注意缺陷/多动障碍儿童的客观与主观嗓音评估
Objective and Subjective Voice Assessment in Children With Attention-Deficit/Hyperactivity Disorder.
文献信息
| PMID | 42844034 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Armon Massoodi |
| 作者单位 | Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. Electronic address: armonmassoodi@gmail.com. |
| 期刊 | Journal of voice : official journal of the Voice Foundation |
| SCI 分区 | Q1 |
| IF | 2.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
引言： 本研究旨在比较注意缺陷/多动障碍（ADHD）儿童与典型发育（TD）同龄人之间的声学嗓音测量、听觉感知嗓音质量和家长报告的嗓音障碍。
研究设计： 病例对照研究。
方法： 对88名ADHD儿童和88名年龄、性别匹配的TD儿童进行了嗓音评估，包括使用Praat进行声学分析、使用GRBAS进行听觉感知评估以及使用波斯语CVHI-10-P进行家长报告的嗓音障碍；86名ADHD儿童和88名TD儿童有CVHI-10-P数据。
结果： 声学分析显示，ADHD儿童的响度显著高于TD儿童（P = 0.007），而TD儿童的基频微扰值显著更高（P = 0.001）。在基频（F0）、振幅微扰、谐噪比（HNR）和s/z比方面未观察到显著差异。在听觉感知评估中，仅GRBAS量表的Grade（G）成分发现显著的组间差异（P = 0.003），而粗糙度、气息声、无力和紧张度在组间无显著差异。根据GRBAS总体发音困难等级，患有发音困难的ADHD儿童比无发音困难者表现出更高的基频微扰和更低的HNR。ADHD儿童在波斯语CVHI-10-P上的得分也显著高于TD儿童（P < 0.001）。总体发音困难严重程度与较高的基频微扰（ρ = 0.493，P < 0.001）和较低的HNR（ρ = -0.334，P = 0.002）显著相关。CVHI-10-P得分与声学测量或总体发音困难严重程度无显著关联（P > 0.05）。
结论： 尽管ADHD儿童与TD组之间的声学测量值大多相似，但ADHD儿童表现出显著更高的家长感知嗓音障碍和更差的总体感知嗓音质量。鉴于波斯语CVHI-10-P在20.93%的ADHD儿童中识别出发音困难，强烈建议将家长报告的嗓音障碍测量纳入常规临床环境。
英文摘要
INTRODUCTION: The aim of this study was to compare acoustic voice measures, auditory-perceptual voice quality, and parent-reported voice handicap between children with attention-deficit/hyperactivity disorder (ADHD) and typically developing (TD) peers.
STUDY DESIGN: Case-control study.
METHODS: Voice assessments including acoustic analysis using Praat, auditory-perceptual assessment using GRBAS, and parent-reported voice handicap using the Persian CVHI-10-P were performed in 88 children with ADHD and 88 age- and sex-matched TD children; CVHI-10-P data were available for 86 children with ADHD and 88 TD children.
RESULTS: Acoustic analysis showed that children with ADHD had significantly higher loudness than TD children (P = 0.007), whereas TD children demonstrated significantly higher jitter values (P = 0.001). No significant differences were observed for fundamental frequency (F0), shimmer, harmonics-to-noise ratio (HNR), and the s/z ratio. In the auditory-perceptual assessment, a significant between-group difference was found only for the Grade (G) component of the GRBAS scale (P = 0.003), while Roughness, Breathiness, Asthenia, and Strain did not differ significantly between groups. Children with ADHD who had dysphonia, based on the overall dysphonia grade of the GRBAS, demonstrated higher jitter and lower HNR than those without dysphonia. Children with ADHD also had significantly higher scores on the Persian CVHI-10-P than TD children (P < 0.001). Overall dysphonia severity was significantly correlated with higher jitter (ρ = 0.493, P < 0.001) and lower HNR (ρ = -0.334, P = 0.002). CVHI-10-P scores were not significantly associated with acoustic measures or overall dysphonia severity (P > 0.05).
CONCLUSION: Although the values of acoustic measurement were mostly similar between children with ADHD and TD group, children with ADHD demonstrated significantly higher parent-perceived voice handicap and worse overall perceptual voice quality. Given that the Persian CVHI-10-P identified dysphonia in 20.93% of children with ADHD, incorporating parent-reported voice handicap measures into routine clinical settings is strongly recommended.