Karen M. K. Chan

Reliability and confidence in using a paired comparison paradigm in perceptual voice quality evaluation.

One of the ways to improve the reliability in perceptual voice quality rating is to provide listeners with external anchors. A paired comparison matching paradigm using synthesized Cantonese voice stimuli that covered a range of rough and breathy qualities were used to investigate the rating reliability. Twenty‐five speech pathology students rated the severity of roughness and breathiness of natural pathological voice samples using two paradigms: an eight‐point anchored matching (paired comparison) paradigm and an eight‐point non‐anchored equal‐appearing‐interval (EAI) scale paradigm. The listeners also rated their confidence in judging each testing stimulus on a seven‐point EAI scale. The results showed that the paired comparison method specifically improved the inter‐rater reliability in rating male rough stimuli and mildly dysphonic female stimuli. The intra‐rater agreement and confidence ratings remained similar across the two rating paradigms. These results suggest that the paired comparison paradigm may be used as an alternative perceptual voice quality evaluation tool.

Preliminary Data on Prevention and Treatment of Voice Problems in Student Teachers

OBJECTIVES/HYPOTHESES To assess the utility of a targeted voice hygiene (VH) program compared to VH plus voice training intervention (VH+VT) for the prevention and treatment of voice problems in student teachers. STUDY DESIGN Prospective, randomized. METHODS Thirty-one student teachers with low (good) and high (poor) voice handicap index (VHI) scores in Pittsburgh and Hong Kong were randomly assigned to (1) a targeted, individually tailored VH program, (2) the VH program plus resonant VT (VH+VT), or (c) a control group. Participants assigned to intervention groups were monitored for their adherence to their programs for their first 4 weeks of student teaching. VHI data were collected again 4 weeks postintervention (both sites) and 8 weeks postintervention, following a no-contact washout period (Pittsburgh). RESULTS Descriptive data analysis indicated that across both sites, for initially healthy participants, the VH program was sufficient to prevent worsening of VHI scores that occurred in all control participants over the first 4-8 weeks of student teaching. The addition of VT did not consistently enhance protective benefits over VH alone. In contrast, for participants with initially poor VHI scores, the VH program failed to produce VHI benefits over the control condition. The addition of VT was required to optimize results for that cohort. CONCLUSIONS Preliminary data suggest that a minimalist, individually tailored VH program may be sufficient to prevent voice problems from teaching in healthy student teachers. However, for student teachers with existing voice problems, VT may be required to optimize results of intervention.

A preliminary study of a quantitative analysis method for high speed laryngoscopic images.

High speed laryngoscopic study provides new information on the vocal fold vibratory patterns which has not been made possible before. Qualitative analysis of high speed laryngoscopic images is commonly reported in the literature. However, quantitative studies are necessary to provide objective measures for research and clinical purposes. This study reports the development of the High Speed Video Processing Program in analysing high-speed laryngoscopic video images obtained from 15 non-dysphonic speakers. Nine glottal ratio indices that represented the full opened glottal area, glottal width and glottal length were computed using the processing program. Data from two dysphonic participants were included to illustrate the manifestation of these glottal measures in dysphonic voices. Some of these glottal ratio index measures showed high variability across participants. However, significant differences were found in a number of index measures among the creaky, modal and falsetto registers in the non-dysphonic participants. In addition, the glottal area ratio index was found to be specifically sensitive in detecting dysphonia in high speed glottal images. The proposed semi-automatic High Speed Video Processing Program showed value in the analysis of high speed laryngoscopic images.

Noise levels in an urban Asian school environment

Background noise is known to adversely affect speech perception and speech recognition. High levels of background noise in school classrooms may affect student learning, especially for those pupils who are learning in a second language. The current study aimed to determine the noise level and teacher speech-to-noise ratio (SNR) in Hong Kong classrooms. Noise level was measured in 146 occupied classrooms in 37 schools, including kindergartens, primary schools, secondary schools and special schools, in Hong Kong. The mean noise levels in occupied kindergarten, primary school, secondary school and special school classrooms all exceeded recommended maximum noise levels, and noise reduction measures were seldom used in classrooms. The measured SNRs were not optimal and could have adverse implications for student learning and teachers′ vocal health. Schools in urban Asian environments are advised to consider noise reduction measures in classrooms to better comply with recommended maximum noise levels for classrooms.

