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Integrating the theory of workplace deviance with person–environment fit theory, we propose a two‐pathway model to explain why and how employees who feel overqualified engage in time theft behavior. Specifically, we anticipate that feeling overqualified will negatively influence focal employees' experienced authority fairness and erode their work meaningfulness, which in turn will lead to increased time theft behavior. Further, we argue that voice endorsement serves as a key boundary condition mitigating the negative effects of perceived overqualification. We conducted two multi‐waved and multi‐sourced field studies to test our proposed hypotheses. Study 1 (247 employees and 47 supervisors) revealed that perceived overqualification is associated with time theft behavior through the mediators of experienced authority fairness and meaningfulness. Study 2 (405 employees and 73 supervisors) replicated the findings of Study 1 and tested our full model. We discuss the theoretical and practical implications of our findings. [ABSTRACT FROM AUTHOR]

Purpose: This scoping review aims to summarize and explore current literature on the usefulness and clinical implications of pharyngeal high-resolution (impedance) manometry (HRM/HRIM) in head and neck cancer (HNC) patients. Method: Three online databases (MEDLINE, Embase, Scopus, and additionally Google Scholar) were searched until December 2023. Studies using pharyngeal HRM/HRIM to assess swallowing or voicing in HNC patients, written in any language and published in peer-reviewed journals, were considered eligible. Quality check was performed using the Quality Assessment Tool for Quantitative Studies from the Effective Public Healthcare Practice Project. Information about the study population and HRM/HRIM data (equipment, protocol, analysis, and outcomes) were extracted. Results: Eight papers met the inclusion criteria, six utilizing HRM and two HRIM. The study design consisted of case-series (five) and case–control (three). The quality assessment indicated a weak global rating for seven papers and a moderate rating for one for the remaining study. Findings suggest that HNC patients with dysphagia suffer from reduced pressures in the pharynx and upper esophageal sphincter compared to healthy individuals, potentially influenced by tumor characteristics and treatment. Decreased pressures may indicate poor functioning of swallowing musculature and mechanism. Conclusions: Pharyngeal HRM/HRIM is sparsely used for swallowing assessment in HNC patients. However, wider use seems warranted, as it can offer valuable insights into swallowing biomechanics. This can help quantifying the degree and timing of pressures involved in swallowing (problems) and holds potential for clinical applications, such as earlier diagnosis of radiation-induced therapy or surgery complications. Additionally, it can be beneficial in evaluating therapeutic swallowing strategies. [ABSTRACT FROM AUTHOR]

Purpose: Voice and swallowing are distinct functions that share anatomical and physiological properties; however, research investigating their intersection is limited. The purpose of this scoping review was to explore the literature surrounding the relationship between voice and swallowing measures in healthy adults and those with non-degenerative disorders. Specifically, we aimed to elucidate whether objective voice measures could be used as correlates of swallowing function. Method: We systematically searched four databases (Embase, PubMed, CINAHL, and Web of Science) for relevant literature using a combination of key words and controlled vocabulary generated from the Yale Mesh Analyzer. The inclusion criteria consisted of peer-reviewed studies in the English language that reported on healthy adults and/or patients with non-degenerative neurological disorders and pulmonary diseases and contained instrumental and/or objective voice and swallowing measures. Two raters completed the abstract screening process followed by independent full-text reviews. Case studies, review studies, gray literature, or abstract-only studies were excluded. Results: Among 5,485 screened studies, 182 were fully reviewed, with only 11 studies meeting the inclusion criteria. Eight studies found an association between voice and swallowing objective measures, whereas the other three did not. Significant voice measures that were related to swallowing safety and/or physiology included maximum fundamental frequency (F0), F0 range, maximum phonation time, biomechanics of effortful pitch glides, and voice onset time. Conclusions: Although there was heterogeneity in the measures used, specific objective voice measures showed promise in clinical practice as a screening tool for dysphagia. Further investigations are needed to validate the clinical utility of these measures across diverse patient populations. [ABSTRACT FROM AUTHOR]

Objective: Measuring patient motivation for voice therapy is an important component of determining prognosis and estimating compliance. Voice stimulability testing is assumed to influence the patient’s motivation by improving their perception of the sound and/or feel of the voice. The purpose of this study was to validate a Voice Therapy Motivation and Voice Perception Inventory and to determine whether stimulability testing elicits improvements in motivation and patient-perceived voice status. Method: Seventy-five patients who underwent initial voice therapy evaluation completed a four-item inventory that queried their commitment to voice therapy, confidence that they could change their voice through voice therapy, perception of their voice severity, and ratings of their vocal effort. Inventories were completed shortly before and after stimulability testing. A psychometric analysis of the survey was conducted, including the internal consistency of each construct of the inventory along with content, predictive, and concurrent validity. Pairedsamples statistical analyses were conducted to determine differences before and after stimulability testing, and Spearman correlations between voice and motivation ratings were conducted to determine relationships between the patient’s perception of their voice and their motivation for voice therapy. Results: Internal consistency reliability was acceptable to good for each construct, particularly after stimulability testing. Motivation scales were predictive of returning for voice therapy sessions, subjective improvement of voice by the first therapy session, and likelihood of the patient practicing the home practice program. Patient ratings of voice severity and effort were positively correlated with clinician ratings of overall severity. Motivation and voice impairment perception improved following stimulability testing. Reduction in vocal effort was related to improved motivation, but change in voice severity was not. Conclusions: Voice stimulability testing can influence patient motivation for voice therapy and patient-perceived voice improvements. It should be considered a critical part of the voice evaluation. [ABSTRACT FROM AUTHOR]

Introduction: Vagal nerve stimulator (VNS) implantation is a vital therapy for epilepsy refractory to other treatments; however, it is associated with a very high rate of voice changes. Relatively few of these patients are evaluated for vocal fold motion impairments. In this series, we evaluate 5 such patients with a novel phenotype of forced abduction with VNS stimulation. Methods: Retrospective case series. Results: Five patients with a VNS implant who underwent operative direct or in-office rigid laryngoscopy and had vocal fold motion impairment associated with VNS activation are included. All 5 patients had vocal fold mobility with VNS off and a fixed with activation. All patients exhibited vocal fold abduction with VNS activation. Patient 2 has since undergone laryngeal reinnervation, which helped her intermittent dysphonia but left a small glottic gap. A type 1 thyroplasty corrected this gap and improved her voice further. Patient 3 has undergone laryngeal reinnervation for which early results show improvement in perceptual and patient reported outcomes. Patients 4 and 5 have both undergone laryngeal reinnervation with improvement in voice. Conclusion: Previous reported cases of stimulated immobility associated with VNS use describe only adduction of the vocal fold. This series expands the previous work showing the VNS activation can also cause stimulated immobility in an abducted position, for which reinnervation and other medialization procedures offer promising treatment. [ABSTRACT FROM AUTHOR]

Purpose: To cross-culturally adapt and validate the Radboud Dysarthria Assessment (RDA) and the speech component of the Radboud Oral Motor inventory for Parkinson's disease (ROMP-speech) into the Arabic language among Lebanese subjects with dysarthria. Materials and methods: This study included 50 participants with dysarthria. The Arabic versions of the RDA (A-RDA) and the ROMP-speech (A-ROMP-speech) were administered in addition to the Arabic Speech Intelligibility test, the Lebanese Voice Handicap Index–10 (VHI-10lb) and semantic verbal fluency tasks. The maximum performance tasks were analyzed using the Praat software. The A-RDA qualitative recording form and the A-ROMP-speech were assessed for construct validity and internal consistency. The convergent validity of the maximum performance tasks, the severity scale, and the A-ROMP-speech were evaluated. Results: Exploratory factor analysis of the qualitative recording form extracted 3 factors explaining 82.973% of the total variance, and it demonstrated high internal consistency (α = 0.912). The maximum performance tasks of the RDA correlated significantly with the corresponding Praat scores. The severity scale and the A-ROMP-speech correlated fairly to strongly with the Arabic Speech Intelligibility test (rs=-0.695 and −0.736, p < 0.001) and the VHI-10lb (r = 0.539 and 0.640, p < 0.001). Conclusion: The A-RDA and the A-ROMP-speech are valid and reliable dysarthria tools among Lebanese subjects. IMPLICATIONS FOR REHABILITATION: The present study cross-culturally adapts and validates a dysarthria assessment tool in the Arab culture. The Arabic Radboud Dysarthria Assessment (A-RDA) and the speech component of the Arabic Radboud Oral Motor inventory for Parkinson's disease-speech component (A-ROMP-speech) are valid and reliable measures to be used among Lebanese individuals with dysarthria. The use of the A-RDA and the A-ROMP-speech will contribute to better therapeutic outcomes and will lead to a common language among speech and language therapists. [ABSTRACT FROM AUTHOR]

