The effect of task on determination of habitual loudness

The purpose of this study was to investigate if there is an effect of task on determination of habitual loudness. Four tasks commonly used to elicit habitual loudness were compared (automatic speech, elicited speech, spontaneous speech, and reading aloud). Participants were adult female speakers (N=30) with normal voice. A one-way analysis of variance (ANOVA) revealed a statistically significant (p < 0.05) effect of task, with post-hoc analyses indicating that there was a statistically significant difference in habitual loudness elicited via automatic versus spontaneous speech (p < 0.05), and automatic speech versus reading aloud (p < 0.001). The issue of how habitual loudness is defined is considered. Implications of the use of one task for determination of habitual loudness are discussed, as is the possibility of a task effect on determination of other clinically useful vocal parameters.     

Mid-Basal-to-Ceiling Versus Mid-Ceiling-to-Basal Elicitation of Maximum Phonational Frequency Range

The purpose of this study was to investigate if there was an effect of task on the determination of maximum phonational frequency range (MPFR). Two tasks commonly used to elicit MPFR in clinical voice evaluations were compared. Normal adult females (n = 30) were examined. No statistically significant effect of task was found. Both tasks (mid-basal-to-ceiling and mid-ceiling-to-basal) were found to have a high positive correlation (0.89). Implications of the use on one task to determine maximum phonational frequency range are discussed, as is the possibility of a task effect on determination of other voice parameters.     

The Effect of Speaking Sample Duration on Determination of Habitual Pitch

The purpose of this study was to investigate if there was an effect of duration of speaking on determination of habitual pitch. Five speaking periods commonly used to elicit habitual pitch in clinical voice evaluations were compared (1, 5, 15, 30, and 60 seconds). Thirty female speakers with normal voices participated. Results of a within-subject univariate F-test revealed a statistically significant (p < 0.001) difference in habitual pitch among the speaking periods. Habitual pitch for the 1-second and 60-second speaking periods were found to be statistically significantly (p < 0.05) different than all remaining speaking periods, and the habitual pitch for the 30-second speaking period was found to be statistically significantly (p < 0.05) different than 60-second speaking period. Implications for the use of various speaking durations when determining habitual pitch are discussed, as is the possibility of a speaking duration effect on determination of other pitch-related voice parameters.     

The effect of task on determination of maximum phonational frequency range

The purpose of this study was to investigate if there was an effect of task on determination of maximum phonational frequency range (MPFR). Two tasks commonly used to elicit MPFR in clinical voice evaluations were compared. Normal adult females (N = 30) were examined. No statistically significant effect of task was found. Both tasks (glissando and discrete-step) were found to have a high positive correlation (0.84). Implications of the use of one task for determination of maximum phonational frequency range are discussed, as is the possibility of a task effect on determination of other voice parameters.     

Acoustic Changes in Student Actors' Voices After 12 Months of Training

This study was to evaluate acoustic changes in student actors' voices after 12 months of actor training. The design used was a longitudinal study. Eighteen students enrolled in an Australian tertiary 3-year acting program (nine male and nine female) were assessed at the beginning of their acting course and again 12 months later using a questionnaire, interview, maximum phonation time (MPT), reading, spontaneous speaking, sustained phonation tasks, and a pitch range task. Samples were analyzed for MPT, fundamental frequency across tasks, pitch range for speaking and reading, singing pitch range, noise-to-harmonic ratio, shimmer, and jitter. After training, measures of shimmer significantly increased for both male and female participants. Female participants' pitch range significantly increased after training, with a significantly lower mean frequency for their lowest pitch. The finding of limited or negative changes for some measures indicate that further investigation is required into the long-term effects of actor voice training and which parameters of voicing are most targeted and valued in training. Particular investigation into the relationship between training targets and outcomes could more reliably inform acting programs about changes in teaching methodologies. Further research into the relationship between specific training techniques, physiological changes, and vocal changes may also provide information on implementing more evidence-based training methods.     

