Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP)最新文献

{"title":"Erratum.","authors":"","doi":"10.1159/fpl/acvag011","DOIUrl":"https://doi.org/10.1159/fpl/acvag011","url":null,"abstract":"","PeriodicalId":520626,"journal":{"name":"Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP)","volume":" ","pages":"1"},"PeriodicalIF":0.7,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship between Cepstral Peak Prominence and Traditional Acoustic Measures with Self-Assessment Scales in Organic Voice Disorders.","authors":"Tuba Kaya, Çiğdem Fırat Koca, Maide Selis, Mehmet Burak Kanıkara","doi":"10.1159/fpl/acvag010","DOIUrl":"10.1159/fpl/acvag010","url":null,"abstract":"<p><strong>Introduction: </strong>Cepstral peak prominence (CPP) has emerged as a useful acoustic indicator in the evaluation of dysphonia; however, its relationship with self-reported voice outcomes in individuals with organic voice disorders remains unclear.</p><p><strong>Methods: </strong>This retrospective cross-sectional study investigated the associations between acoustic parameters - including jitter, shimmer, harmonic-to-noise ratio (HNR), and CPP - and patient-reported measures of voice handicap and vocal fatigue. Data from 51 adults diagnosed with organic voice disorders were analyzed using the Voice Handicap Index-10 (VHI-10) and the Vocal Fatigue Index (VFI). Sustained/a/phonation and CAPE-V sentences were used to extract acoustic measures.</p><p><strong>Results: </strong>After adjustment for multiple comparisons, significant positive correlations were found between VHI-10 scores and jitter and shimmer, while HNR showed a significant negative correlation. CPP derived from sustained/a/phonation demonstrated a moderate negative correlation with VHI-10, whereas CPP derived from connected speech showed no significant association. No significant relationships were observed between the acoustic measures and VFI total or subscale scores.</p><p><strong>Conclusion: </strong>These findings suggest that CPP derived from sustained phonation may reflect certain aspects of perceived voice handicap but does not appear to capture the distinct and multidimensional experience of vocal fatigue in individuals with organic voice disorders. Cepstral, traditional acoustic, and patient-reported measures should therefore be interpreted as complementary components of multidimensional voice assessment.</p>","PeriodicalId":520626,"journal":{"name":"Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP)","volume":" ","pages":"1"},"PeriodicalIF":0.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcultural Adaptation and Validation of the German DIGEST-FEES.","authors":"Susanne Bauer, Stephanie Rieser-Reetz, Jörg E Bohlender, Heather M Starmer, Katherine A Hutcheson, Erich Hartmann, Meike Brockmann-Bauser","doi":"10.1159/fpl/acvag009","DOIUrl":"10.1159/fpl/acvag009","url":null,"abstract":"<p><strong>Introduction: </strong>Flexible endoscopic evaluation of swallowing (FEES) is one of two diagnostic gold standards for pharyngeal dysphagia in patients with head and neck cancer (HNC). However, an evidence-based summary outcome measure was missing until recently. The Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) for FEES was adapted from DIGEST_V2 for videofluoroscopy for this purpose and is a validated analysis method, grading the severity of pharyngeal dysphagia based on the swallowing parameters safety and efficiency. Main aim of this study was to translate and validate DIGEST-FEES into German (DIGEST-FEES-G).</p><p><strong>Methods: </strong>First, the transcultural translation included forward and backward translations, cognitive interviews, and consensus in an expert committee together with the original developers. Subsequently, the 100 endoscopic examination videos of the DIGEST-FEES original validation study were retrospectively analyzed with DIGEST-FEES-G.</p><p><strong>Results: </strong>After a training phase, inter-rater reliability was almost perfect for overall DIGEST-FEES-G grade (Kw = 0.89), DIGEST-FEES-G safety (Kw = 0.9), and DIGEST-FEES-G efficiency (Kw = 0.88). Intra-rater reliability for the DIGEST-FEES-G rating was almost perfect (rater 1: Kw = 0.81-0.88) and substantial to almost perfect (rater 2: Kw = 0.78-0.92). Overall DIGEST-FEES-G grade correlated with the German Murray Secretion Scale (r = 0.47; p < 0.01), German Yale Vallecular Residue (r = 0.74; p < 19 0.01), and German Yale Pyriform Sinus Residue (r = 0.66; p < 0.01).