Auditory-Perceptual Evaluation Research Articles

Listening for Dysphagia: Voice Quality Sequelae of Material in the Airway

Postswallow voice abnormality is often assumed to indicate the presence of material in the laryngeal airway (MIA), but prior research has not shown definitive evidence of a causal relationship. This study investigated if endoscopically confirmed MIA (prandial material or secretions) generates specific voice quality attributes that can be perceptually identified by experienced listeners. Forty-four dysphagic adults underwent endoscopic evaluation of swallowing. Time-linked audiovisual recordings of pre- and postswallow phonation were analyzed to determine the presence, amount, and location of prandial material or secretions in the larynx during phonation. Expert listeners completed auditory-perceptual ratings of phonation samples. Voice quality ratings did not differ significantly when there was MIA during postswallow phonation. However, judgments of voice quality abnormality for MIA samples were elevated when analyses controlled for effects of baseline dysphonia. Listeners were most likely to perceive voice quality abnormality when larger amounts of secretions were present, as compared to prandial material. Interrater reliability was variable and ranged from low to moderate across perceptual parameters. MIA during phonation occurred for many participants, but perception of voice quality abnormality was variable when MIA was present. Baseline dysphonia is common among individuals with dysphagia and may limit perception of voice quality abnormalities generated by MIA. Secretions in the laryngeal airway may have a greater impact on voice quality parameters.

A Scoping Literature Review of Relative Fundamental Frequency (RFF) in Individuals with and without Voice Disorders

Relative fundamental frequency (RFF) is an acoustic measure that characterizes changes in voice fundamental frequency during voicing transitions. Despite showing promise as an indicator of vocal disorder and laryngeal muscle tension, the clinical adoption of RFF remains challenging, partly due to a lack of research integration. As such, this review sought to provide summative information and highlight next steps for the clinical implementation of RFF. A systematic literature search was completed across 5 databases, yielding 37 articles that met inclusion criteria. Studies most often included adults with and without tension-based voice disorders (e.g., muscle tension dysphonia), though patient and control groups were directly compared in only 32% of studies. Only 11% of studies tracked therapeutic progress, making it difficult to understand how RFF can be used as a clinical outcome. Specifically, there is evidence to support within-person RFF tracking as a clinical outcome, but more research is needed to understand how RFF correlates to auditory-perceptual ratings (strain, effort, and overall severity of dysphonia) both before and after therapeutic interventions. Finally, a marked increase in the use of automated estimation methods was noted since 2016, yet there remains a critical need for a universally available algorithm to support widespread clinical adoption.

Effects of Laryngeal Manual Therapy on Primary Muscle Tension Dysphonia (MTD-1): Implications for MTD-1 Type

The study investigated effects of laryngeal manual therapy on different types of primary muscle tension dysphonia (MTD-1). Interventional pre-test post-test design. Thirty-two traditional Iranian singers (mean age of 36.75 ± 9.34 years.) diagnosed with MTD-1, 8 female and 24 male, and recruited by convenience sampling completed the study. MTD-1 was classified as Morrison and Rammage's types 1-5, based on standardized criteria (1993). Pre-post-treatment measures were based on visual ratings of the larynx, acoustic analyses, auditory-perceptual assessments of voice (Auditory-Perceptual Rating Instrument for Operatic Singing Voice: EAI Scale Form), and the Persian Singing Voice Handicap Index (P-SVHI), reported before and after 10 sessions of laryngeal manual therapy (LMT). The most notable finding was that the number of cases with MTD-1 types 1 and 2 actually increased after treatment, while the number of cases with MTD-1 types 3, 4 and 5 decreased. The data suggested that MTD-1 types 3, 4, and 5 tended to convert to types 1 and 2 with LMT. Acoustic analyses showed a significant decrease in F0 (males only; P=0.011), a sharp decrease in HNR from 23.26 dB to 14.74 dB (P=0.000), and an increase in shimmer from 4.18% to 6.90 % while no appreciable change was found in jitter (P=0.57). Mean P-SVHI score decreased significantly from 52.03 to 41.16 (P=0.002) and EAI score increased from 4.41 to 6.31 (P=0.000) after treatment. The primary finding was that the distribution of MTD-1 type changed after treatment in many cases, converting from one to another type. Acoustic as well as glottal closure measures for several participants revealed closure insufficiency after treatment, unveiled as hyperfunction was unloaded with LMT. For those participants, complementary treatments aimed at reinforcement of laryngeal closure functions would be appropriate.