The Effect of Hemodialysis on Voice: An Acoustic Analysis

Because respiration is part of the well-coordinated process necessary for phonation, this study was conducted with the purpose of analyzing the effect of chronic hemodialysis on voice characteristics of patients with chronic renal failure. A total of 57 patients were recruited for the study, including 31 males and 26 females ranging in age from 16 to 85 years. Patients underwent evaluation of their voice directly before and after hemodialysis using the Kay Elemetric VISI Pitch (Model 330; Kay Elemetric Corporation, Lincoln Park, New Jersey). The vocal acoustic parameters studied include habitual pitch, pitch range, relative average perturbation, shimmer, noise-to-harmonic ratio, voice turbulence index, maximum phonation time, and voice energy. The data were analyzed using the paired t-test for the total sample and the nonparametric test for the female and male subgroups. The total sample analysis showed a statistically significant increase in the habitual pitch after the hemodialyis (p < 0.05), with a borderline increase in the pitch range and maximum phonation time (p < 0.10). In the female group, there was a statistically significant increase in the habitual pitch and a borderline increase in the relative average perturbation. In the male group, there was a significant increase in the habitual pitch with a borderline increase in maximum phonation time. Discussion of the after-mentioned results is presented.     

The Effect of Speaking Context on Elicitation of Habitual Pitch

The purpose of this study was to investigate if there was an effect of speaking context on the elicitation of habitual pitch [speaking fundamental frequency (SFF)]. Six simulated speaking contexts were created (speaking during a voice evaluation, speaking in public, speaking to a peer, speaking to a superior, speaking to a subordinate, and speaking to a parent or spouse), and the SFF for 30 adult women with normal voice was compared across these contexts. A one-way analysis of variance (ANOVA) revealed a statistically significant (P < 0.001) effect of simulated speaking context on SFF, with post hoc analyses indicating a statistically significant difference in SFF while "speaking to a superior" (P < 0.001) and "speaking to a subordinate" (P < 0.001). Possible reasons for an effect of speaking context are discussed. Also, the implications of the use of varied speaking contexts when eliciting SFF are discussed, as is the possibility of an effect of speaking context on the elicitation of other clinically useful voice parameters.     

Some physical characteristics of the male falsetto voice

Previous research indicated that, as groups, male (bass/baritone) and female (soprano) professional singers tend to exhibit differing vocal tract and voice source behaviours. The use of an objective measure of voice [xeroradiographic-electrolaryngographic analysis (XEL)] revealed differences between the two voice types, especially at the highest sample pitches (e, 330 Hz for bass/baritones, and e″, 1,320 Hz for sopranos). XEL analysis combines two known techniques, i.e., soft-tissue radiographic imaging (xeroradiography), and an analysis of voice-source vibratory patterning (electrolaryngography). Subsequent to this investigation, interest centered on the male professional falsetto voice over a two-octave range (E 165 Hz to e′ 660 Hz) using a sample (n=9) of professional countertenors. Results suggest that there are characteristic trends in the patterning of the male professional falsetto register, but there is also evidence of within-group variability. The subjects significantly increased the size of the pharyngeal tube area during phonation. ANOVA and Trend Analysis revealed ventricular space as the only measure to expand systematically and consistently as sung pitch increases.     

Effects of HearFones on speaking and singing voice quality

HearFones (HF) have been designed to enhance auditory feedback during phonation. This study investigated the effects of HF (1) on sound perceivable by the subject, (2) on voice quality in reading and singing, and (3) on voice production in speech and singing at the same pitch and sound level.

Test 1: Text reading was recorded with two identical microphones in the ears of a subject. One ear was covered with HF, and the other was free. Four subjects attended this test. Tests 2 and 3: A reading sample was recorded from 13 subjects and a song from 12 subjects without and with HF on. Test 4: Six females repeated [pa:p:a] in speaking and singing modes without and with HF on same pitch and sound level.

Long-term average spectra were made (Tests 1–3), and formant frequencies, fundamental frequency, and sound level were measured (Tests 2 and 3). Subglottic pressure was estimated from oral pressure in [p], and simultaneously electroglottography (EGG) was registered during voicing on [a:] (Test 4). Voice quality in speech and singing was evaluated by three professional voice trainers (Tests 2–4).

HF seemed to enhance sound perceivable at the whole range studied (0–8 kHz), with the greatest enhancement (up to ca 25 dB) being at 1–3 kHz and at 4–7 kHz. The subjects tended to decrease loudness with HF (when sound level was not being monitored). In more than half of the cases, voice quality was evaluated “less strained” and “better controlled” with HF. When pitch and loudness were constant, no clear differences were heard but closed quotient of the EGG signal was higher and the signal more skewed, suggesting a better glottal closure and/or diminished activity of the thyroarytenoid muscle.     

