and voice SPL (dBA) were significantly different in medium voice compared to >80dBA (p<0.01). In medium phonations girls had a higher F0 than boys (girls: 276.7(50.7), boys: 261.5(33.7)), but with >80dBA this difference was only minimal (girls: 328.9(52.2), boys 327.9(51.2)). Mean jitter (0.27(0.10)) and shimmer (4.34(1.68)) were smaller and showed less spread (jitter: 0.5(0.26); shimmer: 9.47(3.47)) with >80dBA. Gender, age, height and weight had no significant effects on F0, jitter, shimmer and voice SPL in both phonation types (p-range=0.42-0.99).ConclusionsNeither without nor with controlled voice SPL there were systematic gender, age, height or weight effects on voice F0, jitter and shimmer. Gender related F0 discrepancies were equalized in phonations with >80dBA. In children below 10 years gender related acoustic voice differences may be mainly linked to behavior, which should be considered in future works regarding physiologic voice development.Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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