The ChatterVox™ Portable Voice Amplifier: A Means to Vibration Dose Reduction?

By speaking loudly for extended periods, teachers are vulnerable to laryngeal and voice changes associated with vocal fold “vibration overdose.” Voice clinicians frequently recommend voice amplification ostensibly designed to reduce vibration dose and improve voice. However, there are few data regarding the degree of vocal loudness attenuation achieved by specific amplification devices. The purpose of this investigation was to examine the effectiveness of the ChatterVox™ Portable Voice Amplification System (Siemens Hearing Instruments) for reducing the sound pressure level (SPL) of a speaker's voice during a simulated classroom lecture. Ten participants were instructed to continuously read one of two phonetically balanced passages while amplified and unamplified. Voice intensity measurements were obtained at three inches from the mouth (i.e., mouth level) and at the back of a classroom in both amplified and unamplified conditions. When amplified with the ChatterVox™, speakers experienced an average decrease in vocal intensity at mouth-level of 6.03 dB SPL (p < 0.002). Furthermore, an average increase of 2.55 dB SPL (p < 0.038) at the back of the classroom was observed. Collectively, these results indicate that the ChatterVox™ amplification device reduced the speaker's vocal intensity level at the microphone, while it augmented the voice heard at the back of the classroom. By inference, this degree of vocal attenuation at mouth level should contribute to a desirable reduction in vibration dose, thus lowering the risk of vibration overdose.     

The effect of voice amplification on occupational vocal dose in elementary school teachers

Two elementary school teachers, one with and one without a history of vocal complaints, wore a vocal dosimeter all day at school for a 3-week period. In the second week, each teacher wore a portable voice amplifier. Each teacher showed a reduction in vocal intensity during the week of amplification, with a larger effect for the teacher with vocal difficulties. This teacher also showed a decrease in hourly vocal fold distance dose as measured by the dosimeter despite incurring longer phonation times. Fundamental frequency and vocal fold cycle dose did not appear to be affected by the use of amplification during the teaching day. Both teachers showed evidence of a possible moderate effect of adjusting vocal intensity in the week after amplification, possibly as a means to recalibrate their perceived vocal loudness. This study demonstrates the usefulness of both vocal dosimetry and amplification in monitoring and modifying vocal dose in an occupational setting and reinforces previous data suggesting the effectiveness of amplification in reducing the vocal load in schoolteachers. Implications of the data for future research regarding prevention and treatment of occupational voice disorders are discussed.     

Acoustic Measures and Self-reports of Vocal Fatigue by Female Teachers

This study investigated the relation of symptoms of vocal fatigue to acoustic variables reflecting type of voice production and the effects of vocal loading. Seventy-nine female primary school teachers volunteered as subjects. Before and after a working day, (1) a 1-minute text reading sample was recorded at habitual loudness and loudly (as in large classroom), (2) a prolonged phonation on [a:] was recorded at habitual speaking pitch and loudness, and (3) a questionnaire about voice quality, ease, or difficulty of phonation and tiredness of throat was completed. The samples were analyzed for average fundamental frequency (F0), sound pressure level (SPL), and phonation type reflecting alpha ratio (SPL [1-5 kHz]-SPL [50 Hz-1 kHz]). The vowel samples were additionally analyzed for perturbation (jitter and shimmer). After a working day, F0, SPL, and alpha ratio were higher, jitter and shimmer values were lower, and more tiredness of throat was reported. The average levels of the acoustic parameters did not correlate with the symptoms. Increase in jitter and mean F0 in loud reading correlated with tiredness of throat. The results seem to suggest that, at least among experienced vocal professionals, voice production type had little relevance from the point of view of vocal fatigue reported. Differences in the acoustic parameters after a vocally loading working day mainly seem to reflect increased muscle activity as a consequence of vocal loading.     

