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Objectives: This study aimed to translate and evaluate the psychometric properties of the Children's Voice Handicap Index-10 for Parents (CVHI-10-P) in Persian for assessing voice-related quality of life in Persian-speaking children., Methods: The CVHI-10-P was translated into Persian and assessed for face and content validity by a panel of speech-language pathologists. The questionnaire was administered to 141 children aged 6-11 years, including 35 with voice disorders and 106 without. Reliability was measured using Cronbach's alpha, Spearman-Brown, and Guttman coefficients. Validity was evaluated through sensitivity, specificity, accuracy, precision, F-score metrics, and correlations with the Persian version of the Pediatric Voice Handicap Index (PVHI)., Results: The translated CVHI-10-P demonstrated high reliability, with a Cronbach's alpha of 0.944 for the total score. Significant differences in CVHI scores between children with and without voice disorders confirmed the questionnaire's ability to distinguish between these groups. Receiver operating characteristic (ROC) curve analysis revealed an area under the curve (AUC) of 0.974, indicating excellent diagnostic accuracy. Pearson's correlation showed strong associations between CVHI and PVHI scores across all dimensions., Conclusion: The Persian version of the CVHI-10-P is a reliable and valid tool for assessing the impact of voice disorders on the quality of life in Persian-speaking children. It offers a concise and effective means for parents to report their children's voice-related challenges., (Copyright © 2024 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: This study aims to investigate the immediate effect of straw phonation on the phonation of Persian-speaking children with repaired cleft palate., Study Design: Quasi-experimental preintervention and postintervention., Methods: Seventeen children with repaired cleft palate and velopharyngeal dysfunction were investigated. A control group was established comprising children without a cleft palate (control group), carefully matched in terms of age and gender. All participants underwent straw phonation and assessment. The assessments were made two times: at baseline and immediately after straw phonation. Each participant performs straw phonation (a short straw measuring 3 mm in inner diameter and 20 cm in length) once for 3 minutes. The acoustic analysis including parameters, such as jitter, shimmer, harmonics-to-noise ratio (HNR), cepstral peak prominence (CPP) parameters, as well as the electroglottography (closed quotient [CQ]) analysis were performed at pretreatment and immediately after treatment., Results: Compared with the pretreatment values, after-treatment observation demonstrated a significant reduction in Jitter % and Shimmer %, and a significant enhancement in HNR and CPP among children with repaired cleft palate. There is no significant difference in intragroup data in the CPP and CQ in pretreatment., Conclusions: The proposed straw phonation technique results in an immediate positive change in the quality of voice in both groups. Moreover, assessments in the clinical group showed a significant decrease in shimmer and jitter perturbation, alongside elevated levels of HNR and CPP subsequent to straw phonation, irrespective of the phonatory task., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Speech sound disorder (SSD) is one of the most common communication disorders in children, which must be diagnosed and treated in childhood to prevent its negative psychological, occupational, and social consequences in adulthood. The use of serious games is one technology that could help treat SSD. This study aims to design and evaluate the usability of a digital game for 3-6-year-old children. This developmental study was carried out in three main stages: determining information requirements, designing and developing a digital game, and evaluating the usability of the designed game. In the first stage, the consonants, syllables, words, and sentences that should be used in the game were determined through focus group sessions and a questionnaire completed by 30 speech-language pathologists (SLPs) in two Delphi rounds. In the designing and developing stage, the game design document was first written, and then sketches and wireframes were drawn based on this document. Then, the game was developed in the second phase using Java programming language. In the third stage, the usability of the designed game was evaluated by six experts and 22 SLPs using Nielsen's usability heuristics and the Post-Study System Usability Questionnaire (PSSUQ), respectively. Also, the usability of the game was evaluated by ten children. To determine the information requirements, SLPs confirmed 23 consonants, 138 syllables, 564 words, and 69 sentences to teach children the game. According to Nielsen's usability heuristics, the designed game had 23 unique usability problems with a mean severity of 2.29. "User control and freedom," with five usability problems, was the most frequently identified problem, and "error prevention," with a mean severity of 3.83, was the most severe problem. The results of the SLPs' evaluation also showed that the "interface quality" of the designed game obtained the highest score, with a mean score of 6.25 out of 7. Also, 100% of children stated that the game was designed beautifully, and 90% of children also liked the game. A serious game designed for children with SSDs achieved satisfactory results in usability evaluation. Therefore, this smartphone-based game can be easily used among these children to provide fun therapy sessions under the supervision of parents., (© 2024. The Author(s).)

