Venkataraja U. Aithal

Acoustic Analysis of Voice in Normal and High Pitch Phonation: A Comparative Study

Objectives: Comparison of acoustic parameters of voice between normal and high pitch phonation in normal adults, and comparison between genders. Participants and Methods: A total of 48 normal laryngeal speakers were considered for this study. The acoustic parameters were analyzed using the Multi-Dimensional Voice Program. Descriptive statistics were used for analysis of the acoustic parameters across tasks and genders. Paired-samples t tests were used to compare measures between tasks. Independent-samples t tests were used to compare parameters between genders. Results: Significant differences were found across tasks in the range of fundamental frequency and average fundamental frequency. Females showed a significant difference in the frequency perturbation measures – percent jitter and relative average perturbation, while males demonstrated a significant difference in the noise-to-harmonic ratio. While comparing mean differences between genders, significant differences were observed in fundamental frequency, range of the fundamental frequency, and smoothed pitch perturbation quotient during both phonation tasks. Conclusion: Comparison of acoustic parameters between normal and high pitch phonation would facilitate understanding the effect of high pitch phonation on voice parameters. Subsequently, this would help clinicians to focus on important acoustic parameters while assessing professional voice users who are at risk of developing voice problems.

Acoustic Analysis of Madhya and Taar Saptak/Sthayi in Indian Classical Singers

Objectives: We aimed to compare the acoustic parameters of voice between Madhya Saptak/Sthayi (MS) and Taar Saptak/Sthayi (TS) in trained Indian classical singers and between males and females. Participants and Method: Sixty-five adult trained Indian classical singers were instructed to produce MS and TS; the acoustic parameters were analyzed with the Multidimensional Voice Program. Descriptive statistics were used for analysis across tasks and gender. Two-way random-effects ANOVA was used to test the effect of gender and task. Results: Male participants had a restricted range of fundamental frequency (F0), especially at high pitches. The acoustic analysis showed a statistically significant difference for F0 measures, range of F0, jitter and pitch perturbation quotient between males and females during MS and TS. Conclusion: The use of TS, that is, high-pitch phonation, during the clinical evaluation of singers enables an understanding of their vocal behavior in the higher scales of singing.

Adaptation and Validation of the Kannada Version of the Singing Voice Handicap Index

OBJECTIVE The present study aimed to adapt and validate the Singing Voice Handicap Index (SVHI) into Kannada language using standard procedures. STUDY DESIGN This is a cross-sectional study. METHODS The original English version of SVHI was translated into Kannada. It was administered on 106 Indian classical singers, of whom 22 complained of voice problems. Its internal consistency was determined using Cronbachs alpha coefficient (α), test-retest reliability using Pearsons product moment correlation and paired t test, and the difference in mean scores by independent sample t test. RESULTS The results revealed that the Kannada SVHI exhibited an excellent internal consistency (α = 0.96) with a high item-to-total correlation. Further, excellent test-retest reliability (r = 0.99) and significant differences in SVHI scores were also obtained by singers with and without a voice problem (t = 12.93, df = 104, P = 0.005). CONCLUSION The Kannada SVHI is a valid and reliable tool for self-reported assessment of singers with voice problems. It will provide a valuable insight into the singing-related voice problems as perceived by the singers themselves.

Exploring Attitudes of Indian Classical Singers Toward Seeking Vocal Health Care.

OBJECTIVE The attitude of Indian classical singers toward seeking vocal health care is a dimension yet to be explored. The current study was aimed to determine the attitudes of these singers toward seeking vocal health care and further understand the influence of age and gender. STUDY DESIGN Cross-sectional. METHOD A 10-item self-report questionnaire adapted from a study on contemporary commercial music singers was used. An additional question was added to ask if the singer was aware about the profession and role of speech-language pathologists (SLPs). The questionnaire was administered on 55 randomly selected self-identified trained Indian classical singers who rated the items using a five-point Likert scale. Demographic variables were summarized using descriptive statistics and t test was used to compare the mean scores between genders and age groups. RESULTS Of the singers, 78.2% were likely to see a doctor for heath-related problems, whereas 81.8% were unlikely to seek medical care for voice-related problems; the difference was statistically significant (P < 0.001). Responses for the questions assessing the attitudes toward findings from medical examination by a specialist revealed a statistically significant difference (P = 0.02) between the genders. Age did not have a significant influence on the responses. Only 23.6% of the respondents were aware about the profession and the role of SLPs. CONCLUSION The findings are in tune with western literature reporting hesitation of singers toward seeking vocal health care and draws attention of SLPs to promote their role in vocal health awareness and management.

Cepstral Peak Prominence of Blom-Singer ‘Non-Indwelling Low Pressure’ and ‘Classic Indwelling’ Voice Prosthesis in Male Tracheo-oesophageal Speakers