Cepstral and Perceptual Investigations in Female Teachers With Functionally Healthy Voice

PurposeThe present study aimed at measuring the smoothed and non-smoothed cepstral peak prominence (CPPS and CPP) in teachers who considered themselves to have normal voice but some of them had laryngeal pathology. The changes of CPP, CPPS, sound pressure level (SPL) and perceptual ratings with different voice tasks were investigated and the influence of vocal pathology on these measures was studied.MethodEighty-four Finnish female primary school teachers volunteered as participants. Laryngoscopically, 52.4% of these had laryngeal changes (39.3% mild, 13.1% disordered). Sound recordings were made for phonations of comfortable sustained vowel, comfortable speech, and speech produced at increased loudness level as used during teaching. CPP, CPPS and SPL values were extracted using Praat software for all three voice samples. Sound samples were also perceptually evaluated by five voice experts for overall voice quality (10 point scale from poor to excellent) and vocal firmness (10 point scale from breathy to pressed, with normal in the middle).ResultsThe CPP, CPPS and SPL values were significantly higher for vowels than for comfortable speech and for loud speech compared to comfortable speech (P < 0.001). Significant correlations were found between SPL and cepstral measures. The loud speech was perceived to be firmer and have a better voice quality than comfortable speech. No significant relationships of the laryngeal pathology status with cepstral values, perceptual ratings, or voice SPLs were found (P > 0.05).ConclusionNeither the acoustic measures (CPP, CPPS, and SPL) nor the perceptual evaluations could clearly distinguish teachers with laryngeal changes from laryngeally healthy teachers. Considering no vocal complaints of the subjects, the data could be considered representative of teachers with functionally healthy voice.     

Relationship between subjective voice complaints and acoustic parameters in female teachers'' voices

The aim of the study was to identify the acoustic correlates of female teachers' subjective voice complaints by recording their voices in their working environment. The subjects made recordings during lessons (N = 10) and breaks (N = 11). The subjects were divided into 2 groups: those with few voice complaints (FC group) and those with many voice complaints (MC group). The speech sample made in the breaks was maximally sustained /a/, from which fundamental frequency (F0), jitter, and shimmer were analyzed. The classroom samples were analyzed for F0, sound pressure level (SPL), and F0 time (the active vibration time of the vocal folds). Additionally, an index for assessing voice loading is presented. The results revealed a tendency of the MC group to have higher F0 and lower SPL and perturbation values than the FC group. The index values correlated moderately with the subjective vocal complaints.     

Sound radiation from Caribbean steelpans using nearfield acoustical holography

The sound-field of a Caribbean low tenor steelpan is examined using nearfield acoustical holography (NAH). The particular instrument, a Bertrand Kelman low tenor, has been previously examined in a single plane using a four microphone sound intensity technique. This paper will examine the sound radiation in a cuboid space enclosing the instrument at three frequencies. Presented will be the results of sound pressure level (SPL), active acoustic intensity (AI), and reactive acoustic intensity (RI) obtained through application of the NAH technique. The limitations of NAH when applied to an irregularly shaped object such as a tenor steelpan will also be presented.     

Changes in vocal intensity in Parkinson''s disease following pallidotomy surgery

The present study was designed to examine changes in vocal intensity following unilateral posteroventral pallidotomy (PVP) in a large sample of speakers with Parkinson's disease (PD) that exhibited a range of hypokinetic dysarthria. Twenty-five persons with PD were recorded using a variety of speech tasks, once prior to and once following PVP. The pre-PVP vocal SPL was subtracted from the post-PVP vocal SPL to derive a relative change in vocal SPL. Mildly dysarthric participants had significantly greater relative increases in vocal SPL following PVP than either moderately or severely dysarthric participants who had reduced vocal SPL following PVP. If future results follow those observed in the present data, mildly dysarthric Parkinson's patients may benefit most from unilateral PVP perhaps due to less overall destruction of the basal ganglia sensorimotor control circuits involved in oral facial functions, thus increasing the chances to observe improvements postsurgery.     

Laryngeal airway resistance in teacherswith vocal fatigue: A preliminary study

A noninvasive pressure-flow technique was used to compare laryngealairway resistances in nine female classroom teachers with symptoms of vocal fatigue and seven teachers without symptoms of vocal fatigue. Data were collected two times per day on the Monday, Wednesday, and Friday of a typical work-week. No significant between-group differences were found, but two within-group differences were notable. Airflow in the fatigued subjects decreased across the sampling period (p = .0009). In the controls, air pressure increased across the sampling period (p = .021). These findings suggest that both groups may have reacted to vocal demands during the week by employing two different strategies to maintain habitual laryngeal airway resistance: laryngeal adjustments alone or laryngeal adjustments plus increased respiratory drive. The first strategy, employed by the fatigued subjects, may have been less efficient, thereby provoking conditions associated with their vocal fatigue.     