</p><p><strong>Conclusion: </strong>The validation and reliability findings of the original study could be replicated for DIGEST-FEES-G which increases validity of the DIGEST-FEES scale. The translated version, DIGEST-FEES-G, provides a psychometrically sound analysis method for the severity grading of pharyngeal dysphagia in HNC for German-speaking practitioners.</p>","PeriodicalId":520626,"journal":{"name":"Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP)","volume":" ","pages":"1"},"PeriodicalIF":0.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrative Discourse in Arabic-Speaking Adolescents: Micro- and Macrostructural Analyses.","authors":"Khaloob Kawar, Marilyn A Nippold","doi":"10.1159/fpl/acvag005","DOIUrl":"10.1159/fpl/acvag005","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined narrative retelling in Palestinian Arabic (PA)-speaking adolescents to characterize micro- and macrostructural discourse patterns within a diglossic linguistic context.</p><p><strong>Methods: </strong>Forty-two typically developing seventh-grade students (mean age = 12.7 years) listened to fables presented in Modern Standard Arabic and retold them in PA, the participants' variety of Spoken Arabic. Narratives were analyzed at the microstructural (verbal productivity, lexical diversity, and syntactic complexity) and macrostructural (story grammar and coherence) levels.</p><p><strong>Results: </strong>Narrative performance showed substantial individual variability, with retellings ranging from brief, telegraphic accounts to extended narratives incorporating causal links and evaluative commentary. Story grammar scores were generally high, although references to characters' internal states were infrequent. Verbal productivity was positively associated with story grammar, and story grammar showed a strong association with coherence. In contrast, lexical diversity and syntactic complexity were not positively related to coherence.</p><p><strong>Conclusion: </strong>The findings describe typical patterns and ranges of narrative performance in Arabic-speaking adolescents and demonstrate that strong macrostructural organization and coherence can be achieved even in relatively short narratives. This highlights the importance of accounting for diglossic language contexts and discourse conventions when assessing narrative abilities and designing culturally responsive assessment tools.</p>","PeriodicalId":520626,"journal":{"name":"Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP)","volume":" ","pages":"1"},"PeriodicalIF":0.7,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cross-Linguistic Lexical Task in Tunisian Arabic: Adaptation and Pilot Evidence from Monolingual Children.","authors":"Faten Bouhajeb, Selçuk Güven","doi":"10.1159/fpl/acvag007","DOIUrl":"10.1159/fpl/acvag007","url":null,"abstract":"<p><strong>Introduction: </strong>The Cross-Linguistic Lexical Task (CLT) was developed to support comparable assessment of lexical abilities across languages, particularly in multilingual clinical and research contexts. This study reports the adaptation and pilot evaluation of the CLT in Tunisian Arabic, a spoken Arabic variety for which standardized lexical assessment tools for children are limited.</p><p><strong>Methods: </strong>In study 1, the CLT was adapted following established CLT construction principles. Adult-based adaptation metrics included naming agreement, picture and cultural appropriateness, subjective age-of-acquisition (AoA) ratings, and complexity index (CI) screening. The initial adaptation pool comprised 322 picture/word candidates, of which 299 were retained after CI screening for final item selection. In study 2, the adapted CLT was piloted in 13 monolingual Tunisian Arabic-speaking children recruited in Tunisia.</p><p><strong>Results: </strong>Tunisian Arabic AoA estimates showed strong correlations with the mean AoA of a seven-language CLT comparison dataset (Pearson's r = 0.70; Spearman's ρ = 0.69), supporting their cross-linguistic plausibility. During the pilot administration, overall accuracy was high but varied across subtasks: noun comprehension = 96.4%, verb comprehension = 93.5%, noun production = 95.0%, and verb production = 83.9%. Verb production was the most demanding condition and demonstrated the greatest inter-individual and item-level variability.</p><p><strong>Conclusion: </strong>The findings support the feasibility and linguistic appropriateness of the Tunisian Arabic CLT and provide an important foundation for future normative data collection, reliability studies, and clinical validation in Tunisian Arabic-speaking children.