The Power of Singing in Childhood: Voice Quality and Voice-Related Quality of Life in Children Choir Singers

Casey Dewanckele, Kristiane Van Lierde, Yvonne Gonzales Redman, Imke Kissel, Anke Adriaansen, Tine Papeleu, Julie Daelman, Kim Bettens, Jolien Verbeke, Charis Van der Straeten, Fien Allemeersch, Mira De Ryck, Ellen De Landtsheer, Evelien D'haeseleer, Iris Meerschman

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: This study aimed to examine the voice quality and voice-related quality of life of children choir singers, an understudied population despite the demanding vocal requirements and limited vocal education. Methods: Forty-five choir-singing children (mean age: 13 years, range: 8.11–17.01 years) participated in this cross-sectional study. A multidimensional assessment, including instrumental voice measurements, auditory-perceptual evaluations of the speaking (using GRBASI) and singing (using Consensus Auditory-Perceptual Evaluation of Voice) voice, and participant-reported outcome measures (PROMs), was conducted at Europa Cantat Junior Ghent 2023, a festival for children and youth choirs. Primary outcomes included Dysphonia Severity Index (DSI), Acoustic Voice Quality Index (AVQI), fundamental frequency (fo), Grade, and PROMs. The PROMs contained a self-reported questionnaire gathering voice-related data, the KIDSCREEN-10 assessing general health-related quality of life (HRQoL), and the Children's Voice Handicap Index-10 (CVHI-10). Results: Instrumental analysis revealed a mean DSI of +6.4 (range: +0.9 to +9.7), indicating excellent vocal capabilities. In terms of acoustic voice quality, the mean AVQI of 3.1 (range: 1.7–5.0) suggested mild dysphonia. Auditory-perceptual evaluations revealed a mean Grade score of 0.69 (standard deviation [SD]: 0.56) for the speaking voice and 10.67 (SD: 10.22) for the singing voice, corresponding with a mildly deviant voice quality. Global assessment of the singing voice yielded a mean score of 74.33/100, with 100 representing an outstanding voice. PROMs revealed that most participants reported an average (84.4%) to high (6.7%) HRQoL. However, the mean CVHI-10 score of 3.4 (range: 0–15) reflected some self-perceived voice difficulties. Furthermore, 51.1% reported frequent voice complaints after vocal performances. Conclusion: While choir singing appeared to support excellent vocal capabilities and strong singing abilities, the analyses of the acoustic voice quality and the auditory-perceptual evaluation of both the speaking and singing voice indicated mild dysphonia. Despite their generally good health, half of the children reported vocal complaints after performances. This underscores the importance of further investigating children's understanding of their vocal apparatus, their vocal habits, and the potential impact of singing on their voices.

Original languageEnglish (US)
JournalJournal of Voice
DOIs
StateAccepted/In press - 2025

Keywords

  • Voice—Voice quality—Children—Choir—Singing—Voice-related quality of life

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Speech and Hearing
  • LPN and LVN

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