A Novel Treatment for Hypophonic Voice: Twang Therapy

A hypophonic voice, characterized perceptually as weak and breathy, is associated with voice disorders such as vocal fold atrophy and unilateral vocal fold paralysis. Although voice therapy programs for hypophonia typically address the vocal folds or the sound source, twang voice quality was examined in this study as an alternative technique for increasing vocal power by altering the epilarynx or the sound filter. OBJECTIVE: This study investigated the effect of twang production on physiologic, acoustic, and perceived voice handicap measures in speakers with hypophonia. DESIGN/METHODS: This prospective pilot study compared the vocal outcomes of six participants with hypophonia at pre- and posttreatment time points. Outcome measures included mean airflow rate, intensity in dB sound pressure level (SPL), maximum phonation time, and self-report of voice handicap. RESULTS: All subjects improved in at least three of the four vocal outcome measures. Wilcoxon signed-rank test of paired differences revealed significant differences between pre- and posttherapy group means for airflow rate, SPL, and Voice Handicap Index scores. CONCLUSION: The twang voice quality as a manipulation of the sound filter offers a clinical complement to traditional voice therapies that primarily address the sound source.     

Vowel amplitude variation associated with the heart cycle

Modulation of the acoustic amplitude of a sustained vowel across the cardiac (ECG) cycle was examined by signal-averaging techniques. Ten normal men prolonged [a] at a comfortable Fo maintained within three SPL ranges: 60-68, 70-78, and 80-88 dB. Peak-to-peak amplitude variation associated with the heart cycle averaged 8.5% (s.d. = 5.4) re: mean, varying from about 14% at low SPLs to approximately 3% at high SPLs. The amplitude modulation was estimated to account for 11.8% of the measured short-term amplitude perturbation (shimmer), ranging from about 5% to almost 22% for individual samples. The mean deterministic shimmer (Sd) was 0.036 dB (s.d. = 0.019), with a trend toward decreasing Sd with increasing SPL. Additionally, fundamental frequency variation across the heart cycle within these phonations was comparable to that observed by Orlikoff and Baken [J. Acoust. Soc. Am. 85, 888-893 (1989)], and was shown to be uninfluenced by vocal SPL, although deterministic jitter (Jd) did decrease with vocal intensity. The results are discussed in terms of how the phonovascular relationship may affect the reliability and interpretation of acoustic shimmer measures.     

Adjustment on subjective annoyance of low frequency noise by adding additional sound

Structure-borne noise originating from a heat pump unit was selected to study the influence on subjective annoyance of low frequency noise (LFN) combined with additional sound. Paired comparison test was used for evaluating the subjective annoyance of LFN combined with different sound pressure levels (SPL) of pink noise, frequency-modulated pure tones (FM pure tones) and natural sounds. The results showed that, with pink noise of 250-1000 Hz combined with the original LFN, the subjective annoyance value (SAV) first dropped then rose with increasing SPL. When SPL of the pink noise was 15-25 dB, SAV was lower than that of the original LFN. With pink noise of frequency 250-20,000 Hz added to LFN, SAV increased linearly with increasing SPL. SAV and the psychoacoustic annoyance value (PAV) obtained by semi-theoretical formulas were well correlated. The determination coefficient (R²) was 0.966 and 0.881, respectively, when the frequency range of the pink noise was 250-1000 and 250-20,000 Hz. When FM pure tones with central frequencies of 500, 2000 and 8000 Hz, or natural sounds (including the sound of singing birds, flowing water, wind or ticking clock) were, respectively, added to the original sound, the SAV increased as the SPL of the added sound increased. However, when a FM pure tone of 15 dB with a central frequency of 2000 Hz and a modulation frequency of 10 Hz was added, the SAV was lower than that of the original LFN. With SPL and central frequency held invariable, the SAV declined primarily when modulation frequency increased. With SPL and modulation frequency held invariable, the SAV became lowest when the central frequency was 2000 Hz. This showed a preferable correlation between SAV and fluctuation extent of FM pure tones.     

