Anita McAllister

Observations of the Relationship Between Noise Exposure and Preschool Teacher Voice Usage in Day-Care Center Environments

Although the relationship between noise exposure and vocal behavior (the Lombard effect) is well established, actual vocal behavior in the workplace is still relatively unexamined. The first purpose of this study was to investigate correlations between noise level and both voice level and voice average fundamental frequency (F₀) for a population of preschool teachers in their normal workplace. The second purpose was to study the vocal behavior of each teacher to investigate whether individual vocal behaviors or certain patterns could be identified. Voice and noise data were obtained for female preschool teachers (n=13) in their workplace, using wearable measurement equipment. Correlations between noise level and voice level, and between voice level and F₀, were calculated for each participant and ranged from 0.07 to 0.87 for voice level and from 0.11 to 0.78 for F₀. The large spread of the correlation coefficients indicates that the teachers react individually to the noise exposure. For example, some teachers increase their voice-to-noise level ratio when the noise is reduced, whereas others do not.

Relations between voice range profiles and physiological and perceptual voice characteristics in ten-year-old children**

Pitch and intensity range of 60 children were recorded and plotted in voice range profiles (VRPs). Different aspects were investigated: minimum phonation threshold, pitch range, and maximum dynamic range. Vocal fold status was determined via laryngoscopic examination. Ten percent of the children had vocal nodules, 23% glottal chinks. Seven voice experts listened to the voices recorded on two separate occasions and rated their properties along 16 parameters including hoarseness. Fourteen percent were rated as hoarse on both recordings and were thus classified as being chronically hoarse. Departures from normal in VRP characteristics were found for children suffering from chronic hoarseness, nodules, and glottal chinks. Children in general seem to have somewhat compressed VRP contours compared with adults, reflecting restricted dynamic vocal capabilities; however, children with mutational voices exhibited an approximation to adult upper VRP contours.

Perceptual analysis of child hoarseness using continuous scales

The voices of 58 10-year old children were recorded on audiotape and judged by a panel of voice expert listeners, who rated the voices along 16 voice parameters represented by visual analogue (continuous) scales on a test form. Interjudge reliability was high. Rank ordered rating means revealed a discontinuity in the distribution for most parameters. A factor analysis revealed three factors of major relevance to the perception of these voices. The factors were closely associated with hoarseness, pitch, and phonatory effort. The hoarseness factor was found to have high loadings in gratings, breathiness, hyperfunction, roughness, instability, and voice breaks. A stepwise multiple regression analysis revealed that breathiness, hyperfunction and roughness are good predictors of hoarseness.

Oral motor dysfunction in children with adenotonsillar hypertrophy—effects of surgery

Adenotonsillar hypertrophy is associated with a wide range of problems. The enlargement causes obstructive symptoms and affects different functions such as chewing, swallowing, articulation, and voice. The objective of this study was to assess oral motor function in children with adenotonsillar hypertrophy using Nordic Orofacial Test-Screening (NOT-S) before and 6 months after surgery consisting of adenoidectomy combined with total or partial tonsil removal. A total of 67 children were assigned to either tonsillectomy (n=33) or partial tonsillectomy, ‘tonsillotomy’ (n=34); 76 controls were assessed with NOT-S and divided into a younger and older age group to match pre- and post-operated children. Most children in the study groups had oral motor problems prior to surgery including snoring, open mouth position, drooling, masticatory, and swallowing problems. Post-surgery oral motor function was equal to controls. Improvement was independent of surgery method.

Orofacial dysfunction in ectodermal dysplasias measured using the Nordic Orofacial Test-Screening protocol

Objective. To screen orofacial function in people with various ectodermal dysplasia (ED) syndromes and compare with a healthy reference sample. Material and methods. The ED group comprised 46 individuals (30 M and 16 F; mean age 14.5 years, range 3–55). Thirty-two had hypohidrotic ED, while 14 had other ED syndromes. The reference sample comprised 52 healthy individuals (22 M and 30 F; mean age 24.9 years, range 3–55). Orofacial function was screened using the Nordic Orofacial Test-Screening (NOT-S) protocol containing 12 orofacial function domains (maximum score 12 points). Results. The total NOT-S score was higher in the ED group than in the healthy group (mean 3.5 vs. 0.4; p<0.001). The dysfunctions most frequently recorded in the subjects with ED occurred in the domains chewing and swallowing (82.6%), dryness of the mouth (45.7%), and speech (43.5%). Those with other ED syndromes scored non-significantly higher than those with hypohidrotic ED (mean 4.6 vs. 3.0; p>0.05). Conclusions. Individuals with ED scored higher than a healthy reference sample in all NOT-S domains, especially in the chewing and swallowing, dryness of the mouth, and speech domains. Orofacial function areas and treatment and training outcomes need to be more closely evaluated and monitored.