Individual Voice Dimensions' Prediction of Overall Dysphonia Severity on Two Auditory-Perceptual Scales.

Auditory-perceptual evaluation of dysphonic voice is an essential clinical activity that characterizes the nature of dysphonia and aids in planning its clinical management. Although there are multidimensional acoustic measures that correlate well with overall severity ratings, they tend to include measures that have only small or moderate correlations with individual voice characteristics frequently perceptually measured (e.g., breathiness or roughness). Given this difference between perceptual and acoustic measures, it is unclear how much individual voice characteristics contribute to a listener's perception of overall severity of dysphonia. The purpose of this study was to explore individual voice characteristics' relative contribution to the rating of overall dysphonia severity and to explore sex-related differences. Two hundred ninety-six voice samples were accessed from the Perceptual Voice Qualities Database. Roughness, breathiness, asthenia, strain, pitch, and loudness ratings from the Grade, Roughness, Breathiness, Asthenia, Strain and Consensus Auditory-Perceptual Evaluation of Voice scales were used to predict overall voice quality severity in linear regression with bootstrapped coefficients. Roughness, breathiness, and strain were the strongest predictors of overall severity. Asthenia and, to a lesser extent, pitch were also significant predictors of overall severity. Loudness was not a significant predictor. There were several sex-related differences noted, as well as differences related to the scale used. Breathiness, roughness, and strain were all important predictors of overall severity for all regressions. Clinicians should be aware of scale-related differences if they are using auditory-perceptual measures to choose voice therapy targets. Analyses accounting for perceptual strategy differences were recommended for future studies.

Predicting Perceived Vocal Roughness Using a Bio-Inspired Computational Model of Auditory Temporal Envelope Processing.

Vocal roughness is often present in many voice disorders but the assessment of roughness mainly depends on the subjective auditory-perceptual evaluation and lacks acoustic correlates. This study aimed to apply the concept of roughness in general sound quality perception to vocal roughness assessment and to characterize the relationship between vocal roughness and temporal envelop fluctuation measures obtained from an auditory model. Ten /ɑ/ recordings with a wide range of roughness were selected from an existing database. Ten listeners rated the roughness of the recordings in a single-variable matching task. Temporal envelope fluctuations of the recordings were analyzed with an auditory processing model of amplitude modulation that utilizes a modulation filterbank of different modulation frequencies. Pitch strength and the smoothed cepstral peak prominence were also obtained for comparison. Individual simple regression models yielded envelope standard deviation from a modulation filter with a low center frequency (64.3 Hz) as a statistically significant predictor of vocal roughness with a strong coefficient of determination (r 2 = .80). Pitch strength and CPPS were not significant predictors of roughness. This result supports the possible utility of envelope fluctuation measures from an auditory model as objective correlates of vocal roughness.

Linguistic performance during monologues and correlates of neuropsychological function for adults with multiple sclerosis

ABSTRACT Background Cognitive-linguistic deficits are a concern in multiple sclerosis (MS). Thus, clinical management requires knowledge of how impaired cognition associated with MS impacts language performance during everyday communication tasks. Aims This study investigated language performance in narrative monologues produced by individuals with MS compared to healthy controls and the correlations between language performance and cognitive function for the individuals with MS. Method and Procedure Thirteen individuals with MS and 13 controls were studied. Four neuropsychological tests from the Minimal Assessment of Cognitive Function in MS confirmed that individuals with MS had impaired cognition and an auditory-perceptual evaluation confirmed that they did not have dysarthria. Narratives were analyzed using the Systematic Analysis of Language Transcripts (SALT). Primary linguistic variables included inter-sentence cohesion adequacy, subordination index, moving average type-token ratio (MATTR), and mean length of utterances (MLU). Secondary linguistic measures included the total number of words, mazes, utterances, and abandoned utterances. Measures of disease severity, depression, and fatigue were also obtained. Outcome and Results When controlling for age and fatigue, the total number of words was the only linguistic measure that significantly differed between groups. Participants with MS produced more words than controls. Significant correlations indicated strong associations between MATTR, MLU, abandoned utterances, and subordination index and the cognitive domains of processing speed and/or executive function. Conclusion Results suggest that communicative competence during everyday speaking tasks may be undermined by off-topic verbose speech, reduced detail, and unfinished thoughts for individuals with MS with impaired processing speed and/or executive function.

