# Use of a self-perception questionnaire for screening auditory abilities in children with behavioral dysphonia

## TL;DR

A self-perception questionnaire helps assess auditory abilities in children with behavioral dysphonia, showing strong correlations with voice symptoms and auditory processing tests.

## Contribution

The study introduces a self-perception questionnaire (QAPAC) as a valid tool for initial auditory screening in children with behavioral dysphonia.

## Key findings

- Children's self-assessment scores were higher than parental assessments for auditory abilities.
- Strong correlations were found between QAPAC and voice symptom questionnaires.
- Left ear performed worse than the right ear in frequency pattern tests.

## Abstract

To discuss the use of a self-perception questionnaire on auditory abilities applied to children with behavioral dysphonia and compare it with the perception of auditory and voice symptoms, as well as with performance in temporal tests of auditory processing.

17 children, aged 6–8 years, with a diagnosis of behavioral dysphonia. Individuals with peripheral hearing loss, severe visual and/or language impairments or neurodevelopmental disorders were excluded. The following instruments were applied: pediatric voice symptoms questionnaire (PVSQ, brazilian validated version); questionnaire of self-perception auditory skills (QAPAC) inserted into the online program AudBility with its self-assessment and parental versions; basic audiological evaluation and the temporal tests Random Gap Detection (RGDT), and Frequency Pattern (FPT). Parents’ and children’s responses were compared and Spearman’s correlation measured correlation between the QAPAC and the PVSQ, as well as between questionnaires and temporal tests.

QAPAC self-assessment version showed a mean score of 45.5±7.4, wherein seven (41.2%) children scored below the risk criteria for Central Auditory Processing Disorder (CAPD). The mean score on the parental version was 39.5±10.5, with 11 (64.7%) responses falling below the risk criteria. Parents’ mean score was statistically lower (worse) compared to that of the children (p<0.005). A strong correlation was found between the self-assessment versions of QAPAC and PVSQ (r=0.671), alongside the parental versions (r=0.722). A poorer performance of the left ear in comparison to the right ear was observed in the FPT test (p<0.005), and a moderate correlation between QAPAC and FPT in the left ear during the imitation phase was noted (r=0.597).

The use of self-perception questionnaire on auditory abilities is a valid contribution to initial voice assessment in children with behavioral dysphonia.

Discutir o uso de um questionário de autopercepção das habilidades auditivas em crianças com disfonia comportamental e compará-lo com a percepção de sintomas auditivos e vocais e com o desempenho em testes temporais do processamento auditivo.

Participaram 17 crianças, 6 a 10 anos, com diagnóstico de disfonia comportamental. Perda auditiva periférica, alterações visuais graves, de linguagem ou transtornos do neurodesenvolvimento foram excluídas. O Questionário de Sintomas Vocais Pediátrico (QSV-P) e o Questionário de autopercepção das habilidades auditivas (QAPAC) – inserido no programa de triagem das habilidades auditivas AudBility – ambos em versões autoavaliação e parental, avaliação audiológica básica e os testes temporais Detecção de Intervalo Aleatório (RGDT) e Padrão de Frequência (TPF) foram aplicados. As respostas dos pais e crianças nos questionários foram comparadas e foi mensurado o grau de correlação entre o QAPAC e o QSV-P, bem como entre os questionários e testes temporais.

A média de escore no QAPAC na versão de autoavaliação foi 45,5±7,4, com sete (41,2%) crianças abaixo do critério de risco para o Transtorno do processamento auditivo (TPAC). O escore médio da versão parental foi 39,5±10,5, com 11 (64,7%) respostas alteradas. O escore médio dos pais foi pior em relação ao das crianças (p<0,005). Houve forte correlação entre as versões de autoavaliação do QAPAC e QSV-P (r= 0,671) e versões parentais (r= 0,722). Foi observado pior desempenho da orelha esquerda em relação a orelha direita no TPF (p<0,005) e correlação moderada entre o QAPAC e o TPF na orelha esquerda na etapa de imitação (r= 0,597).

O uso do QAPAC demonstrou válida contribuição para compor um protocolo inicial de avaliação da voz em crianças com disfonia comportamental.