ARTICLE IN PRESS

Maximum Phonation Time and Body Mass Index in

Nondysphonic Eutrophic Children
Leila Susana Finger, Carla Franco Hoffmann, and Carla Aparecida Cielo, Santa Maria, Brazil

SUMMARY: Background. Literature presents controversial maximum phonation time values in children.
Objective. Verify and correlate the maximum phonation time of vowels /a, i, u/ and the body mass index of
children.
Method. Evaluation of 484 children, eutrophic and without dysphonia, aged from 4:00 to 7:11 years. Sampling:
questionnaire, audiometric screening, auditory-perceptual evaluation of voice, and assessment of the body mass
index. Data collection: measurement of the maximum phonation time of /a, i, u/. Descriptive statistics, t test, and
multiple regression at 5% significance.
Results. /a:/ = 3.77 seconds at age 4:00 years, 5 seconds at 5:00, 5.85 seconds at 6:00, and 7.5 seconds at 7:00 for
boys, and 3.89 seconds, 4.89 seconds, 5.61 seconds, and 6.61 seconds for girls, respectively; /i:/ = 3.49 seconds at
age 4:00 years, 4.96 seconds at 5:00, 5.72 seconds at 6:00, and 6.88 seconds at 7:00 for boys, and 3.49 seconds,
4.73 seconds, 5.41 seconds, and 6.63 seconds for girls, respectively; /u:/ = 3.64 seconds at age 4:00 years, 4.85 sec-
onds at 5:00, 5.76 seconds at 6:00, and 7.08 seconds at 7:00 for boys, and 3.54 seconds, 4.73 seconds, 5.64 seconds,
and 6.47 seconds for girls, respectively. There were no significant differences between genders, except for /a:/ at
age 7:00 years. The correlations were not significant.
Conclusion. Maximum phonation time of /a, i, u/ increased with age and its value in seconds was approximately
equal to the age in years. At the age 7:00 years, /a:/ from boys was longer. The body mass index did not show
influence on the maximum phonation times.
Key Words: Voice−Child−Preschool−Phonation−Speech−Language and hearing sciences.

INTRODUCTION
Maximum Phonation Time (MPT) provides information
about the individual’s neuromuscular and aerodynamic con-
trol of voice production1−3 and is used to evaluate glottic
efficiency and vocal quality in adults and children. The
MPT is influenced by the vital capacity, which varies
according to age, gender, stature, weight, and body surface
area.1−5 In another study with 82 children there was no
influence of the body mass index (BMI) on the MPT; but
there was influence of the abdominal circumference on the
vital capacity, and as a consequence on the MPT.6
It is an easily obtained measurement which requires only
the use of a chronometer.1−4 According to the PubMed
database there were only 14 studies published in the last
5 years, including dysphonic children, with some syndrome,
and undergone surgery. However, the MPT is related to the
continuous emission of isolated phonemes, and it is not a
simple task to measure it when evaluating children. One is
required to provide the children means that favor the con-
crete processing of the verbal orientations, thus facilitating
the evaluation of MPT in this population.7
The studies which evaluate MPTs present controversial
results regarding phonation times2,4,7−10 and the differences
between boys and girls,11−15 possibly because they evaluated
Accepted for publication September 30, 2019.
From the Universidade Federal de Santa Maria, Departamento de Fonoaudiolo-
gia, Santa Maria, Rio Grande do Sul, Brazil.
Address correspondence and reprint requests to Leila Susana Finger, Universidade
Federal de Santa Maria, Departamento de Fonoaudiologia, Av. Roraima, 1000,
Camobi, Santa Maria, RS 97105-900, Brazil. E-mail: leilasusi@gmail.com
Journal of Voice, Vol. &&, No. &&, pp. &&−&&
0892-1997
© 2019 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
https://doi.org/10.1016/j.jvoice.2019.09.018
MPT within wide age ranges, and did not considered sex. It
is difficult to compare these results with the results from our
study.