Mitigating Dysphonia, Pain, and Vocal Handicap after Violent Video Game Voice Overs: A Pilot Investigation into Vocal Combat Technique Training

to investigate how the Vocal Combat Technique (VCT) may mitigate vocal symptoms in voice over actors using vocal violence. Five voice over actors (3 male, 2 females, Mean=29.6 years) completed two study sessions of 45 minutes-to-1 hour of vocally violent voice over work held approximately 4 weeks apart. During session one, participants completed voice over work as they typically would, whereas they received 3-hours of VCT training to improve/assist in healthy vocal techniques prior to session two. Pre- and post-session measures for both sessions included self-perceptual ratings of vocal symptoms, auditory-perceptual evaluation, and traditional acoustic measures of frequency and perturbation. Participants showed substantial mitigating effects of VCT training on acoustic perturbation measures (jitter, shimmer, harmonics-to-noise ratio), and self-ratings of vocal symptoms (Vocal-Handicap Index-10, McGill Pain Scale for vocal discomfort, and Evaluation of the Ability to Sing Easily) with calculated medium to large effect sizes (d=0.61-1.95). There were no changes in auditory perceptual ratings across sessions. Our pilot investigation yielded positive improvements in vocal symptomology in five voice over actors who were trained in VCT. Next steps should include a larger enrollment of voice actors to determine optimal preventative and recovery techniques.

Intelligibility, Speech Rate, and Communication Efficiency in Children With Neurological Conditions: A Longitudinal Study of Childhood Dysarthria.

This study aimed to describe communication-related parameters (i.e., intelligibility, speech rate, and communication efficiency) and their developmental courses in children with neurological conditions against the background of typical development. In addition, interrelations between the developmental courses of communication-related parameters and auditory-perceptual ratings related to speech subsystems were investigated. Fourteen children with neurological conditions (CNC) and 14 typically developing children (CTD), matched for age and gender (four girls; 5;1-8;4 [years;months] at first examination), were assessed at three points in time over an 18-month period. Speech samples were collected using the Bogenhausener Dysarthrie Skalen-Kindliche Dysarthrien (English: Bogenhausen Dysarthria Scales-Childhood Dysarthria), a German tool for the assessment of childhood dysarthria. To assess intelligibility, naïve listeners transcribed audio samples of sentence repetitions of the children. Speech rate was measured by acoustic analyses, and communication efficiency was determined by multiplying the proportion of correctly transcribed syllables with speech rate. Age normalization was performed following a recently published approach. On the group level, CNC had conspicuous raw and normalized scores for the three communication-related parameters and were more variable than the CTD group regarding their developmental courses. These differences were more pronounced for intelligibility than for speech rate. A strong relationship between communication-related and speech subsystems-related auditory-perceptual characteristics was apparent only between intelligibility and articulation/resonance. For the first time, age-normalized scores for communication-related parameters were reported in children with neurological disorders and put into a developmental context within the framework of a longitudinal study. Age-normalized intelligibility was more vulnerable to large developmental changes than speech rate and was best predicted by changes in articulation and resonance. Overall, this study may contribute to a more comprehensive and valid clinical assessment of childhood dysarthria and to a better understanding of its developmental dynamics.

Voice Therapy Improves Acoustic and Auditory-Perceptual Outcomes in Children.

