Voice handicap of laryngectomees with tracheoesophageal speech

The evaluation of diagnostics and therapies includes more and more subjective, i.e. emotional and social aspects. Focussing on the handicap experienced by dysphonic patients, the Voice Handicap Index (VHI) has previously been found to be of significant clinical and scientific value for different voices. In this study the VHI questionnaire was applied to demonstrate the voice handicap of 20 male laryngectomees using tracheoesophageal voice (Provox®), aged 65.5 B 8.7 years. Their VHI was 45.5 B 24.1, which was significantly higher than the score of patients with functional voice disorders, but differed only slightly from patients with organic laryngeal dysphonia. Focussing on individual data, VHI scores ranged from values similar to persons without voice disorder to maximum handicap of 101. Comparing the VHI scores with the laryngectomees’ gradual self-perception of voice disorder severity, no consistent relationship was found. Considering the large interindividual differences, the VHI may serve as a valuable instrument for the assessment of individual interventional needs rather than for the identification of a general laryngectomees’ handicap

Automatic detection of sigmatism in children

We propose in this paper an automatic system to detect sigmatism from the speech signal. Sigmatism occurs when the tongue is positioned incorrectly during articulation of sibilant phones like /s / and /z/. For our task we extracted various sets of features from speech: Mel frequency cepstral coefficients, energies in specific bandwidths of the spectral envelope, and the so-called supervectors, which are the parameters of an adapted speaker model. We then trained several classifiers on a speech database of German adults simulating three different types of sigmatism. Recognition results were calculated at a phone, word and speaker level for both the simulated database and for a database of pathological speakers. For the simulated database, we achieved recognition rates of up to 86%, 87 % and 94 % at a phone, word and speaker level. The best classifier was then integrated as part of a Java applet that allows patients to record their own speech, either by pronouncing isolated phones, a specific word or a list of words, and provides them with a feedback whether the sibilant phones are being correctly pronounced

Automatic Quantification of Speech Intelligibility of Adults with Oral Squamous Cell Carcinoma

Objective: It has been the aim of the present study to introduce a novel automatic technique for the objective and quantitative assessment of speech intelligibility to the evaluation of postoperative outcome. Patients and Methods: Forty-six patients with oral carcinomas, mean age 59.8 8 10.1 years, and an age-matched control group of 40 subjects without oral diseases. Recordings of a standard text read by the patients and the control group were analyzed by an automatic speech recognition system. Results: For the patients, automatic speech recognition yielded word recognition rates between 8 and 82% (mean 49 8 19%), for the control group between 60 and 91% (76 8 7%). Automatic evaluation closely correlated with the experts’ perceptual evaluation of intelligibility (r = –0.93; p ! 0.01). The multirater kappa of the experts alone (0.55) differed only slightly from the multi-rater kappa of the experts and the speech recognition system (0.58). Conclusion: For adults with speech disorders, automatic speech recognition may serve as a valuable tool to assess global speech outcome after treatment of oral squamous cell carcinoma objectively and quantitatively for clinical and research purposes

Smoking, Carcinophobia and Voice Handicap Index

Objective: This study focuses on the relation of smoking, carcinophobia and voice handicap in dysphonic patients. Patients and Methods: Fifty-four German-speaking outpatient voice clinic attendees suffering from dysphonia of benign origin took part in this study. All patients completed the German version of the Voice Handicap Index (VHI) and were asked about their fear of suffering from laryngeal cancer without prior information about their diagnosis. Results: Smokers did not fear to suffer from laryngeal cancer more than nonsmokers. However, former smokers were slightly more often found to be carcinophobic than nonsmokers. There was neither a significant difference in VHI scores comparing smokers to non- and former smokers nor when comparing carcinophobic to noncarcinophobic patients. Conclusion: Smoking may cause laryngeal cancer and influence the voice but does not affect patients’ handicap due to dysphonia as measured by the VHI. Smoking habits do not influence the development of carcinophobia and carcinophobic dysphonic patients do not experience their voice problem differently than dysphonic patients without cancerophobia as measured by the VHI

Diagnostik der taktil-kinästhetischen Wahrnehmung bei Vorschulkindern: ein Methodenvergleich

