Vocal aging and adductor spasmodic dysphonia: Response to botulinum toxin injection

Aging of the larynx is characterized by involutional changes which alter its biomechanical and neural properties and create a biological environment that is different from younger counterparts. Illustrative anatomical examples are presented. This natural, non-disease process appears to set conditions which may influence the effectiveness of botulinum toxin injection and our expectations for its success. Adductor spasmodic dysphonia, a type of laryngeal dystonia, is typically treated using botulinum toxin injections of the vocal folds in order to suppress adductory muscle spasms which are disruptive to production of speech and voice. A few studies have suggested diminished response to treatment in older patients with adductor spasmodic dysphonia. This retrospective study provides a reanalysis of existing pre-to-post treatment data as function of age. Perceptual judgments of speech produced by 42 patients with ADSD were made by two panels of professional listeners with expertise in voice or fluency of speech. Results demonstrate a markedly reduced positive response to botulinum toxin treatment in the older patients. Perceptual findings are further elucidated by means of acoustic spectrography. Literature on vocal aging is reviewed to provide a specific set of biological mechanisms that best account for the observed interaction of botulinum toxin treatment with advancing age

FUNDAMENTOS TEÓRICOS DA CONCEPÇÃO DO PROCESSO PEDAGÓGICO COMO UM TIPO ESPECIAL DE ACTIVIDADE DE GRUPO

In the article, categories are considered, which are used to designate project educational activities in the conditions of an educational institution. The essence, defining characteristics of this type of training are revealed. The goal, principles, tasks and functions of the implementation of educational design technology, requirements for the organization of educational design are established. It was revealed that nowadays work on an educational project causes changes in the student's personality - it contributes to his development during the independent implementation of the project. Definitions of the concepts "educational project technology" and "educational project" are proposed. It is argued that project activity is a specific type of activity aimed at creating significantly new ideas, products that are the result of creative search efforts of an individual or a team and have personal and social significance. The project method is a learning system in which students acquire knowledge and skills in the process of planning and executing projects.No artigo, são consideradas as categorias que são utilizadas para designar as actividades educativas do projeto nas condições de uma instituição de ensino. A essência, as características definidoras deste tipo de formação são reveladas. São estabelecidos o objetivo, os princípios, as tarefas e as funções da implementação da tecnologia de design educacional, os requisitos para a organização do design educacional. Foi revelado que, atualmente, o trabalho num projeto educativo provoca mudanças na personalidade do aluno - contribui para o seu desenvolvimento durante a implementação independente do projeto. São propostas definições dos conceitos "tecnologia de projeto educativo" e "projeto educativo". Defende-se que a atividade de projeto é um tipo específico de atividade que visa criar ideias significativamente novas, produtos que são o resultado de esforços de pesquisa criativa de um indivíduo ou de uma equipa e que têm significado pessoal e social. O método de projeto é um sistema de aprendizagem em que os alunos adquirem conhecimentos e competências no processo de planeamento e execução de projectos

Vocal aging and adductor spasmodic dysphonia: response to botulinum toxin injection

Aging of the larynx is characterized by involutional changes which alter its biomechanical and neural properties and create a biological environment that is different from younger counterparts. Illustrative anatomical examples are presented. This natural, non-disease process appears to set conditions which may influence the effectiveness of botulinum toxin injection and our expectations for its success. Adductor spasmodic dysphonia, a type of laryngeal dystonia, is typically treated using botulinum toxin injections of the vocal folds in order to suppress adductory muscle spasms which are disruptive to production of speech and voice. A few studies have suggested diminished response to treatment in older patients with adductor spasmodic dysphonia. This retrospective study provides a reanalysis of existing pre-to-post treatment data as function of age. Perceptual judgments of speech produced by 42 patients with ADSD were made by two panels of professional listeners with expertise in voice or fluency of speech. Results demonstrate a markedly reduced positive response to botulinum toxin treatment in the older patients. Perceptual findings are further elucidated by means of acoustic spectrography. Literature on vocal aging is reviewed to provide a specific set of biological mechanisms that best account for the observed interaction of botulinum toxin treatment with advancing age

Spectral amplitude measures of adductor spasmodic dysphonic speech

Spectral amplitude measures are sensitive to varying degrees of vocal fold adduction in normal speakers. This study examined the applicability of harmonic amplitude differences to adductor spasmodic dysphonia (ADSD) in comparison with normal controls. Amplitudes of the first and second harmonics (H1, H2) and of harmonics affiliated with the first, second, and third formants (A1, A2, A3) were obtained from spectra of vowels and /i/ excerpted from connected speech. Results indicated that these measures could be made reliably in ADSD. With the exception of H1*-H2*, harmonic amplitude differences (H1*-A1, H1*-A2, and H1*-A3*) exhibited significant negative linear relationships (P \u3c 0.05) with clinical judgments of overall severity. The four harmonic amplitude differences significantly differentiated between pre-BT and post-BT productions (P \u3c 0.05). After treatment, measurements from detected significant differences between ADSD and normal controls (P \u3c 0.05), but measurements from /i/ did not. LTAS analysis of ADSD patients\u27 speech samples proved a good fit with harmonic amplitude difference measures. Harmonic amplitude differences also significantly correlated with perceptual judgments of breathiness and roughness (P \u3c 0.05). These findings demonstrate high clinical applicability for harmonic amplitude differences for characterizing phonation in the speech of persons with ADSD, as well as normal speakers, and they suggest promise for future application to other voice pathologies. © 2005 The Voice Foundation

Influence of consonant voicing characteristics on sentence production in abductor versus adductor spasmodic dysphonia