This study employed acoustic measures as well as auditory-perceptual assessments to examine the effects of voice therapy in children presenting with benign vocal fold lesions. A retrospective, observational cohort design was employed. Sustained vowels produced by 129 children diagnosed with benign vocal fold lesions were analyzed, as well as connected speech samples produced by 47 children. Treatment outcome measures included Consensus of Auditory-Perceptual Evaluation of Voice (CAPE-V), jitter, shimmer, Noise-to-Harmonic Ratio (NHR), cepstral peak prominence (CPP), and Low-to-High Ratio (LHR) on sustained vowels, and CPP and LHR on connected speech. Following voice therapy, significant improvements in CAPE-V ratings (p < 0.001) were observed. Additionally, jitter (p=0.041), NHR (p=0.019), and CPP (p < 0.01) on sustained vowels, and CPP (p=0.002), and LHR (p=0.008) on connected speech significantly improved following voice therapy. CPP increased with age in males but did not change in females. CAPE-V ratings and perturbation measures indicated that dysphonia was more severe in younger children pre and post-therapy. Auditory-perceptual and acoustic measures demonstrated improved voice quality following voice therapy in children with dysphonia. CPP effectively quantified voice therapy gains and allowed for analysis of connected speech, in addition to sustained vowels. These findings demonstrate the value of CPP as a tool in assessing therapy outcomes and support the efficacy of voice therapy for children presenting with vocal fold lesions. 4 Laryngoscope, 133:977-983, 2023.

Vocal outcomes after COVID-19 infection: acoustic voice analyses, durational measurements, self-reported findings, and auditory-perceptual evaluations.

PurposeThe ongoing literature suggests that COVID-19 may have a potential impact on voice characteristics during the infection period. In the current study, we explored how the disease deteriorates different vocal parameters in patients who recovered from COVID-19.MethodsA total of 80 participants, 40 patients with a prior history of COVID-19 (20 male, 20 female) with a mean age of 39.9 ± 8.8 (range, 21–53) and 40 gender and age-matched healthy individuals (mean age, 37.3 ± 8.8; range, 21–54) were included to this study. The data of acoustic voice analyses, durational measurements, patient-reported outcomes, and auditory-perceptual evaluations were compared between the study group and the control group. Correlation analyses were conducted to examine the association between the clinical characteristics of the recovering patients and measured outcomes.ResultsMaximum phonation time (MPT) and the scores of both Voice Handicap Index-10 (VHI-10) and Voice-Related Quality of Life (V-RQOL) questionnaires significantly differed between the groups, which was more evident in female participants. The overall severity score of dysphonia was found to be higher in the study group than the control group (p = 0.023), but gender-based comparisons reached significance only in males (p = 0.032). VHI-10 and V-RQOL revealed significant correlations with the symptom scores of the disease.ConclusionsPatients with a prior history of COVID-19 had significantly lower MPT, increased VHI-10 scores, decreased voice-related quality of life based on the V-RQOL questionnaire, and higher overall severity scores in the auditory-perceptual evaluation. Self-reported voice complaints disclosed close relationships with the symptom scores of COVID-19 disease.

Cross-cultural adaptation of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) into Malay: A validity study

Auditory-perceptual rating of voice is one component of voice evaluation, and the CAPE-V is one of the tools for this purpose. Because of its advantages, the CAPE-V has been adapted into several languages. Accordingly, the adaptation of the CAPE-V into Malay is essential for its utility among the Malaysian population, which this study aimed to accomplish. This study involved translating the CAPE-V into Malay, termed the Malay CAPE-V, followed by establishing its validity. The translation processes (i.e., forward translation and backward translation) involved four different translators i.e., 3 speech-language therapists (SLTs) and 1 linguist with at least 14 years of experience. Most items were similarly translated, except for a few, which were subsequently accepted as similar, following consensus among the translators. In the examination of content validity, two raters (i.e., SLTs) with at least 12 years of clinical experience reviewed and scored the tested items. Given that the scale-level content validity index average value (S-CVI/Ave) was above the acceptable level, all items were retained. The examination of construct validity and concurrent validity involved ratings of voice samples recorded from 38 participants, comprising 19 individuals with normal and disordered voices, respectively. The ratings were performed by three raters (i.e., SLTs) with at least 12 years of clinical experience. For the construct validity, the Mann-Whitney U test indicated significantly higher scores of the vocal parameters of the Malay CAPE-V for the disordered voice group than for the normal voice group. Meanwhile, for the concurrent validity, the Spearman correlation indicated that all relationships between the scores of the vocal parameters of the Malay CAPE-V and GRBAS Scale were significant, with most of them achieving a very strong positive correlation. The results demonstrated that the Malay CAPE-V is a valid tool for an auditory-perceptual rating of voice among the Malaysian population.

