Discourse Strategies and the Production of Prosody by Prelingually Deaf Adolescent Cochlear Implant Users.

Objectives: The purpose of this study is to assess the use of discourse strategies and the production of prosody by prelingually deaf adolescent users of cochlear implants (CIs) when participating in a referential communication task. We predict that CI users will issue more directives (DIRs) and make less use of information requests (IRs) in completing the task than their normally hearing (NH) peers. We also predict that in signaling these IRs and DIRs, the CI users will produce F0 rises of lesser magnitude than the NH speakers. Design: Eight prelingually deaf adolescent CI users and 8 NH adolescents completed a referential communication task, where participants were required to direct their interlocutor around a map. Participants were aged from 12.0 to 14.2 years. The mean age at implantation for the CI group was 2.1 years (SD 0.9). The use of IRs, DIRs, acknowledgments, and comments was compared between the two groups. The use and magnitude of fundamental frequency (F0) rises on IRs and DIRs was also compared. Results: The CI users differed from the NH speakers in how they resolved communication breakdown. The CI users showed a preference for repeating DIRs, rather than seeking information as did the NH speakers. A nonparametric Mann-Whitney U test indicated that the CI users issued more DIRs (U = 8, p = 0.01), produced fewer IRs (U = 13, p = 0.05) and fewer acknowledgments (U = 5, p = 0.003) than their NH counterparts. The CI users also differed in how they used F0 rises as a prosodic cue to signal IRs and DIRs. The CI users produced larger F0 rises on DIRs than on IRs, a pattern opposite to that displayed by the NH speakers. An independent samples t-test revealed that the CI users produced smaller rises on IRs compared with those produced by the NH speakers [t(12) = -2.762, p = 0.02]. Conclusions: The CI users differed from the NH speakers in how they resolved communication breakdown. The CI users showed a preference for repeating DIRs, rather than seeking information to understand their interlocutor's point of view. Their use of prosody to signal discourse function also differed from their NH peers. These differences may indicate a lack of understanding of how prosody is used to signal discourse modality by the CI users. This study highlights the need for further research focused on the interaction of prosody, discourse, and language comprehension. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Discourse Strategies and the Production of Prosody by Prelingually Deaf Adolescent Cochlear Implant Users.

Objectives: The purpose of this study is to assess the use of discourse strategies and the production of prosody by prelingually deaf adolescent users of cochlear implants (CIs) when participating in a referential communication task. We predict that CI users will issue more directives (DIRs) and make less use of information requests (IRs) in completing the task than their normally hearing (NH) peers. We also predict that in signaling these IRs and DIRs, the CI users will produce F0 rises of lesser magnitude than the NH speakers. Design: Eight prelingually deaf adolescent CI users and 8 NH adolescents completed a referential communication task, where participants were required to direct their interlocutor around a map. Participants were aged from 12.0 to 14.2 years. The mean age at implantation for the CI group was 2.1 years (SD 0.9). The use of IRs, DIRs, acknowledgments, and comments was compared between the two groups. The use and magnitude of fundamental frequency (F0) rises on IRs and DIRs was also compared. Results: The CI users differed from the NH speakers in how they resolved communication breakdown. The CI users showed a preference for repeating DIRs, rather than seeking information as did the NH speakers. A nonparametric Mann-Whitney U test indicated that the CI users issued more DIRs (U = 8, p = 0.01), produced fewer IRs (U = 13, p = 0.05) and fewer acknowledgments (U = 5, p = 0.003) than their NH counterparts. The CI users also differed in how they used F0 rises as a prosodic cue to signal IRs and DIRs. The CI users produced larger F0 rises on DIRs than on IRs, a pattern opposite to that displayed by the NH speakers. An independent samples t-test revealed that the CI users produced smaller rises on IRs compared with those produced by the NH speakers [t(12) = -2.762, p = 0.02]. Conclusions: The CI users differed from the NH speakers in how they resolved communication breakdown. The CI users showed a preference for repeating DIRs, rather than seeking information to understand their interlocutor's point of view. Their use of prosody to signal discourse function also differed from their NH peers. These differences may indicate a lack of understanding of how prosody is used to signal discourse modality by the CI users. This study highlights the need for further research focused on the interaction of prosody, discourse, and language comprehension. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Discourse Strategies and the Production of Prosody by Prelingually Deaf Adolescent Cochlear Implant Users.