The influence of the BMI on the MPT from children6 and
from adults16 lacks exploration, so more evidences are
needed. In general, the expected MPT in seconds for the
population of children is approximately the child’s number
of years, increasing with age and also revealing the nervous
and muscle maturation that occurs as the child physically
grows.5,17
Therefore, our study’s objective is to verify and to corre-
late the MPTs of vowels /a, i, u/ and the BMI of nondy-
sphonic children with ages from 4:00 to 7:11 years.
MATERIALS AND METHODS
This is an analytical, quantitative, and contemporary cross-
sectional observational research that meets the recommen-
dation of regulation 466/2012 of the Brazilian National
Research Ethics Committee (CONEP/2012) and was
approved by the Research Ethics Committee of the author’s
institution under number 0306.0.243.000-10.
We contacted the schools, and their directors were invited
to read and sign the Institutional Authorization Term after
receiving the clarifications about the research. The care-
givers were also invited to read and sign the Free and
Informed Consent Form (FICF). The children were also
free to opt for participating or not in the study.
All participants received written feedback regarding the
performed assessments, as well as activities to promote
human communication aimed at students and teachers, in
the institutions that manifested interest.
 ARTICLE IN PRESS
2 Journal of Voice, Vol. &&, No. &&, 2019
Sampling
The target population was composed of children who went
to schools within private, municipal, and state networks
from two medium-sized cities. To obtain 5% significance
this study’s sample would have to be composed by at least
385 children.
Procedures for selecting schools and children
To recruit the schools, we performed a survey of the institu-
tions and listed them alphabetically. Then, we conducted a
draw of the schools to contact. When the school did not
accept to participate in the research, we invited the next one
on the list.
For the schools that opted to participate, we sent the
FICFs to the 4:00 to 7:11 years old children’s caregivers.
The children who were authorized by their caregivers and
who manifested interest in participating in the study went
through the inclusion and exclusion criteria to compose the
sample.
Inclusion and exclusion criteria to compose the
sample
The criteria for including children into the sample were:
ages from 4:00 to 7:11 years, to avoid children with accumu-
lation of adipose tissue observed in the prepubertal phase14;
adhesion of the caregiver to the FICF and agreement of the
child to participate; and BMI among the 5 to 85 percentiles,
ie, eutrophic.
The exclusion criteria were: report, by the caregiver of the
child, of current speech therapy or otorhinolaryngological
treatments for voice, of laryngeal surgery, of current laryn-
geal affections,2,3,18 of periodically practicing any singing
style (at least once a week)17; not passing the hearing screen-
ing18; BMI indicative of overweight, obesity, or under-
weight; and speech therapy diagnosis of dysphonia through
auditory-perceptual evaluation of the voice.2,3
The caregiver of the children answered a questionnaire
for gathering personal data about the children (inclusion cri-
teria) and ascertaining the data related to current speech
therapy and/or otorhinolaryngological treatments for voice,
to laryngeal surgery, to the presence of current laryngeal
affections, and to the periodic practice of singing (exclusion
criteria).
We also submitted the children to audiometric screenings
using the scanning of pure tones at the 0.5, 1, 2, and 4 kHz
frequencies at 20 dB, only through air conduction, to evalu-
ate the presence of hearing alterations and contemplate the
exclusion criteria.19 We conducted the screenings in a quiet
room20 assessed through the Icel-DL-4200 digital sound
pressure measurer (Resolution 274/01 of the Brazilian Fed-
eral Council of Speech, Language, and Hearing Sciences).
To exclude the obese, overweight, and underweight sub-
jects and include only those eutrophics, we calculated the
BMI, which was considered an instrument to apply the
exclusion criteria as well as to collect study data. The chil-
dren who presented alterations in some of the assessments
described were excluded from the research and referred to
more complete evaluations.