Taktil-kinästhetische Wahrnehmung (TKW) ist die Verarbeitung, Ordnung und Bewertung sowie die Integration von Sinneseindrücken zur Oberflächen- und Tiefensensibilität, die über spezifische Rezeptoren unterschiedlicher Lokalisation vermittelt werden. Im phoniatrisch-pädaudiologischen Umfeld ist sie insbesondere für die Sprachentwicklung bedeutsam. In dieser Studie werden zwei deutschsprachige Testverfahren zur Beurteilung der TKW, nämlich der «Diagnostische Elternfragebogen zur taktil-kinästhetischen Responsivität » (DEF-TK) und der «Göttinger Entwicklungstest der taktil- kinästhetischen Wahrnehmung» (TAKIWA), bei 30 sprachentwicklungsgestörten Vorschulkindern verglichen. Beim DEF-TK fällt die grosse Zahl nicht beobachtbarer Items auf. Sie ist grösser als bei den im Testmanual dargelegten Normierungsdaten, entspricht jedoch den Ergebnissen einer früheren Studie. Drei Viertel der Kinder wurden im DEF-TK als taktil-kinästhetisch auffällig eingestuft. Beim TAKIWA haben ein Viertel der Probanden Auffälligkeiten in der TKW. Der Fragebogen zur taktil-kinästhetischen Responsivität ist für eine klinische Anwendung ungeeignet, besser ist der TAKIWA-Test, dessen nosologischer und prognostischer Wert in weiteren Studien untersucht werden muss.Tactile-kinesthetic perception (TKP) is the processing, arrangement, evaluation, and integration of sensations, which are transmitted via both surface and depth sensibility. In the phoniatric field TKP is of special importance for speech development. In this study, two German diagnostic test procedures for the assessment of TKP, i.e. the ‘Diagnostischer Elternfragebogen zur taktil-kinästhetischen Responsivität’ (DEF-TK) and the ‘Göttinger Entwicklungstest der taktilkinästhetischen Wahrnehmung’ (TAKIWA), were evaluated in 30 preschool children. The DEF-TK could not be analyzed in 14/30 of the children because of too many unobservable (not missing) items. This result does not correspond with data presented in the test manual but with results obtained in a former study of the reporting group. Three quarters of the children showed abnormal tactile-kinesthetic features in their DEF-TK, whereas in the TAKIWA test, a quarter of the children were found to have abnormal TKP. The DEF-TK questionnaire is not suited for clinical purposes. The nosologic and prognostic value of the TAKIWA has to be investigated in the future

The Pitch Rise Paradigm: A New Task for Real-Time Endoscopy of Non-Stationary Phonation

As standard stroboscopy is restricted to the recording of periodic vocal fold vibrations, observations of non-stationary laryngeal mechanisms demand real-time recording systems, the most advanced being the high-speed video technique. It allows the registration of laryngeal parameters during a variation of the fundamental frequency. The aim of this study was to compare amplitude and frequency parameters of vocal fold vibration during stationary and non-stationary phonation, i.e. a monotonous pitch rise. Twenty-nine young female adults with no incidence of voice disorders were examined while performing two diff erent phonation tasks: sustained phonation with a constant frequency and a monotonous pitch rise. Endoscopic recordings and the acoustic signals were acquired simultaneously. Both acoustic and laryngeal parameters were derived for short time intervals of 17.8 ms for the constant pitch and pitch rise conditions. Instantaneous frequency, sound pressure level, vibratory amplitudes of the vocal folds and the type of glottal closure were compared. At the beginning of the pitch rise, the acoustic and laryngeal parameters were similar to the parameters that occurred within the sustained phonation conditions. In contrast, the laryngeal parameters at the middle and at the end of the pitch rise diff ered substantially from those during sustained phonation. For the fi rst time, quantitative measures of the growing glottal chink and the vibration amplitude decrease during pitch increase could be taken. In general, the image evaluation of the pitch rise paradigm can be subdivided into the starting, the raising and the final phase. As each phase can be considered as quasi-stationary, existing software modules are capable of analysing the process by treating each phase separately. Hence, the pitch rise condition may be suitable for clinical examination to detect information of voice disturbances that cannot be visualized during sustained phonation