</p>","PeriodicalId":520626,"journal":{"name":"Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP)","volume":" ","pages":"1"},"PeriodicalIF":0.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Cluttering on Professional Life: A Qualitative Study.","authors":"Seyma Coksen Dogan, Ayse Aydin Uysal, Aylin Basaran","doi":"10.1159/fpl/acvag008","DOIUrl":"10.1159/fpl/acvag008","url":null,"abstract":"<p><strong>Introduction: </strong>This qualitative study explores how cluttering influences the professional lives of adults and identifies workplace changes that may support individuals with this fluency disorder.</p><p><strong>Methods: </strong>A qualitative descriptive methodology approach was employed to gain a better understanding of the experiences of thirteen participants, aged 20 to 54, who experience cluttering in their professional lives and were recruited using purposeful sampling strategies. Each interview was audiotaped, transcribed, and analyzed using the reflexive thematic analysis framework.</p><p><strong>Results: </strong>Two overarching themes emerged: effects of speech on professional life and suggested changes. Participants frequently reported involuntary rapid and disfluent speech, communication breakdowns, and heightened anxiety in work settings. Many described difficulties being understood, particularly in online meetings, as well as challenges regulating speech rate, which sometimes led to feelings of inadequacy, avoidance of speech-heavy tasks, or selecting jobs requiring minimal verbal interaction. Some participants recounted prejudiced attitudes or misjudgments of competence based on their speech, while others noted that cluttering occasionally escalated workplace conflicts. Suggested changes focused on organizational rather than individual responsibility. Participants emphasized the value of workplace training to increase awareness of cluttering, respectful communication practices, supportive managerial attitudes, and opportunities to gain presentation experience. A few participants expressed no need for change, noting that cluttering did not significantly hinder their current roles.</p><p><strong>Conclusion: </strong>Overall, the findings highlight the multifaceted ways cluttering can shape professional experiences and underscore the importance of inclusive workplace practices to enhance participation and well-being.</p>","PeriodicalId":520626,"journal":{"name":"Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP)","volume":" ","pages":"1"},"PeriodicalIF":0.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-Attempt Articulation Error Counts and Digit Span Scores in Japanese Preschool Children: An Exploratory Cross-Sectional Study.","authors":"Shiho Yamasaki, Shinsuke Nagami, Masashi Shiomi","doi":"10.1159/fpl/acvag006","DOIUrl":"https://doi.org/10.1159/fpl/acvag006","url":null,"abstract":"<p><strong>Introduction: </strong>Digit span tasks are commonly used as indicators of verbal short-term memory, but their relation to speech production accuracy is complex and remains insufficiently examined in Japanese preschool children. This exploratory study examined whether a task-specific count of first-attempt articulation errors was associated with Number Recall scaled scores from the Kaufman Assessment Battery for Children, Second Edition (KABC-II).</p><p><strong>Methods: </strong>In this exploratory cross-sectional study, 31 community-based Japanese children aged 56-82 months completed the Japanese Articulation Test 50-word version and the Number Recall subtest of the Kaufman Assessment Battery for Children, Second Edition. The primary speech outcome was the first-attempt articulation error count, defined as the number of elicited words containing at least one substitution, omission, or distortion on the first response. Spearman correlation was used for the primary analysis, with bias-corrected and accelerated bootstrap 95% confidence intervals. Age-adjusted sensitivity analyses included partial Spearman correlation and negative binomial regression.</p><p><strong>Results: </strong>First-attempt articulation error counts were right-skewed (mean, 3.0; standard deviation, 3.4; range, 0-16). The mean KABC-II Number Recall scaled score was 10.3 (standard deviation, 2.5). Higher error counts had a negative point estimate for association with Number Recall scaled scores, but the estimate was imprecise and compatible with no association (rho = -0.341; p = 0.061; BCa 95% CI, -0.638 to 0.065). The age-adjusted partial Spearman correlation was similar to the unadjusted estimate (rho = -0.341; p = 0.066). In negative binomial regression adjusted for age in months, the digit-span term yielded an incidence rate ratio of 0.900 (95% CI, 0.78-1.04; p = 0.147).