We applied the Consensus Auditory-Perceptual Evalua-
tion of Voice (CAPE-V) scale to investigate the occurrence
of dysphonia (exclusion criteria). We included in the study
the children who presented scores up to 33/100 (mildly devi-
ant - MI). This criterium, including children mildly deviant
according to CAPE-V, was adopted based on some studies
stating that voices with mild levels of hoarseness, nasality,
and/or breathiness are considered “expected voices” in
infancy.3,21,22
Evaluation of the BMI
To obtain the BMI, we evaluated the children measuring
their weight and height. We measured the weight using a
duly calibrated Toledo 150 digital scale, with a capacity of
125 g to 150 kg. We measured the height using a Caumaq
Ltda stadiometer fixed on a flat wall without baseboard.
The children were in orthostatic positions, barefoot, and
wearing light clothes.23,24 We calculated the BMI values by
dividing the weight in kilograms by the squared height in
meters (BMI = kg/m2).23-25
The BMI normality values employed were those proposed
by the World Health Organization. We considered as under-
weight children who were below the fifth percentile for their
age and gender; as eutrophic children, those who were
between the 5th and 85th percentiles; as overweight chil-
dren, those with BMI values higher or equal to the 85th per-
centile; and as obese children, those above the 95th
percentile. We only included eutrophic children in the
study.24,25
Speech therapy evaluations for sampling
The children in the sample had three MPT/a/ and MPT/i/
sustained emissions (for CAPE-V) timed in seconds and
recorded in a quiet room, with a noise level below 50
dBSPL, as established by a digital Icel-DL-4200 sound pres-
sure measurer.25−27 We performed the collections before
recess and the physical education classes so to avoid the
interference of intensive and/or abusive voice use.18
For data collection, in an orthostatic position, the child
was instructed to emit the MPT, after a deep inspiration, in
habitual pitch and loudness, until the end of the air expira-
tion. Furthermore, we collected samples of spontaneous
speech and CAPE-V phrases adapted to Portuguese27−29:


“Erica tomou suco de pera e amora” (The blue spot is on the
key again); “Agora
e hora de acabar” (We eat eggs every
Easter); “S^onia sabe sambar sozinha” (How hard did he hit
him); “Minha m~ae namorou um anjo” (My mama makes
lemon muffins); “Olha l
a o avi~ao azul” (We were away a
year ago); and “Papai trouxe pipoca quente” (Peter will keep
at the peak).
We also asked the children to talk about recess, the physi-
cal education classes, and the activities they performed at
school. When the spontaneous speech sample was small, we
also asked them to talk about the people that lived in their
 ARTICLE IN PRESS
Leila Susana Finger, et al MPT and BMI in Nondysphonic Eutrophic Children
homes, their toys, and their pets. We then cut out a 30 sec-
ond excerpt from the spontaneous speech to perform the
auditory-perceptual evaluation of voice, based on CAPE-
V’s recommendation of using at least 20 seconds of sponta-
neous speech.2-4,28-30
For the recordings, we positioned the Behringer ECM8000
omnidirectional microphone with a 15 to 20 kHz frequency-
capturing flat range, attached to a Zoom H4n professional
digital recorder (96 kHz, 16 bits, and signal capturing regu-
lated at 50%), in front of the child's mouth and at a 90° angle.
We kept the microphone 4 cm from the mouth to collect the
sustained vowel,31 and 10 cm to collect phrase repetition and
spontaneous speech.3,30
Auditory-perceptual evaluation of voice
We used the auditory-perceptual evaluation of voice to
exclude dysphonic children. Three speech therapists with
experience in the area of voice and with their audiometric
exams within normality performed judgments based on the
MPT/a, i/ sample, the CAPE-V phrase repetition, and the
spontaneous speech of each child.27,31
We edited the voice and speech samples on a Crystal
Sound Fusion soundboard with its capturing characteristics
preserved. We transferred the files from the WAV extension
to the PCM audio format; 44,100 Hz, 16 bits, Mono. We
edited the samples so to present the sustained emission of
vowels /a, i/, the chained speech, and the CAPE-V phrases
sequentially in a single audio file. This grouping aimed to
reduce the difficulties in the auditory-perceptual evaluation
inherent to children’s voices, considering the importance of
the production of a single evaluation of the vocal deviation,
regarding all types of samples produced by the individual.32
We recorded the files onto CDs and sent them to the judges
for them to perform their judgments independently.
