Multidimensional Assessment of the Effectiveness of Group Voice Therapy

Publication date: Available online 1 March 2017
Source:Journal of Voice
Author(s): Giovanna Cantarella, Sara Torretta, Silvia Ferruta, Annaclara Ciabatta, Claudia Manfredi, Lorenzo Pignataro, Philippe Dejonckere
ObjectiveGroup voice therapy has been successfully used in patients with dysphonia, but there is little objectively documented evidence of its effects on voice quality and the self-perception of voice fatigue. The aim of this study was to investigate the effectiveness of group therapy in patients with functional dysphonia and minor anatomic vocal fold pathologies linked by appearance and history to voice use in an objective and multidimensional manner.Study designThis is a prospective longitudinal study.MethodsBefore and after treatment, 34 adult women underwent perceptual voice assessments using the grade of dysphonia, roughness, breathiness, asthenia, and strain (GRBAS) scale, Evaluation Vocale Assistée (EVA) system aerodynamic and acoustic assessments, and maximum phonation time measurements, and made subjective evaluations using the Voice Handicap Index. The pretreatment baseline values of the participants were obtained by means of two examinations separated by an interval of 1 week. The parameters belonging to each main dimension were clustered by means of Z-transformation, and the corresponding Z-scores were analyzed.ResultsGroup therapy was associated with a statistically significant improvement in the perceptual (P = 0.008), acoustic (P = 0.040), aerodynamic (P = 0.009 and <0.001), and self-evaluation parameters (P = 0.011).ConclusionsOur findings provide evidence that group voice therapy can be associated with improvements in perceptual, acoustic, aerodynamic, and self-evaluated parameters in some patients with dysphonia. Controlled, randomized studies are needed in follow-up. This method of treatment may be a means of reducing the costs and waiting lists associated with rehabilitative treatment, and enhancing patients' motivation and compliance.



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Aging Effect on Categorical Perception of Mandarin Tones 2 and 3 and Thresholds of Pitch Contour Discrimination

Purpose

The purpose of the study was to examine the aging effect on the categorical perception of Mandarin Chinese Tone 2 (rising F0 pitch contour) and Tone 3 (falling-then-rising F0 pitch contour) as well as on the thresholds of pitch contour discrimination.

Method

Three experiments of Mandarin tone perception were conducted for younger and older listeners with Mandarin Chinese as the native language. The first 2 experiments were in the categorical perception paradigm: tone identification and tone discrimination for a series of stimuli, the F0 contour of which systematically varied from Tone 2 to Tone 3. In the third experiment, the just-noticeable differences of pitch contour discrimination were measured for both groups.

Results

In the measures of categorical perception, older listeners showed significantly shallower slopes in the tone identification function and significantly smaller peakedness in the tone discrimination function compared with younger listeners. Moreover, the thresholds of pitch contour discrimination were significantly higher for older listeners than for younger listeners.

Conclusion

These results suggest that aging reduced the categoricality of Mandarin tone perception and worsened the psychoacoustic capacity to discriminate pitch contour changes, thereby possibly leading to older listeners' difficulty in identifying Tones 2 and 3.

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Aging Effect on Categorical Perception of Mandarin Tones 2 and 3 and Thresholds of Pitch Contour Discrimination

Purpose

The purpose of the study was to examine the aging effect on the categorical perception of Mandarin Chinese Tone 2 (rising F0 pitch contour) and Tone 3 (falling-then-rising F0 pitch contour) as well as on the thresholds of pitch contour discrimination.

Method

Three experiments of Mandarin tone perception were conducted for younger and older listeners with Mandarin Chinese as the native language. The first 2 experiments were in the categorical perception paradigm: tone identification and tone discrimination for a series of stimuli, the F0 contour of which systematically varied from Tone 2 to Tone 3. In the third experiment, the just-noticeable differences of pitch contour discrimination were measured for both groups.

Results

In the measures of categorical perception, older listeners showed significantly shallower slopes in the tone identification function and significantly smaller peakedness in the tone discrimination function compared with younger listeners. Moreover, the thresholds of pitch contour discrimination were significantly higher for older listeners than for younger listeners.

Conclusion

These results suggest that aging reduced the categoricality of Mandarin tone perception and worsened the psychoacoustic capacity to discriminate pitch contour changes, thereby possibly leading to older listeners' difficulty in identifying Tones 2 and 3.

