Viveka Lyberg-Åhlander

Children's Subjective Ratings and Opinions of Typical and Dysphonic Voice After Performing a Language Comprehension Task in Background Noise

OBJECTIVE Previous studies suggest that dysphonic voices are perceived more negatively than typical voices, and it is possible that vocal perception influences academic achievement and comprehension. This study assessed childrens subjective ratings and opinions of a typical and dysphonic voice after performing a language comprehension task in background noise. It also explored if subjective ratings were related to performance in the comprehension task. STUDY DESIGN Ninety-three 8-year-old children participated and were randomly allocated to two groups. METHODS A digital version of the Test for Reception of Grammar, version 2 (TROG-2) was used. In TROG-2, the child listens to a sentence and then, out of four possible pictures, selects the picture that corresponds to the sentence content. Each sentence assesses a specific grammatical construction. Test instructions were recorded using one speaker with two different voice qualities (typical voice and provoked dysphonic voice). One group of children performed TROG-2 with the typical voice and the other with the dysphonic voice, both presented in a multitalker babble noise using earphones. All children rated their subjective perception of the voice. RESULTS The dysphonic voice received poorer ratings than the typical voice. Children making more positive ratings of the voice performed better on earlier blocks in TROG-2, but only in the typical voice group. CONCLUSIONS Children perceived the dysphonic voice more negatively even when listening to the same speaker. Performance is related to the perception of the voice, but only when the perceptual load of the task-relevant stimuli is sufficiently low.

On the interaction of speakers’ voice quality, ambient noise and task complexity with children’s listening comprehension and cognition

Suboptimal listening conditions interfere with listeners’ on-line comprehension. A degraded source signal, noise that interferes with sound transmission, and/or listeners’ cognitive or linguistic limitations are examples of adverse listening conditions. Few studies have explored the interaction of these factors in pediatric populations. Yet, they represent an increasing challenge in educational settings. We will in the following report on our research and address the effect of adverse listening conditions pertaining to speakers’ voices, background noise, and children’s cognitive capacity on listening comprehension. Results from our studies clearly indicate that children risk underachieving both in formal assessments and in noisy class-rooms when an examiner or teacher speaks with a hoarse (dysphonic) voice. This seems particularly true when task complexity is low or when a child is approaching her/his limits of mastering a comprehension task.

Psychotropic drug use in adolescents born with an orofacial cleft: a population-based study

Objectives Being born with an orofacial cleft (OFC) can, due to an incomplete closure of the lip and/or palate, convey a deviant speech and/or deviant facial aesthetics, which may in turn increase the risk for poor psychological health later in life. Previous investigations have been based on small samples and self-reports, not distinguishing between the three different types of OFC: cleft lip (CL), CL and palate (CLP) and cleft palate only (CPO). We present a large population-based study, considering psychotropic drug use as a proxy for poor psychological health and distinguishing between three different types of OFC. Design and methods Using the Swedish Medical Birth Register, and linking to it the Swedish Prescribed Drug Register, the National Mortality Register, the Emigration Register and the National Inpatient Register, we identified all singletons born to native mothers in Sweden between 1987 and 1993, alive and residing in Sweden at the end of an 18-year follow-up period (N=626 109). We compared psychotropic drug use among individuals with and without OFC during the individuals’ adolescence (2005–2008) by multiple logistic regressions, using ORs with 95% CIs. Results When adjusted for potential confounders, having a CL (OR=1.63, 95% CI 1.08 to 2.46) or a CPO (OR=1.54, 95% CI 1.18 to 2.01) increased the risk of psychotropic drug use. Results were not significant regarding adolescents who had a CLP (OR=1.21, 95% CI 0.81 to 1.80). Conclusions Being born with a CL or a CPO increases the risk for psychotropic drug use in adolescence, but not for adolescents born with a CLP. Our findings suggest that, since the three OFC types are associated with different long-term risks of poor psychological health, the three groups should be studied separately concerning long-term psychosocial consequences.