Short-Term Effects of Endotracheal Intubation on Voice

The objective of this study was to examine the vocal symptoms and acoustic changes perceived in the short period after endotracheal intubation, and to find the association between these changes and the endotracheal tube parameters. A total of 35 subjects were included. They were examined preoperatively, and 2 and 24 hours postoperatively. The vocal symptoms of hoarseness, vocal fatigue, loss of voice, throat clearing, globus pharyngeus, throat pain, and the acoustic variables mainly average fundamental frequency, relative average perturbation, shimmer, noise to harmony ratio, voice turbulence index, habitual pitch, and maximum phonation time (MPT) were assessed as such and in relation to the following endotracheal tube parameters: duration of anesthesia, number of intubation attempts, size of the tube, cuff volume, cuff mean pressure, and the emergence. The association between anesthesia parameters with incidence of vocal complaints and changes in acoustic parameters were examined using logistic and linear regression. Vocal fatigue was associated significantly with the increase in cuff volume and the number of intubation attempts. Throat clearing was associated significantly with the increase in cuff mean pressure. Only the increase in habitual pitch was associated significantly with the increase in cuff volume. The acute short-term effect of endotracheal intubation on voice is significant. The most important endotracheal tube parameters that affect the vocal changes are the cuff mean pressure and volume. The laryngeal contribution to these vocal changes seems to be minimal. All vocal symptoms increased significantly except for globus pharyngeus at 2 hours postoperatively. The acoustic parameters did not change significantly except for a decrease in MPT. At 24 hours postoperatively, all vocal symptoms subsided with no significant difference to baseline value. The habitual pitch increased significantly, and the rest of the parameters remained comparable to baseline value.     

Effects of Testosterone Replacement on a Male Professional Singer

Testosterone has been known to play an important role in the development of the postpubertal male voice for many centuries. In fact, the prevention of pubertal development of the voice by castrating young male singers was a well-known practice, especially in Italy beginning in the sixteenth century. The “castrati” were well known for their clear, high-pitched voices. Because of the resulting small larynx and vocal folds, castrati apparently produced a distinctive resonance as well as the high pitch, which cannot be matched even by the counter tenors of today. Busy voice labs occasionally see males with sex hormone deficiencies secondary to chromosomal or gonadal problems. This is a presentation of an unusual patient who was a trained tenor singer and was found to have hypogonadism on a premarital health examination. Administration of replacement testosterone resulted in significant vocal register and voice quality changes.     

Voice characteristics, effects of voice therapy, and long-term follow-up of contact granuloma patients

This study evaluates the laryngoscopic findings and voice characteristics of male contact granuloma patients before and after voice therapy and at a follow-up about 9 years later. Pre- and posttherapy recordings as well as follow-up recordings were made for 19 granuloma patients. Pretherapy revealed the most salient perceptual voice characteristics were low pitch, monotony, and a high degree of vocal fry and hyperfunction. Interjudge reliability for these traits was high. Immediately following therapy the healed patients (n = 10) had a decrease in hyperfunction, vocal fry, and monotony, while the unhealed patients (n = 9) had an increase in hyperfunction and vocal fry decreased only marginally. Monotony decreased significantly in this group. As regards the acoustic analyses, no significant differences were found in mean fundamental frequency (F₀) or perturbation. At the follow-up assessment 4 patients had granuloma while 15 had normal laryngeal status. Perceptually their voice characteristics resembled those pretherapy independently of the laryngeal findings. The results suggest that reduced hyperfunction and decreased vocal fry may create better circumstances for the healing process at the posterior glottis.     

Perceived phonatory effort and phonation threshold pressure across a prolonged voice loading task: a study of vocal fatigue

Although the problem of vocal fatigue is not uncommon in people with voice disorders, research on objective quantifiable indicators of vocal fatigue is limited. It has been suggested that a speaker's perception of increased phonatory effort associated with periods of prolonged voice use is related to increased lung pressure required to initiate and sustain phonation. The purpose of this study was to examine the relationship among perceived phonatory effort (PPE), which was used as a subjective index of vocal fatigue, and phonation threshold pressure (PTP), a quantifiable measure defined as the minimal lung pressure required to initiate and sustain vocal fold oscillation. PTP and PPE were recorded before, during, and after five adult male and five adult female speakers engaged in a prolonged oral reading task designed to induce vocal fatigue. The results supported a direct, moderately strong relationship between PTP and PPE, particularly when PTP was measured during speech produced at comfortable and low-speaking pitch levels. No gender effects were found. PTP returned to baseline levels within 1 hour after the fatiguing task. PPE returned to baseline within 1 day. The data support the use of PTP as an objective index of vocal fatigue.     