Treatment Options and Voice Outcomes for Patients With Unilateral Vocal Fold Paralysis After Thyroidectomy.

ObjectivesThis study investigated the treatment options and clinical outcomes of voice therapy (VT), hyaluronic acid (HA) injection, autologous fat injection (FI), and medialization thyroplasty (MT) in patients with unilateral vocal fold paralysis (UVFP) after thyroidectomy.Study DesignRetrospective case series.SettingA tertiary teaching hospital.MethodsThis study included 51 patients with post-thyroidectomy UVFP who underwent VT (n = 20), HA injection (n = 14), FI (n = 12), or MT (n = 5) from January 2016 to June 2021. The treatment outcomes were evaluated using 10-item voice handicap index (VHI-10), maximal phonation time (MPT), and auditory perceptual rating using GRB scales (i.e., grade, roughness, and breathiness) before and 3 to 6 months after treatment.ResultsPatients received HA injection presented a significantly shorter interval after thyroidectomy (mean: 4.6 months), followed by VT (6.7 months), FI (12.3 months), and MT (22.4 months). The results exhibited improvement in most of the outcomes after all of the four treatments. Additional comparisons indicated that VHI-10 scores improved the most among patients receiving MT, followed by HA, FI, and VT. The differences of MPT and GRB scores among the 4 treatment groups were non-significant.ConclusionsThe results revealed that VT, HA, FI, and MT can all improve the voice outcomes of patients with post-thyroidectomy UVFP. The optimal treatment approach should be individualized according to the patient’s preference and vocal demand, and the interval between thyroidectomy and intervention.

The Correlation Between Perceptual Ratings and Nasalance Scores in Resonance Disorders: A Systematic Review.

Assessment of resonance characteristics is essential in research and clinical practice in individuals with velopharyngeal impairment. The purpose of this study was to systematically review correlations between auditory-perceptual ratings and nasalance scores obtained by a nasometer in individuals with resonance disorders and to identify factors that affected the correlations between these two measures. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search was conducted for studies reporting a correlation between nasality ratings and nasalance scores using six electronic databases based on predefined inclusion and exclusion criteria. A total of 27 studies were included in this systematic review. Characteristics of study components including participants, types of assessment and stimuli, correlation coefficients, and reliability values of each study were identified, and a narrative synthesis was conducted. The methodological quality of each study was also appraised. The correlation level between nasalance values and nasality ratings varied from nonsignificant to strong (r = .92). The quality rating scores of the selected studies ranged from 44% to 94%, with an average score of 75%. Factors that did or did not affect the varied correlation between nasality ratings and nasalance scores were discussed. Speech stimuli and the listeners' background were associated with correlations between the two measures. In addition, the sex of the speakers could be a factor affecting its correlation. However, the types of perceptual scales and listening conditions did not influence its correlations between the two measures. https://doi.org/10.23641/asha.19653207.

Effect of Anchor Term on Auditory-Perceptual Ratings of Feminine and Masculine Speakers.