Objectives: The purpose of this study is to assess the use of discourse strategies and the production of prosody by prelingually deaf adolescent users of cochlear implants (CIs) when participating in a referential communication task. We predict that CI users will issue more directives (DIRs) and make less use of information requests (IRs) in completing the task than their normally hearing (NH) peers. We also predict that in signaling these IRs and DIRs, the CI users will produce F0 rises of lesser magnitude than the NH speakers. Design: Eight prelingually deaf adolescent CI users and 8 NH adolescents completed a referential communication task, where participants were required to direct their interlocutor around a map. Participants were aged from 12.0 to 14.2 years. The mean age at implantation for the CI group was 2.1 years (SD 0.9). The use of IRs, DIRs, acknowledgments, and comments was compared between the two groups. The use and magnitude of fundamental frequency (F0) rises on IRs and DIRs was also compared. Results: The CI users differed from the NH speakers in how they resolved communication breakdown. The CI users showed a preference for repeating DIRs, rather than seeking information as did the NH speakers. A nonparametric Mann-Whitney U test indicated that the CI users issued more DIRs (U = 8, p = 0.01), produced fewer IRs (U = 13, p = 0.05) and fewer acknowledgments (U = 5, p = 0.003) than their NH counterparts. The CI users also differed in how they used F0 rises as a prosodic cue to signal IRs and DIRs. The CI users produced larger F0 rises on DIRs than on IRs, a pattern opposite to that displayed by the NH speakers. An independent samples t-test revealed that the CI users produced smaller rises on IRs compared with those produced by the NH speakers [t(12) = -2.762, p = 0.02]. Conclusions: The CI users differed from the NH speakers in how they resolved communication breakdown. The CI users showed a preference for repeating DIRs, rather than seeking information to understand their interlocutor's point of view. Their use of prosody to signal discourse function also differed from their NH peers. These differences may indicate a lack of understanding of how prosody is used to signal discourse modality by the CI users. This study highlights the need for further research focused on the interaction of prosody, discourse, and language comprehension. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Amplitude of Glottal Mucosal Wave After Vocal Fold Microflap With or Without Fibrin Glue

Publication date: Available online 11 August 2016
Source:Journal of Voice
Author(s): Ramón González-Herranz, Elizabeth Amarillo, Estefanía Hernández-García, José Montojo Woodeson, Guillermo Plaza-Mayor
IntroductionThe vocal fold microflap technique is the ideal to remove benign vocal fold pathology. Our objective is to compare the amplitudes of the mucosal wave before and after the closure of microflap defect with fibrin glue, and when microflap is left to heal by secondary intention.Materials and MethodsThe present study is a retrospective series, including 32 patients treated by intracordal phonosurgery, with closure of the microflap either with fibrin glue or by healing by secondary intention. They all had both preoperative and 6-month postoperative track records to allow voice analysis, a subjective Voice Handicap Index 10 (VHI-10), and a good image quality strobe.ResultsAfter selecting the patients was found that the mean overall preoperative VHI-10 was 26.6, and improved up to 10.5 after surgery, a statistical differences (P = 0.03). When comparing both groups, with or without fibrin glue, fibrin glue did not improved results in VHI-10. On the contrary, there was a significant difference in the improvement of the open glottal phase after surgery (P = 0.03), showing a much higher improvement when fibrin glue was used.ConclusionsThe use of fibrin glue after a vocal fold microflap for advanced pathology, such as sulcus vocalis in pocket, vergeture, or vocal fold scar, increases the amplitude of the mucosal wave of the vocal folds, but does not improve the VHI-10 results in our cohort of female patients. So far, patient-reported outcome shows that healing by secondary intention continues to provide excellent voice results.