Voice Problems of Future Speech-Language Pathologists

Students training to be educators frequently exhibit voice disorders prior to employment. To date, there exist no similar studies of future speech-language pathologists (SLPs). The study is designed as a prospective, nonrandomized survey. The objective of this study is to determine the voice problems of first year graduate students training to be SLPs. Participants were 104 first year graduate students majoring in speech-language pathology at two universities. The Quick Screen for Voice was administered. Participants who failed completed a questionnaire regarding voice problems, medical history, daily habits, and voice use. When responses further indicated voice-related problems, endoscopic examination was completed. Fourteen percent (N=15) of the participants failed the screening by demonstrating two or more abnormal voice characteristics. These included persistent glottal fry (present in all who failed), low habitual pitch, juvenile resonance, hoarse, breathy, or strained phonation, abnormally low pitch on sustained vowels, and voice breaks during the frequency range. Twelve percent (N=12) failed both the screening and follow-up questionnaire. Responses included self-reported dysphonia, medical history with voice-related side effects, difficulty with excessive voice use, and voice problems occurring daily or weekly. Endoscopic evaluation showed one participant with bilateral vocal nodules. The results suggest that voice problems among future SLPs (12%) are more common than the 3-9% reported in the general population and similar to the 11% previously reported for teachers. However, future SLP voice problems are less frequent than those reported among education majors (21%) and all college students (17%). Faculty should identify students with voice problems and emphasize optimal voice use in classroom and clinical settings.     

Vocal Warm-up Increases Phonation Threshold Pressure in Soprano Singers at High Pitch

Vocal warm-up is thought to optimize singing performance. We compared effects of short-term, submaximal, vocal warm-up exercise with those of vocal rest on the soprano voice (n = 10, ages 19-21 years). Dependent variables were the minimum subglottic air pressure required for vocal fold oscillation to occur (phonation threshold pressure, Pth), and the maximum and minimum phonation fundamental frequency. Warm-up increased Pth for high pitch phonation (p = 0.033), but not for comfortable (p = 0.297) or low (p = 0.087) pitch phonation. No significant difference in the maximum phonation frequency (p = 0.193) or minimum frequency (p = 0.222) was observed. An elevated Pth at controlled high pitch, but an unchanging maximum and minimum frequency production suggests that short-term vocal exercise may increase the viscosity of the vocal fold and thus serve to stabilize the high voice.     

Relationship between changes in voice pitch and loudness

Changes in mean fundamental frequency accompanying changes in loudness of phonation are analyzed in 9 professional singers, 9 nonsingers, and 10 male and 10 female patients suffering from vocal functional dysfunction. The subjects read discursive texts with noise in earphones, and some also at voluntarily varied vocal loudness. The healthy subjects phonated as softly and as loudly as possible at various fundamental frequencies throughout their pitch ranges, and the resulting mean phonetograms are compared. Mean pitch was found to increase by about half-semitones per decibel sound level. Grossly, the subject groups gave similar results, although the singers changed voice pitch more than the nonsingers. The voice pitch changes may be explained as passive results of changes of subglottal pressure required for the sound level variation.     

Feminine after cricothyroid approximation?

A number of studies have evaluated the effectiveness of a cricothyroid approximation (CA) in creating a more female voice in male-to-female transsexuals (MFTs) from an acoustic perspective. An increase in pitch is of little value, however, unless it accurately indicates listeners' perceptions of gender. The purpose of this study was to further investigate the effectiveness of a CA in feminizing the voice from a perceptual perspective. Video recordings of nine MFTs, nine nontranssexual males (NTMs), and nine nontranssexual females (NTFs) were presented twice to the panel of judges in a randomized order: first auditory only (only hearing a subject's speech) and subsequently audiovisual (hearing and seeing a subject's speech). The panel of judges, 42 students (21 female, 21 male) from different disciplines, rated the participants' voices on a 100-mm visual analog scale with "very male" and "very female" as left and right extremes, respectively. The group of MFT obtained scores that were situated in between those of the NTM and the NTF, both for the auditory only and the audiovisual mode of presentation. Perception of femaleness significantly correlated with average fundamental frequency for both modes of presentation. It can be concluded that a CA approximation is a viable option to raise the voice pitch in MFTs but that this surgery alone may not be sufficient to create a voice that is perceived as a totally female.     