The influence of voice quality on sentence processing and recall performance in school-age children with normal hearing

ABSTRACT Previous findings suggest that working memory capacity (WMC) is influenced by a dysphonic voice quality. The present study examines the influence of voice quality on sentence processing and word recall in a working memory task. Fifty-seven children (8:1–9:1 years old) with normal hearing participated. Working memory capacity (WMC) was assessed using a competing language processing task (CLPT) which consists of a sentence processing segment (judgements of semantic acceptability in sentences) and a final word recall segment. All children completed two versions of the CLPT; once listening to a typical voice and once listening to a vocally loading induced dysphonic voice. The two voices were recorded from the same female speaker. In addition, the children’s executive functioning was assessed using Elithorn’s mazes. The dysphonic voice quality significantly decreases scores on the sentence processing segment but not on the recall segment. Children with better executive functioning (i.e., response inhibition, organizing, processing, and planning) were less disturbed by the dysphonic voice in the recall segment. Children’s judgements of semantic acceptability in sentences in a working memory task are affected by a dysphonic voice quality, but not the recall segment (the measure of WMC). However, children with lower executive functioning may be more disturbed by the dysphonic voice. These findings suggest that listening to a dysphonic voice seems to require more cognitive resources than listening to a typical voice, but only when the task is sufficiently easy to allow for allocation of cognitive resources to process the degraded signal content. Abbreviations: CLPT: Competing language processing task; ISTS: International speech test signal; RMS: root-mean-square; SLP: speech and language pathologists; WMC: Working memory capacity

The effect of voice quality and competing speakers in a passage comprehension task: perceived effort in relation to cognitive functioning and performance in children with normal hearing

Abstract The study investigates the effect of voice quality and competing speakers on perceived effort in a passage comprehension task in relation to cognitive functioning. In addition, it explores if perceived effort was related to performance. A total of 49 children (aged 7:03 to 12:02 years) with normal hearing participated. The children performed an auditory passage comprehension task presented with six different listening conditions consisting of a typical voice or a dysphonic voice presented in quiet, with one competing speaker, and with four competing speakers. After completing the task, they rated their perceived effort on a five-grade scale. The children also performed tasks measuring working memory capacity (WMC) and executive functioning. The results show that voice quality had no direct effect on perceived effort but the children’s ratings of perceived effort were related to their executive functioning. A significant effect was seen for background listening condition indicating higher perceived effort for background listening conditions with competing speakers. The effects of background listening condition were mainly related to the children’s WMC but also their executive functioning. It can be concluded that the individual susceptibility to the effect of the dysphonic voice is related to the child’s executive functioning. The individual susceptibility to the presence of competing speakers is related to the child’s WMC and executive functioning.

Recovery From Heavy Vocal Loading in Women With Different Degrees of Functional Voice Problems

TYPE OF STUDY This is a longitudinal, case-control clinical trial. OBJECTIVES This study aims to track recovery time following a vocal loading task (VLT) imposing vocal fatigue and to explore if patients with functional dysphonia (FD) are worse affected by vocal loading, and if these patients take longer than others to recover. METHODS Fifty (n = 50) female participants in four vocal subgroups on a spectrum of everyday vocal loading and functional voice complaints, including n = 20 patients with FD, took part in a clinical VLT, inflicting vocal fatigue through loud speech in ambient noise. Short-term recovery was explored through self-assessment of unspecified voice problems every 15 minutes for 2 hours following loading. Long-term recovery was tracked through self-assessments of specific voice symptoms during 3 days following vocal loading. Effects of heavy vocal loading were evaluated through voice recordings, long-time-average spectrum, perceptual assessments, and assessments of digital imaging performed pre- and post vocal loading. RESULTS Patients with FD did not return to baseline for unspecified voice problems within 2 hours of vocal loading and were worse affected by vocal loading than other groups. Women with high everyday vocal loading with no voice complaints identified vocal loading more evidently than other groups. Long-term recovery took 7-20 hours for all groups. CONCLUSIONS Short-term recovery is slower for patients with FD and these patients are worse affected by a VLT than others.