An Exploration of Skin Acceleration Level as a Measure of Phonatory Function in Singing

Two kinds of fluctuations are observed in phonetogram recordings of singing. Sound pressure level (SPL) can vary due to vibrato and also due to the effect of open and closed vowels. Since vowel variation is mostly a consequence of vocal tract modification and is not directly related to phonatory function, it could be helpful to suppress such variation when studying phonation. Skin acceleration level (SAL), measured at the jugular notch and on the sternum, might be less influenced by effects of the vocal tract. It is explored in this study as an alternative measure to SPL. Five female singers sang vowel series on selected pitches and in different tasks. Recorded data were used to investigate two null hypotheses: (1) SPL and SAL are equally influenced by vowel variation and (2) SPL and SAL are equally correlated to subglottal pressure (P(S)). Interestingly, the vowel variation effect was small in both SPL and SAL. Furthermore, in comparison to SPL, SAL correlated weakly to P(S). SAL exhibited practically no dependence on fundamental frequency, rather, its major determinant was the musical dynamic. This results in a non-sloping, square-like phonetogram contour. These outcomes show that SAL potentially can facilitate phonetographic analysis of the singing voice.     

Comfortable effort level revisited

The purpose of this study was to measure the variability of frequency and intensity of speech, using multiple voice samples obtained over a period of time at a speaker's “comfortable effort level.” Variability in vocal output within and across several experimental sessions was assessed from measures of speaking fundamental frequency (SFF) and vocal intensity for utterances repeated three times a day over a 3-day period. Three distinct age groups of men and women—young, middle-aged and elderly—repeated the vowel /a/, read a standard passage, and spoke extemporaneously during each experimental session. Results indicated that variability in SFF and intensity were present across experimental sessions, age groups, gender, and speaking samples. Generally, group means indicated that ±1 semitone of variability for SFF and 2 db sound pressure level (SPL) variation in vocal intensity from any one experimental session to the next could be expected; individual variations within any group may reach two semitones and 6 db SPL.     

Voice Changes During Work: Subjective Complaints and Objective Measurements for Female Primary and Secondary Schoolteachers

The purpose of this investigation was to study voice changes during a working day. The subjects consisted of 33 female primary and secondary schoolteachers who recorded their first and last lessons during one school day. The subjects were studied both as one group and two subgroups (those with many and those with few voice complaints). Estimates of fundamental frequency (F0), sound pressure level (SPL), the standard deviations of these values (F0 SD; SPL SD) and F0 time (vibration time of vocal folds) were made. The most obvious change due to loading was the rise of F0 that was 9.7 Hz between the first and last lesson (P = 0.00). F0 increased more (12.8. Hz, P = 0.006) in the subgroup with few complaints.     

Siamang gibbons exceed the saccular threshold: intensity of the song of Hylobates syndactylus

Measurements are reported of the intensity of the siamang gibbon loud call obtained from the vocal bouts of three family groups at Twycross Zoo, UK. Across 25 samples the maximum intensity ranged from 95 to 113 dB SPL (linear frequency-weighting and fast time-weighting) and exhibited three frequency modes of 250-315 Hz, 630-800 Hz and 1.2-1.6 kHz. The lowest frequency mode, which may correspond to the "boom" sound produced by resonance of the siamang inflated vocal sac, had a mean maximum intensity of 99 dB SPL. These values, which are in excess of the saccular acoustic threshold of about 90 dB at 300 Hz for air conducted sound, suggest that primate loud calls recruit a primitive mode of acoustic sensitivity furnished by the sacculus. Thus reproductive vocal behavior of primates may be influenced by a primitive acoustical reward pathway inherited from a common ancestor with anamniotes. In humans such a pathway could explain the compulsion for exposure to loud music.     

What is “Twang”?

A single female professional vocal artist and pedagogue sang examples of “twang” and neutral voice quality, which a panel of experts classified, in almost complete agreement with the singer's intentions. Subglottal pressure was measured as the oral pressure during the occlusion during the syllable /pae/. This pressure tended to be higher in “twang,” whereas the sound pressure level (SPL) was invariably higher. Voice source properties and formant frequencies were analyzed by inverse filtering. In “twang,” as compared with neutral, the closed quotient was greater, the pulse amplitude and the fundamental were weaker, and the normalized amplitude tended to be lower, whereas formants 1 and 2 were higher and 3 and 5 were lower. The formant differences, which appeared to be the main cause of the SPL differences, were more important than the source differences for the perception of “twanginess.” As resonatory effects occur independently of the voice source, the formant frequencies in “twang” may reflect a vocal strategy that is advantageous from the point of view of vocal hygiene.     

