Voice Quality of Children With Cerebral Palsy

Purpose Many children with cerebral palsy (CP) are described as having altered vocal quality. The current study utilizes psychoacoustic measures, namely, low-amplitude (H1*–H2*) and high-amplitude (H1*–A2*) spectral tilt and cepstral peak prominence (CPP), to identify the vocal fold articulation characteristics in this population. Method Eight children with CP and eight typically developing (TD) peers produced vowel singletons [i, ɑ, u] and a story retell task with the same vowels in the words “beets, Bobby, boots.” H1*–H2*, H1*–A2*, and CPP were extracted from each vowel. Results were analyzed with mixed linear models to identify the effect of Group (CP, TD), Task (vowel singleton, story retell), and Vowel [i, ɑ, u] on the dependent variables. Results Children with CP have lower spectral tilt values (H1*–H2* and H1*–A2*) and lower CPP values than their TD peers. For both groups, vowel singletons were associated with lower CPP values as compared to story retell. Finally, the vowel [ɑ] was associated with higher spectral tilt and higher CPP values as compared to [i, u]. Conclusions Children with CP have more constricted and creaky vocal quality due to lower spectral tilt and greater noise. Unlike adults, children demonstrate poorer vocal fold articulation when producing vowel singletons as compared to story retell. Finally, low vowels like [ɑ] seem to be produced with less constriction and noise as compared to high vowels.

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ELECTROENCEPHALOGRAPHY—SLEEP FINDINGS IN CEREBRAL PALSY

PEDIATRICS ◽

10.1542/peds.16.1.88 ◽

1955 ◽

Vol 16 (1) ◽

pp. 88-92

Author(s):

Don L. Winfield ◽

James G. Hughes ◽

William E. Sayle

Keyword(s):

Cerebral Palsy ◽

Prognostic Value ◽

Prognostic Significance ◽

High Amplitude ◽

Diagnostic Value ◽

Children With Cerebral Palsy

EEG sleep records were obtained on 144 children with cerebral palsy (128 spastics and 16 athetoids). The results agree with those of earlier studies. Electroencephalographic tracings taken while the patient is asleep are of definite diagnostic value but are of limited prognostic value. A larger population of athetoids is needed to determine the significance of the continuous high amplitude spindling which was observed. Serial studies should be done on those patients with seizure discharges but without clinical seizures to determine the prognostic significance of such activity in the EEG.

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Comparing Measures of Voice Quality From Sustained Phonation and Continuous Speech

Journal of Speech Language and Hearing Research ◽

10.1044/2016_jslhr-s-15-0307 ◽

2016 ◽

Vol 59 (5) ◽

pp. 994-1001 ◽

Cited By ~ 20

Author(s):

Bruce R. Gerratt ◽

Jody Kreiman ◽

Marc Garellek

Keyword(s):

Vocal Fold ◽

Voice Quality ◽

Quality Analysis ◽

Perceptual Information ◽

Continuous Speech ◽

Voice Source ◽

Acoustic Measures ◽

Vocal Fold Vibration ◽

Vocal Quality ◽

Quality Deviation

Purpose The question of what type of utterance—a sustained vowel or continuous speech—is best for voice quality analysis has been extensively studied but with equivocal results. This study examines whether previously reported differences derive from the articulatory and prosodic factors occurring in continuous speech versus sustained phonation. Method Speakers with voice disorders sustained vowels and read sentences. Vowel samples were excerpted from the steadiest portion of each vowel in the sentences. In addition to sustained and excerpted vowels, a 3rd set of stimuli was created by shortening sustained vowel productions to match the duration of vowels excerpted from continuous speech. Acoustic measures were made on the stimuli, and listeners judged the severity of vocal quality deviation. Results Sustained vowels and those extracted from continuous speech contain essentially the same acoustic and perceptual information about vocal quality deviation. Conclusions Perceived and/or measured differences between continuous speech and sustained vowels derive largely from voice source variability across segmental and prosodic contexts and not from variations in vocal fold vibration in the quasisteady portion of the vowels. Approaches to voice quality assessment by using continuous speech samples average across utterances and may not adequately quantify the variability they are intended to assess.

