Altered Voice Quality Research Articles

A protocol for identification of early bulbar signs in amyotrophic lateral sclerosis

The purpose of this project is to identify characteristics that may be of assistance in establishing the diagnosis and monitoring early progression of bulbar dysfunction in patients with Amyotrophic Lateral Sclerosis (ALS). Early identification of bulbar dysfunction would assist in clinical trials and management decisions. A database of 218 clinic visits of patients with ALS was developed and formed the basis for these analyses. As a framework for the description of our methodology, the Disablement Model [World Health Organization. WHO International classification of impairment, activity, and participation: beginner's guide. In: WHO, editor. Beta-1 draft for field trials; 1999] was utilized. Our data identified that the strongest early predictors of bulbar speech dysfunction include altered voice quality (laryngeal control), speaking rate, and communication effectiveness. A protocol for measuring these speech parameters was therefore undertaken. This paper presents the protocol used to measure these bulbar parameters.

Genetic counselling for handicapped school leavers.

A total of 287 school leavers with 299 unassociated handicaps from seven special schools for physically handicapped, visually handicapped, and deaf children were given genetic counselling from 1973 to 1979. The practical aspects of running this project are described. The risks needed were those of having an affected child: 54 (18.8%) were given a high risk (greater than 1 in 10), 89 (31.0%) were given a moderate risk (1 in 10 to 1 in 40), 69 (24.0%) were given a low risk (less than 1 in 40), and 83 (28.5%) were told that risk was the same as that of general population. Of the 299 total handicaps, 25 (8.4%) were thought to be autosomal dominant conditions, 38 (12.7%) to be autosomal recessive conditions, and 8 (2.7%) to be X linked conditions. Empirical risks were given for 145 (48.5%) diagnoses, and general population risks for the remaining 83 (27.7%).