Studies investigating auditory perception of gender expression vary greatly in the specific terms applied to gender expression in rating scales. This study examined the effects of different anchor terms on listeners' auditory perceptions of gender expression in phonated and whispered speech. Additionally, token and speaker cues were examined to identify predictors of the auditory-perceptual ratings. Inexperienced listeners (n = 105) completed an online rating study in which they were asked to use one of five visual analog scales (VASs) to rate cis men, cis women, and transfeminine speakers in both phonated and whispered speech. The VASs varied by anchor term (very female/very male, feminine/masculine, feminine female/masculine male, very feminine/not at all feminine, and not at all masculine/very masculine). Linear mixed-effects models revealed significant two-way interactions of gender expression by anchor term and gender expression by condition. In general, the feminine female/masculine male scale resulted in the most extreme ratings (closest to the end points), and the feminine/masculine scale resulted in the most central ratings. As expected, for all speakers, whispered speech was rated more centrally than phonated speech. Additionally, ratings of phonated speech were predicted by mean fundamental frequency (f o) within each speaker group and by smoothed cepstral peak prominence in cisgender speakers. In contrast, ratings of whispered speech, which lacks an f o, were predicted by indicators of vocal tract resonance (second formant and speaker height). The current results indicate that differences in the terms applied to rating scales limit generalization of results across studies. Identifying the patterns across listener ratings of gender expression provide a rationale for researchers and clinicians when making choices about terms. Additionally, beyond f o and vocal tract resonance, predictors of listener ratings vary based on the anchor terms used to describe gender expression. https://doi.org/10.23641/asha.19617564.

Evaluation of Voice After Open Airway Surgery in Children: A Systematic Review.

ObjectiveThis review aims to describe the methods used to assess the vocal quality and quality of life of children after airway reconstruction and their limitations.Data SourcesA systematic review was carried out in 10 databases for articles published between 2000 and 2021 following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses).Review MethodsArticles were included that described perceptual voice assessment with or without acoustic measures and/or voice quality impact questionnaires. Articles with no description of a specific voice assessment were excluded.ResultsA total of 12 studies were included, yielding 263 patients. The mean age at evaluation was 9 years. Follow-up varied from 5 months to 20 years with most patients being evaluated at least a year after surgery. Methods used to evaluate voice were perceptual, aerodynamic, and acoustic analysis and quality of life questionnaires. CAPE-V (Consensus Auditory Perceptual Evaluation–Voice) was the most used auditory-perceptual instrument (72.7%). Of the acoustic parameters, fundamental frequency and maximum phonation time were the most described (58.3%), and among the quality of life assessment questionnaires, pVHI (Pediatric Voice Handicap Index) was the most used (54.5%).ConclusionMultidimensional evaluations tailored to the individual child can be recommended after open airway surgery. CAPE-V scale, fundamental frequency, maximum phonation time, and pVHI are the most frequently used methods; therefore, their use may help broaden communication among authors. In the multitude of methods available, cognitive ability and degree of voice disturbance should be considered since they are the most important limiting factors in this population.

Laryngeal pathologies in dysphonic children with Down Syndrome

IntroductionDown syndrome is the most common chromosomal abnormality and is associated with a higher incidence of congenital heart defects, which often require surgery within the first year of life. Previous studies have found that children with Down syndrome are at higher risk for subglottic stenosis, vocal fold paralysis, and laryngomalacia. The goal of this study is to review children with Down syndrome presenting with dysphonia and to characterize their laryngeal pathologies. MethodsA retrospective review was performed of patients with Down syndrome seen at a tertiary pediatric hospital's department of otolaryngology from Jan. 2007–Jul. 2021 for voice-related concerns. Inclusion criteria included age less than 18 years, diagnosis of Trisomy 21, and complaint of dysphonia. The data extracted included history of dysphonia, co-morbidities, demographic information, age at presentation, perceptual voice assessments, voice quality of life scores, acoustic data, laryngoscopic and/or videostroboscopic exams, and surgical procedures. ResultsTwenty-three total patients met the study criteria. Of these children, 13 (57%) were male and 10 (43%) were female. The mean age at first presentation was 4.08 years (range 12 days–16.3 years). Eleven of the 23 patients presented within the first 12 months of life. Sixteen patients were diagnosed with vocal fold immobility, 13 of which were left-sided unilateral immobility and the remaining 3 were bilateral immobility. 5 patients were diagnosed with vocal fold nodules. 12 children in the immobility group had a history of cardiothoracic surgery at our institution. Only 3 patients had Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) assessments, though all three showed overall dysphonia ratings of severely deviant, with roughness and strain scores being the most severe. DiscussionThe most common etiology of dysphonia in our Down syndrome patient population was vocal fold immobility and hypomobility, as opposed to vocal fold nodules (which is the most common in the general pediatric population). The higher likelihood of cardiac surgery in patients with Trisomy 21 may result in the increased incidence of vocal fold immobility. There should be a low threshold to refer dysphonic patients with Down syndrome for laryngoscopic evaluation, as treatment options may be available.