Objectives: Voice disorders can profoundly impact health, quality of life, job performance, and social interactions. Traditional evaluations have expanded to include quality-of-life assessments, emphasizing self-reported outcomes. The Voice Handicap Index (VHI) stands out among relevant questionnaires, with the VHI-10 being a concise derivative. This study was conducted to translate and validate the Voice Handicap Index-10 (VHI-10) questionnaire for Persian speakers, enhancing clinical assessments of voice disorders and quality of life., Methods: This cross-sectional study, conducted in Iran, involved (1) translating the VHI-10 into Persian, (2) confirming face and content validity using Content Validity Ratio (CVR), and Content Validity Index (CVI), and (3) evaluating its reliability through a survey. A panel of experts confirmed the validity, and reliability of the study, which was assessed using Cronbach's alpha, Spearman-Brown, and Guttman coefficients. The survey involved 225 participants, including 150 healthy people and 75 patients with voice disorders, who were selected using a convenience sampling method., Results: All question items demonstrated a CVI greater than 0.79 and a CVR between 0.62 and 1. Reliability analysis yielded high Cronbach's alpha values for functional, physical, and emotional domains (0.909) and total (0.961). The mean overall scores of VHI-10 for healthy and disordered groups were 18.78 and 0.74, respectively. The VHI-10 effectively discriminated between healthy and disordered groups in all domains, with an accuracy of 97.33%. The determined cut-off point was 4.5, with a strong area under the Receiver Operating Characteristic (ROC) curve (0.989)., Conclusion: This study successfully adapted and validated the Persian version of the VHI-10. The questionnaire demonstrated high reliability and validity, distinguishing between individuals with and without voice disorders. This Persian version is now a valuable tool for speech and language pathologists conducting clinical voice evaluations in Iran and also it could be applied in studies to determine the effects of voice problems on participant's quality of life., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2024 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

The aim was to define the association between the severity of depression, prosody, and voice acoustic features in women suffering from depression and its comparisons with nondepressed people. Prosody and acoustic features in 30 women with major depression hospitalized in a psychiatric ward and 30 healthy women were investigated in a cross-sectional study. To define the severity of depression, the Hamilton Rating Scale for Depression (HRS-D) was applied. Acoustic parameters such as jitter, shimmer, cepstral peak prominence (CPP), standard deviation of fundamental frequency (SD F 0), harmonic-to-noise ratio, and F 0 and also some speech prosodic features including the speed of speech, switching pause duration means, and durations of produced sentences with different modals were measured quantitatively. Also, six raters judged the patient's prosody qualitatively. SPSS V.28 was used for all statistical analyses ( p < 0.05). There was a significant correlation between HRS-D with jitter, SD F 0, speed of speech, and switching pause means ( p ≤ 0.05). The means of CPP and duration of producing emotional sentences differed between the depression and control groups. The HRS-D scores were significantly correlated with switching pauses in patients (Pearson coefficient = 0.47, p =0.05). The results of the perceptual evaluation of prosody judged by six raters showed an 85% correlation between them ( p ≤ 0.001). Some acoustic and prosodic parameters are different between healthy women and those with depression disorder (e.g., CPP and duration of emotional sentences) and may also have an association with the severity of depression (e.g., jitter, SD F 0, speed of speech, and switching pause means) in women with depression disorder. It was indicated that the best sentence modal to assess prosody in patients with depression would be exclamatory ones compared to declarative and interrogative sentences., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2023 Mohammad-Sadegh Seifpanahi et al.)

