The purpose of this study is to observe childrens adaptation to an electropalatographic (EPG) sensor. Sound recordings of six children between the ages of 7;0 and 9;11 sampled at 30-minute intervals over a two-hour period of wearing an EPG sensor were perceptually evaluated to quantify the children's adaptation over time. Twenty native speakers of American English evaluated the pronunciation of a series of words with embedded stops and fricatives produced with and without an EPG sensor in place. When collapsed over speaker and stimulus type, listener ratings decreased significantly after inserting the EPG sensor. Ratings then increased significantly after the sensor was in place for 30 minutes, and again after 60 minutes. No significant improvement in pronunciation was noted between the 60- and 120-minute test intervals, and adaptation did not reach preplacement levels until the sensor was removed. Mixed results were found in how speakers adapted across the different stimulus types. Adaptation was most consistent across speakers for the conversation conditions, but occurred most rapidly for /s/ and /k/. Speakers showed the best overall adaptation for the phoneme /t/ by the end of testing. These results are similar to several adaptation studies with adults, and the two studies with children. Results from this study will help speech pathologists effectively use EPG technology to help children accurately pronounce speech sounds, and to generalize these pronunciations to their normal speech.

The purpose of this study is to observe childrens adaptation to an electropalatographic (EPG) sensor. Sound recordings of six children between the ages of 7;0 and 9;11 sampled at 30-minute intervals over a two-hour period of wearing an EPG sensor were perceptually evaluated to quantify the children's adaptation over time. Twenty native speakers of American English evaluated the pronunciation of a series of words with embedded stops and fricatives produced with and without an EPG sensor in place. When collapsed over speaker and stimulus type, listener ratings decreased significantly after inserting the EPG sensor. Ratings then increased significantly after the sensor was in place for 30 minutes, and again after 60 minutes. No significant improvement in pronunciation was noted between the 60- and 120-minute test intervals, and adaptation did not reach preplacement levels until the sensor was removed. Mixed results were found in how speakers adapted across the different stimulus types. Adaptation was most consistent across speakers for the conversation conditions, but occurred most rapidly for /s/ and /k/. Speakers showed the best overall adaptation for the phoneme /t/ by the end of testing. These results are similar to several adaptation studies with adults, and the two studies with children. Results from this study will help speech pathologists effectively use EPG technology to help children accurately pronounce speech sounds, and to generalize these pronunciations to their normal speech.

No description available.

The purpose of this study was to conduct perceptual analyses, using the initial two-second portions, of prolonged vowels /a/, /i/, and /o/. Two groups of adolescents and young adults were analyzed- one group consisting of 20 individuals with Friedreich's ataxia who were compared to 20 individuals with normal voice (control participants). A trained group of 10 graduate students listened to 132 vowel samples (3 vowels X 40 participants, + 12 samples (10%) for reliability purposes) for a total of 132 perceptual judgments. The students listened to the samples which were randomized onto Dell computers (Optiplex 755) and played through headphones that were set at a comfortable level by the listeners prior to analyzing the voice samples. Listeners used a modified version of the Consensus-Auditory Perceptual Evaluation of Voice (CAPE-VM) to rate the vocal qualities of 'roughness', 'breathiness', and 'strain' in the samples on a 100 millimeter visual analog scale with 0 representing a perception of no roughness, breathiness, or strain, and 100 indicating the most extreme amount of variance from normal voice quality. Statistical analyses were conducted to determine if perceptual measures were significantly different between the two groups. Values on these analyses were expected to be larger for individuals with Friedreich's ataxia than those with normal voice. Results revealed that all three measures were significantly different between the two groups, with those in the Friedreich's ataxia group reported as having increased rough, breathy, and strained components in their voice quality as compared to normal voiced peers. Findings support perceptual measures as useful indicators for reporting changes in the phonatory system due to Friedreich's ataxia.

