Development and Validation of the Children's Voice Handicap Index 10 for Parents.
OBJECTIVES/HYPOTHESIS The Children's Voice Handicap Index 10 (CVHI 10) was introduced as a tool for self assessment of children's dysphonia. However, in the management of children with voice disorders, both parents' and children's perspectives play an important role. Because a self tool including both a children's and a parents' version does not exist yet, the aim of the study was to develop and validate an assessment tool which parallels the CVHI 10 for parents to assess the level of voice handicap in their child's voice. STUDY DESIGN Observational, prospective, cross sectional study. METHODS To develop a CVHI 10 for parents, called "CVHI 10 P" the CVHI 10 items were adapted to reflect parents' responses about their child. Fifty five children aged 7 12 years completed the CVHI 10, whereas their parents completed the CVHI 10 P. Each child's voice was also perceptually assessed by an otolaryngologist using the Grade Breathness Roughness (GRB) scale. Fifty one of the 55 children underwent voice therapy (VT) and were assessed afterward using the GRB, CVHI 10, and CVHI 10 P. RESULTS CVHI 10 P internal consistency was satisfactory (Cronbach alpha .78) Correlation between CVHI 10 P and CVHI 10 was moderate (r 0.37) CVHI 10 P total scores were lower than CVHI 10 scores in most of the cases. Single item mean scores were always lower in CVHI 10 P compared with CVHI 10, with the exception of the only one item of the CVHI 10 P that directly involves the parent's experience (item 10) Data gained from one tool are not directly related to the other, suggesting that these two tools appraise the child's voice handicap from different perspectives. The overall perceptual assessment scores of the 51 children after VT significantly improved. There was a statistically significant reduction of the total scores and for each item in CVHI 10 and CVHI 10 P after VT. These data support the adoption of the CVHI 10 P as an assessment tool and an outcome measure for management of children's voice disorders. CONCLUSIONS CVHI 10 P is a valid tool to appraise parents' perspective of their child's voice disorder. The use of the CVHI 10 and the CVHI 10 P is recommended for objectively determining the level of voice handicap in children by parents and child.
Journal of voice official journal of the Voice Foundation