School of Paediatrics and Child Health

Postgraduate Research Profiles

Victoria Reynolds


Victoria Reynolds

School of Paediatrics & Child Health
The University of Western Australia
Princess Margaret Hospital for Children
PO Box D 184, Subiaco
WA 6840

Phone (+61) 9340 8606
Fax (+61) 9388 2097


Start Date

11 June 2012

Submission Date

19 June 2015

Victoria Reynolds


Dysphonia in very preterm children at school age: incidence, pathology and responsiveness to therapy.


Dysphonia refers to disruption of the voice signal. People with dysphonia may have a hoarse, husky, raspy or soft voice. It can be difficult or painful to speak, and hard to make themselves understood. Dysphonia occurs across the lifespan and is known to have adverse effects on academic, social and employment outcomes. Dysphonia can have a significant impact on the quality of life of those affected.

Mild dysphonia in childhood is common, affecting up to 40% of otherwise typically-developing children. Communication behaviours frequently seen in childhood, such as shouting, making noises in play and prolonged voice use at elevated volumes, place strain on the vocal mechanism resulting in hoarseness. Most cases usually resolve with changes to the larynx associated with puberty, and the maturation of communication behaviour in adolescence and adulthood. More severe forms of dysphonia in childhood are rare and may be long-lasting.

Intubation is a known cause of structural damage to the larynx, and resultant voice difficulties may be permanent. Our laboratory has published a pilot study into dysphonia in extremely preterm children at school age, and demonstrated that there is an association between intubation and voice outcomes. Children born very preterm may also be at high risk of developing dysphonia, as they frequently require respiratory support in the neonatal period.

The aim of this study is to investigate the incidence of dysphonia in very preterm children at school age, and examine laryngeal structure and function in those children with a significant voice difficulty. This will tell us more about the laryngeal pathology underlying the children’s voice problems. We are also trialling a behavioural voice treatment protocol, designed to promote the use and maintenance of healthy vocal function.

Why my research is important

Many more children than ever before survive and thrive following very preterm birth. Invasive ventilation is inevitable in the care of many of these children, and for many, may cause ongoing voice problems. For many children, dysphonia may be the only, or one of the few, ongoing consequences of their preterm birth that limit daily activities and participation. It is estimated that approximately one third of adults are professional voice users. That is, good, reliable vocal quality is required to participate in their employment tasks (e.g., teachers, police officers, sales assistants, clerks and health professionals).  Very preterm children with dysphonia may be limited in their future employment opportunities if  their voice problems persist. Our study will lead to better understanding of the incidence, risks for and nature of voice problems in very preterm children, and will also demonstrate whether or not voice therapy is effective in these cases.


  • Australian Postgraduate Award
  • WIRF Preterm Voice Top-Up






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