Purpose: Breathing is ubiquitous in speech production, crucial for structuring speech, and a potential diagnostic indicator for respiratory diseases. However, the acoustic characteristics of speech breathing remain underresearched. This work aims to characterize the spectral properties of human inhalation noises in a large speaker sample and explore their potential similarities with speech sounds. Speech sounds are mostly realized with egressive airflow. To account for this, we investigated the effect of airflow direction (inhalation vs. exhalation) on acoustic properties of certain vocal tract (VT) configurations. Method: To characterize human inhalation, we describe spectra of breath noises produced by human speakers from two data sets comprising 34 female and 100 male participants. To investigate the effect of airflow direction, three-dimensional-printed VT models of a male and a female speaker with static VT configurations of four vowels and four fricatives were used. An airstream was directed through these VT configurations in both directions, and their spectral consequences were analyzed. Results: For human inhalations, we found spectra with a decreasing slope and several weak peaks below 3 kHz. These peaks show moderate (female) to strong (male) overlap with resonances found for participants inhaling with a VT configuration of a central vowel. Results for the VT models suggest that airflow direction is crucial for spectral properties of sibilants, /ç/, and /i:/, but not the other sounds we investigated. Inhalation noise is most similar to /ə/ where airflow direction does not play a role. Conclusions: Inhalation is realized on ingressive airflow, and inhalation noises have specific resonance properties that are most similar to /ə/ but occur without phonation. Airflow direction does not play a role in this specific VT configuration, but subglottal resonances may do. For future work, we suggest investigating the articulation of speech breathing and link it to current work on pause postures. [ABSTRACT FROM AUTHOR]

Purpose: People with Parkinson's disease (PwP) typically experience impairments in vowel articulation; however, less is known about how this measure varies with speech task type and clinical characteristics such as cognitive impairment. We characterized vowel space in PwP with and without mild cognitive impairment (MCI) comparing performance across phonation, reading, and picture description tasks. We evaluated associations between vowel space and cognitive impairment, as well as motor symptom severity to elucidate the factors contributing to variability in this acoustic measure. Method: PwP (n = 48) and age-matched controls (n = 15) performed sustained phonation of corner vowels, a reading passage, and a picture description task (Cookie Theft picture). PwP participants were classified as with normal cognition (PD-NC) or MCI (PD-MCI), and motor symptoms were assessed using the Movement Disorders Society Unified Parkingson's Disease Rating Scale Part III (MDSUPDRS Part III). Vowel articulation index (VAI) for each task and mean difference in VAI between tasks was compared between the groups using linear mixed models adjusted for age, sex, and education. The impact of motor severity was assessed by additionally adjusting the model for MDS-UPDRS Part III score. Results: In the adjusted mixed model, mean VAI was significantly lower in the PD-MCI group compared to the PD-NC group for all tasks. Within participants, adjusted mean differences demonstrated that all groups declined in VAI when sustained phonation was compared to either reading or picture description tasks. Adjustment for MDS-UPDRS Part III did not alter the results, suggesting no major association of motor impairment with vowel space variability within or between individuals or groups. Conclusions: Variability in vowel space is impacted by cognitive impairment and speech task in PwP. These findings are relevant to the further development of speech markers in PwP and other neurogenerative diseases that impact both cognitive and motor functions. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the voice quality of patients with temporomandibular disorders (TMDs) compared with healthy subjects using cepstral analysis and investigate the relationship between the TMD severity and the values of cepstral analysis. Methods: Subjects who met the inclusion criteria completed a general health questionnaire and the Fonseca Anamnestic Index. Patients who had TMDs with FAI were subjected to an examination based on the Diagnostic Criteria for Temporomandibular Disorders. The final sample included 65 subjects, 31 TMDs patients (with a mean age ± standard deviation of 36.64 ± 13.67 years), and 34 healthy individuals in the control group (with a mean age ± standard deviation of 30.35 ± 7.78 years). Cepstral Peak Prominence (CPP) and Smoothened Cepstral Peak Prominence (CPPS) of a sustained vowel and connected speech were computed using Praat software. Results: TMD patients indicated lower cepstral values and lower voice quality compared to the control group. Significant differences were found between TMD and control groups for all cepstral parameters (P <.001) and cepstral measurements showed a moderate to strong negative correlation with TMD severity (P <.001, rho = − 0.57 to − 0.88). Conclusion: The outcomes of the present study indicate that cepstral analysis can accurately distinguish the reduced voice quality of TMD patients from normal voice. [ABSTRACT FROM AUTHOR]

Objective: to compare the immediate effects of low-frequency TENS employment on vocal quality in women with behavioral dysphonia before and after vocal exercises. Methodology: 30 women (mean = 31.3 years old), diagnosed with behavioral dysphonia received low-frequency TENS before (TENS + VE Group) and after vocal exercises (VE + TENS Group) with a 1-week washout. They had their sustained vowel/a/and running speech recorded before and after each procedure for auditory-perceptual analysis and acoustic measures. The low-frequency TENS parameters applied were symmetrical biphasic quadratic pulse, 200 µs phase, 10 Hz frequency, intensity on the motor threshold, and the electrodes were positioned on the submandibular and superior fibers of the trapezius muscle region. The vocal exercises: tongue trill, humming, finger kazoo, and water resistance therapy were performed totalizing 20 min. Results: intragroup analysis of sustained vowel/a/showed reduction in both groups of strain parameter and increased the breathiness; only VE + TENS Group increased the instability parameter, decreased fundamental frequency, and increased in SPI values; the running speech analysis showed an increase in the overall degree, roughness, and breathiness parameters. However, in VE + TENS Group, there was a statistically significant decrease in the intensity of the strain and an increase in breathiness. The acoustic measures showed that VE + TENS Group had a higher variation than TENS + VE Group regarding NHR. Conclusion: vocal exercises followed by low-frequency TENS have more immediate positive effects on voice quality than the low-frequency TENS followed by vocal exercises. This is a preliminary immediate effects study, and these effects could be verified through long-term assessments. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this pilot study was to explore the efficacy of an intensive 3 week water resistance phonation (WRP) therapy program for people with presbyphonia. Method: Participants included 13 people with presbyphonia who received intensive WRP therapy. All participants completed eight sessions of therapy over 3 weeks. Auditory perceptual ratings, and acoustic and aerodynamic assessments were performed before and after treatment. Participants also completed the voice-related quality of life questionnaire before and after the treatment. Result: After 3 weeks of intensive voice therapy, significant improvements were demonstrated in acoustic, aerodynamic, and auditory perceptual parameters, as well as patient perceptions of voice-related quality of life. Acoustically, it was found there were significant decreases in shimmer (p = 0.019), noise-to-harmonic ratio (p = 0.016), and smoothed cepstral peak prominence (p = 0.001). Perceptually, the clients with presbyphonia showed significant reductions in the ratings of the overall grade, roughness, asthenia, and strain. Moreover, there was a significant increase in the total score of the Mandarin version of the Voice-Related Quality of Life measure post-therapy. Conclusion: The investigation provides preliminary evidence that people with presbyphonia can improve their vocal function and voice-related quality of life through intensive WRP therapy within a short period of time. [ABSTRACT FROM AUTHOR]

Background: Sleep inertia, characterized by reduced alertness and cognitive functioning upon waking, has been well-researched in its effects on cognitive and motor abilities. However, its impact on voice quality remains less clear. Objectives: This study aimed to investigate the relationship between sleep inertia following nocturnal sleep and changes in acoustic and perceptual voice parameters in adults. Methods: Ninety healthy participants (45 females, 45 males, ages: 18 - 30 years) took part in a pre-post study using convenience sampling. Their voices were recorded before and after nocturnal sleep across multiple tasks, including vowel /a/ phonation, spontaneous speech, text reading, and maximum phonation time (MPT). Recordings were made in a quiet room using a Zoom H6 recorder at a 44.1 kHz rate. The acoustic analysis included measures of fundamental frequency (F0), standard deviation of F0 (SD F0), vocal intensity, harmonics-to-noise ratio (HNR), cepstral peak prominence smoothed (CPPS), jitter, shimmer, and formant frequencies. Auditory-perceptual evaluation was conducted using the GRBAS Scale. Statistical analysis was performed using SPSS-19. The Shapiro-Wilk test assessed normality, and a paired t -test compared variables, separately for males and females at a 0.05 significance level. Results: Acoustic analysis revealed that both females and males experienced a decrease in mean F0, mean intensity, HNR, and CPPS, and an increase in jitter, shimmer, and SD F0 across most voice samples after sleeping. These changes were particularly significant for females in all voice samples (P < 0.001). Perceptual analysis also showed a significant increase in grade, roughness, breathiness, asthenia, and strain for both genders after sleep (P < 0.001). Conclusions: This study demonstrated that sleep inertia negatively impacts vocal performance, resulting in a decline in voice quality for both genders after sleep compared to before. Notably, this decline in voice quality was more pronounced in women than in men. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder affecting one in five women of reproductive age. Polycystic appearance of the ovaries in ultrasonography is associated with oligomenorrhea, and clinical and or biochemical hyperandrogenism. PCOS has been associated with voice alterations for many years. However, there is insufficient research on voice analysis in PCOS patients. Objectives: This research aimed to examine the voice characteristics among women with PCOS. Patients and methods: Our study included 25 women confirmed with PCOS and 25 control. A complete voice assessment was performed for all participants using primary demographic data, vocal symptoms, auditory perceptual evaluation of the voice, Arabic version of the Voice Handicap Index, acoustic analysis, and video laryngoscopic examination of the larynx. Results: Our study revealed statistically significant differences between PCOS and control groups in phonasthenic symptoms, auditory perceptual assessment of the voice, acoustic parameters, and laryngoscopic examination. Conclusion: PCOS women with hirsutism are complaining of vocal symptoms, changes in vocal characters, and deterioration of the acoustic parameters of the voice. High serum levels of androgen can cause the deepening of the voice, which is essential for the early detection of vocal symptoms in PCOS patients to prevent virilization of their voice. Trial registration: NCT06085170. Registered 20 August 2023—retrospectively registered, https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://classic.clinicaltrials.gov/ct2/show/NCT06085170&ved=2ahUKEwjEyLqUq6KGAxWxRPEDHb57DIQQFnoECBQQAQ&usg=AOvVaw1xTurnA6mJEZ9PK0vQS8VL. [ABSTRACT FROM AUTHOR]