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Changes in Voice Quality after Speech-Language Therapy Intervention in Older Children with Cerebral Palsy

Folia Phoniatrica et Logopaedica ◽

10.1159/000355864 ◽

2013 ◽

Vol 65 (4) ◽

pp. 200-207 ◽

Cited By ~ 7

Author(s):

Nick Miller ◽

Lindsay Pennington ◽

Sheila Robson ◽

Ella Roelant ◽

Nick Steen ◽

...

Keyword(s):

Cerebral Palsy ◽

Voice Quality ◽

Older Children ◽

Language Therapy ◽

Children With Cerebral Palsy ◽

Therapy Intervention

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Update: Behavioral Management of Unilateral Vocal Fold Paralysis and Paresis

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig3-2018-0018 ◽

2019 ◽

Vol 4 (3) ◽

pp. 474-482

Author(s):

Sarah L. Schneider

Keyword(s):

Vocal Fold ◽

Treatment Plan ◽

Traumatic Injury ◽

Voice Therapy ◽

Valuable Insight ◽

Behavioral Management ◽

Use Patterns ◽

Vocal Quality ◽

And Function ◽

Voice Use

PurposeVocal fold motion impairment (VFMI) can be the result of iatrogenic or traumatic injury or may be idiopathic in nature. It can result in glottic incompetence leading to changes in vocal quality and ease. Associated voice complaints may include breathiness, roughness, diplophonia, reduced vocal intensity, feeling out of breath with talking, and vocal fatigue with voice use. A comprehensive interprofessional voice evaluation includes auditory-perceptual voice evaluation, laryngeal examination including videostroboscopy, acoustic and aerodynamic voice measures. These components provide valuable insight into laryngeal structure and function and individual voice use patterns and, in conjunction with stimulability testing, help identify candidacy for voice therapy and choice of therapeutic techniques.ConclusionA comprehensive, interprofessional evaluation of patients with VFMI is necessary to assess the role of voice therapy and develop a treatment plan. Although there is no efficacy data to support specific voice therapy techniques for treating VFMI, considerations for various techniques are provided.

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Prevalence of Speech Problems and the Use of Augmentative and Alternative Communication in Children With Cerebral Palsy: A Registry-Based Study in Norway

Perspectives on Augmentative and Alternative Communication ◽

10.1044/aac19.1.12 ◽

2010 ◽

Vol 19 (1) ◽

pp. 12-20 ◽

Cited By ~ 29

Author(s):

Guro Andersen ◽

Tone R. Mjøen ◽

Torstein Vik

Keyword(s):

Cerebral Palsy ◽

Motor Function ◽

Gestational Age ◽

Augmentative And Alternative Communication ◽

Alternative Communication ◽

Gross Motor ◽

Gross Motor Function ◽

Children With Cerebral Palsy ◽

Communicative Abilities ◽

Normal Speech

Abstract This study describes the prevalence of speech problems and the use of augmentative and alternative communication (AAC) in children with cerebral palsy (CP) in Norway. Information on the communicative abilities of 564 children with CP born 1996–2003, recorded in the Norwegian CP Registry, was collected. A total of 270 children (48%) had normal speech, 90 (16%) had slightly indistinct speech, 52 (9%) had indistinct speech, 35 (6%) had very indistinct speech, 110 children (19%) had no speech, and 7 (1%) were unknown. Speech problems were most common in children with dyskinetic CP (92 %), in children with the most severe gross motor function impairments and among children being totally dependent on assistance in feeding or tube-fed children. A higher proportion of children born at term had speech problems when compared with children born before 32 weeks of gestational age 32 (p > 0.001). Among the 197 children with speech problems only, 106 (54%) used AAC in some form. Approximately 20% of children had no verbal speech, whereas ~15% had significant speech problems. Among children with either significant speech problems or no speech, only 54% used AAC in any form.

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