Objective: This study aimed to verify the relationships between voice, and behavior in children and adolescents with and without dysphonia based on parents' reports and perceptual voice analysis by Phoniatricans. Study Design: This is a case control study. Patients and Methods:The study involved 51 of dysphonic school-age children and adolescents and 62 vocally normal controls aged from 6-18 years. Participants were assessed with auditory perceptual voice analysis, clinical laryngoscopic examination (CLE). Parents of all participants completed the Child Behavior Checklist for ages 6-18 years (CBCL).. Results: Children and adolescents with dysphonia scored higher on Internalizing, Externalizing, Anxiety/depression, Withdrawal/depression, Somatic complaints, Social problems, Attention problems, Rule-breaking, and Aggressive behavior. Children and adolescents with vocal problem scored lower on Activities, Social, School, and thought problems. Correlation analysis between dysphonia severity and CBCL scores demonstrated significant positive correlation in the following scales (Internalizing scale r=0.549; P=0.001, externalizing scale (r=0.370; P= 0.001 and total Behavior scales (r= 0.581; P=0.00), school scale score (r= 0.288; P=0.002), and total Competence indicators (r= 0.230; P= 0.014), withdrawal/depression, social problems, rule-breaking, and aggressive behavior . Conclusion:Vocal fold nodules may be a risk for behavior problems due to the higher scores on behavior problems scales in children and adolescents, especially internalization and externalization aspects and significant positive correlation found between dysphonia severity and CBCL scores. Early interventions of these problems are needed to prevent the persistence of such problems, and reduce its negative impact.
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