Objectives: Maximum phonation time is a simple test used to assess glottic competency. Our objective was to evaluate any correlation between maximum phonation time and spasmodic dysphonia as adductor spasmodic dysphonia and abductor spasmodic dysphonia have an adductor and abductor overdrive, respectively. Methods: A 3-year data-review was performed for patients diagnosed with adductor spasmodic dysphonia, abductor spasmodic dysphonia and mixed spasmodic dysphonia. Maximum phonation time was noted on the first visit and compared with a control group. Results: Average maximum phonation time in adductor spasmodic dysphonia, abductor spasmodic dysphonia and control group was 25 seconds, 9 seconds and 16 seconds. A significant difference was found for adductor spasmodic dysphonia and abductor spasmodic dysphonia. A receiver operating characteristic curve analysis between adductor spasmodic dysphonia and control groups showed a positive predictive value of 81.3 per cent, negative predictive value of 83.9 per cent, sensitivity of 79.6 per cent and specificity of 85.2 per cent. Level of evidence = 4. Conclusion: We recommend that maximum phonation time be added to the diagnostic armamentarium of spasmodic dysphonia. This correlation between maximum phonation time and spasmodic dysphonia has not been previously published. [ABSTRACT FROM AUTHOR]

Introduction: Inflammatory bowel diseases, which are among the most common chronic gastrointestinal diseases, can also affect the voice for different reasons. The aim of this study was to investigate acoustic, perceptual, and subjective voice evaluation parameters in inflammatory bowel diseases (IBD). Methods: This prospective case-control study included a total of 80 participants: 28 patients with ulcerative colitis (UC), 22 patients with Crohn's disease (CD), and 30 healthy controls. Following the endoscopic examination, the fundamental frequency (F0), shimmer (dB), jitter (%), and harmonic/noise ratio (HNR) were measured. GRBAS (grade, roughness, breathiness, asthenia, strain) scale was used for perceptual evaluation, and Voice Handicap Index-10 (VHI-10) Turkish version was used for subjective assessment. Results: The F0 value was within normal limits in both disease groups in male and female participants and in the control group. Jitter and shimmer values were statistically higher in the UC and CD groups than in the control group. HNR did not differ between CD and control; however, it was statistically lower in the UC group when compared to both the control and CD groups. The total GRBAS score did not differ between the UC and CD groups; however, it was greater in IBD patients compared to the control group. However, these differences were within normative parameters. Although total VHI-10 score did not differ between UC and CD groups, both had a higher voice handicap than the control group. Conclusion: IBD might have an effect on the voice and voice quality. This disease group was discovered to have perceptual and subjective voice problems additionally. [ABSTRACT FROM AUTHOR]

Introduction: This study examined the immediate acoustic, auditory-perceptual, and self-perceptual effects of two semi-occluded vocal tract exercises (SOVTs): straw phonation and straw phonation into a cup of water, delivered in a remote setting. Method: Thirty-six participants (19 females and 17 males) completed a baseline battery of acoustic recordings, followed by one of two SOVTs, and an identical post-task battery. The procedure repeated itself to include the other SOVT. Participants were also asked to rate their self-perceived vocal effort and quality following each condition. Recordings were presented to three expert listeners for completion of auditory-perceptual analysis. Results: Acoustically, a significant decrease in shimmer was noted following straw phonation. Auditory-perceptual analysis revealed a significant increase in the perception of strain following straw phonation into a cup of water. While no significant differences were found between SOVT tasks in self-perception of vocal effort, a significant increase in self-perception of vocal loudness was reported following straw phonation into a cup of water. Conclusion: SOVTs have a varied, yet significant short-term impact across acoustic, auditory-perceptual, and self-perceptual measures of voice production. Straw phonation provided consistently significant acoustic results, with nearly every variable improving to some degree. Results also support the notion that shimmer is an acoustic measure that is particularly susceptible to change following modest manipulation. These results, in addition to the auditory-perceptual and self-perceptual findings, have a direct impact on how SOVTs are being used clinically and may generalize to inform the way voice metrics are collected and analyzed. [ABSTRACT FROM AUTHOR]

Introduction: Hearing loss (HL) strongly impacts communication abilities and impairs social interactions. Moreover, it modifies the vocal parameters of affected patients. The effects of hearing rehabilitation through hearing aids (HA) on the vocal production of patients suffering from HL have not been thoroughly analyzed in the literature. The aim of this study was to use the ambulatory phonation monitor (APM), a portable vocal dosimeter, to evaluate the variations in the vocal production of a group of patients suffering from moderate-to-severe HL treated with HA and the relationship between such modifications and quality of life (QoL). Materials and Methods: Twenty-six patients suffering from a variable degree of HL and treated with HA have been enrolled. Each of them underwent an evaluation before and 4 months after rehabilitation with HA. The analysis of daily voice production was carried out with the APM, while subjective QoL data were collected through the Speech, Spatial, and Qualities questionnaire (SSQ) and the International Outcome Inventory for Hearing Aids (IOI-HA). The differences in phonatory measurements and subjective evaluations before and after HA rehabilitation were assessed using Wilcoxon signed rank test. The Spearman correlation test was used to analyze the correlation between phonatory measurements, auditory measurements, and SSQ scores. Results: Significant differences in the APM parameters before and after HA rehabilitation were found. After 4 months of HA use, we recorded a significant increase in phonation time and percentage of phonation time and a significant decrease in average amplitude in dB SPL. We also found a significant increase in the SSQ scores after HA rehabilitation. Finally, we were able to detect low but significant correlations between phonatory measurements and SSQ results. Conclusions: The APM proved to be a useful instrument in the evaluation of the benefits of HA and its measurements can be used as indicators of the participation in communication and social life of patients with HL, which are strongly related to QoL. [ABSTRACT FROM AUTHOR]

Background: Hearing Voices Groups (HVGs) are a peer support system for people with acoustic-verbal hallucinations. Few empirical studies have assessed their effectiveness. The main objective of this study is to evaluate a wide range of effects of HVGs and to compare them to those of regular therapeutic groups. Method: This comparative study is based on the responses of 20 French-speaking voice- hearers to an original self-administered questionnaire on the effects of their participation in a HVG in addition to a recovery assessment, the STORI. Our control group is composed of participants in Metacognitive Training programs (MCT, n = 14). Results: Results show a good homogeneity between the two populations in terms of sociodemographics, diagnosis, care pathways, and stages of recovery. The averages of the total satisfaction scores are very similar (162.15/230 for the HVG and 165.28 for the MCT groups) and indicate a very positive appraisal. Some differences can be observed in the type of benefits derived. Discussion: HVGs can be considered as settings that favour recovery and could have a complementary role, especially for users who would otherwise tend to leave or avoid the conventional field of psychiatric treatment. [ABSTRACT FROM AUTHOR]

This study investigates the synchronization of manual gestures with prosody and information structure using Turkish natural speech data. Prosody has long been linked to gesture as a key driver of gesture–speech synchronization. Gesture has a hierarchical phrasal structure similar to prosody. At the lowest level, gesture has been shown to be synchronized with prosody (e.g., apexes and pitch accents). However, less is known about higher levels. Even less is known about timing relationships with information structure, though this is signaled by prosody and linked to gesture. The present study analyzed phrase synchronization in 3 hr of narrations in Turkish annotated for gesture, prosody, and information structure—topics and foci. The analysis of 515 gesture phrases showed that there was no one-to-one synchronization with intermediate phrases, but their onsets and offsets were synchronized. Moreover, information structural units, topics, and foci were closely synchronized with gesture phrase medial stroke + post-hold combinations (i.e., apical areas). In addition, iconic and metaphoric gestures were more likely to be paired with foci, and deictics with topics. Overall, the results confirm synchronization of gesture and prosody at the phrasal level and provide evidence that gesture shows a direct sensitivity to information structure. These show that speech and gesture production are more connected than assumed in existing production models. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this study was to determine the relationship between the perceptual measure of speech naturalness and objective measures of pitch, loudness, and rate control as a potential tool for assessment of ataxic dysarthria. Method: Twenty-seven participants with ataxia and 29 age- and sex-matched control participants completed the pitch glide and loudness step tasks drawn from the Frenchay Dysarthria Assessment-Second Edition (FDA-2) in addition to speech diadochokinetic (DDK) tasks. First, group differences were compared for pitch variability in the pitch glide task, loudness variability in the loudness step task, and syllable duration and speech rate in the DDK task. Then, these acoustic measures were compared with previously collected ratings of speech naturalness by speech-language pathology graduate students. Results: Robust group differences were measured for pitch variability and both DDK syllable duration and speech rate, indicating that the ataxia group had greater pitch variability, longer DDK syllable duration, and slower DDK speech rate than the control group. No group differences were measured for loudness variability. There were robust relationships between speech naturalness and pitch variability, DDK syllable duration, and DDK speech rate, but not for loudness variability. Conclusions: Objective acoustic measures of pitch variability in the FDA-2 pitch glide task and syllable duration and speech rate in the DDK task can be used to validate perceptual measures of speech naturalness. Overall, speechlanguage pathologists can incorporate both perceptual measures of speech naturalness and acoustic measures of pitch variability and DDK performance for a comprehensive evaluation of ataxic dysarthria. [ABSTRACT FROM AUTHOR]