The speech-therapist judges, who are not authors of this
work, were blinded regarding the identification of the sub-
jects and the evaluations of the other judges. They received
a CD with recordings of the voices to be analyzed. The first
six tracks were of children’s voices whose vocal quality was
neutral to serve as an anchor during the evaluations. These
voices could be heard freely to guide their judgment.32 The
anchor voices were independently analyzed by four speech
therapists uninvolved in the research and deemed normal.
We oriented the judges not to perform the analyses at the
end of the day or tired, and to hear the voices using ear-
phones as many times as necessary.
For the analysis, we employed the CAPE-V analog visual
scale, which evaluates six predetermined parameters with
the possibility of including two additional ones. The linear
analog scale presented 100 mm of length (from 0 to 100
mm), in which each judge marked her classification regard-
ing the degree of deviation observed in each parameter.27,31
The auditory-perceptual vocal parameters of the CAPE-
V protocol are the following: global severity degree (global
impression of voice alteration); roughness (irregularity in
the sound source); breathiness (escape of air audible in the
3
voice); tension (excessive vocal effort); pitch (perceptive cor-
relation of the fundamental frequency); and loudness (per-
ceptive correlation of the sound pressure).27,31 Pitch and
loudness were not employed in this work’s evaluations
because the judges were blinded regarding the gender and
age of the children.
The degree of alteration was defined as the average of the
percentages attributed by each of the three judges for each
parameter and for each child. This was the result of the
auditory-perceptual evaluation of the voice. Due to ana-
tomic characteristics and to the body growth process, chil-
dren with a mild global severity degree were considered
nondysphonic.15
Data collection
We sent 3,240 FICFs to the parents, and, after applying the
inclusion and exclusion criteria, 484 children remained with
ages from 4:00 to 7:11 years, thus composing this study’s
sample. We stratified them in age ranges of 4:00, 5:00, 6:00,
and 7:00 years, with each age range subdivided into boys
and girls.
We also obtained the MPT/u/ to compose the corpus of
data, in the same occasion and conditions used for the
MPT/a, i/ emissions described previously. We considered
the longest emission time for each of the vowels and strati-
fied the data by age range (4:00, 5:00, 6:00, or 7:00 years)
and sex (boys or girls).
Statistical analysis
We performed the statistical analysis using the SPSS v19
software, at a 5% significance level (P ≤ 0.05). We con-
ducted descriptive statistical analysis and evaluated the dif-
ference between genders (in each age range) using the t test.
We also performed multiple regression, seeking to relate the
BMI variable in the prediction of the MPTs for the different
age ranges and genders.
RESULTS
Table 1 shows MPT of vowels /a, i, u/ from boys by age
range. It was observed that within our study the observed
MPT in seconds corresponds to the child’s age in years.
Table 2 shows MPT of vowels /a, i, u/ from girls by age
range. It was observed that within our study the observed
MPT in seconds corresponds to the child’s age in years.
Table 3 shows MPT from boys and girls by age range.
There was significant difference between MPT /a/ from boys
and girls 7:00 years old.
Table 4 shows multiple regression between MPT and
BMI from boys by age range. There is no significant correla-
tion between the variables.
Table 5 shows multiple regression between MPT and
BMI from girls by age. There is no significant correlation
between the variables.
 ARTICLE IN PRESS
4 Journal of Voice, Vol. &&, No. &&, 2019

TABLE 1.
