ESS - DM - Terapia da Fala
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- Acoustic characterization of children´s healthy voice: A systematic review with meta-analysisPublication . Viveiros, Tânia Moniz; Araújo, Pedro André G. M.; Martins, João PauloThis study is a systematic review with meta-analysis focused at gathering and synthesizing data from the literature on pediatric acoustic assessment, evaluating the possibility of establishing reference values for clinical practice through meta-analysis. The research was conducted based on a PICO question ("in non-dysphonic children aged between 2 and 12 years (P) submitted to vocal assessment (I), what are the reference values of acoustic parameters (O)?"), and the procedures followed the PRISMA protocol. Included studies were published between 2014 and 2024, written in Portuguese or English, and reported acoustic assessment in children aged 2 to 12 years without pathology. They were extracted from LILACS, Scopus, and PubMed databases. Risk of bias was assessed using Joanna Briggs Institute (JBI) Critical Appraisal tools for Analytical Cross-Sectional Studies, for Case-Control Studies, and for Cohort Studies scales, and funnel plots, Egger's test, and the Trim-and-Fill method were applied to screen for possible publication bias. A total of 49 studies were included. The most mentioned parameter (mean fo) was studied according to 1863 girls’ samples,1940 boys’, while other parameters were studied with less than 200 voice samples for girls, boys and both. The followed where analysed through meta-analysis: fundamental frequency parameters (mean fo, Hfo, Lfo, TVR, vfO%), intensity measures (mSPL (dB), hSPL (dB), lSPL (dB), vAmp%), perturbation measures (jit%, PPQ%, shim%, APQ%, NHR, HNR), spectral and cepstral measures (L/H ratio, CPP, CPPS, CPP F0), and multiparametric indexes (SPI, VTI). Short-term measures were more mentioned than long-term measures, although the last have been showing potential in gathering robust data. Only mean fo demonstrated significant difference according to sex, while mean fo, lfo, TVR, CPP F0 showed significant difference according to age. Our sample showed mostly subtle differences between sex and age since it was composed by children < 12 years not having yet reached puberty. Reported tasks showed significative differences in almost every parameters, enhacing to importance to attend to its correlation with clinical conditions. Other variables showed impact in results – software used for analysis and linguistic context -, showing the influence of confounders in vocal assessment and the relevance of taking them into account when studying voice.