Purpose: Prior studies have shown that bilingual children who do not stutter (CWNS) exhibit a high number of disfluencies in both languages, increasing the risk of misidentification by speech-language pathologists as children who stutter (CWS). Conversely, there is a risk of misidentifying CWS with a relatively low incidence of disfluencies as CWNS. This study aims to explore the qualitative and quantitative distinctions in speech disfluency profiles between CWNS and CWS. The assessment covers both the dominant and nondominant language to examine the impact of language dominance on disfluency patterns. Method: A total of 92 Lebanese bilinguals (70 CWNS and 22 CWS) from 4;06 to 7;06 (years;months) were included. Language dominance was determined based on parental assessments. Spontaneous and narrative speech samples were collected for each child in both languages and all stuttering-like disfluencies (SLD) and other disfluencies (OD) were coded. Results: On average, CWNS showed a significantly lower percentage of total SLD, weighted SLD, SLD subtypes, and iterations compared to CWS. However, the number of disfluencies of CWNS exceeded monolingual clinical standards. Language dominance did not impact SLD and OD percentages, but some differences for SLD subtypes emerged. Binary logistic regression analyses showed that repetitions and dysrhythmic phonations are good predictors for correct CWS or CWNS classification, in contrast to OD. A combination of predictors from both languages led to better classification than using predictors from either language alone. Conclusions: The current study shows that speech disfluency percentages in bilingual CWNS typically surpass monolingual standards and can be at par with those of CWS. However, through careful consideration of disfluency characteristics, ideally in both languages, an accurate differential diagnosis of stuttering in bilingual children can be achieved. [ABSTRACT FROM AUTHOR]

Auditory training can lead to notable enhancements in specific tasks, but whether these improvements generalize to untrained tasks like speech-in-noise (SIN) recognition remains uncertain. This study examined how training conditions affect generalization. Fifty-five young adults were divided into "Trained-in-Quiet" (n = 15), "Trained-in-Noise" (n = 20), and "Control" (n = 20) groups. Participants completed two sessions. The first session involved an assessment of SIN recognition and voice discrimination (VD) with word or sentence stimuli, employing combined fundamental frequency (F0) + formant frequencies voice cues. Subsequently, only the trained groups proceeded to an interleaved training phase, encompassing six VD blocks with sentence stimuli, utilizing either F0-only or formant-only cues. The second session replicated the interleaved training for the trained groups, followed by a second assessment conducted by all three groups, identical to the first session. Results showed significant improvements in the trained task regardless of training conditions. However, VD training with a single cue did not enhance VD with both cues beyond control group improvements, suggesting limited generalization. Notably, the Trained-in-Noise group exhibited the most significant SIN recognition improvements posttraining, implying generalization across tasks that share similar acoustic conditions. Overall, findings suggest training conditions impact generalization by influencing processing levels associated with the trained task. Training in noisy conditions may prompt higher auditory and/or cognitive processing than training in quiet, potentially extending skills to tasks involving challenging listening conditions, such as SIN recognition. These insights hold significant theoretical and clinical implications, potentially advancing the development of effective auditory training protocols. [ABSTRACT FROM AUTHOR]

Children with cochlear implants (CI) communicate in noisy environments, such as in classrooms, where multiple talkers and reverberation are present. Speakers compensate for noise via the 'Lombard effect'. The present study examined the Lombard effect on the intensity and duration of stressed vowels in the speech of children with Cochlear Implants (CIs) as compared to children with Normal Hearing (NH), focusing on the effects of speech-shaped noise (SSN) and speech-shaped noise with reverberation (SSN+Reverberation). The sample consisted of 7 children with CIs and 7 children with NH, aged 7–12 years. Regarding intensity, a) children with CIs produced stressed vowels with an overall greater intensity across acoustic conditions as compared to NH peers, b) both groups increased their stressed vowel intensity for all vowels from Quiet to both noise conditions, and c) children with NH further increased their intensity when reverberation was added to SSN, esp. for the vowel /u/. Regarding duration, longer stressed vowels were produced by children with CIs as compared to NH in Quiet and SSN conditions but the effect was retained only for the vowels /i/, /o/ and /u/ when reverberation was added to noise. The SSN+Reverberation condition induced systematic lengthening in stressed vowels for children with NH. Furthermore, although greater intensity and duration ratios of stressed/unstressed syllables were observed for children with NH as compared to CIs in Quiet condition, they diminished with noise. The differences observed across groups have implications for speaking in classroom noise. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the effectiveness of a specialized manual physical therapy (PT) program at improving voice among patients diagnosed with concomitant muscle tension dysphonia (MTD) and cervicalgia at a tertiary care voice center. Materials and Methods: Cervicalgia was determined by palpation of the anterior neck. Both voice therapy (VT) and PT was recommended for all patients diagnosed with MTD and cervicalgia. PT included full-body manual physical therapy with myofascial release. Patients underwent: 1) VT alone, 2) concurrent PT and VT (PT with VT), 3) PT alone, 4) VT, but did not have PT ordered by treating clinician (VT without PT order) or 5) VT followed by PT (VT then PT). The pairwise difference in post–Voice Handicap Index-10 (VHI-10) controlling for baseline variables was calculated with a linear regression model. Results: 178 patients met criteria. All groups showed improvement with treatment. The covariate-adjusted differences in mean post–VHI-10 improvement comparing the VT alone group as a reference were as follows: PT with VT 9.95 (95% confidence interval 7.70, 12.20); PT alone 8.31 (6.16, 10.45); VT without PT order 8.51 (5.55, 11.47); VT then PT 5.47 (2.51, 8.42). Conclusion: Among patients diagnosed with MTD with cervicalgia, treatment with a specialized PT program was associated with improvement in VHI-10 scores regardless of whether they had VT. While VT is the standard of care for MTD, PT may also offer benefit for MTD patients with cervicalgia. [ABSTRACT FROM AUTHOR]

Purpose: This case study measured how well the Lee Silverman Voice Treatment (LSVT) improved vocal features, intelligibility, and communicative effectiveness for a multilingual participant with hypokinetic-hyperkinetic dysarthria secondary to suspected progressive supranuclear palsy. LSVT treatment was chosen for the participant due to the strengths and deficits he presented with prior to treatment, and for the anticipated challenges in treatment that may arise from the presence of multilingualism and impaired cognitive functioning. Methods: A multilingual patient in their 60's (English, Spanish, and French) with hypokinetic-hyperkinetic dysarthria secondary to suspected progressive supranuclear palsy completed the standard treatment sessions for LSVT. Assessment measures were taken at baseline, immediately post-treatment, and three-months post-treatment. Results: Improvementswere measured in vocal quality, vocal loudness, intelligibility, and communicative effectiveness immediately post-treatment. Three months posttreatment, improvements in vocal quality and intelligibility were maintained. Conclusion: This case study illustrates that LSVT may be a beneficial treatment for complex clients who are multilingual and present with complex comorbidities and cognitive deficits. LSVT resulted in some meaningful changes in vocal quality, intelligibility, and communicative effectiveness for this individual. Clinicians who work with complex patients may wish to consider the theoretical underpinnings of LSVT, client profile, areas of client need, and ability and desire to complete an intensive treatment program to determine if trialing LSVT is appropriate. The use of LSVT with complex clients may yield positive outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This study explored how respiration, voice, and speech were affected following expiratory muscle strength training (EMST) and maintenance training in persons with Parkinson's disease (PD) or multiple sclerosis (MS). Method: Nine participants with PD and six with MS participated in a randomised study, where the effects of EMST, sham, and maintenance treatment were investigated. Outcome measures included maximum expiratory pressure (MEP); maximum phonation time (MPT); intelligibility; verbal diadochokinesis (DDK); speech rate; a self-report form on voice, speech, and communication; and open questions about how the participants experienced the intervention. Group comparisons were performed within and between groups. Result: The PD and the MS groups both improved significantly in MEP, and this improvement remained after 3 months of maintenance EMST. An improvement was also seen in DDK. Post-EMST, 33% of the PD group and 80% of the MS group reported a positive effect on communication. Conclusion: The results of this study support previous evidence that EMST has positive effects on expiratory pressure in persons with PD or MS, but its effect on voice and speech remains unclear. Since subjective reports of the intervention and effects on communication were predominantly positive, further research is needed on larger groups to explore appropriate outcome measures. [ABSTRACT FROM AUTHOR]