The effect of voice quality and competing speakers in a passage comprehension task: performance in relation to cognitive functioning in children with normal hearing

Abstract Objective: This study explores the effect of voice quality and competing speaker/-s on children’s performance in a passage comprehension task. Furthermore, it explores the interaction between passage comprehension and cognitive functioning. Methods: Forty-nine children (27 girls and 22 boys) with normal hearing (aged 7–12 years) participated. Passage comprehension was tested in six different listening conditions; a typical voice (non-dysphonic voice) in quiet, a typical voice with one competing speaker, a typical voice with four competing speakers, a dysphonic voice in quiet, a dysphonic voice with one competing speaker, and a dysphonic voice with four competing speakers. The children’s working memory capacity and executive functioning were also assessed. Results: The findings indicate no direct effect of voice quality on the children’s performance, but a significant effect of background listening condition. Interaction effects were seen between voice quality, background listening condition, and executive functioning. Conclusions: The children’s susceptibility to the effect of the dysphonic voice and the background listening conditions are related to the individual’s executive functions. The findings have several implications for design of interventions in language learning environments such as classrooms.

Part Summary of the Project ‘Speakers' Comfort’: Teachers' Voice Use in Teaching Environments:

Classroom acoustics not always take the speakers comfort into consideration. The purpose of the presented papers was to investigate voice use, vocal behavior and prevalence of voice problems in Swedish teaching staff. Ratings of features in the work-environment on voice use were explored in n = 487 teachers. Based on their answers the respondents were split into two groups: teachers with self-assessed voice problems and voice-healthy teachers. Teachers with voice problems and were matched to a voice-healthy colleague from the same school and were investigated and compared for clinical findings and for vocal behavior. Acoustic properties of their teaching environments were measured. Teachers with voice-problems were more affected by any loading factor in the work-environment and were more aware of the room acoustics. Differences between the groups were found during field-measurements, while there were no differences in the findings from the clinical examinations of the larynx and voice. Voice problems seem to emerge in the interplay with and use of the classroom acoustics.

Is children’s listening effort in background noise influenced by the speaker’s voice quality?

Abstract The present study aims at exploring the influence of voice quality on listening effort in children performing a language comprehension test with sentences of increasing difficulty. Listening effort is explored in relation to gender ( = cisgender). The study has a between-groups design. Ninety-three mainstreamed children aged 8;2 to 9;3 with typical language development participated. The children were randomly assigned to two groups (n = 46/47) with equal allocation of boys and girls and for the analysis to four groups depending of gender and voice condition. Working memory capacity and executive functions were tested in quiet. A digital version of a language comprehension test (the TROG-2) was used to measure the effect of voice quality on listening effort, measured as response time in a forced-choice paradigm. The groups listened to sentences through recordings of the same female voice, one group with a typical voice and one with a dysphonic voice, both in competing multi-talker babble noise. Response times were logged after a time buffer between the sentence-ending and indication of response. There was a significant increase in response times with increased task difficulty and response times between the two voice conditions differed significantly. The girls in the dysphonic condition were slower with increasing task difficulty. A dysphonic voice clearly adds to the noise burden and listening effort is greater in girls than in boys when the teacher speaks with dysphonic voice in a noisy background. These findings might mirror gender differences as for coping strategies in challenging contexts and have important implications for education.

The influence of voice quality and multi-talker babble noise on sentence processing and recall performance in school children using cochlear implant and/or hearing aids

Abstract Purpose: This study examines the influence of voice quality and multi-talker babble noise on processing and storage performance in a working memory task performed by children using cochlear implants (CI) and/or hearing aids (HA). Methods: Twenty-three children with a hearing impairment using CI and/or HA participated. Age range was between 6 and 13 years. The Competing Language Processing Task (CLPT) was assessed in three listening conditions; a typical voice presented in quiet, a dysphonic voice in quiet, and a typical voice in multi-talker babble noise (signal-to-noise ratio +10 dB). Being a dual task, the CLPT consists of a sentence processing component and a recall component. The recall component constitutes the measure of working memory capacity (WMC). Higher-level executive function was assessed using Elithorns mazes. Results: The results showed that the dysphonic voice did not affect performance in the processing component or performance in the recall component. Multi-talker babble noise decreased performance in the recall component but not in the processing component. Higher-level executive function was not significantly related to performance in any component. Conclusions: The findings indicate that multi-talker babble noise, but not a dysphonic voice quality, seems to put strain on WMC in children using CI and/or HA.