<p>In Sweden over 10.000 patients annually, mostly children, undergo tonsillar surgery. The most common surgical method is total removal of the tonsil, tonsillectomy (TE). During the last decade partial tonsil resection, tonsillotomy (TT), has been reintroduced and is associated with lower primary morbidity and less postoperative pain. The aim of the present study was to evaluate if and to what extent 4-5 year old children’s voice function are affected by tonsillar hypertrophy compared to controls and to study the effects of the two surgical techniques on vocal function. Sixty-seven children with tonsillar hypertrophy, where randomized either to TE or TT. A voice material consisting of words with only sonorants and three sustained vowels was recorded preoperatively and six months postoperatively. Eighty-two preschool children formed two control groups. The material was evaluated perceptually by three voice specialized speech and language pathologist and analyzed acoustically. Before surgery the children with tonsillar hypertrophy are rated to have higher prevalence of hoarseness, hyponasality and ‘compressed/throaty voice’ compared with the controls. The acoustic analysis show that the children with tonsillar hypertrophy have higher prevalence of perturbation (jitter (%), shimmer (%) and NHR) compared to the controls. Postoperatively there are no significant difference between the children with tonsillar hypertrophy and the control group perceptually. The acoustic analysis of the children with tonsillar hypertrophy still show more perturbation compared to the control group. The children operated with TE are rated to have less prevalence of roughness and hyponasality after surgery. The children in the TT-group have less prevalence of roughness, hyponasality and ‘compressed/throaty voice’. The acoustic analysis show no significant difference between the two postoperative groups.</p> / <p>Över 10 000 patienter tonsillopereras årligen i Sverige, de flesta av dem barn. Den vanligaste kirurgiska metoden har sedan länge varit totalt avlägsnande av tonsillerna, tonsillektomi (TE). Under det senaste decenniet har partiellt borttagande av tonsillvävnad, tonsillotomi (TT) erövrat terräng då operationen är förknippad med lägre postoperativ morbiditet och lägre smärta. Syftet med föreliggande studie var att undersöka om och hur röstfunktionen är påverkad av tonsillhypertrofi hos barn i 4-5 års ålder i jämförelse med köns- och åldersmatchade kontroller samt att studera effekterna på röstfunktionen efter två olika typer av kirurgisk behandling, TE respektive TT. I föreliggande studie deltog 67 barn med tonsillhypertrofi som randomiserades till antingen TE eller TT. Ett röstmaterial bestående av ord som till största del bestod av sonoranter samt tre uthållna vokaler spelades in omedelbart före operation samt 6 månader postoperativt. Åttiotvå köns- och åldersmatchade förskolebarn utgjorde två kontrollgrupper. Materialet bedömdes perceptuellt av tre röstlogopeder samt analyserades akustiskt. Barnen med tonsillhypertrofi uppfattas före operation ha högre förekomst av de perceptuella parametrarna heshet, hyponasalitet, och klämd/halsig i jämförelse med köns- och åldersmatchade kontroller. Den akustiska analysen i sin tur visar på mer perturbation (jitter (%), shimmer (%) och NHR) hos barnen med tonsillhypertrofi. Efter kirurgisk behandling visar den perceptuella röstbedömningen att det inte föreligger någon signifikant skillnad mellan de barn som genomgått kirurgisk behandling och kontrollerna. Den akustiska analysen visar på att både barnen som genomgått TE och barnen som genomgått TT har mer perturbation i jämförelse med köns- och åldersmatchade kontroller. Vid jämförelse pre- och postoperativt visar röstbedömningen på en minskning av skrovlighet och hyponasalitet för barnen som genomgått TE samt skrovlighet, hyponasalitet och klämd/halsig för barnen som genomgått TT. Den akustiska analysen visar på att det inte föreligger någon större skillnad mellan barnen som genomgått TE och barnen som genomgått TT.</p>

No description available.