Background: Music learning induces significant neural changes, enhancing auditory, verbal, and visuospatial skills, IQ, and speech perception. Research studies reveal structural and functional brain plasticity due to music training in adults and children. While musical abilities are linked to formal training, the existence of "musical sleepers" with heightened speech perception without formal training is noteworthy in adults. This study addresses the gap in understanding such phenomena in children, exploring psychophysical abilities in musically adept children, and aiming to impact rehabilitation models. Materials and method: A pre-experimental study involved 164 typically developing children (mean age: 9.93) without musical training. Musical abilities were evaluated using the abbreviated version of Montreal Battery for Evaluation of Musical Abilities (MBEMA) test in DMDX software, covering melody, rhythm, and memory subtests. Psychophysical tests in MATLAB assessed temporal, frequency, intensity, timbre, and binaural resolution. Results: Using a median split based on MBEMA test scores (median: 42), 84 children exhibited poor musical abilities, while 80 showed good ones. Descriptive statistics for MBEMA scores and psychophysical tests were conducted. As data did not follow normal distribution, non-parametric inferential statistics were employed. Mann–Whitney U tests revealed significant differences favouring good musical abilities in all assessments: gap deduction (p = 0.01), pitch discrimination at 500 Hz and 4 kHz (p = 0.00), intensity discrimination at 500 Hz (p = 0.00) and 4 kHz (p = 0.01), profile analysis (p = 0.01), interaural level difference (p = 0.023), and interaural time difference (p = 0.038). Spearman correlation showed highest correlation with pitch discrimination at 500 Hz (r = − 0.538), 4 kHz (− 0.416), intensity discrimination at 4 kHz (r = − 0.367), and 500 Hz (r = − 0.311), profile analysis (r = − 0.313), interaural level difference (r = − 0.276), and gap deduction (r = − 0.235). All were significant (p < 0.01), except for the interaural time difference. Conclusion: Children excelling in music surpassed those with weaker abilities in psychophysical tasks. This echoes past research, underscoring auditory discrimination's influence on musical skills in untrained children. These results potentially support the concept of musical sleepers in children. Key predictors include pitch discrimination, while interaural time difference exhibited minimal correlation. Utilising such assessments may predict musical training outcomes for children with auditory disorders, but additional robust statistical investigation is necessary. [ABSTRACT FROM AUTHOR]

Background and Aim: To date, little research is available that objectively quantifies female adolescent singing-voice characteristics in light of the physiological and functional developments that occur from puberty to adulthood. This exploratory study sought to augment the pool of data available that offers objective voice analysis of female singers in late adolescence. Methods: Using long-term average spectra (LTAS) and inverse filtering techniques, dynamic range and voice-source characteristics were determined in a cohort of vocally healthy cis-gender female adolescent singers (17 to 19 years) from high-school choirs in Aotearoa New Zealand. Non-parametric statistics were used to determine associations and significant differences. Results: Wide intersubject variation was seen between dynamic range, spectral measures of harmonic organisation (formant cluster prominence, FCP), noise components in the spectrum (high-frequency energy ratio, HFER), and the normalised amplitude quotient (NAQ) suggesting great variability in ability to control phonatory mechanisms such as subglottal pressure (Psub), glottal configuration and adduction, and vocal tract shaping. A strong association between the HFER and NAQ suggest that these non-invasive measures may offer complimentary insights into vocal function, specifically with regard to glottal adduction and turbulent noise in the voice signal. Conclusion: Knowledge of the range of variation within healthy adolescent singers is necessary for the development of effective and inclusive pedagogical practices, and for vocal-health professionals working with singers of this age. LTAS and inverse filtering are useful non-invasive tools for determining such characteristics. [ABSTRACT FROM AUTHOR]

Background: The health measures imposed by COVID-19 on workplaces created adverse communication settings. Our cross-sectional study aimed to document the nature and severity of the vocal difficulties experienced by educational professionals a few weeks after the implementation of health measures in schools and early childhood settings in Quebec, Canada while teaching in class. Methods: To this end, we conducted a self-report survey containing nine close-ended questions and one open-ended question regarding self-reported vocal difficulties and the implementation of health measures. The survey was answered by 194 educational professionals in October 2020. Results: Since the introduction of the health measures, respondents reported often or always: having difficulty making themselves heard (66.5%), needing to strain their voice (68.1%), having throat pain after work (38.1%), and being concerned about their vocal health (25.2%). 35.6% perceived that their voice changed moderately or a lot and 75.3% did not feel equipped to take care of their vocal health. Fisher's exact tests revealed the difficulties overall were more present in women (p < 0.05). Discussion: The qualitative analysis of open-ended question answers shows a circular process at play, where the vocal responses to the COVID-19-induced communication barriers contribute to creating more problematic communication settings, thus increasing the challenges for vocal health. Better equipping the professionals to take care of their vocal health by developing resources in their professional settings to help them face vocal challenges in both every day as well as extreme situations, should be a priority. [ABSTRACT FROM AUTHOR]

Voice interventions for transgender individuals can address several speech and voice parameters – fundamental frequency, resonance, intonation, rhythm, and intensity. In this study, we focus on fundamental voice frequency and build on existing research to test one technique that has been shown in a preliminary study to effectively adjust fundamental voice frequency in line with clients' goals. More specifically, we employed an adaptation of melodic intonation therapy (MIT) to assess whether it can raise trans women's average fundamental frequency to a significant degree. Eleven trans women participated in two one-to-one therapy sessions, four weeks apart. Results pointed to a statistically significant rise in both their singing and speaking fundamental frequencies following the adapted MIT therapy sessions. Participants were also successful in imitating upward fundamental frequency contours when singing and in producing them independently in the speech modality. Longitudinal studies are warranted to determine whether the observed positive results translate into long-term benefits. [ABSTRACT FROM AUTHOR]

Background and Aim: Hearing-impaired individuals have difficulty comprehending and producing speech sounds. Cochlear implantation is used to augment hearing. The present study aims to compare the production of fricatives /s/ and /ʃ/ and affricate /ʧ/ by Persianspeaking Cochlear-Implanted (CI) and Normal-Hearing (NH) children Methods: Fifteen Persian-speaking NH children and 15 Persian-speaking CI children, matched for age, gender, and general health conditions, were included in the study. The stimuli included two voiceless Persian fricatives /s/ and /ʃ/ and one voiceless Persian affricate /ʧ/ along with the open front vowel /æ/ in three Consonant-Vowel (CV), Consonant-VowelConsonant (CVC), and Vowel-Consonant (VC) contexts (/sæ/, /æsæ/, /æs/, /ʃæ/, /æʃæ/, /æʃ/, /ʧæ/, /æʧæ/, /æʧ/). After recording all utterances, Praat software was used to measure the friction duration, rise time, and spectral peak of the consonants Results: The CI children could not distinguish between /ʃ/ and /ʧ/ and produced affricate /ʧ/ as an allophone of /ʃ/ (p=0.01). Moreover, distinguishing between two fricatives /s/ and /ʃ/ was difficult for both groups. While NH children slightly treated these two sounds differently, the CI group produced fricative /s/ as an allophone of /ʃ/ (p=0.02). The rise time of /ʃ/ was longer in the NH children, except for /ʧæ/, where the CI children had a longer rise time. Conclusion: The speech of CI children is different in producing /s/, /ʃ/, and /ʧ/ from their NH peers. The results can help speech therapists, clinical linguists, and application designers focus on speech sounds that are challenging for CI children to produce. [ABSTRACT FROM AUTHOR]

Purpose: There is a dearth of literature in determining whether language groups for whom aspiration and/or voicing is phonologically contrastive show better perception relative to those who do not use these features contrastively and whether the cue type modulates perception in noise. This study addresses perception of laryngeal cues (voicing and aspiration) by Hindi, English, and Tamil listeners, in quiet and in noise. Method: Sixteen participants between 20 and 45 years of age were included in each of the three language groups. The stimuli were bilabial stops that contrasted phonetically in voicing and aspiration, voicing-lead [ba], short-lag [pa], and long-lag aspirated [pha], with one set corresponding to the Hindi phonemes /ba/, /pa/, and /ph a/ and the second set to the English phonemes /ba/ and /pa/ (which are phonetically [pa] and [pha], respectively). Tamil includes only the short-lag [pa] as a bilabial stop consonant. The stimuli were presented at 70 dB SPL, in quiet and in speech-shaped noise at a signal-to-noise ratio of 0. Participants performed two speech identification tasks and a speech discrimination task. Results: Patterns of perceptual assimilation related to the first language were observed in all three language groups, and accuracy was generally higher in quiet than in noise. Hindi participants identified the English /pa/ as Hindi /ph a/ and English /ba/ as Hindi /pa/. The American English participants identified Hindi /ph a/ as English /pa/ and both the Hindi /pa/ and Hindi /ba/ as English /ba/. In contrast, Tamil listeners generally perceived both Hindi and English bilabial stops as one category, regardless of voicing and aspiration. English and Hindi participants generally showed higher accuracy for native language stimuli. Patterns of assimilation in quiet and noise differed across language groups for each stimulus type. The aspirated stimuli were most likely to be misperceived in noise by all groups (often as /ha/). Conclusions: The results serve as evidence that listeners accurately access native language speech cues, even in noise. The results contribute toward a better understanding of cross-linguistic speech processing in noise. [ABSTRACT FROM AUTHOR]