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Aging Effect on Categorical Perception of Mandarin Tones 2 and 3 and Thresholds of Pitch Contour Discrimination

Purpose

The purpose of the study was to examine the aging effect on the categorical perception of Mandarin Chinese Tone 2 (rising F0 pitch contour) and Tone 3 (falling-then-rising F0 pitch contour) as well as on the thresholds of pitch contour discrimination.

Method

Three experiments of Mandarin tone perception were conducted for younger and older listeners with Mandarin Chinese as the native language. The first 2 experiments were in the categorical perception paradigm: tone identification and tone discrimination for a series of stimuli, the F0 contour of which systematically varied from Tone 2 to Tone 3. In the third experiment, the just-noticeable differences of pitch contour discrimination were measured for both groups.

Results

In the measures of categorical perception, older listeners showed significantly shallower slopes in the tone identification function and significantly smaller peakedness in the tone discrimination function compared with younger listeners. Moreover, the thresholds of pitch contour discrimination were significantly higher for older listeners than for younger listeners.

Conclusion

These results suggest that aging reduced the categoricality of Mandarin tone perception and worsened the psychoacoustic capacity to discriminate pitch contour changes, thereby possibly leading to older listeners' difficulty in identifying Tones 2 and 3.

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Exploring Use of the Coordinate Response Measure in a Multitalker Babble Paradigm

Purpose

Three experiments examined the use of competing coordinate response measure (CRM) sentences as a multitalker babble.

Method

In Experiment I, young adults with normal hearing listened to a CRM target sentence in the presence of 2, 4, or 6 competing CRM sentences with synchronous or asynchronous onsets. In Experiment II, the condition with 6 competing sentences was explored further. Three stimulus conditions (6 talkers saying same sentence, 1 talker producing 6 different sentences, and 6 talkers each saying a different sentence) were evaluated with different methods of presentation. Experiment III examined the performance of older adults with hearing impairment in a subset of conditions from Experiment II.

Results

In Experiment I, performance declined with increasing numbers of talkers and improved with asynchronous sentence onsets. Experiment II identified conditions under which an increase in the number of talkers led to better performance. In Experiment III, the relative effects of the number of talkers, messages, and onset asynchrony were the same for young and older listeners.

Conclusions

Multitalker babble composed of CRM sentences has masking properties similar to other types of multitalker babble. However, when the number of different talkers and messages are varied independently, performance is best with more talkers and fewer messages.

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Exploring Use of the Coordinate Response Measure in a Multitalker Babble Paradigm

Purpose

Three experiments examined the use of competing coordinate response measure (CRM) sentences as a multitalker babble.

Method

In Experiment I, young adults with normal hearing listened to a CRM target sentence in the presence of 2, 4, or 6 competing CRM sentences with synchronous or asynchronous onsets. In Experiment II, the condition with 6 competing sentences was explored further. Three stimulus conditions (6 talkers saying same sentence, 1 talker producing 6 different sentences, and 6 talkers each saying a different sentence) were evaluated with different methods of presentation. Experiment III examined the performance of older adults with hearing impairment in a subset of conditions from Experiment II.

Results

In Experiment I, performance declined with increasing numbers of talkers and improved with asynchronous sentence onsets. Experiment II identified conditions under which an increase in the number of talkers led to better performance. In Experiment III, the relative effects of the number of talkers, messages, and onset asynchrony were the same for young and older listeners.

Conclusions

Multitalker babble composed of CRM sentences has masking properties similar to other types of multitalker babble. However, when the number of different talkers and messages are varied independently, performance is best with more talkers and fewer messages.

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Exploring Use of the Coordinate Response Measure in a Multitalker Babble Paradigm

Purpose

Three experiments examined the use of competing coordinate response measure (CRM) sentences as a multitalker babble.

Method

In Experiment I, young adults with normal hearing listened to a CRM target sentence in the presence of 2, 4, or 6 competing CRM sentences with synchronous or asynchronous onsets. In Experiment II, the condition with 6 competing sentences was explored further. Three stimulus conditions (6 talkers saying same sentence, 1 talker producing 6 different sentences, and 6 talkers each saying a different sentence) were evaluated with different methods of presentation. Experiment III examined the performance of older adults with hearing impairment in a subset of conditions from Experiment II.