O objetivo é caracterizar a voz e vibração glótica de pregas vocais com paralisia unilateral. Método: trata-se de um estudo retrospectivo que utilizou o banco de dados do grupo de pesquisa em engenharia médica da Universidade Federal de São Carlos. Foram utilizados dados de 35 pacientes adultos (11 homens e 24 mulheres) e cinco instrumentos de análise multidimensional. O primeiro deles foi o protocolo de auto-avaliação (Índice de Desvantagem Vocal - IDV). Foram extraídos os escores de domínio: físico, orgânico, emocional e total. Foram utilizados sinais de voz para realizar as análises: perceptivo-auditiva (escala analógica visual - EVA e parâmetros: grau global - G, rugosidade - R, soprosidade - S, tensão - T e Instabilidade na emissão vocal - I); acústica tradicional (parâmetros de perturbação - Jitter e Shimmer), experimental (parâmetro Coaptação Glótica - CG) e a análise não linear (NL) da dinâmica vocal (parâmetros qualitativos: número de loops, graus de convergência e regularidade; e quantitativos: desvio padrão do eixo e da dispersão - DPE, DPD). A quinta análise utilizou quimografias geradas de videolaringoscopias em alta velocidade para extração de parâmetros quantitativos (Razão de Abertura - RA, de Fechamento - RF e Assimetria). Análise estatística: descritiva e correlação de Spearman. Resultados: A análise perceptiva caracterizou intensidade moderada do desvio vocal. A rugosidade foi o tipo de voz predominante em amostras masculinas (55,84%) e a soprosidade em amostras femininas (63,59%). Os domínios de IDV apresentaram baixo impacto da disfonia na qualidade de vida dos pacientes. Houve correlação do domínio físico com S em amostras masculinas e com todos os parâmetros perceptivos em amostras femininas. Ambas as amostras apresentaram parâmetros de perturbação aumentados (Jitter: 0,90% homens e 1,20% mulheres; Shimmer: 3,30% homens e 2,76% mulheres), e de CG diminuídos (0,28 homens e 0,25 mulheres). Amostras femininas apresentaram correlação de Jitter e Shimmer com os parâmetros perceptivos. Amostras masculinas apresentaram correlação de Jitter com R e de Shimmer com R e T. A CG correlacionou com a S e l em amostras masculinas. Na análise NL da dinâmica vocal de ambas as amostras apresentaram reduzidos: número de loops, grau de convergência e de regularidade, enquanto que os valores de DPE e DPD apresentaram-se aumentados. Houve correlação de parâmetros perceptuais com os da análise NL em ambas as amostras. Os resultados de parâmetros quimográficos são: RA 1,55 para homens e 1,50 para mulheres; RF 0,37 para homens e 0,18 para mulheres; e Assimetria: 23,68º para homens e 9, 85º para mulheres. Todos os parâmetros perceptuais femininos correlacionaram com os quimográficos, exceto a I. A I de amostras masculinas correlacionou com RF. Conclusão: a caracterização vocal de pacientes com paralisia unilateral de pregas vocais foi possível usando a avaliação multidimensional da voz. / The goal is to characterize the voice and glottal vibration of patients with unilateral vocal fold paralysis. Method: this is a retrospective study that used database samples of Universidade de São Carlos\'s research group in medical engineering. Data from 35 adults patients (11 men and 24 women) and five were used. They were used five tools for multidimensional analysis. The first one was the self-assessment protocol (Voice Handicap Index - VHI). Physical, organic, emotional and total scores were extracted. Voice signals were used in analyzes: perceptual (visual analogue scale - VAS and parameters: overall degrees - G, roughness - R, Breathiness - B, tension - T and instability in phonation - I); traditional acoustic (perturbation parameters - Jitter and Shimmer), experimental (glottal cloure parameter - GC) and nonlinear (NL) dynamic vocal analysis (Qualitative: number of loops, regularity and convergence degree. Quantitative: standard deviation of dispersion - SDD and standard deviation of the axis - SDA). The fifth analysis it was performed through extraction of kymographic parameters generated of the High speed videolaryngoscopys (Opening reason - Or; Closed reason - Cr and Asymmetry). Statistical analysis: descriptive and Spearman correlation. Results: perceptual analysis characterized moderate intensity of vocal deviation. Roughness was the predominant kind of voice in males samples (55,84%) and Breathiness in females samples (63,59%). VHI\'s scores showed low impact of dysphonia in the patients\' quality of life. There was correlation between score physical and B in the male samples and between score physical and all perceptual parameters in the female samples. Both samples showed increased of perturbation parameters (Jitter: 0.90% men and 1.20% women and Shimmer: 3.30% men and 2.76% women) and GC decreased (0.28 men and women 0.25). Female samples showed correlation of Jitter and Shimmer with all perceptual parameters. Male samples showed correlation of Jitter with the R and Shimmer with R and T. GC correlation with B and I only male samples. Qualitative NL dynamic vocal analysis showed number of loops, regularity and convergence degree reduced, whereas quantitative analysis of SDD and SDA increased. There were correlations between perceptual parameters and of nonlinear dynamic vocal analysis for both the samples. Results of Kymographic parameters are Or: 1.55 for men and 1.50 for women; Cr: 0.37 for men and 0.18 for women; and Asymmetry: 23.68º for men and 9.85º for women. All perceptual parameters correlate with Or and Cr at female samples, except I. Male samples showed correlation between I and Cr. Conclusion: the vocal characterization of patients with unilateral vocal fold paralysis was possible using the multidimensional voice assessment.