Purpose: Researchers often use identification or goodness rating tasks to assess speech perception for different populations. These tasks provide useful information about a listener’s willingness to accept a range of acoustically variable stimuli as belonging to the same category and also about assessing how stimuli that are labeled the same may not be perceived as equally good versions of a particular speech sound. Many methodological aspects of these simple tasks have been tested, but one aspect that has not is the choice of label. In this study, we examine response patterns to images versus letters, as studies with different populations (children vs. adults) or different methods (typical behavioral study vs. visual world paradigm) may vary in the type of label used. Method: Eighty-one adult listeners completed phoneme identification and goodness ratings tasks with either images of response options (a picture of a bear and a picture of a pear) or with letter labels (a capital B and P). Results: The results suggest that choice of label does not alter performance within the tasks studied here. In addition, the results did show the expected finding that the slope of the response curve is steeper in an identification task than in a goodness rating task. Conclusion: These results suggest that it is possible to compare across studies that use different response options, a benefit to research and practice because letter labels can be used for non-imageable words and nonwords, whereas images may be best used for participants who are younger or have poorer reading skills. [ABSTRACT FROM AUTHOR]

Purpose: Although different factors and voice measures have been associated with phonotraumatic vocal hyperfunction (PVH), it is unclear what percentage of individuals with PVH exhibit such differences during their daily lives. This study used a machine learning approach to quantify the consistency with which PVH manifests according to ambulatory voice measures. Analyses included acoustic parameters of phonation as well as temporal aspects of phonation and rest, with the goal of determining optimally consistent signatures of PVH. Method: Ambulatory neck-surface acceleration signals were recorded over 1 week from 116 female participants diagnosed with PVH and age-, sex-, and occupation-matched vocally healthy controls. The consistency of the manifestation of PVH was defined as the percentage of participants in each group that exhibited an atypical signature based on a target voice measure. Evaluation of each machine learning model used nested 10-fold cross-validation to improve the generalizability of findings. In Experiment 1, we trained separate logistic regression models based on the distributional characteristics of 14 voice measures and durations of voicing and resting segments. In Experiments 2 and 3, features of voicing and resting duration augmented the existing distributional characteristics to examine whether more consistent signatures would result. Results: Experiment 1 showed that the difference in the magnitude of the first two harmonics (H1–H2) exhibited the most consistent signature (69.4% of participants with PVH and 20.4% of controls had an atypical H1–H2 signature), followed by spectral tilt over eight harmonics (73.6% participants with PVH and 32.1% of controls had an atypical spectral tilt signature) and estimated sound pressure level (SPL; 66.9% participants with PVH and 27.6% of controls had an atypical SPL signature). Additionally, 77.6% of participants with PVH had atypical resting duration, with 68.9% exhibiting atypical voicing duration. Experiments 2 and 3 showed that augmenting the best-performing voice measures with univariate features of voicing or resting durations yielded only incremental improvement in the classifier’s performance. Conclusions: Females with PVH were more likely to use more abrupt vocal fold closure (lower H1–H2), phonate louder (higher SPL), and take shorter vocal rests. They were also less likely to use higher fundamental frequency during their daily activities. The difference in the voicing duration signature between participants with PVH and controls had a large effect size, providing strong empirical evidence regarding the role of voice use in the development of PVH. [ABSTRACT FROM AUTHOR]

Introduction: Smart devices are widely available and capable of quickly recording and uploading speech segments for health-related analysis. The switch from laboratory recordings with professional-grade microphone setups to remote, smart device-based recordings offers immense potential for the scalability of voice assessment. Yet, a growing body of literature points to a wide heterogeneity among acoustic metrics for their robustness to variation in recording devices. The addition of consumer-grade plug-and-play microphones has been proposed as a possible solution. The aim of our study was to assess if the addition of consumer-grade plug-and-play microphones increases the acoustic measurement agreement between ultra-portable devices and a reference microphone. Methods: Speech was simultaneously recorded by a reference high-quality microphone commonly used in research and by two configurations with plug-and-play microphones. Twelve speech-acoustic features were calculated using recordings from each microphone to determine the agreement intervals in measurements between microphones. Agreement intervals were then compared to expected deviations in speech in various neurological conditions. Each microphone's response to speech and to silence was characterized through acoustic analysis to explore possible reasons for differences in acoustic measurements between microphones. The statistical differentiation of two groups, neurotypical and people with multiple sclerosis, using metrics from each tested microphone was compared to that of the reference microphone. Results: The two consumer-grade plug-and-play microphones favored high frequencies (mean center of gravity difference ≥ +175.3 Hz) and recorded more noise (mean difference in signal to noise ≤ −4.2 dB) when compared to the reference microphone. Between consumer-grade microphones, differences in relative noise were closely related to distance between the microphone and the speaker's mouth. Agreement intervals between the reference and consumer-grade microphones remained under disease-expected deviations only for fundamental frequency (f0, agreement interval ≤0.06 Hz), f0 instability (f0 CoV, agreement interval ≤0.05%), and tracking of second formant movement (agreement interval ≤1.4 Hz/ms). Agreement between microphones was poor for other metrics, particularly for fine timing metrics (mean pause length and pause length variability for various tasks). The statistical difference between the two groups of speakers was smaller with the plug-and-play than with the reference microphone. Conclusion: Measurement of f0 and F2 slope was robust to variation in recording equipment, while other acoustic metrics were not. Thus, the tested plug-and-play microphones should not be used interchangeably with professional-grade microphones for speech analysis. Plug-and-play microphones may assist in equipment standardization within speech studies, including remote or self-recording, possibly with small loss in accuracy and statistical power as observed in the current study. [ABSTRACT FROM AUTHOR]

Background: Maximum phonation time (MPT) is used to assess speech and other oral rehabilitation‐related issues. Various factors contribute to MPT decline in older individuals. Although the impact of physical frailty on MPT has been suggested, this has not been conclusively determined. Objective: To examine the relationship between MPT and physical frailty in community‐dwelling individuals aged ≥60 years who were independently mobile. MPT‐associated factors were investigated. Methods: This cross‐sectional study analysed the clinical data of 122 patients (age [interquartile range]: 80.0 [74.0–83.0] years) without dementia who visited a neurology department between 1 February 2021 and 31 January 2023. Investigated factors included age, sex, weight, height, body mass index, smoking history, grip strength, functional independence measure, vital capacity, oral diadochokinesis, MPT and the Japanese Cardiovascular Health Study score. Physical frailty was assessed based on the total score from five items (weight loss, weakness, exhaustion, slowness and low physical activity). The relationship between MPT and physical frailty was examined using Spearman's rank correlation coefficient and hierarchical multiple regression analysis. Results: The MPT was negatively correlated with age (r = −0.347, p <.01) and physical frailty (r = −0.681, p <.01) and positively correlated with vital capacity (r = 0.474, p <.01) and height (r = 0.248, p <.01). The hierarchical multiple regression analysis, conducted with MPT as the dependent variable, demonstrated that physical frailty (β = −.59, 95% confidence interval: −0.74 to 0.43, p <.001) had a strong influence on MPT. Conclusion: In older individuals, MPT is associated with physical frailty. When assessing MPT in clinical settings, it is advisable to perform a concurrent assessment of physical frailty. [ABSTRACT FROM AUTHOR]