Objective Analysis of Vocal Warm-Up with Special Reference to Ergonomic Factors

Vocal warm-up was studied in terms of changes in voice parameters during a 45-minute vocal loading session in the morning. The voices of a randomly chosen group of 40 female and 40 male young students were loaded by having them read a novel aloud. The exposure groups (5 females and 5 males per cell) consisted of eight combinations of the following factors: (1) low (25 +/- 5%) or high (65 +/- 5%) relative humidity of ambient air; (2) low [< 65 dB(SPL)] or high [> 65 dB(SPL)] speech output level during vocal loading; (3) sitting or standing posture during vocal loading. Two sets of voice samples were recorded: a resting sample before the loading session and a loading sample after the loading session. The material recorded consisted of /pa:ppa/ words produced normally, as softly and as loudly as possible in this order by all subjects. The long /a/ vowel of the test word was inverse-filtered to obtain the glottal flow waveform. Time domain parameters of the glottal flow [open quotient (OQ), closing quotient (CQ), speed quotient (SQ), fundamental frequency (F0)], amplitude domain parameters of the glottal flow [glottal flow (fAC) and its logarithm, minimum of the first derivative of the glottal flow (dpeak) and its logarithm, amplitude quotient (AQ), and a new parameter, CQAQ], intraoral pressure (p), and sound pressure level (SPL) values of the phonations were analyzed. Voice range profiles (VRP) and the singer's formant (g/G, a/A, cl/c, e1/e, g1/g for females/males) of the loud phonation were also measured. Statistically significant differences between the preloading and postloading samples could be seen in many parameters, but the differences depended on gender and the type of phonation. In females the values of CQ, AQ, and CQAQ decreased and the values of SQ and p increased in normal phonations; the values of fAC, dpeak, and SPL increased in soft phonations; the values of AQ and CQAQ decreased in loud phonations; the harmonic energy in the singer's formant region increased significantly at every pitch. In males the values of OQ and AQ decreased and the values of dpeak, F0, p, and SPL increased in normal phonations; the values of fAC and p increased in soft phonations. The changes could be interpreted as signs of a shift toward hyperfunctional voice production. Low humidity was associated with more hyperfunctional changes than high humidity. High output was associated with more hyperfunctional changes than low output. Sitting position was associated with an increasing trend at both margins of male VRP, whereas the case was the opposite for standing position.     

The Impact of Voice Disorders Among Teachers: Vocal Complaints, Treatment-Seeking Behavior, Knowledge of Vocal Care, and Voice-Related Absenteeism

Objectives

Teachers are at increased risk for developing voice disorders. Occupational risk factors have been extensively examined; however, little attention has been paid to the consequences of the vocal complaints. The objective of this study was to investigate the knowledge that teachers have about vocal care, treatment-seeking behavior, and voice-related absenteeism.

Methods

The study group comprised 994 teachers and 290 controls whose jobs did not involve vocal effort. All participants completed a questionnaire inquiring about vocal complaints, treatment-seeking behavior, voice-related absenteeism, and knowledge about vocal care. Comparisons were made between teachers with and without vocal complaints and with the control group.

Results

Teachers reported significantly more voice problems than the control population (51.2% vs 27.4%) (χ² = 50.45, df = 1, P < 0.001). Female teachers reported significantly higher levels of voice disorders than their male colleagues (38% vs 13.2%, χ² = 22.34, df = 1, P < 0.001). Teachers (25.4%) sought medical care and eventually 20.6% had missed at least 1 day of work because of voice problems. Female teachers were significantly more likely to seek medical help (χ² = 7.24, df = 1, P = 0.007) and to stay at home (χ² = 7.10, df = 1, P = 0.008) in comparison with their male colleagues. Only 13.5% of all teachers received information during their education.

Conclusions

Voice disorders have an impact on teachers' personal and professional life and imply a major financial burden for society. A substantial number of teachers needed medical help and was obligated to stay at home because of voice problems. This study strongly recommends the implementation of vocal education during the training of teacher students to prepare the vocal professional user.     

Performance demands and the performer's vocal capabilities

Performers could benefit by knowing in advance and by objective means, what vocal requirements for a particular role or performance are potentially harmful to them. By combining the concept of the “phonetogram” (F₀ — SPL Profile) with automatic pitch extraction of vocal performances, a contour of the vocal performance demands can be superimposed on the profile of the individual's vocal capabilities. Vocal productions that are near to or exceeding the vocal capabilities of a performer can be presumed to be potentially hazardous. Likewise, performance demands that are clearly within the profile of a given individual can be presumed to be nonhazardous with respect to pitch and amplitude range.