Vocal quality of children with altered frenulum in the tongue

Abstract

Children with a disordered lingual frenulum are said to be more prone to various difficulties in the development process. Although these children tend to present changes in chewing, swallowing and speech, it can be assumed that the voice is practically not focused, with few studies concerned on vocal function (Camargo et al, 2017, 2017a). With the aim of investigating voice quality in children with and without lingual frenulum disorder, 61 children were clinically evaluated regarding the characteristics of the lingual frenulum (Marchesan, 2012) and the perceptual judgments of voice quality in semi-spontaneous (audio) speech samples. Video samples of orofacial clinical examinations and semi-spontaneous (audio) speech samples were recorded in a soundproof room. 28 children presented altered lingual frenulum (19 boys and 09 girls) and 33 frenulum without alterations (20 boys and 13 girls). We adopted the phonetic description of voice quality model as the theoretical background (Laver, 1980) and the Vocal Profile Analysis Scheme – VPAS (Laver et al, 1981; adapted for brazilian portuguese: Camargo, Madureira, 2008) for perceptual data analysis. Voice quality settings regarding the position of lips, tongue (tip and body), jaw, pharyngeal cavity configuration and vocal tract muscle tension occurred in a greater proportion (in terms of number of the occurrences and the degree of manifestation) in children with lingual frenulum disorded. When observing the data differently by male and female subgroups, we estimate that the former accounted for most of the occurrences related to labiodentalization, retracted and lowered tongue body and pharyngeal constriction. In the girls' subgroup, pharyngeal constriction was also recurrent. With regard to our previous explorations on the topic (Camargo et al, 2017, 2017a), we were able to advance in terms of a broader understanding of children's voice quality profiles and, particularly, those related to congenital orofacial motricity limitations. The relationships between size and position of the hyoid bone in children with an altered frenulum of the tongue (Ardekani et al, 2016), especially the raised and posterior position of the hyoid bone and the posteriorization of the jaw compared to children without frenulum disorerss, seem to influence the voice quality findings reported in this study. The high incidence rates of dysphonia in childhood tend to make it difficult to associate the alterations of the lingual frenulum to phonatory settings, although they may, hypothetically, appear as aggravating factors for dysphonia.