Background: Perceptual measures such as speech intelligibility are known to be biased, variant and subjective, to which an automatic approach has been seen as a more reliable alternative. On the other hand, automatic approaches tend to lack explainability, an aspect that can prevent the widespread usage of these technologies clinically. Aims: In the present work, we aim to study the relationship between four perceptual parameters and speech intelligibility by automatically modelling the behaviour of six perceptual judges, in the context of head and neck cancer. From this evaluation we want to assess the different levels of relevance of each parameter as well as the different judge profiles that arise, both perceptually and automatically. Methods and Procedures: Based on a passage reading task from the Carcinologic Speech Severity Index (C2SI) corpus, six expert listeners assessed the voice quality, resonance, prosody and phonemic distortions, as well as the speech intelligibility of patients treated for oral or oropharyngeal cancer. A statistical analysis and an ensemble of automatic systems, one per judge, were devised, where speech intelligibility is predicted as a function of the four aforementioned perceptual parameters of voice quality, resonance, prosody and phonemic distortions. Outcomes and Results: The results suggest that we can automatically predict speech intelligibility as a function of the four aforementioned perceptual parameters, achieving a high correlation of 0.775 (Spearman's ρ). Furthermore, different judge profiles were found perceptually that were successfully modelled automatically. Conclusions and Implications: The four investigated perceptual parameters influence the global rating of speech intelligibility, showing that different judge profiles emerge. The proposed automatic approach displayed a more uniform profile across all judges, displaying a more reliable, unbiased and objective prediction. The system also adds an extra layer of interpretability, since speech intelligibility is regressed as a direct function of the individual prediction of the four perceptual parameters, an improvement over more black box approaches. WHAT THIS PAPER ADDS: What is already known on this subject: Speech intelligibility is a clinical measure typically used in the post‐treatment assessment of speech affecting disorders, such as head and neck cancer. Their perceptual assessment is currently the main method of evaluation; however, it is known to be quite subjective since intelligibility can be seen as a combination of other perceptual parameters (voice quality, resonance, etc.). Given this, automatic approaches have been seen as a more viable alternative to the traditionally used perceptual assessments. What this study adds to existing knowledge: The present work introduces a study based on the relationship between four perceptual parameters (voice quality, resonance, prosody and phonemic distortions) and speech intelligibility, by automatically modelling the behaviour of six perceptual judges. The results suggest that different judge profiles arise, both in the perceptual case as well as in the automatic models. These different profiles found showcase the different schools of thought that perceptual judges have, in comparison to the automatic judges, that display more uniform levels of relevance across all the four perceptual parameters. This aspect shows that an automatic approach promotes unbiased, reliable and more objective predictions. What are the clinical implications of this work?: The automatic prediction of speech intelligibility, using a combination of four perceptual parameters, show that these approaches can achieve high correlations with the reference scores while maintaining a certain degree of explainability. The more uniform judge profiles found on the automatic case also display less biased results towards the four perceptual parameters. This aspect facilitates the clinical implementation of this class of systems, as opposed to the more subjective and harder to reproduce perceptual assessments. [ABSTRACT FROM AUTHOR]

In bi- and monolingual children, nonword repetition tasks (NWRTs) differentiate typically developing (TD) children from children with Developmental Language Disorder (DLD) or children with a risk of DLD. Previous research has highlighted the importance of considering language specificity in nonword (NW) construction especially for bilingual children. A novel NWRT has been designed for the screening of DLD risk in the bilingual Italian-German preschool population, creating lists of language-specific (for the two target languages) and language-non-specific NWs. This study aimed to test the discriminative validity of this NWRT and to identify the characteristics of the NWs that maximise discriminative validity within language-specific and language-non-specific subsets. The findings confirm the role of language specificity (in terms of target language alikeness) but also of other characteristics related to word structure complexity. [ABSTRACT FROM AUTHOR]

This study investigated a sound change in progress by which the Central Bavarian dialect feature of complementary length between consonant and the preceding vowel is giving way to the unrestricted combination possibility of long (Vː) and short (V) vowels with following longer fortis (Cː) and shorter lenis (C) stops, respectively. This 2 × 2 system is also found in the standard variety of German. While previous studies have regarded any such findings of convergence toward Standard German as being a result of language contact, the present study specifically tested the possibility of fast-speech-induced hypoarticulation being a system-internal driver of this change. The focus of this study was on acoustic cues to the postvocalic stop. Following the apparent-time paradigm, acoustic analyses of 10 younger and 10 older dialect speakers revealed that (1) younger dialect speakers produced both VC and VːCː (both formerly illegal in the dialect), but (2) older dialect speakers produced only VːCː sequences with duration patterns similar to those of the control group of 10 Standard German speakers. Analyses of various dependent variables further showed (3) the (apparently) delayed emergence of aspiration as an additional cue to the fortis–lenis contrast in Western Central Bavarian particularly in younger dialect speakers, (4) no considerable effect of speech rate on the dispersion of and overlap between any of the four vowel-plus-stop combinations, and (5) the irregular spread of this change that appears to be gradual. As such, the findings support a model of linguistic change that also accounts for gradual changes in dialect borrowing. [ABSTRACT FROM AUTHOR]

Prosodic aspects of cross-linguistic contact are under-researched, especially past contact that has subsequently ceased. In this paper, we investigate declarative and polar question tunes of contemporary Cretan Greek, a regional variety of Greek whose speakers were in contact with Venetian speakers during the four and half centuries of Venetian rule on the island, from 1204 to 1669. The F0 contours of the Cretan tunes and alignment of peaks and troughs of interest with the nuclear vowel are compared to the corresponding tunes in Venetian dialect and Venetian Italian and to those in Athenian (Standard) Greek, which are used as control. The data (1610 declarative utterances and 698 polar questions) were drawn from natural speech corpora based on pragmatic criteria: broad focus for declaratives, broad focus, and information-seeking interpretation for polar questions. The pitch contour shapes of the tunes are modeled using polynomial basis functions, and the F0 alignment points are determined analytically. The results show the robustness of contact effects almost three and a half centuries after regular contact ceased and indicate that the shapes of the F0 contours of Cretan and Venetian declarative and polar question tunes are similar. In addition, Cretan alignment patterns are similar to Venetian and significantly different from Athenian. Insights are gained from research into how long prosodic characteristics may persist in a recipient language—decades or even centuries after the cessation of contact. [ABSTRACT FROM AUTHOR]

Purpose: The present study examined whether participants respond to unperturbed parameters while experiencing specific perturbations in auditory feedback. For instance, we aim to determine if speakers adjust voice loudness when only pitch is artificially altered in auditory feedback. This phenomenon is referred to as the “accompanying effect” in the present study. Method: Thirty native Mandarin speakers were asked to sustain the vowel /ɛ/ for 3 s while their auditory feedback underwent single shifts in one of the three distinct ways: pitch shift (±100 cents; coded as PT), loudness shift (±6 dB; coded as LD), or first formant (F1) shift (±100 Hz; coded as FM). Participants were instructed to ignore the perturbations in their auditory feedback. Response types were categorized based on pitch, loudness, and F1 for each individual trial, such as Popp_Lopp_Fopp indicating opposing responses in all three domains. Results: The accompanying effect appeared 93% of the time. Bayesian Poisson regression models indicate that opposing responses in all three domains (Popp_Lopp_Fopp) were the most prevalent response type across the conditions (PT, LD, and FM). The more frequently used response types exhibited opposing responses and significantly larger response curves than the less frequently used response types. Following responses became more prevalent only when the perturbed stimuli were perceived as voices from someone else (external references), particularly in the FM condition. In terms of isotropy, loudness and F1 tended to change in the same direction rather than loudness and pitch. Conclusion: The presence of the accompanying effect suggests that the motor systems responsible for regulating pitch, loudness, and formants are not entirely independent but rather interconnected to some degree. [ABSTRACT FROM AUTHOR]

Purpose: Literature suggests a dependency of the acoustic metrics, smoothed cepstral peak prominence (CPPS) and harmonics-to-noise ratio (HNR), on human voice loudness and fundamental frequency (F0). Even though this has been explained with different oscillatory patterns of the vocal folds, so far, it has not been specifically investigated. In the present work, the influence of three elicitation levels, calibrated sound pressure level (SPL), F0 and vowel on the electroglottographic (EGG) and time-differentiated EGG (dEGG) metrics hybrid open quotient (OQ), dEGG OQ and peak dEGG, as well as on the acoustic metrics CPPS and HNR, was examined, and their suitability for voice assessment was evaluated. Method: In a retrospective study, 29 women with a mean age of 25 years (± 8.9, range: 18–53) diagnosed with structural vocal fold pathologies were examined before and after voice therapy or phonosurgery. Both acoustic and EGG signals were recorded simultaneously during the phonation of the sustained vowels /ɑ/, /i/, and /u/ at three elicited levels of loudness (soft/comfortable/loud) and unconstrained F0 conditions. Results: A linear mixed-model analysis showed a significant effect of elicitation effort levels on peak dEGG, HNR, and CPPS (all p < .01). Calibrated SPL significantly influenced HNR and CPPS (both p < .01). Furthermore, F0 had a significant effect on peak dEGG and CPPS (p < .0001). All metrics showed significant changes with regard to vowel (all p < .05). However, the treatment had no effect on the examined metrics, regardless of the treatment type (surgery vs. voice therapy). Conclusions: The value of the investigated metrics for voice assessment purposes when sampled without sufficient control of SPL and F0 is limited, in that they are significantly influenced by the phonatory context, be it speech or elicited sustained vowels. Future studies should explore the diagnostic value of new data collation approaches such as voice mapping, which take SPL and F0 effects into account. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine (a) diagnostic accuracy of acoustic measures of glottal stop production (GSP; intensity differences, slopes, complete voicing cessation) to distinguish between unilateral vocal fold paresis/ paralysis (UVFP) patients and controls; (b) if acoustic measures of GSP significantly correlated with an acoustic measure of voice disorder severity, acoustic voice quality index (AVQI); and (c) if acoustic measures from another type of voicing cessation, voiceless consonant production, also significantly differed between groups. Method: Ninety-seven patients with unilateral paresis/paralysis and 35 controls with normal laryngostroboscopic signs produced two sets of five repeated [i] and four repeated [isi]. Tokens were randomized by type between groups and analyzed blinded using a customized Praat program that computed intensity differences and slopes between vowel maxima and glottal stop minima for inter-[i] tokens and vowel maxima and voiceless consonant minima for intra-[isi] tokens. The number of voicing cessations for inter-[i] tokens was obtained. Results: Onset and offset intensity differences and number of voicing cessations from inter-[i] tokens had the greatest areas under the curve (.854, .856, and .835, respectively). Correlation coefficients were significant (p < .01) between AVQI and all GSP acoustic measures with weak/medium effect sizes. No significant differences were found between controls and participants with UVFP for acoustic measures from intra-[isi]. Conclusions: Acoustic GSP measures demonstrated good diagnostic accuracy and some relationship to severity of voice disorder. No significant differences in acoustic measures for medial voiceless fricative consonants between controls and participants with UVFP suggested that voicing cessation for voiceless fricatives differs from voicing cessation for GSP. [ABSTRACT FROM AUTHOR]