Long-term effects of palatal plate therapy on oral motor function in children with Down syndrome evaluated by video registration.

Oral motor function was evaluated after 4 years of palatal plate therapy in nine children with Down syndrome (DS); 11 children with DS constituted the control group. During the treatment period all children had orofacial physiotherapy with their speech pathologist. An extraoral examination was performed, as was a video registration of the face. Nine different variables showing positions of the lips, tongue, and facial expression were examined. Children in the palatal plate group (n = 9) had significantly more rounding lips during speech (P < 0.05 ) than children in the control group (n = 11). The active variables describing normal muscle tension were diagnosed to constitute 81.0% ± 11.0% of the registered video time in the palatal plate group, compared with 68.2% ± 22.5% in the control group. Statistically significant differences were found between the groups in the summary variables describing an inactive open mouth and inactive tongue protrusion (P < 0.01). The results indicate that palatal plate therapy has a long-term effect on oral motor function.

Aetiologic Factors Associated with Hoarseness in Ten-Year-Old Children

The parents of 55 10-year-old children answered questionnaires concerning 51 elements of potential relevance to voice function such as vocal habits, speech and language development, medical history, social history, physical environment and family relations. In addition, personality profiles of each child were assessed by its teacher and parents. The results were compared to an expert listening panels evaluation of hoarseness and vocal-fold status as determined by a visual examination by a phoniatrician. Eight boys were identified as being chronically hoarse. Gender, personality and hours spent per day in large groups were highly significant factors associated with hoarseness. A discriminant analysis based on the significant background variables correctly grouped 86.3% of the children.

Right-hemispheric cortical contributions to language ability in healthy adults.

In this study we investigated the correlation between individual linguistic ability based on performance levels and their engagement of typical and atypical language areas in the brain. Eighteen healthy subjects between 21 and 64 years participated in language ability tests, and subsequent functional MRI scans measuring brain activity in response to a sentence completion and a word fluency task. Performance in both reading and high-level language tests correlated positively with increased right-hemispheric activation in the inferior frontal gyrus (specifically Brodmann area 47), the dorsolateral prefrontal cortex (DLPFC), and the medial temporal gyrus (Brodmann area 21). In contrast, we found a negative correlation between performance and left-hemispheric DLPFC activation. Our findings indicate that the right lateral frontal and right temporal regions positively modulate aspects of language ability.

Treatment with a combination of intra-oral sensory stimulation and electropalatography in a child with severe developmental dyspraxia

This paper describes the use of a combination of intra-oral sensory stimulation and electropalatography (EPG) in the treatment of a case with severe developmental verbal dyspraxia. A multiple-baseline design was used. The treatment duration was 11 months and started when the subject was 5 years old. The efficacy of the treatment was assessed by calculations of percentage of correctly articulated words, percentage of consonants correct, percentage of phonemes correct and percentage of words correct. Intelligibility assessments were conducted by both naïve and expert listeners. The experts also assessed visual deviances in articulatory gestures from video recordings. Qualitative analysis of EPG data was made. The subjects speech was significantly improved by the treatment in all aspects. The results and their generalization to other cases of developmental verbal dyspraxia are discussed.

Acoustic measurements and perceptual evaluation of hoarseness in children's voices

According to a previous investigation of childrens voices hoarseness was found to be a stable concept consisting of three main predictors: hyperfunction, breathiness, and roughness. The present investigation analyzes the relation between these perceptual voice characteristics, complemented by instability and gratings (high pitched roughness) on the one hand and four acoustic measures: pitch perturbation quotient, amplitude perturbation quotient and two types of normalized noise energy measures on the other. The analysis was carried out on a sample of vowels sustained by 50 ten-year-old school children representing different degrees of hoarseness. Significant correlations were found between hoarseness, breathiness, and roughness, and two acoustic measures, namely a frequency perturbation quotient and one harmonics-to-noise measure.