Objectives: This systematic review aims to explore the effectiveness of voice health education interventions among singers, particularly focusing on vocal hygiene treatment programs tailored for professional voice users., Study Design: Systematic review., Methods: Preferred Reporting Items on Systematic Reviews and Meta-Analysis guidelines were followed to conduct this systematic review. Comprehensive searches were conducted in PubMed, Web of Science, Scopus, Science Direct, and Cochrane Library databases. Four articles were selected for detailed review. The studies were evaluated using the Effective Public Health Practice Project tool for quality assessment., Results: The four reviewed studies primarily utilized the pretest-posttest design to examine the effectiveness of vocal hygiene interventions on singers' vocal health. Two studies investigated the effect of hydration as a treatment method, while the remaining two focused on vocal hygiene instruction. Significant improvements were observed in various vocal health parameters, including maximum phonation time, intensity, Dysphonia Severity Index, and number of daily vocal breaks taken., Conclusion: This systematic review provides valuable insights into the efficacy of vocal hygiene treatment programs for singers. The positive outcomes observed in the reviewed studies underscore the importance of voice health education tailored to singers' specific needs. However, the limited number of eligible studies and the common limitation of small sample sizes highlight the need for further research in this area. Vocal health practitioners, educators, and researchers can utilize the findings of this review to develop evidence-based vocal hygiene interventions that promote the well-being and longevity of singers' vocal performance careers., (Copyright © 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objectives: Singers' self-reporting of their voice problems can be helpful in the treatment of voice disorders by speech-language pathologists (SLP), which requires a valid questionnaire. This study was conducted to translate and validate the Singing Voice Handicap Index-10 (SVHI-10) questionnaire in the Persian language., Methods: This cross-sectional study was conducted in two main steps (1) translation of the questionnaire and determination of face and content validity and (2) survey of singers. The questionnaire was first translated by a SLP who was an expert in voice disorder and also proficient in the English language. The face and content validity of the questionnaire was confirmed by experts through impact score, content validity ratio, and content validity index. Then it was translated into English and adapted to its original version. A valid questionnaire was given to 70 singers to determine their ability to distinguish singers with voice problems from healthy singers and their internal consistency., Results: The face and content validity of the questionnaire was confirmed without excluding any item. The results showed that the questionnaire has excellent internal consistency (α = 0.930). With the optimal cut-off point of 14.5, this questionnaire was able to identify singers with voice problems with 90% accuracy. Also, the sensitivity and specificity were 84.85% and 94.59%, respectively. Also, the area under the Receiver Operating Characteristic (ROC) curve was equal to 0.937., Conclusion: The results revealed that the Persian version of SVHI-10 is a reliable and valid instrument to identify singers with voice problems, so it can be used by SLPs., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Background: Mobile health (mHealth) technology could be used in different ways to treat various speech and language disorders. The attitude of speech-language pathologists (SLPs) towards this technology and their willingness to use it can play a significant role in the success of the therapies they provide. This study was conducted to investigate the willingness and attitude of SLPs towards the use of mHealth technology., Methods: This cross-sectional study was conducted from September 2021 to April 2022 in Iran. A researcher-made questionnaire consisting of three parts (information related to demographic variables, attitude and willingness) was designed based on the past studies, and then given to all SLPs throughout Iran. Data were analyzed by SPSS software, using descriptive and inferential statistics (frequency, mean, Fisher's exact test, and analysis of variance). Also, the SLPs' willingness to use the desired technology was interpreted as a percentage as follows: 0-20% = not at all willing, 21-40% = slightly willing, 41-60% = moderately willing, 61-80% = highly willing, and above 80% = extremely willing., Results: One hundred sixty speech-language pathologists from all over Iran participated in this study. The results showed that the willingness of 65.25% of SLPs to use the mentioned technology was at a good level, and according to the mentioned category, they had a high willingness to use this technology. In regard to the attitude of SLPs, the findings showed that SLPs believed that patients receive a higher quality of care during in-person visits than through mHealth technology. Also, this survey showed that SLPs were more inclined to use this technology to answer patients' questions. Non-payment of services provided through mHealth technology and privacy concerns were the reasons for the lack of use of this technology by SLPs., Conclusions: SLPs are willing to use mHealth technology after solving the related challenges, including payment of costs and privacy concerns. However, SLPs believed that this technology will not be a suitable alternative to face-to-face sessions., (© 2023. The Author(s).)