</p><p><strong>Conclusion: </strong>In this small exploratory sample, first-attempt articulation error counts showed an imprecise inverse association with KABC-II Number Recall scaled scores that was compatible with no association. The findings should be interpreted as preliminary and hypothesis-generating and should not be used to infer clinical severity, mechanism, or diagnostic implications. Larger studies with age-balanced samples, formal hearing screening, and phonologically motivated task designs are needed.</p>","PeriodicalId":520626,"journal":{"name":"Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP)","volume":" ","pages":"1"},"PeriodicalIF":0.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the Impact of Light Settings on Whiteout Frames during Flexible Endoscopic Evaluation of Swallowing.","authors":"Gayathri Karthikeyan, Jessica M Pisegna","doi":"10.1159/fpl/acvag004","DOIUrl":"10.1159/fpl/acvag004","url":null,"abstract":"<p><strong>Introduction: </strong>This study sought to assess whether an endoscope's light setting influenced the number of flexible endoscopic evaluation of swallowing (FEES) whiteout or pinkout frames in healthy subjects. We hypothesized that the number of whiteout frames during swallows from healthy participants would differ depending on the manual or automatic light setting.</p><p><strong>Methods: </strong>Data were collected to assess the effect of Olympus endoscope light settings during FEES from healthy participants. Following a protocol of standard boluses, the light source was alternated between automatic and manual settings. During each swallow, purely white frames (\"whiteout\") and other hue frames (\"pinkout\") were counted for each bolus and light setting. A linear mixed-effects model was used to compare automatic and manual light settings while accounting for repeated swallows within participants and adjusting for bolus type.</p><p><strong>Results: </strong>Retrospective FEES videos from 8 healthy volunteers were used, and 117 swallows were analyzed. In descriptive analyses, the mean number of pure whiteout frames per swallow was 1.50 frames in the automatic setting and 13.97 frames in the manual setting. In the mixed-effects model, pure whiteout frame count was significantly lower in the automatic setting than in the manual setting (adjusted mean scores: 1.45 vs. 13.76 frames; p < 0.001). Pinkout frame count showed the opposite pattern and was significantly higher in the automatic setting than in the manual setting (adjusted mean scores: 14.42 vs. 3.26 frames; p < 0.001). When whiteout and pinkout frames were combined, there was no significant difference between automatic and manual light settings (adjusted mean scores: 16.17 vs. 16.84 frames; p = 0.681). A greater proportion of combined whiteout + pinkout frame counts fell within the expected normative whiteout-duration range under the automatic versus manual light setting (84.8% vs. 81.7%, respectively).</p><p><strong>Conclusion: </strong>These preliminary findings suggest that endoscopic light settings may influence the appearance and measured frame counts of whiteout and pinkout during FEES. Automatic and manual light settings produced different patterns of pure whiteout and pinkout frames, while combined whiteout + pinkout frame counts were more similar across settings. These findings support the importance of documenting and, when possible, standardizing light and brightness settings in FEES research and clinical reporting.</p>","PeriodicalId":520626,"journal":{"name":"Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP)","volume":" ","pages":"1"},"PeriodicalIF":0.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vocal Tasks to Detect a Decline in Swallowing Function among the Community-Dwelling Older Adults: Acoustic Characteristics of Laryngeal Diadochokinesis.","authors":"Hiroki Tokushima, Emi Katsumata, Toshiaki Tamura, Airi Seto, Masako Fujiu-Kurachi","doi":"10.1159/fpl/acvag003","DOIUrl":"10.1159/fpl/acvag003","url":null,"abstract":"<p><strong>Introduction: </strong>Age-related decline in laryngeal function can lead to dysphagia and dysphonia. While both swallowing and phonation involve laryngeal closure, their mechanisms and control differ. Laryngeal diadochokinesis (LDDK) provides a simple insight into the neuromotor function of the larynx. We hypothesized that the acoustic characteristics of LDDK are associated with performance on the 100 mL of water swallowing test. We aimed at acoustically describing the vocal characteristics of LDDK in healthy older adults and investigating its relationship with swallowing function.