OBJECTIVES/HYPOTHESIS: This study evaluated the hypotheses that sentence production by speakers with adductor (AD) and abductor (AB) spasmodic dysphonia (SD) may be differentially influenced by consonant voicing and manner features, in comparison with healthy, matched, nondysphonic controls. STUDY DESIGN: This was a prospective, single blind study, using a between-groups, repeated measures design for the independent variables of perceived voice quality and sentence duration. METHODS: Sixteen subjects with ADSD and 10 subjects with ABSD, as well as 26 matched healthy controls produced four short, simple sentences that were systematically loaded with voiced or voiceless consonants of either obstruant or continuant manner categories. Experienced voice clinicians, who were blind as to speakers\u27 group affixations, used visual analog scaling to judge the overall voice quality of each sentence. Acoustic sentence durations were also measured. RESULTS: Speakers with ABSD or ADSD demonstrated significantly poorer than normal voice quality on all sentences. Speakers with ABSD exhibited longer than normal duration for voiceless consonant sentences. Speakers with ADSD had poorer voice quality for voiced than for voiceless consonant sentences. Speakers with ABSD had longer durations for voiceless than for voiced consonant sentences. CONCLUSIONS: The two subtypes of SD exhibit differential performance on the basis of consonant voicing in short, simple sentences; however, each subgroup manifested voicing-related differences on a different variable (voice quality vs sentence duration). Findings suggest different underlying pathophysiological mechanisms for ABSD and ADSD. Findings also support inclusion of short, simple sentences containing voiced or voiceless consonants as part of the diagnostic protocol for SD, with measurement of sentence duration in addition to judments of voice quality severity

Dynamic indicators of mother-infant prosodic and illocutionary coordination

This report introduces tools designed to detect and quantify ways in which caregivers and infants coordinate their face-to-face communicative interactions. The tools analyze this coordination at multiple levels, linking prosodic patterns to illocutionary aspects of prelinguistic discourse. Data include fundamental voice frequency and sound pressure level parameters extracted from recorded interactions and observers‟ codings of vocalizations according to their perceived illocutionary forces. In this approach, we do not assume that the infants‟ prosodic records associate categorically with any specific mature forms of linguistic or pragmatic constructs, but propose that the dyadic use of these parameters can be seen as evidence for the development of a foundational social system between mothers and infants upon which linguistic conventions can then be built. The tools are drawn accordingly from dynamic recurrence analysis and coupled-oscillators modeling and present possibilities for objective and quantitative indices of social interaction

Dynamic indicators of Mother-Infant Prosodic and Illocutionary Coordination

This report introduces tools designed to detect and quantify ways in which caregivers and infants coordinate their face-toface communicative interactions. The tools analyze this coordination at multiple levels, linking prosodic patterns to illocutionary aspects of prelinguistic discourse. Data include fundamental voice frequency and sound pressure level parameters extracted from recorded interactions and observers ‟ codings of vocalizations according to their perceived illocutionary forces. In this approach, we do not assume that the infants ‟ prosodic records associate categorically with any specific mature forms of linguistic or pragmatic constructs, but propose that the dyadic use of these parameters can be seen as evidence for the development of a foundational social system between mothers and infants upon which linguistic conventions can then be built. The tools are drawn accordingly from dynamic recurrence analysis and coupled-oscillators modeling and present possibilities for objective and quantitative indices of social interaction. 1

Vibratory Regime Classification of Infant Phonation

Summary: Infant phonation is highly variable in many respects, including the basic vibratory patterns by which the vocal tissues create acoustic signals. Previous studies have identified the regular occurrence of nonmodal phonation types in normal infant phonation. The glottis is like many oscillating systems that, because of nonlinear relationships among the elements, may vibrate in ways representing the deterministic patterns classified theoretically within the mathematical framework of nonlinear dynamics. The infant\u27s preverbal vocal explorations present such a variety of phonations that it may be possible to find effectively all the classes of vibration predicted by nonlinear dynamic theory. The current report defines acoustic criteria for an important subset of such vibratory regimes, and demonstrates that analysts can be trained to reliably use these criteria for a classification that includes all instances of infant phonation in the recorded corpora. The method is thus internally comprehensive in the sense that all phonations are classified, but it is not exhaustive in the sense that all vocal qualities are thereby represented. Using the methods thus developed, this study also demonstrates that the distributions of these phonation types vary significantly across sessions of recording in the first year of life, suggesting developmental changes. The method of regime classification is thus capable of tracking changes that may be indicative of maturation of the mechanism, the learning of categories of phonatory control, and the possibly varying use of vocalizations across social contexts. © 2008 The Voice Foundation

Identification of prelinguistic phonological categories

Purpose: The prelinguistic infant\u27s babbling repertoire of syllables- the phonological categories that form the basis for early word learning-is noticed by caregivers who interact with infants around them. Prior research on babbling has not explored the caregiver\u27s role in recognition of early vocal categories as foundations for word learning. In the present work, the authors begin to address this gap. Method: The authors explored vocalizations produced by 8 infants at 3 ages (8, 10, and 12months) in studies illustrating identification of phonological categories through caregiver report, laboratory procedures simulating the caregiver\u27s natural mode of listening, and the more traditional laboratory approach (phonetic transcription). Results: Caregivers reported small repertoires of syllables for their infants. Repertoires of similar size and phonetic content were discerned in the laboratory by judges who simulated the caregiver\u27s natural mode of listening. However, phonetic transcription with repeated listening to infant recordings yielded repertoire sizes that vastly exceeded those reported by caregivers and naturalistic listeners. Conclusions: The results suggest that caregiver report and naturalistic listening by laboratory staff can provide a new way to explore key characteristics of early infant vocal categories, a way that may provide insight into later speech and language development. © American Speech-Language-Hearing Association