Introduction: Tracheo-oesophageal (TE) speech is one of the most commonly used alaryngeal voice restoration options for individuals who have undergone a total laryngectomy. Cepstral Peak Prominence (CPP) implies the overall voice quality objectively. Aim: To compare the CPP between Blom-Singer non-indwelling low pressure and classic indwelling voice prosthesis across vowel phonation /a/ and text-reading tasks in male TE speakers. Materials and Methods: The study included 10 male TE speakers in the age range of 45-75 years. Dr. Hillenbrand’s ‘Speech Tool’ software was used to measure CPP. Two types of speech prosthesis used were Blom-Singer non-indwelling low pressure and classic indwelling voice prosthesis (both of 16 French diameter) and the tasks vowel phonation and text-reading were considered. The SPSS software, version 15.0 (SPSS Inc., Chicago, IL) was used for data analysis. The parametric paired t-test was applied to compare CPP between two types of voice prostheses across speech tasks. Results: There was no significant difference between Blom-Singer non-indwelling low pressure voice prosthesis and classic indwelling voice prosthesis for CPP during vowel phonation/a/task {t(9)=0.74, p=0.516} and text-reading task {t(9)=0.72, p=0.947)}. Similarly, there was no significant difference for CPP between speech tasks for Blom-Singer non-indwelling low pressure voice prosthesis {t(9)=1.11, p=0.347)} and Blom-Singer classic indwelling voice prosthesis {t(9)=0.51, p=0.644)}. Conclusion: In TE speakers, CPP is not influenced by prosthesis type in terms of mode of fitting, prosthesis design and valve opening pressure across speech tasks, implying no difference in the objective measure of overall voice quality.

Training individuals with speech and hearing impairment in basic life support: A pilot study

Current data suggests that ischaemic heart disease (IHD), is the eading cause of death globally [1]. If untreated, IHD can lead to cariac arrest which is an economic burden for the health care system. he incidence of out-of-hospital cardiac arrest (OHCA) is 110.8 per 00 000 people [2]. Cardiopulmonary resuscitation (CPR) is a lifeaving intervention for victims suffering from cardiac arrest [3]. he key determinants of survival in OHCA victims are the timely erformance of bystander CPR and early defibrillation for those n ventricular fibrillation or pulseless ventricular tachycardia [4]. lthough, it is proven that immediate bystander CPR along with arly defibrillation can double the survival rate for OHCA [5], it as been seen that only 45.7% receive bystander CPR, and only 0.6% survive [2]. This highlights the need to increase the response or bystander CPR and to improve the survival rates for OHCA. In ertain situations, disabled individuals may be bystanders. A physially challenged individual can also be proficient in knowledge and kills of CPR [6]. However, no studies have attempted to train a peech and hearing impaired individual (SHI) in the skill of CPR, .e., basic life support (BLS). The aim of this study was, therefore, to ssess the barriers, feasibility and explore possible modifications or training and teaching SHIs on adult BLS. This study was conducted during the month of April 2015, eceived institutional ethics clearance (IEC 70/2015) and was regstered in Clinical Trials Registry India (CTRI/2015/03/005647). A ritten informed consent was taken from all the SHI participants. ll the participants were trained using the 2010 American Heart ssociation (AHA) guidelines [3]. A special education school teacher SEST) proficient in total communication (TC) was identified as a ommunicator between the AHA certified instructor (AHA-CI) and he participants. An AHA-CI taught the SEST skills for adult BLS layperson) which was assessed later by a post-session skill demontration. The participants were trained in adult BLS, very next day y the same AHA-CI along with SEST. At the end of the session, paricipants were evaluated using a checklist as recommended by the HA for the BLS training program. Six SHI individuals (mean age 23 ± 8.14 years) trained and xperienced in TC, with disability ranging between 80 and 90% paricipated in the study. Two participants were using hearing aids for uditory awareness. None of them had prior exposure or knowldge in CPR, first aid or BLS. Barriers during the training program ere identified and are summarized in Table 1. The major chalenges were activating emergency services (EMS) and following oice prompts of the Automated external defibrillator (AED).

Evaluation of direct and indirect methods of Sub-neoglottic pressure measurement in tracheoesophageal speakers: A systematic review and Meta-analysis

Objective: Tracheoesophageal (TE) prosthetic voice is one of the voice restoration options for individuals who have undergone a total laryngectomy. Aerodynamic analysis of the TE voice provides insight into the physiological changes that occur at the level of the neoglottis with voice prosthesis in situ. The present study is a systematic review and meta-analysis of sub-neoglottic pressure (SNP) measurement in TE speakers by direct and indirect methods. Patients and Methods: The screening of abstracts and titles was carried out for inclusion of articles using 10 electronic databases spanning the period from 1979 to 2016. Ten articles which met the inclusion criteria were considered for meta-analysis with a pooled age range of 40–83 years. Results: The pooled mean SNP obtained from the direct measurement method was 53.80 cm H2O with a 95% confidence interval of 21.14–86.46 cm H2O, while for the indirect measurement method, the mean SNP was 23.55 cm H2O with a 95% confidence interval of 19.23–27.87 cm H2O. Conclusion: Based on the literature review, the various procedures followed for direct and indirect measurements of SNP contributed to a range of differences in outcome measures. The meta-analysis revealed that the “interpolation method” for indirect estimation of SNP was the most acceptable and valid method in TE speakers.

Honored Members of IALP

Since the founding of the IALP in 1924, a total of 19 individuals have been named Honored Members of the Association. The three most recent recipients of this great and rare honor include Prof. Dr. M. Nasser Kotby and Prof. Dr. Harm K. Schutte, both given the honor at the 2007 IALP World Congress in Copenhagen, Denmark, and Dr. Herman Peters, given the honor at the most recent IALP World Congress (2010) in Athens, Greece. Each of these men has made unique and important contributions to the IALP, but they also have something in common that played a critical role in their being awarded this honor: a recognition that a clinical, scientific, and professional enterprise is moved forward, across history, by people who serve an idea bigger than any single individual, by seeing one’s own efforts translate to an accomplishment shared by many. Please enjoy, in the pages that follow, these too-brief summaries of three remarkable individuals. Gary Weismer Editor in Chief, Folia Phoniatrica et Logopaedica Published online: November 16, 2011