Objective: This study analyses the incidence of subjectively experienced dysphagia and voice change in post-thyroidectomy and parathyroidectomy patients without recurrent laryngeal nerve palsy. Methods: A total of 400 patients were invited to participate in a telephone questionnaire based on the Dysphagia Handicap Index and Voice Handicap Index. At 6–24 months following surgery, participants were divided into: post-thyroid surgery (total, hemi-, parathyroidectomy) groups and controls (other ENT procedures). A total of 254 responses were received (127 following thyroid surgery, 127 controls). Results: Twenty-two per cent of post-thyroidectomy patients had a Voice Handicap Index score of more than 3, compared to 15 per cent of parathyroid patients and 4 per cent of controls. The mean Dysphagia Handicap Index score for patients post thyroidectomy and hemi-thyroidectomy was 2.0. Parathyroidectomy patients had a mean Dysphagia Handicap Index score of 1.3, higher than controls at 1.0. Conclusion: Dysphagia and voice alteration are common following thyroid surgery, even in the absence of recurrent laryngeal nerve injury. Both deficits occur more frequently following thyroid surgery than parathyroid surgery. [ABSTRACT FROM AUTHOR]

Tracheostomy involves a challenging care process in which both patients and caregivers have difficulty communicating. Loss of speaking ability negatively affects caregivers as well as patients. The objective of this study was to examine the experiences of caregivers of patients with tracheostomy during care and after the first vocal exercise. This is a qualitative interview study using in-depth interviews. We used Colaizzi's method of data analysis. The interviews were carried out with 17 caregivers from March to July 2023. Two main themes were identified: the communication process and the first time hearing the patient's voice. In addition, communication techniques, difficulty in communication, providing motivation, and emotions were considered as subthemes. A better quality of care can be provided by understanding the experiences of caregivers of patients with tracheostomy, by sharing feelings and thoughts, and by using patient-specific communication methods. [ABSTRACT FROM AUTHOR]

Objective: Bilateral vocal fold paralysis is characterised by complete or partial immobilisation of the vocal folds, resulting in narrowing of the airway at the glottic level and breathing difficulty. This study aimed to evaluate the outcomes of surgical treatments for bilateral vocal cord paralysis, focussing on airway patency, voice quality, and associated complications. Materials and Methods: A prospective study was conducted on 25 female patients, aged 20–50 years, who presented to our department between June 2016 and May 2021 with a diagnosis of bilateral vocal cord paralysis. All patients underwent posterior cordotomy or partial arytenoidectomy. Results: Following surgery, significant improvement was observed in breathing, and voice quality improved to an acceptable level over a 2-month period. The applied surgical procedures demonstrated satisfactory outcomes in terms of breathing and voice functions. Conclusion: The findings of this study suggest that posterior cordotomy and partial arytenoidectomy are effective surgical interventions for treating bilateral abductor vocal fold paralysis. These procedures resulted in improved airway patency and acceptable voice quality, thereby providing satisfactory outcomes for patients. [ABSTRACT FROM AUTHOR]

Objective: Antineutrophil cytoplasmic antibody-associated vasculitides (AAV) can affect the upper and lower respiratory tract. Evaluation of voice quality was aimed at patients with AAV in this paper. Materials and Methods: In this study, AAV-diagnosed patients and their age-gender-compatible healthy counterparts were enrolled. Participants with histories of airway surgery, smoking, laryngopharyngeal reflux symptoms, allergy, active nose, throat, and larynx infection were excluded. After the otolaryngologic examination, Voice Handicap Index-10 (VHI) scores, maximum phonation times (MPT), auditory-perceptual analysis of voice (GRBAS score), and acoustic analysis were performed. The MPT, VHI, GRBAS, F0, jitter, shimmer, and harmonic-to-noise ratio (HNR) values of both groups were compared statistically. Parameters were evaluated using the PRAAT software. Results: There were 30 subjects in each group (16 women and 14 men). The mean ages were 51.1 and 51.5 years in the patient and control groups. Significant differences were found between the two groups regarding median VHI scores, MPT, and GRBAS scores (p<0.05). While median VHI and GRBAS scores were higher in the vasculitis group, median MPT was shorter. Conclusion: Voice quality may disturb patients with AAV, especially in terms of VHI, MPT, and GRBAS scores. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the vocal behaviors of group fitness instructors (GFIs), explore awareness among GFIs about voice-specialized health care, and assess the potential utility of a GFI-specific voice handicap questionnaire. Method: An anonymous 27-question survey was distributed digitally to GFIs. In addition to collecting demographic data and information about vocal behaviors and demands, the survey included a 10-question GFI-specific questionnaire (GFI-VHI-10) adapted from the Singing Voice Handicap Index-10. Results: Fifty-two GFIs participated in the study (75% female, 25% male) with a mean age of 44.6 years. Forty-six percent reported having a voice problem (VP) since entering the fitness industry. Of those 24 individuals, only four received treatment. There was a statistically significant difference in mean GFIVHI- 10 scores between the VP group (11.87) and the non-VP group (6.1), (p < .001). Of all respondents, 56% reported never or almost never wearing a microphone while instructing. When asked what they would do if they experienced a VP that lasted for longer than 2 weeks, only 9.6% would see a laryngologist, 23% would see an otolaryngologist, 31% would see their primary care provider, 11.5% were unsure, and 25% would ignore it and hope for spontaneous improvement. Conclusions: Although GFIs are at increased risk for vocal health challenges due to their occupational voice demands, their adherence to vocal health maintenance behaviors and awareness of voice-specialized health care may be limited. The GFI-VHI-10 is a promising tool in that it captured higher scores in the VP group than the non-VP group; however, further exploration is warranted. [ABSTRACT FROM AUTHOR]

Introduction: Parkinson's disease (PD) is the second most common neurodegenerative disease and affects millions of people. Accurate diagnosis and subsequent treatment in the early stages can slow down disease progression. However, making an accurate diagnosis of PD at an early stage is challenging. Previous studies have revealed that even for movement disorder specialists, it was difficult to differentiate patients with PD from healthy individuals until the average modified Hoehn-Yahr staging (mH&Y) reached 1.8. Recent researches have shown that dysarthria provides good indicators for computer-assisted diagnosis of patients with PD. However, few studies have focused on diagnosing patients with PD in the early stages, specifically those with mH&Y ≥ 1.5. Method: We used a machine learning algorithm to analyze voice features and developed diagnostic models for differentiating between healthy controls (HCs) and patients with PD, and for differentiating between HCs and patients with mild PD (mH&Y ≥ 1.5). The models were independently validated using separate datasets. Results: Our results demonstrate that, a remarkable diagnostic performance of the model in identifying patients with mild PD (mH&Y ≥ 1.5) and HCs, with area under the ROC curve 0.93 (95% CI: 0.851.00), accuracy 0.85, sensitivity 0.95, and specificity 0.75. Conclusion: The results of our study are helpful for screening PD in the early stages in the community and primary medical institutions where there is a lack of movement disorder specialists and special equipment. [ABSTRACT FROM AUTHOR]

Individuals make faster left responses to small/er numbers and faster right responses to large/r numbers than vice versa. This "spatial–numerical association of response codes" (SNARC) effect represents evidence for an overlap between the cognitive representations of number and space. Theories of the SNARC effect differ in whether they predict bidirectional S-R associations between number and space or not. We investigated the reciprocity of S-R priming effects between number and location in three experiments with vocal responses. In Experiments 1 and 2, participants completed a number–location task, with digits as stimuli and location words as responses, and a location–number task, with physical locations as stimuli and number words as responses. In addition, we varied the S-R mapping in each task. Results revealed a strong SNARC effect in the number–location task, but no reciprocal SNARC effect in the location–number task. In Experiment 3, we replaced physical location stimuli with location words and digit stimuli with number words. Results revealed a regular and a reciprocal SNARC effect of similar size. Reciprocal SNARC effects thus seem to emerge with verbal location stimuli and vocal responses, but not with physical location stimuli and vocal responses. The S-R associations underlying the SNARC effect with vocal responses thus appear bidirectional and symmetrical for some combinations of stimulus and response sets, but not for others. This has implications for theoretical accounts of the SNARC effect which need to explain how stimulus mode affects the emergence of reciprocal but not regular SNARC effects. [ABSTRACT FROM AUTHOR]