Classification of accurate and misarticulated /ɑr/ for ultrasound biofeedback using tongue part displacement trajectories

ABSTRACT Ultrasound biofeedback therapy (UBT), which incorporates real-time imaging of tongue articulation, has demonstrated generally positive speech remediation outcomes for individuals with residual speech sound disorder (RSSD). However, UBT requires high attentional demands and may therefore benefit from a simplified display of articulation targets that are easily interpretable and can be compared to real-time articulation. Identifying such targets requires automatic quantification and analysis of movement features relevant to accurate speech production. Our image-analysis program TonguePART automatically quantifies tongue movement as tongue part displacement trajectories from midsagittal ultrasound videos of the tongue, with real-time capability. The present study uses such displacement trajectories to compare accurate and misarticulated American-English rhotic /ɑr/ productions from 40 children, with degree of accuracy determined by auditory perceptual ratings. To identify relevant features of accurate articulation, support vector machine (SVM) classifiers were trained and evaluated on several candidate data representations. Classification accuracy was up to 85%, indicating that quantification of tongue part displacement trajectories captured tongue articulation characteristics that distinguish accurate from misarticulated production of /ɑr/. Regression models for perceptual ratings were also compared. The simplest data representation that retained high predictive ability, demonstrated by high classification accuracy and strong correlation between observed and predicted ratings, was displacements at the midpoint of /r/ relative to /ɑ/ for the tongue dorsum and blade. This indicates that movements of the dorsum and blade are especially relevant to accurate production of /r/, suggesting that a predictive parameter and biofeedback target based on this data representation may be usable for simplified UBT.

Speech Changes After Transcranial Direct Current Stimulation in Individuals Diagnosed With Parkinson's Disease

Purpose: Parkinson's disease (PD) is a progressive neurological disease that results in motor and cognitive impairments, including impaired speech production. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that shows promise in improving limb motor skills and executive function in individuals with PD. The aim of this study was to examine the impact of tDCS on speech production in individuals diagnosed with PD. Method: Six males, aged 65–78 years, with a diagnosis of PD, participated in a double-blinded controlled crossover study to assess the immediate effects of tDCS to the premotor cortex on speech production. Auditory–perceptual (Consensus Auditory–Perceptual Evaluation—Voice) and acoustic voice outcomes (e.g., fundamental frequency, intensity, noise-to-harmonic ratio [NHR], and speech rate) were gathered pre- and post-anodal simulation and sham conditions. Measures were compared across times and conditions. Results: Speech rate was below normative levels for all participants prior to tDCS. Speech rate increased significantly in conversation following stimulation but not sham conditions and exceeded normative values for two participants. NHR increased following stimulation. No significant difference in other perturbation measures, perceptual ratings, fundamental frequency, or intensity were noted. Conclusions: All participants completed the protocol without discomfort. The observed increase in speech rate needs to be interpreted in the context of excitation resulting from neurostimulation using tDCS.

Acoustic characteristics of fricatives, amplitude of formants and clarity of speech produced without and with a medical mask.