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Risk Factors of Voice Disorders and Impact of Vocal Hygiene Awareness Program Among Teachers in Public Schools in Egypt

Publication date: Available online 11 August 2016
Source:Journal of Voice
Author(s): Sarah A. Bolbol, Marwa M. Zalat, Rehab A.M. Hammam, Nasser L. Elnakeb
ObjectivesEven though many studies have explored the problem of voice disorders among teachers worldwide, this problem is still not adequately studied in Egypt. The following study was conducted to investigate the risk factors of voice disorders among an Egyptian sample of school teachers, to measure the effect of a vocal hygiene awareness program on them, and to investigate their vocal cord lesions.MethodsOne hundred fifty-six teachers working in public schools and 180 administrative workers in the Faculty of Medicine in the same city participated in this study. They completed a self-administered questionnaire investigating voice disorders, and were subjected to a voice awareness program and a clinical examination.ResultsVoice-related symptoms and Voice Handicap Index were statistically significantly higher among teachers compared with the control subjects. Work duration and high frequency of classes per week of ≥15 were the most statistically significant indicators influencing a teacher's voice. Three months after application of vocal hygiene awareness program, the teachers who were studied showed a statistically significant increase in their awareness about vocal hygiene tips.ConclusionsEgyptian teachers working in public schools are dealing with classes that include a great number of students per class. They also have to deal with unprofessional facilities and limited assisting resources. Therefore, they are highly exposed to the risk of voice-related disorders. Increasing awareness about healthy behavior with the voice in their occupations will help in improving their quality of work and in minimizing any permanent impairments and/or disability.



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The Identification of High-pitched Sung Vowels in Sense and Nonsense Words by Professional Singers and Untrained Listeners

Publication date: Available online 11 August 2016
Source:Journal of Voice
Author(s): Andrea Deme
High-pitched sung vowels may be considered phonetically “underspecified” because of (i) the tuning of the F1 to the f0 accompanying pitch raising and (ii) the wide harmonic spacing of the voice source resulting in the undersampling of the vocal tract transfer function. Therefore, sung vowel intelligibility is expected to decrease as the f0 increases. Based on the literature of speech perception, it is often suggested that sung vowels are better perceived if uttered in consonantal (CVC) context than in isolation even at high f0. The results for singing, however, are contradictory. In the present study, we further investigate this question. We compare vowel identification in sense and nonsense CVC sequences and show that the positive effect of the context disappears if the number of legal choices in a perception test is similar in both conditions, meaning that any positive effect of the CVC context may only stem from the smaller number of possible responses, i.e., from higher probabilities. Additionally, it is also tested whether the training in production (i.e., singing training) may also lead to a perceptual advantage of the singers over nonsingers in the identification of high-pitched sung vowels. The results show no advantage of this kind.



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Treatment for Vocal Polyps: Lips and Tongue Trill

Publication date: Available online 11 August 2016
Source:Journal of Voice
Author(s): Daniela de Vasconcelos, Adriana de Oliveira Camargo Gomes, Cláudia Marina Tavares de Araújo
Vocal polyps do not have a well-defined therapeutic indication. The recommended treatment is often laryngeal microsurgery, followed by postoperative speech therapy. Speech therapy as the initial treatment for polyps is a new concept and aims to modify inappropriate vocal behavior, adjust the voice quality, and encourage regression of the lesion. This study aimed to determine the effectiveness of the sonorous lips and tongue trill technique in the treatment of vocal polyps. The sample consisted of 10 adults diagnosed with a polyp who were divided into two subgroups: treatment and control. Ten speech therapy sessions were conducted, each lasting 30–45 minutes, based on the sonorous lips and tongue trill technique, accompanied by continuous guidance about vocal health. Speech therapy was effective in three of the five participants. The number of symptoms presented by the participants decreased significantly after voice therapy (P = 0.034) and vocal self-evaluation (P = 0.034). The acoustic evaluation showed improvements in parameters of noise values (P = 0.028) and jitter (P = 0.034). The size of the polyp and the degree of severity of dysphonia, hoarseness, and breathiness showed a significant reduction after treatment (P = 0.043). Among the remaining two participants, one opted out of laryngeal surgery, indicating that the improvement obtained was sufficient to avoid surgery. The sonorous lips and tongue trill technique was thus considered effective in 60% of the participants, and as laryngeal surgery was avoided in 80% of them, it should be considered a treatment option for vocal polyps.



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