Incidence of supraglottic activity in males and females: a preliminary report

Supraglottic activity was rated from flexible endoscopic video recordings of subjects with normal laryngeal structure and function as they sustained vowels and repeated syllables and sentences. Judges rated these recordings for false vocal fold (FVF) adduction and anterior-to-posterior (A-P) compression at the initiation of the speech task, throughout the whole speech task (static supraglottic activity), and as brief individual adductions within a speech task (dynamic supraglottic activity). Significant differences in A-P (p < 0.0003) and FVF (p < 0.0000001) compression were found between tasks. Dynamic FVF activity was associated with glottal stops. Static A-P and FVF activities were present in males significantly more (p < 0.0001) than females. FVF activity associated with speech initiation was found in females significantly more (p = 0.0256) than males. Supraglottic activity plays a role in normal speech production, and should not necessarily be considered suggestive of a voice use pattern with excessive muscle tension.     

Voice Therapy Improves Quality of Life in Age-Related Dysphonia: A Case-Control Study

The objective of the study is to determine the efficacy of voice therapy in the treatment of age-related dysphonia. The study was conducted using a retrospective case-control chart review. The medical records of 54 patients older than 60 years diagnosed with age-related dysphonia without complicating diagnoses were reviewed. Patients who chose to undergo voice therapy were grouped as cases. Patients who chose not to undergo voice therapy were grouped as controls. The voice-related quality of life (VRQOL) measure was used to measure outcomes before and after treatment in cases and at a minimum 2-month follow-up in controls. Of the 54 patients, 19 (10 female, 9 male; mean age 73 years) chose to undergo voice therapy and filled in >1 VRQOL questionnaire. Six patients (3 female, 3 male; mean age 66 years) chose not to undergo voice therapy and filled in >1 VRQOL questionnaire. The 19 cases experienced a mean improvement in VRQOL score of 19.21 (2-tailed matched pairs t test P=0.00038) after a mean of 4.1 voice therapy sessions and 5.1 months. The six controls experienced a mean change in VRQOL score of 0.42 (2-tailed matched pairs t test P=0.96) after a mean of 3.3 months. Voice therapy leads to statistically significant improvement in the VRQOL life in elderly patients with age-related dysphonia. It is an efficacious noninvasive therapy for this disease.     

Vocal loudness and frequency capabilities of the voice

A phonetogram is a graph showing the sound pressure level (SPL) of softest and loudest phonation over the entire fundamental frequency range of a voice. A physiological interpretation of a phonetogram is facilitated if the SPL is measured with a flat frequency curve and if the vowel /a/ is used. It was found that in soft phonation, the SPL is mainly dependent on the amplitude of the fundamental, while in loud phonation, the SPL is mainly determined by overtones. The short-term SPL variation, i.e., the level variation within a tone, was about 5 dB in soft phonation and close to 2 dB in loud phonation. For two normal voices the long-term SPL variation, calculated as the mean standard deviation of SPL for day-to-day variation, was found to be between 2.4 and 3.4 dB in soft and loud phonation. Speakers who raise their loudness of phonation also tend to raise their mean voice fundamental frequency. Measures obtained from speaking at various voice levels were combined so that typical pathways could be introduced into the phonetogram. The average slope of these pathways was 0.3–0.5 st/dB for healthy subjects. Averaged phonetograms for male singers and male nonsingers did not differ significantly, but averaged phonetograms for female singers and female nonsingers did, in that the upper contour was higher for the female singers. Averaged phonetograms for female patients with non-organic dysphonia showed significantly lower SPL values in loudest phonation as compared to healthy female subjects, while no corresponding difference was seen for males in this regard. With respect to the SPL values for softest phonation, male dysphonic patients showed significantly higher SPL values than healthy male subjects, while no corresponding difference was seen in female subjects. The subglottal pressure mirrored these phonetogram differences between healthy and pathological voices. The averaged phonetograms of female patients after voice therapy showed an increased similarity with those of normal voices. For the male patients the averaged phonetogram did not change significantly after therapy.