The high prevalence and psychosocial impact of pediatric dysphonia highlight the need for evidencebased
practice. Effectiveness studies of voice therapy in children with dysphonia are extremely
limited and show methodological limitations. There is a general need for randomized controlled
trials with larger sample sizes, multidimensional voice assessments, well-described therapy
programs, a control group receiving sham treatment, blinded assessors, and long-term follow-up
Vocal techniques based on the physics of a semi-occluded vocal tract (SOVT) seem promising as they
might obtain economic and efficient voice use. To date, no studies investigated the effect of SOVT
therapy in children with dysphonia. There is an urgent need to understand the impact of different
SOVT techniques on the multidimensional facets of the children’s voice, as these techniques are
nowadays frequently used in clinical practice. This project will specifically focus on "non-intuitive"
SOVT techniques for which instructions, feedback, and self-corrections can be reduced to a
The purpose of this project is to determine and compare the short- and long-term effect of two
“non-intuitive” SOVT therapy programs (straw phonation and cup phonation) with a more
traditional “intuitive” resonant voice therapy program on (a) the vocal quality, (b) the laryngeal
anatomy and function, and (c) the psychosocial wellbeing in children with vocal fold nodules using a
randomized sham-controlled trial.