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Voice therapy is recommended as the preferable treatment option for VFNs in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this systematic review is to provide an overview of the existing literature concerning the effects of voice therapy in children with VFNs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>This systematic literature review was developed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses) guidelines. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed) and Embase were searched and the grey literature was checked. The search strategy was based on three concepts: VFNs, voice therapy and children. Two examiners independently determined article eligibility and extracted all relevant data from the included studies. The methodological quality of the included study was assessed using the QualSyst tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main contributions<\/jats:title><jats:p>By identifying, evaluating and summarizing the results of all relevant studies about voice therapy in paediatric VFNs, this systematic review makes the available evidence more accessible to voice therapists, otolaryngologists and other relevant stakeholders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>24 studies were included in this systematic review. Eight studies (8\/24) reported a significant improvement for at least one outcome parameter after voice therapy. However, five papers (5\/24) could not demonstrate significant changes after voice therapy. All studies that did not test for significance (11\/24) found improvements for one or more outcome parameters. The overall quality of the included studies is adequate (55%). In sum, there is some evidence that voice therapy is effective in children with VFNs, but further well\u2010designed research, especially randomized controlled trials, is necessary to confirm these results.<\/jats:p><\/jats:sec><jats:sec><jats:title>WHAT THIS PAPER ADDS<\/jats:title><jats:sec><jats:title>What is already known on the subject<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Voice therapy is preferable in children with VFNs because of the phonotraumatic nature of the nodules and the associated high recurrence rate after phonosurgery. Most voice therapists in clinical practice offer an eclectic voice therapy programme, consisting of direct and indirect voice therapy techniques.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What this study adds to existing knowledge<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>This systematic review provides a clear overview of the available evidence concerning the effects of voice therapy in paediatric VFNs. There is some evidence that voice therapy is an effective treatment option in children with VFNs, but well\u2010designed research is scarce on this subject.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What are the potential or actual clinical implications of this work?<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>This review shows that effectiveness studies with strong designs are very scarce in children with VFNs. Clinicians should be aware that few therapy techniques have been thoroughly investigated in this population. However, this review may guide voice therapists when creating a treatment plan for a child with VFNs because it identifies, evaluates and summarizes the results of all relevant individual studies about voice therapy in paediatric VFNs. Voice therapy seems to be effective in treating paediatric patients with VFNs, given the fact that a considerable number of included studies report significant improvements after voice therapy. Both direct and indirect therapy approaches appear to have a positive effect on the phonation of children with VFNs.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><\/jats:sec>","DOI":"10.1111\/1460-6984.12754","type":"journal-article","created":{"date-parts":[[2022,6,27]],"date-time":"2022-06-27T10:43:24Z","timestamp":1656326604000},"page":"1160-1193","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Effects of voice therapy in children with vocal fold nodules: A systematic review"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4406-7306","authenticated-orcid":false,"given":"Anke","family":"Adriaansen","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS) Ghent University  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Meerschman","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS) Ghent University  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristiane","family":"Van Lierde","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS) Ghent University  Ghent Belgium"},{"name":"Department of Otorhinolaryngology Ghent University Hospital  Ghent Belgium"},{"name":"Department of Speech\u2013Language Pathology and Audiology University of Pretoria  Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3956-5936","authenticated-orcid":false,"given":"Evelien","family":"D'haeseleer","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS) Ghent University  Ghent Belgium"},{"name":"Department of Otorhinolaryngology Ghent University Hospital  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2003.11.005"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2013.06.007"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2014.10.018"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010020\u201006059\u20108"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7916(91)90004-O"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2014.11.001"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13309"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.110121"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1044\/2018_AJSLP\u201017\u20100226"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2005.07.004"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2006.09.005"},{"issue":"2","key":"e_1_2_8_13_1","article-title":"Childhood dysphonia: clinical and therapeutic considerations","volume":"4","author":"Cornut G.","year":"1995","journal-title":"Voice"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2014.07.019"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2014.12.001"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2005.11.006"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1044\/jshd.4103.390"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/2229\u20103485.86879"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjebm-2018-111107"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.110404"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1044\/2020_AJSLP\u201020\u201000304"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.11.003"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9924(82)90019-3"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.4103\/2249\u20104863.109934"},{"key":"e_1_2_8_25_1","first-page":"43","article-title":"Do hoarse children get voice problem in adulthood?","volume":"412","author":"Hakansson B.","year":"1984","journal-title":"Acta Oto\u2010Laryngologica"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2013.05.032"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2017.2618"},{"key":"e_1_2_8_28_1","doi-asserted-by":"crossref","unstructured":"Higgins J.P.T. 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