Maximum Phonation Times of Vowels /a, i, u/ From Boys by Age Range
Percentiles
Measurement Age (Years) 5 10 25 50 75 90 95
MPT/a/ (s) 4 1.72 2.10 2.42 3.64 4.49 5.67 7.38
5 2.34 2.59 3.49 4.77 6.60 7.71 8.80
6 2.88 3.11 4.14 5.49 7.51 9.03 10.06
7 3.85 4.29 5.44 7.61 9.40 10.93 11.87
MPT/i/ (s) 4 1.61 1.84 2.32 3.15 4.50 5.82 6.49
5 2.29 2.47 3.35 4.81 6.33 8.27 9.08
6 2.61 2.91 3.68 5.51 7.29 9.01 10.29
7 3.26 4.11 5.37 6.55 8.42 10.22 10.67
MPT/u/ (s) 4 1.53 1.66 2.62 3.25 4.55 5.50 8.01
5 2.39 2.49 3.18 4.39 6.19 7.90 9.35
6 2.61 2.90 3.86 5.55 7.18 9.19 9.96
7 3.36 4.23 5.16 6.83 8.83 10.38 11.59
Abbreviations: MPT, maximum phonation time; s, seconds.

TABLE 2.
Maximum Phonation Times of Vowels /a, i, u/ From Girls by Age Range
Percentiles
Measurement Age (Years) 5 10 25 50 75 90 95
MPT/a/ (s) 4 1.67 1.92 2.45 3.41 4.99 6.17 7.84
5 2.47 2.72 3.41 4.59 6.42 7.43 7.99
6 2.52 2.58 3.47 4.78 6.96 9.66 10.41
7 3.73 3.96 4.92 6.02 8.15 10.52 11.31
MPT/i/ (s) 4 1.79 1.93 2.26 3.21 4.57 5.30 6.21
5 2.28 2.60 3.35 4.25 6.14 7.43 7.99
6 2.52 2.59 3.47 4.78 6.96 9.66 10.64
7 2.99 3.42 5.16 6.77 8.30 9.78 10.57
MPT/u/ (s) 4 1.78 1.98 2.55 3.26 4.43 5.21 6.25
5 2.46 2.59 3.37 4.38 5.71 7.42 8.45
6 2.61 3.03 3.80 4.72 7.87 9.23 10.94
7 2.90 3.59 5.20 6.30 7.88 9.43 10.90
Abbreviations: MPT, maximum phonation time; s, seconds.

TABLE 3.
Maximum Phonation Times From Boys and Girls by Age Range
Age (Years) 4 5 6 7
Measurement B G P B G P B G P B G P
(Mean SD) (n = 42) (n = 50) Value (n = 58) (n = 84) Value (n = 70) (n = 57) Value (n = 60) (n = 63) Value
MPT/a/ (s) 3.77§1.68 3.89§1.82 0.76 5.00§1.9 4.89 §2.18 0.72 5.85§2.18 5.61§2.17 0.54 7.50§2.45 6.61§2.34 0.049*
MPT/i/ (s) 3.49§1.50 3.49 §1.36 0.99 4.96§2.00 4.73 §1.80 0.50 5.72§2.26 5.41§2.40 0.50 6.88§2.26 6.63§2.20 0.53
MPT/u/ (s) 3.64§1.64 3.54§1.39 0.76 4.85§2.05 4.73 §1.78 0.70 5.76§2.32 5.64§2.39 0.78 7.08§2.39 6.47§2.20 0.14
* Significant t test (P ≤ 0.05).
Abbreviations: B, boy; G, girl; MPT, maximum phonation time; s, seconds; § standard deviation.
