Shimon Sapir

Vocal attrition in teachers: survey findings.

A survey questionnaire, designed in part to assess prevalence and impact of vocal attrition, was administered to school teachers in different locations across the USA. Analysis of 237 questionnaires obtained from female teachers suggests that vocal attrition may be prevalent among teachers. The mean number of symptoms of vocal attrition reported by the teachers was 3.8. Over one half of the teachers reported multiple (3+) symptoms. A significant number of teachers, especially those with multiple symptoms, reported that their symptoms adversely affected their ability to teach effectively and that their voice was a chronic source of stress or frustration. The implications of these and other findings are discussed.

Vocal attrition in voice students: Survey findings

A questionnaire designed in part to survey symptoms of vocal attrition and possible factors contributing to it was administered to 79 university female voice students. Of the 74 students (94%) completing the questionnaire, 10 (13%) were free of symptoms, 19 (26%) had few (one or two), and 45 (61%) had multiple (three or more) symptoms. Thirty-five students (47%) had sought medical help for voice problems since they began their singing career. Students with multiple symptoms were significantly more likely to (a) be bothered, frustrated, worried, depressed, or anxious about their voice; (b) quit performance, forgo audition, limit their repertoire, or quit singing altogether; (c) speak in a voice that is too low in pitch; and (d) have a general tendency to worry, be depressed or anxious, or have mood swings. The clinical implications of these and other findings are discussed.

The intrinsic pitch of vowels: Theoretical, physiological, and clinical considerations

Summary This article reviews theories and physiologic data regarding the mechanisms underlying the intrinsic pitch of vowels (IPV). It is suggested that the IPV is probably a result of both mechanical and neural coupling of the phonatory and articulatory systems. The clinical implications of the present findings for singing and voice disorders are discussed.

Symptoms of vocal attrition in women army instructors and new recruits : results from a survey

Symptoms of vocal attrition were surveyed with a questionnaire in 130 Israeli women army instructors, a high‐risk group for vocal attrition, and in 386 Israeli women recruits, presumably a low‐risk group. Results showed!, a high prevalence of symptoms in both groups, but a significantly higher prevalence among the instructors; 2. significant correlation between number of symptoms and rapid, excessive, and loud speech habits in both groups; and 3. significant correlation between number of symptoms and difficulties in performing instructional duties. These findings suggest that 1. vocal attrition is related to both external demands on the voice and idiosyncratic speech habits; and 2. vocal attrition has a significant impact on performance and work‐efficiency.

Psychogenic spasmodic dysphonia: A case study with expert opinions

Spasmodic (spastic) dysphonia (SD) is considered by some to be a neurologic syndrome and by others a symptom complex of multiple etiologies, neurologic and psychogenic. A case of a 26-year-old female psychiatric nurse with psychogenic SD (PSD) is presented. The dysphonia was alleviated within one session of voice therapy. Psychogenic etiology was established by the author, based on three diagnostic criteria--symptom incongruity, symptom reversibility, and symptom psychogenicity. Seven nationally recognized voice experts listened to audio-recorded samples of the patients pre- and posttherapy voice during conversational speech. The experts agreed that the dysphonia was psychogenic and characterized it as staccato-like speech, effortful phonation, and interrupted flow of speech; six characterized it with intermittent voice arrests (voice stoppages); five with hoarse-harsh voice; and four with waxing and waning, strained-strangled phonation. These are often described as salient features of SD. Nevertheless, the experts disagreed among themselves as to whether the dysphonia was characteristic of SD and should be labeled as such. The author argues that as long as the voice characteristics and pathophysiologic findings that constitute SD are not well delineated, and as long as the diagnosis of SD is based on symptoms alone, patients with psychogenic or poorly understood voice disorders are likely to be misdiagnosed with organic (neurologic) SD and thus subjected to undue medical treatment. The author also argues that the debate over the etiology of SD can be resolved if SD is considered a neurologic syndrome, PSD a nonorganic phonatory disorder that mimics the syndrome, and if the voice symptoms and pathophysiologic characteristics of SD are well defined and agreed on.