Introduction: Treatment of speech disorders during childhood is essential. Many technologies can help speech and language pathologists (SLPs) to practice speech skills, one of which is digital games. This study aimed to systematically investigate the games developed to treat speech disorders and their challenges in children., Methods: A comprehensive search was conducted in four databases, including Medline (through PubMed), Scopus, Web of Science, and IEEE Xplore, to retrieve English articles published by July 14, 2021. The articles in which a digital game was developed to treat speech disorders in children were included in the study. Then, the features of the designed games and their challenges were extracted from the studies., Results: After reviewing the full texts of 69 articles and assessing them in terms of inclusion and exclusion criteria, 27 articles were included in the systematic review. In these articles, 59.25% of the games had been developed in English language and children with hearing impairments had received much attention from researchers compared to other patients. Also, the Mel-Frequency Cepstral Coefficients (MFCC) algorithm and the PocketSphinx speech recognition engine had been used more than any other speech recognition algorithm and tool. In terms of the games, 48.15% had been designed in a way that children could practice with the help of their parents. The evaluation of games showed a positive effect on children's satisfaction, motivation, and attention during speech therapy exercises. The biggest barriers and challenges mentioned in the studies included sense of frustration, low self-esteem after several failures in playing games, environmental noise, contradiction between games levels and the target group's needs, and problems related to speech recognition., Conclusion: The results of this study showed that the games positively affect children's motivation to continue speech therapy, and they can also be used as the SLPs' aids. Before designing these tools, the obstacles and challenges should be considered, and also, the solutions should be suggested., Competing Interests: The authors declare that they have no conflicts of interest in the research., (Copyright © 2022 Soheila Saeedi et al.)

Purpose: The religious singing is a popular group of professional voice users in Iran which is performed in a sadness form to persuade the audiences to cry and think to holy persons. This style has its own unique vocal demands and abuses. Therefore, the present study, for the first time, aimed to investigate the prevalence of self-reported vocal complaints, vocal discomfort symptoms, and its effects on the vocal-related life of the Iranian religious singers., Methods: In a cross-sectional study, 62 religious singers (28 women, 34 men) completed Singers Voice Handicap Index (SVHI), Vocal Tract Discomfort (VTD), and also a non-standard self-rated vocal complaint question. Spearman correlation test was applied to analyze correlations. Furthermore, 39 non-singers (18 women, 21 men) as a control group participated in this study., Results: The religious singer's mean score of the SVHI test was 34.84 (SD = 24.89). According to the self-rated vocal complaint question, almost 80% of the participants reported mild to the severe vocal complaints that was significantly higher than control group which was about 10%. The self-rated complaints indicated a significant positive correlation with the SVHI and the VTD reported by singers (p ≤ 0.001). The mean scores of the VTD symptoms in singers were significantly greater than control group. There was also a significant positive correlation between the two VTD and SVHI tests (p ≤ 0.001)., Conclusion: Religious singers are at a great risk of developing voice problems. Therefore, their vocal demands and requirements need to be followed precisely. The SVHI and VTD tests should also be considered as two efficient tools for religious singers.