Speaking Voice in Children and Adolescents: Normative Data and Associations with BMI, Tanner Stage, and Singing Activity

Abstract

The aim of this study was to establish normative data concerning the speaking voice of children and adolescents for clinical diagnostics. Population-based mixed cross-sectional and longitudinal childhood cohort study. Normative data measuring the speaking voice profile of 1352 male and 1274 female participants aged 6 to 17 years were collected. To evaluate the voice range, five different intensity levels as the quietest voicing speaking voice (Level I), conversational voice (Level II), classroom voice (Level III), shouting voice (Level IV), and again the quietest speaking voice (Level V) were investigated. Multivariable analyses were performed to describe the effects of body mass index, Tanner stage, and singing activity on the outcome variables. A clear distinction in frequencies and sound pressure levels between the five different voice levels can be found in both genders. In females the mean fundamental frequency of the conversational voice lowers from 223.3 to 205.8 Hz. In male participants it lowers from 223.3 to 102.3 Hz. The most substantial decrease in the fundamental frequency of the speaking voice in boys occurs at 13.5 years. Girls show an almost continuous decline in their fundamental frequency. Only the Tanner stage showed significant positive relationships with the grade of lowering of the fundamental frequency in both sexes. It was shown that the investigation of the speaking voice using predefined intensity-levels represents a feasible examination for children and adolescents. This study provides reference data on the range and age-adjusted normative values of the speaking voice.