BackgroundPrevious research has found that high‐frequency energy of speech signals decreased while wearing face masks. However, no study has examined the specific spectral characteristics of fricative consonants and vowels and the perception of clarity of speech in mask wearing.AimsTo investigate acoustic–phonetic characteristics of fricative consonants and vowels and auditory perceptual rating of clarity of speech produced with and without wearing a face mask.Methods & ProceduresA total of 16 healthcare workers read the Rainbow Passage using modal phonation in three conditions: without a face mask, with a standard surgical mask and with a KN95 mask (China GB2626‐2006, a medical respirator with higher barrier level than the standard surgical mask). Speech samples were acoustically analysed for root mean square (RMS) amplitude (A RMS) and spectral moments of four fricatives /f/, /s/, /ʃ/ and /z/; and amplitude of the first three formants (A1, A2 and A3) measured from the reading passage and extracted vowels. Auditory perception of speech clarity was performed. Data were compared across mask and non‐mask conditions using linear mixed models.Outcomes & ResultsThe A RMS of all included fricatives was significantly lower in surgical mask and KN95 mask compared with non‐mask condition. Centre of gravity of /f/ decreased in both surgical and KN95 mask while other spectral moments did not show systematic significant linear trends across mask conditions. None of the formant amplitude measures was statistically different across conditions. Speech clarity was significantly poorer in both surgical and KN95 mask conditions.Conclusions & ImplicationsSpeech produced while wearing either a surgical mask or KN95 mask was associated with decreased fricative amplitude and poorer speech clarity.WHAT THIS PAPER ADDSWhat is already known on the subject Previous studies have shown that the overall spectral levels in high frequency ranges and intelligibility are decreased for speech produced with a face mask. It is unclear how different types of the speech signals that is, fricatives and vowels are presented in speech produced with wearing either a medical surgical or KN95 mask. It is also unclear whether ratings of speech clarity are similar for speech produced with these face masks. What this paper adds to existing knowledge Speech data collected using a real‐world, clinical and non‐laboratory‐controlled settings showed differences in the amplitude of fricatives and speech clarity ratings between non‐mask and mask‐wearing conditions. Formant amplitude did not show significant differences in mask‐wearing conditions compared with non‐mask. What are the potential or actual clinical implications of this work? Wearing a surgical mask or a KN95 mask had different effects on consonants and vowels. It appeared from the findings in this study that these masks only affected fricative consonants and did not affect vowel production. The poorer speech clarity in these mask‐wearing conditions has important implications for speech perception in communication between clinical staff and between medical officers and patients in clinics, and between people in everyday situations. The impact of these masks on speech perception may be more pronounced in people with hearing impairment and communication disorders. In voice evaluation and/or therapy sessions, the effects of wearing a medical mask can occur bidirectionally for both the clinician and the patient. The patient may find it more challenging to understand the speech conveyed by the clinician while the clinician may not perceptually assess patient's speech and voice accurately. Given the significant correlation between clarity ratings and fricative amplitude, improving fricative signals would be useful to improve speech clarity while wearing these medical face masks.

Auditory perceptual assessment of voices: Examining perceptual ratings as a function of voice experience

Understanding voice usage is vital to our understanding of human interaction. What is known about the auditory perceptual evaluation of voices comes mainly from studies of voice professionals, who evaluate operatic/lyrical singing in specific contexts. This is surprising as recordings of singing voices from different musical styles are an omnipresent phenomenon, evoking reactions in listeners with various levels of expertise. Understanding how untrained listeners perceive and describe voices will open up new research possibilities and enhance vocal communication between listeners. Here three studies with a mixed-methods approach aimed at: (1) evaluating the ability of untrained listeners to describe voices, and (2) determining what auditory features were most salient in participants’ discrimination of voices. In an interview (N = 20) and a questionnaire study (N = 48), free voice descriptions by untrained listeners of 23 singing voices primarily from popular music were compared with terms used by voice professionals, revealing that participants were able to describe voices using vocal characteristics from essential categories indicating sound quality, pitch changes, articulation, and variability in expression. Nine items were derived and used in an online survey for the evaluation of six voices by trained and untrained listeners in a German (N = 216) and an English (N = 50) sample, revealing that neither language nor expertise affected the assessment of the singers. A discriminant analysis showed that roughness and tension were important features for voice discrimination. The measurement of vocal expression created in the current study will be informative for studying voice perception and evaluation more generally.