<p>In Sweden surgical treatment of vocal fold lesions in children is fairly uncommon. At Falun hospital they have adapted a more generous attitude towards phonosurgery of children’s vocal folds. The purpose of the present study was to evaluate surgical treatment of organic vocal fold lesions in children and to assess the phonosurgical patient utility. The study was carried out at the Ear-, Nose- and Throat clinic, Falun hospital, Sweden. Based on case sheets, data was collected regarding the different vocal fold lesions that were surgically treated. The most frequent vocal fold abnormalities were vocal fold nodules, vocal fold cysts and sulcus/vergeture. Further on, assessment of pre- and postoperative voice recordings and stroboscopic examinations were carried out. The general tendency was that vocal fold closure and mucosal wave was estimated as normal or less abnormal following surgery in most patients. Postoperatively, hoarseness, breathiness and roughness were estimated to be significantly lower. For hyperfunction, only a tendency to lower occurrence was observed. The estimation of high pitch was similar pre- and postoperatively. A mail questionnaire showed that most patients/parents estimated a high degree of perceived voice related problems preoperatively. Most patients rated their own vocal function at the time of the study as highly functional. The majority were satisfied with the choice of undergoing surgical treatment. The conclusion was that surgical treatment may be a good option in organic vocal fold lesions in children.</p> / <p>I Sverige är kirurgisk behandling vid stämbandsförändringar hos barn relativt ovanligt. Vid Falu lasarett har man en generösare inställning till fonokirurgi av barns stämband. Syftet med föreliggande studie var att utvärdera kirurgisk behandling vid organiska stämbandsförändringar hos barn för att bedöma vilket värde fonokirurgi har för patienten. Studien genomfördes vid Öron-, Näs- och Halskliniken, Falu lasarett. Journaluppgifter inhämtades angående vilka olika stämbandsförändringar som åtgärdats kirurgiskt. De vanligast förekommande stämbandsförändringarna var knottror, cystor samt sulcus/vergeture. Vidare genomfördes bedömning av pre- och postoperativa röstinspelningar och stroboskopiska undersökningar. Den generella tendensen var att stämbandsslutning och slemhinnevåg i större utsträckning skattades normal eller mindre avvikande efter operation i jämförelse med före operation. Förekomst av röstparametrarna heshet, läckage och skrovlighet bedömdes vara signifikant lägre efter kirurgi. För press kunde endast tendens till lägre förekomst observeras medan det generellt höga röstläget skattades lika före och efter operation. Genom en enkät framkom att flertalet patienter/patienters målsmän skattade förhållandevis höga värden av upplevda röstbesvär före operation. Flertalet skattade höga värden angående hur väl rösten fungerade vid studiens genomförande. Majoriteten var nöjd med valet att genomgå operation. Slutsatsen var att kirurgisk behandling kan vara ett bra behandlingsalternativ vid organiska stämbandsförändringar hos barn.</p>