Results

In Experiment I, performance declined with increasing numbers of talkers and improved with asynchronous sentence onsets. Experiment II identified conditions under which an increase in the number of talkers led to better performance. In Experiment III, the relative effects of the number of talkers, messages, and onset asynchrony were the same for young and older listeners.

Conclusions

Multitalker babble composed of CRM sentences has masking properties similar to other types of multitalker babble. However, when the number of different talkers and messages are varied independently, performance is best with more talkers and fewer messages.

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The Cry of the Child and its Relationship to Hearing Loss in Parental Guardians and Health Care Providers.

Related Articles

The Cry of the Child and its Relationship to Hearing Loss in Parental Guardians and Health Care Providers.

J Evid Inf Soc Work. 2016;13(2):198-205

Authors: Calderon LE, Carney LD, Kavanagh KT

Abstract
In this study the authors investigate the sound pressure levels produced by crying children and discuss the possible adverse effects that direct exposure may impose on a tending guardian or healthcare professional. Sound intensity levels from various pediatric patients (N = 26) were measured under two segregate conditions, one imitating the exposure of an examining physician and the other resembling that of parental guardians. Interestingly, all of the recorded sound levels fell between 99-120 dB(A) of sound pressure; children presenting the greatest risk for intense cries with potentially harmful sound intensities were between the ages of 9 months and 6 years. The authors found that elevated noise levels produced from crying children can cause acute discomfort and mild pain to those exposed. In addition, there is a theoretical risk that chronic exposure to these intense sound pressures may result in noise-induced hearing loss in a parental guardian or an examining physician. Parents of young children may be more likely to succumb to impulsive reactions in attempting to arrest the crying, which could be a precipitating factor for child abuse, responding to physical stress as much as emotional stress. Social workers and medical personnel should consider suggesting the use of ear plugs by parental guardians of frequently crying children as a modality for the prevention of child abuse.

PMID: 25844672 [PubMed - indexed for MEDLINE]

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Practical guidelines to minimise language and cognitive confounds in the diagnosis of CAPD: a brief tutorial

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Practical guidelines to minimise language and cognitive confounds in the diagnosis of CAPD: a brief tutorial

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Practical guidelines to minimise language and cognitive confounds in the diagnosis of CAPD: a brief tutorial

.


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Efficacy and Safety of Adjunctive Steroid Injection After Microsurgical Removal of Benign Vocal Fold Lesions

Publication date: Available online 28 February 2017
Source:Journal of Voice
Author(s): Jung-Hae Cho, Sang-Yeon Kim, Young-Hoon Joo, Young-Hak Park, Woo-Seob Hwang, Dong-Il Sun
ObjectiveThis study aims to investigate the clinical efficacy and safety of immediate intralesional steroid injection in patients undergoing laryngeal microsurgery (LMS) for benign vocal fold lesions (BVFLs).Study designThis is a single-institution, retrospective cohort study.MethodsPatients were divided into two groups according to whether or not they received adjunctive steroid injection after LMS. We evaluated the outcomes using objective, perceptual voice analysis and videostroboscopy. We also analyzed clinical parameters and identified risk factors associated with persistent dysphonia after LMS.ResultsThe study included a total of 211 patients with BVFLs (82 men and 129 women), which comprised 136 vocal polyps (64.5%), 49 nodules (23.2%), and 30 cysts (14.2%); 84 patients (39.8 %) had intralesional steroid administration combined with LMS. The overall results for postoperative voice parameters in both groups were significantly improved. On videostroboscopic examination, the rate of recurrent lesions was lower in the group that received adjunctive steroid injection than in the group with only LMS (P = 0.014). In the multivariate analysis, older age (compared to <50 years of age; odds ratio [OR] = 2.697, 95% confidence interval [CI]: 1.300–5.595, P = 0.008) and duration of hoarseness longer than 6 months (compared to <3 months; OR = 2.729, 95% CI: 1.193–6.242, P = 0.017) were identified as independent risk factors associated with persistent dysphonia. Nevertheless, adjunctive steroid injection was associated with a 0.3-fold (OR = 0.345, 95% CI: 0.152–0.784, P = 0.011) lower risk of persistent dysphonia.ConclusionSteroid injection combined with LMS in the treatment of BVFLs was safe and associated with improved voice quality.



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