</p><p><strong>Methods: </strong>This retrospective study analyzed existing data from a previous study conducted by Katsumata (2021). The participants were 70 healthy community-dwelling older adults who were independent in daily living. Swallowing function was assessed using the 100 mL of water swallowing test, classifying participants into two groups: one with declined swallowing function (DSF) and the other with good swallowing function (GSF). Vocal function was evaluated through acoustic analysis of recorded voice samples obtained from the LDDK task. Three parameters (i.e., LDDK repetition rate, voicing duration, and percentage of signal fusion) were measured.</p><p><strong>Results: </strong>The age of the DSF group was significantly older than the GSF group. LDDK measures demonstrated high intra- and inter-examiner reliability. Male participants showed significantly longer voicing duration and higher percentage of signal fusion than females. All measured LDDK parameters revealed statistically significant differences between the two groups: slower repetition rate, longer voicing duration, and higher percentage of signal fusion in DSF than in GSF. Voicing duration demonstrated moderate sensitivity for detecting abnormal findings in the 100 mL of water swallowing test.</p><p><strong>Conclusions: </strong>The results of this study suggest that LDDK acoustic parameters are associated with age-related laryngeal changes and are related to the decline in vocal and swallowing functions in community-dwelling older adults.</p>","PeriodicalId":520626,"journal":{"name":"Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP)","volume":" ","pages":"1"},"PeriodicalIF":0.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Voice Ergonomic Study in Icelandic Preschools: What Causes the Activity Noise and How to Attenuate It.","authors":"Valdís Ingibjörg Jónsdóttir, Eeva Sala, Guðmundur Kr Óskarsson","doi":"10.1159/fpl/acvag002","DOIUrl":"10.1159/fpl/acvag002","url":null,"abstract":"<p><strong>Introduction: </strong>Preschool sound environments are predominantly shaped by activity noise generated by voices, object impacts, furniture movement, and daily transitions. Although Icelandic preschools typically comply with reverberation standards, staff frequently report excessive noise, high listening effort, and vocal strain.</p><p><strong>Methods: </strong>This mixed-method pre-post study examined the sources and reducibility of activity noise in three Icelandic preschools using a voice-ergonomic framework. Data included objective noise measurements at child ear height, structured observations, and teacher questionnaires. The intervention combined voice-ergonomic and noise-awareness education for staff and children with targeted organisational, behavioural, and material adjustments.</p><p><strong>Results: </strong>Baseline mapping identified children's voices and object impacts as the dominant noise sources. Following the intervention, measured noise decreased significantly, with mean L_Aeq reduced by 1.9 dB (p = 0.013), corresponding to an approximate 35% reduction in acoustic energy. The largest improvements occurred in high-noise areas such as dining rooms. Despite these improvements, voice symptoms and stress remained prevalent, suggesting that substantial vocal demands persisted despite the intervention and that increased voice awareness may also have influenced symptom reporting.</p><p><strong>Conclusion: </strong>The findings indicate that activity noise represents the primary acoustic challenge in preschool environments and highlight children's particularly high local noise exposure. The results support the need for more child-centred acoustic standards that extend beyond reverberation time alone and place greater emphasis on favourable signal-to-noise conditions, listening effort, speech communication, and vocal health in preschool environments.</p>","PeriodicalId":520626,"journal":{"name":"Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP)","volume":" ","pages":"1"},"PeriodicalIF":0.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}