Vocal attrition related to idiosyncratic dysphonia: Re-analysis of survey data

In a recent survey study it was found that female army instructors were significantly more likely to suffer from symptoms of vocal attrition than new female recruits, supporting the clinical impression that those who are engaged in a vocally taxing vocation are at higher risk for vocal attrition than those who are not. In the present study we found that instructors who reported having rapid, excessive or loud speech, or a combination of these, were significantly more likely to report symptoms of vocal attrition than instructors who reported not having these speech habits. Difference in prevalence of vocal attrition symptoms among recruits with and without these speech habits was statistically non-significant. The present findings confirm the clinical impression that idiosyncratic dysphonia can increase the risk of vocal attrition, especially in people who are engaged in a vocally demanding profession or vocation.

Supralaryngeal muscle activity during sustained vibrato in four sopranos: surface EMG findings.

Four classically trained sopranos, aged 22-41 years, sustained a vibrato at a comfortable loudness level, and at different vowels (/u/, /i/, or /a/) and pitch levels (220, 277, 349, 440, 554, 698, or 880 Hz). Pairs of surface electrodes were placed on each singers right side over the submandibular region, the thyroid cartilage, mandibular ramus, and upper lip to record electromyographic (EMG) activity from the anterior suprahyoid (ASH), extralaryngeal (ELAR), massetter (MAS), and perioral (PER) muscles, respectively. A headset-mounted miniature microphone transduced the voice, and a Kay Visi-Pitch extracted the voice fundamental frequency (F0). The output of the Visi-Pitch, a voltage analog of the F0 (VF0), and the EMG signals were digitized, the EMG signals rectified and smoothed, and the VF0 and smoothed EMG signals were subjected to Fast Fourier Transform (FFT) analysis. Spectral peaks in the FFT records indicated vibrato-related activity in the ASH and ELAR muscles, with occasional vibrato-related activity in the MAS and PER muscles. The role of supralaryngeal muscles in vibrato is discussed.

Average speaking fundamental frequency in soprano singers with and without symptoms of vocal attrition

Nineteen trained soprano singers aged 18-30 years vocalized tasks designed to assess average speaking fundamental frequency (SFF) during spontaneous speaking and reading. Vocal range and perceptual characteristics while singing with low intensity and high frequency were also assessed, and subjects completed a survey of vocal habits/symptoms. Recorded signals were digitized prior to being analyzed for SFF using the Kay Computerized Speech Lab program. Subjects were assigned to a normal voice or impaired voice group based on ratings of perceptual tasks and survey results. Data analysis showed group differences in mean SFF, no differences in vocal range, higher mean SFF values for reading than speaking, and 58% ability to perceive speaking in low pitch. The role of speaking in too low pitch as causal for vocal symptoms and need for voice classification differentiation in vocal performance studies are discussed.

Effects of frequency modulated tones and vowel formants on perioral muscle activity during isometric lip rounding

Summary Two studies were conducted to assess the sensitivity of perioral muscles to vowel-like auditory stimuli. In one study, normal young adults produced an isometric lip rounding gesture while listening to a frequency modulated tone (FMT). The fundamental of the FMT was modulated over time in a sinusoidal fashion near the frequency ranges of the first and second formants of the vowels /u/ and /i/ (rate of modulation = 4.5 or 7 Hz). In another study, normal young adults produced an isometric lip rounding gesture while listening to synthesized vowels whose formant frequencies were modulated over time in a sinusoidal fashion to simulate repetitive changes from the vowel /u/ to /i/ (rate of modulation = 2 or 4 Hz). The FMTs and synthesized vowels were presented binaurally via headphones at 75 and 60 dB SL, respectively. Muscle activity from the orbicularis oris superior and inferior and from lip retractors was recorded with surface electromyography (EMG). Signal averaging and spectral analysis of the rectified and smoothed EMG failed to show perioral muscle responses to the auditory stimuli. Implications for auditory feedback theories of speech control are discussed.