SLPPilotJournal of voice : official journal of the Voice Foundation2025

Voiced-Voiceless Consonant Distinction in Children With Vocal Fold Nodules: A Preliminary Study.

Meghan Littlejohn, Geralyn Harvey Woodnorth, Anne Hseu and 2 others

PMID 40157856

WHAT IT FOUND

Most consonant timing measures did not track voice disorder in children with vocal fold nodules.

Voiced-voiceless distinction did track voice disorder in the 5 to 6 and 6 to 7 groups.

Key findings

01No significant age group differences were found for the voice quality measure, overshoot, accuracy, range, or variability.

02Voiced-voiceless distinction differed by age group, with the 5 to 6 group lower than the 6 to 7 and 3 to 5 groups.

03The voice quality measure was related to voiced-voiceless distinction in the 5 to 6 and 6 to 7 groups, not in the 3 to 5 group.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study included only 24 children, with eight in each age group, so it had limited power. It was retrospective and selected from an existing database, and the speech samples were collected for another purpose, a CAPE-V usability study. There was no age-matched control group of children without vocal fold nodules. The groups were not gender matched, and males were disproportionately represented in the older groups. The analysis used average timing values and could not control for factors such as articulatory context, place of articulation, gender, aerodynamic factors, auditory acuity, or clinical perception. Overshoot was low in the sample, with 29 of 48 average VOTs at 0% overshoot and 41 of 48 at less than 50%. The study examined several measures at once, and the significance level was set to 0.01 to correct for multiple comparisons.

The easy way to misread this

Do not conclude that vocal fold nodules cause poor voiced-voiceless distinction, or that treating voice quality will improve consonant production. The study found associations in a small retrospective sample, and most timing measures did not relate to voice quality.

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