In Sweden surgical treatment of vocal fold lesions in children is fairly uncommon. At Falun hospital they have adapted a more generous attitude towards phonosurgery of children’s vocal folds. The purpose of the present study was to evaluate surgical treatment of organic vocal fold lesions in children and to assess the phonosurgical patient utility. The study was carried out at the Ear-, Nose- and Throat clinic, Falun hospital, Sweden. Based on case sheets, data was collected regarding the different vocal fold lesions that were surgically treated. The most frequent vocal fold abnormalities were vocal fold nodules, vocal fold cysts and sulcus/vergeture. Further on, assessment of pre- and postoperative voice recordings and stroboscopic examinations were carried out. The general tendency was that vocal fold closure and mucosal wave was estimated as normal or less abnormal following surgery in most patients. Postoperatively, hoarseness, breathiness and roughness were estimated to be significantly lower. For hyperfunction, only a tendency to lower occurrence was observed. The estimation of high pitch was similar pre- and postoperatively. A mail questionnaire showed that most patients/parents estimated a high degree of perceived voice related problems preoperatively. Most patients rated their own vocal function at the time of the study as highly functional. The majority were satisfied with the choice of undergoing surgical treatment. The conclusion was that surgical treatment may be a good option in organic vocal fold lesions in children. / I Sverige är kirurgisk behandling vid stämbandsförändringar hos barn relativt ovanligt. Vid Falu lasarett har man en generösare inställning till fonokirurgi av barns stämband. Syftet med föreliggande studie var att utvärdera kirurgisk behandling vid organiska stämbandsförändringar hos barn för att bedöma vilket värde fonokirurgi har för patienten. Studien genomfördes vid Öron-, Näs- och Halskliniken, Falu lasarett. Journaluppgifter inhämtades angående vilka olika stämbandsförändringar som åtgärdats kirurgiskt. De vanligast förekommande stämbandsförändringarna var knottror, cystor samt sulcus/vergeture. Vidare genomfördes bedömning av pre- och postoperativa röstinspelningar och stroboskopiska undersökningar. Den generella tendensen var att stämbandsslutning och slemhinnevåg i större utsträckning skattades normal eller mindre avvikande efter operation i jämförelse med före operation. Förekomst av röstparametrarna heshet, läckage och skrovlighet bedömdes vara signifikant lägre efter kirurgi. För press kunde endast tendens till lägre förekomst observeras medan det generellt höga röstläget skattades lika före och efter operation. Genom en enkät framkom att flertalet patienter/patienters målsmän skattade förhållandevis höga värden av upplevda röstbesvär före operation. Flertalet skattade höga värden angående hur väl rösten fungerade vid studiens genomförande. Majoriteten var nöjd med valet att genomgå operation. Slutsatsen var att kirurgisk behandling kan vara ett bra behandlingsalternativ vid organiska stämbandsförändringar hos barn.

This thesis consists of five articles and a summary. Thethesis deals with methods for measuring properties of thevoice. The methods are all computer-based, but utilisedifferent approaches for measuring different aspects of thevoice. Paper I introduces the Visual Sort and Rate (VSR) method forperceptual rating of voice quality. The method is based on theVisual Analogue Scale (VAS), but simultaneously shows allstimuli as icons along the VAS on the computer screen. As thelistener places similar-sounding stimuli close to each otherduring the rating process, comparing stimuli becomeseasier. Paper II introduces the correlogram. Fundamental frequencyF0 sometimes cannot be strictly defined, particularly forperturbed voice signals. The method displays multipleconsecutive correlation functions in a grey scale image. Thus,the correlogram avoids selecting a single F0 value. Rather itpresents an unbiased image of periodicity, allowing theinvestigator to select among several candidates, ifappropriate. PaperIII introduces a method for detection of phonation tobe utilised in voice accumulators. The method uses twomicrophones attached near the subject’s ears. Phase andamplitude relations of the microphone signals are used to forma phonation detector. The output of the method can be used tomeasure phonation time, speaking time and fundamental frequencyof the subject, as well as sound pressure level of both thesubject’s voicing and the ambient sounds. Paper IV introduces a method for Fourier analysis ofhigh-speed laryngoscopic imaging. The data from the consecutiveimages are re-arranged to form time-series that reflect thetime-variation of light intensity in each pixel. Each of thesetime series is then analysed by means of Fouriertransformation, such that a spectrum for each pixel isobtained. Several ways of displaying these spectra aredemonstrated. Paper V examines a test set-up for simultaneous recording ofairflow, intra-oral pressure, electro-glottography, audio andhigh-speed imaging. Data are analysed with particular focus onsynchronisation between glottal area and inverse filteredairflow. Several methodological aspects are also examined, suchas the difficulties in synchronising high-speed imaging datawith the other signals. / QC 20100609