Reliability of laryngostroboscopic evaluation on lesion size and glottal configuration: A revisit

This study investigated the inter‐rater and intrarater reliability of four basic visual perceptual parameters (lesion size rating and glottal configuration) in laryngostroboscopic evaluation.

Quantitative High-Speed Laryngoscopic Analysis of Vocal Fold Vibration in Fatigued Voice of Young Karaoke Singers

PURPOSE The present study aimed to determine whether there were physiological differences in the vocal fold vibration between nonfatigued and fatigued voices using high-speed laryngoscopic imaging and quantitative analysis. METHODS Twenty participants aged from 18 to 23 years (mean, 21.2 years; standard deviation, 1.3 years) with normal voice were recruited to participate in an extended singing task. Vocal fatigue was induced using a singing task. High-speed laryngoscopic image recordings of /i/ phonation were taken before and after the singing task. The laryngoscopic images were semiautomatically analyzed with the quantitative high-speed video processing program to extract indices related to the anteroposterior dimension (length), transverse dimension (width), and the speed of opening and closing. RESULTS Significant reduction in the glottal length-to-width ratio index was found after vocal fatigue. Physiologically, this indicated either a significantly shorter (anteroposteriorly) or a wider (transversely) glottis after vocal fatigue. CONCLUSION The high-speed imaging technique using quantitative analysis has the potential for early identification of vocally fatigued voice.

Effects of immediate feedback on learning auditory perceptual voice quality evaluation.

Abstract The study investigated the effect of immediate feedback in training listeners to perceive subtle differences in voice quality, a perceptual skill that is important for speech-language pathologists. Sixty naive listeners were randomly assigned to a feedback group (Group F), a no feedback group (Group NF), and a no training group acting as a control group (Group C). The task was to evaluate the severity of a perceptual voice quality (breathiness) by using a reference-matching paradigm. All participants took part in three rating sessions (pre-training, 2 days after training and 1 week after training). Group F and Group NF participated in a training session immediately after the first rating session, where Group F practiced with immediate feedback given and Group NF practice with no immediate feedback given. The results showed that Group F and Group NF had significant improvement after training, but Group F did not retain the improvement in the third rating session. The use of a reference-matching training paradigm without giving frequent immediate feedback is suggested for auditory-perceptual voice evaluation training. The most effective frequency of immediate feedback is yet to be determined.

Wound-healing effect of acupuncture for treating phonotraumatic vocal pathologies: A cytokine study.

Acupuncture is a less‐invasive procedure when compared with surgical treatment for benign vocal pathologies caused by vocal overuse. This study aimed to determine the wound‐healing effect of acupuncture in treating phonotraumatic vocal fold lesions.

Indicators of Dysphagia in Aged Care Facilities

Purpose The current cross-sectional study aimed to investigate risk factors for dysphagia in elderly individuals in aged care facilities. Method A total of 878 individuals from 42 aged care facilities were recruited for this study. The dependent outcome was speech therapist-determined swallowing function. Independent factors were Eating Assessment Tool score, oral motor assessment score, Mini-Mental State Examination, medical history, and various functional status ratings. Binomial logistic regression was used to identify independent variables associated with dysphagia in this cohort. Results Two statistical models were constructed. Model 1 used variables from case files without the need for hands-on assessment, and Model 2 used variables that could be obtained from hands-on assessment. Variables positively associated with dysphagia identified in Model 1 were male gender, total dependence for activities of daily living, need for feeding assistance, mobility, requiring assistance walking or using a wheelchair, and history of pneumonia. Variables positively associated with dysphagia identified in Model 2 were Mini-Mental State Examination score, edentulousness, and oral motor assessments score. Conclusions Cognitive function, dentition, and oral motor function are significant indicators associated with the presence of swallowing in the elderly. When assessing the frail elderly, case file information can help clinicians identify frail elderly individuals who may be suffering from dysphagia.

Impact of Head and Neck Cancer Treatment on Survivors' Mealtime Experience: HNC Treatment Impact on Mealtime Experience

The objectives of the study were to develop a mealtime experience self‐assessment questionnaire that was head and neck cancer (HNC) survivors–driven and based on the International Classification of Functioning, Disability and Health (ICF) framework, and to identify common mealtime issues reported by HNC survivors.