Leila Susana Finger, et al MPT and BMI in Nondysphonic Eutrophic Children 5

TABLE 4. A study7 that obtained the MPTs of 20 children with ages

Multiple Regression Between MPT and BMI from Boys from 7:00 to 9:00 years using visual support concluded that
by Age Range MPTs obtained with the aid were longer than those without
it. The average MPTs of vowels /a, e, i/ were of 9.72 sec-
BMI
onds, 9.29 seconds, and 10.20 seconds on the first collection;
Age (Years) 4 5 6 7 10.82 seconds, 11.03 seconds, and 12.17 seconds on the sec-
MPT/a/ (s) corr 0.05 0.20 0.07 0.25 ond; 12.42 seconds, 12.80 seconds, and 12.66 seconds on the
0.73 0.13 0.54 0.055 third; and 10.56 seconds, 11.17 seconds, and 11.50 seconds
MPT/i/ (s) corr 0.09 0.24 0.06 0.22 on the fourth. The authors7 associate the MPT improve-
0.58 0.074 0.603 0.095 ment to previous training and, especially, to the use of visual
MPT/u/ (s) corr 0.06 0.13 0.10 0.07 support to obtain them.
0.71 0.35 0.40 0.61 The MPT/a/ obtained in the study in reference2 were of
There is no significant correlation between the variables. 5.77 seconds at age 4:00 years, 7.16 seconds at 5:00, and
Multiple regression (P ≤ 0.05). 10.32 seconds at 6:00 years old, ie, emissions longer than the
respective chronological ages, which are results similar to
those obtained in other studies.7,14 However, they disagree
TABLE 5. with the MPT/a/ found in the present research (Tables 1 and
Multiple Regression Between MPT and BMI From Girls 2) and in other studies3,4 whose results show average MPTs
by Age Range in seconds which are numerically close to the age of the
child in years. Some works that evaluated MPTs diverge
IMC
when the phonation times2,3,5,11 and the gender differen-
Age (years) 4 5 6 7 ces5,11−15 are considered.
MPT/a/ (s) corr 0.17 0.08 0.07 0.05 When evaluating 200 children, average MPT/a/ of 14.2 sec-
0.23 0.45 0.63 0.69 onds for boys and 13.1 seconds for girls with age 6:00 years
MPT/i/ (s) corr 0.25 0.016 0.03 0.08 were observed,9 which are longer than those found in this
0.089 0.89 0.84 0.53 research (Table 3). Another study,10 in which the MPT/a/ for
MPT/u/ (s) corr 0.165 0.063 0.10 0.24 girls were of 8.86 seconds at age 4:00 years, 10.47 seconds at
0.26 0.57 0.48 0.052 5:00, and 13.81 seconds at 6:00, and for boys were respec-
There is no significant correlation between the variables. tively of 9.99 seconds, 10.2 seconds, and 14.2 seconds, also
Multiple regression (P ≤ 0.05). obtained longer MPTs than those found in the present investi-
gation. A longer MPT/a/ in boys compared to girls was
observed,9 which agrees with the present study when deter-
mining a longer MPT/a/ in boys at age 7:00 years than that
DISCUSSION found in other research.13,14 However, only the MPT/a/ in
Several authors consider that within the children population boys at age 7:00 years was significantly longer; for the other
the expected MPT in seconds corresponds to the child’s age vowels and age ranges in this work and those of other studies,
in years,3,4,33 which was corroborated by this study’s results there were no significant differences between genders.11,12
(Tables 1 and 2) and by the study in reference32 which When assessing 71 children with ages from 6:00 to
observed an MPT/a/ of 5.6 s for children with ages from 10:00 years, the obtained MPT/a,i,u/ were of respectively
4:00 to 6:00 years, 8.2 seconds from 7:00 to 9:00 years, and 10.44 seconds, 11.22 seconds, and 10.09 seconds for girls,
10.4 seconds from 10:00 to 12:00 years, as well as MPT/s/ of and 9.90 seconds, 10.69 seconds, and 10.19 seconds for boys
4.7 seconds from 4:00 to 6:00 years, 7.3 seconds from 7:00 with ages 6:00, 7:00, and 8:00 years.11 A study,12 which also
to 9:00 years, and 10.1 seconds from 10:00 to 12:00 years. did not demonstrate differences between MPTs from boys
For some authors,9 school-age children without voice alter- and girls, evaluated children with ages from 4:00 to
ations have MPTs around 10 seconds. Other researchers1 10:00 years and showed that the MPT/a/ of boys varied
subdivide children into two groups: children and small chil- from 4.88 seconds at 4:00 years to 10.04 seconds at 10:00
dren, considering average MPTs of 8.95 seconds and 7.5 years; for girls, the values ranged from 5.39 seconds to 11.1
seconds, respectively. seconds.
It is important to consider the MPT results by age range, The work in reference13 evaluated 150 children with ages
due to the neuromuscular development during the child’s from 8:00 to 10:00 years and revealed that the averages for
growth; so one can establish reliable comparisons, applica- girls and boys were, respectively, of 12.35 seconds and 13.70
ble in the clinical practice.2,33 Other authors suggest7 that seconds for MPT/a/; 12.72 seconds and 13.67 seconds for
an increase in the MPT may be possible after several emis- MPT/i/; and 12.04 seconds and 11.64 seconds for MPT/u/.
sions performed with visual support and emphasize the The authors considered the MPTs predominantly longer
importance of implementing verbal instructions for the chil- than those found in other studies.11,12 The results of the
dren with the purpose of improving their performance in work above also showed there was no correlation among
this activity that requires abstraction. MPT, age, and height of the children, yet the occurrence of
 ARTICLE IN PRESS
6 Journal of Voice, Vol. &&, No. &&, 2019
these correlations was not constant for all the MPT emis-
sions nor all the groups.
Children’s MPTs increase with age,1,2,7,14 which was also
observed in the present work (Tables 1 and 2). In the investi-
gation in reference,2 the MPTs were significantly longer at
age 6:00 when compared to the emissions at age 4:00, results
which are corroborated by our study (Tables 1 and 2) and
several other studies,2,5,13,14 thus making evident the ner-
vous and muscular maturation that occurs as the child phys-
ically grows.1-3
The study in reference2 found a significant positive corre-
lation between the BMI and the MPT/s,z/. The authors
related this result to the influence of the body dimensions on
the acoustic measurements of children.25 Such findings seem
to demonstrate the relationship between the expiratory and
phonatory control and body measurements.1-3
In the present study, the BMI variable did not affect the
MPT/a,i,u/ in the different age ranges (Tables 4 and 5). Such
findings agree with those described in the study in reference14
which evaluated 150 children with ages from 8:00 to
10:11 years and found MPT/a/ longer in boys, whereas the
MPT/i/ and MPT/u/ did not show significant differences.
It is known that MPTs suffer influence from countless
variables and these influences are not yet fully understood,
especially during infancy, when significant changes occur in
body growth, influencing size and shape of structures, as
well as their functions and the interrelation among them.15
Thus, we suggest that future studies about the MPTs of chil-
dren may also contemplate the evaluation of body posture
and pulmonary function, besides exploring the influence of
issues related to emotional maturity and cognition, abdomi-
nal circumference, neuromuscular and aerodynamic control
during phonation, as well as the effect of using previous
training and visual support in obtaining the MPT.
CONCLUSIONS
Upon analyzing the MPT/a,i,u/ and the BMI of eutrophic
nondysphonic children within the age range from 4:00 to
7:11 years, we concluded that the MPT in seconds is approx-
imately the children’s age in years, and increased with age;
that, at age 7:00 years, the MPT/a/ was longer in boys; and
that the BMI did not show influence over the MPT.
ACKNOWLEDGMENTS
C. A. Cielo acknowledges support from Brazilian agency
CNPq (Grant 301326/2017-7). The authors thank Prof L S
Dorneles (English revision).
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