The effects of therapeutic group singing on voice, cough and quality of life in parkinson’s disease

Purpose: To examine the effect of a group therapeutic singing intervention on voice, cough, and quality of life in persons with Parkinson Disease (PD) in a community-based outpatient setting using a repeated measures design.Methods: 19 volunteer participants with PD completed the study. Ten participants participated in the intervention and nine served voluntarily as controls. Participants completed one hour group singing sessions over 12 weeks led by a music therapist. Sessions consisted of 30 min of high intensity vocal exercise and 15 to 20 minutes of group singing. Data on phonation, speech, cough, and quality of life were collected pre-intervention and one week post intervention with final data collection 12 weeks post-intervention.Results: No significant change in voice measures although 50% of participants showed improvement. A main effect was found for breathiness (p=0.023), appropriate pitch level (p=0.037) and speaking rate (p=0.009). No main effect for cough but pairwise comparisons were nearly significant pre to post intervention (p=0.053) and pre-intervention to final follow up (p=0.023). No main effect found for QOL but singing participants demonstrated better QOL scores than controls.Conclusions: Results from this small sample suggest that there are some speech benefits from singing intervention as well as potential improvement in cough for airway clearance. Additional study is needed to confirm these results.

Speech sound production accuracy produced by North Korean defectors’ adolescent children born in China

Purpose:Children from North Korean defector families possess different characteristics from children with other multicultural and multilingual backgrounds in Korea, partially due to the fact that the number of children born in third countries is higher than those of children born in North Korea. The purpose of the study is to analyze the word-level speech sound productions of adolescent children of North Korean refugee mothers, primarily through a calculation of speech sound accuracy.Methods: The participants consisted of 11 adolescent children whose mothers were North Korean defectors, and whose fathers were Chinese. Participants’ speech sound production skills were assessed using 103 words from the KS-PAPT and U-TAP.Results: Korean defectors’ adolescent children have lower consonant accuracy (PCC= 79.14%) compared to vowel accuracy (PVC=94.71%). The consonant accuracy of liquid/ㄹ/ was significantly lower than those of other manners of articulation. The consonant accuracy of word-final codas was significantly lower than those of other positions in word.Conclusions: This current research has clinical implications for the assessment and analysis of the speech production abilities of the adolescent children of North Korean refugees.

Word association analysis of children with disabilities

Purpose: This study aimed to compare the types of response words for stimuli in children with language impairment and normal children through the word association task.Methods: For this study, 60 children with language impairment aged 9-11 years old and 60 normal children of the same language age as them were selected. The list of stimulus words for the word association task consisted of 25 nouns, 6 verbs and 6 adjectives.Results: The research results were as follows. First, it was found that the appearance rate of association words in the form and syntax among the intra-linguistic association was higher in the children with language impairment than in the normal children, and the appearance rate of association words in the meaning and pragmatics was lower than that of the normal children. Second, in children with language impairment, the appearance rate of verb response words was high in the noun stimulus words, and the noun response words appeared high in the verb and adjective stimulus words.Conclusions: In conclusion, compared to the normal children, the form and syntax-oriented syntagmatic associative responses were higher than the semantic-oriented paradigmatic associative responses, indicating that the stimulus and response words were used side by side in sentences.

Impact of deep brain stimulation surgery on speech and swallowing in patients with essential tremor

Purpose: The ventral intermediate nucleus (VIM) of the thalamus is the typical target of deep brain stimulation (DBS) for controlling tremor in essential tremor (ET). It remains unclear whether the outcomes are significantly different on speech and/or swallowing functions. This study was to compare speech and swallowing outcomes in patients with ET without VIM DBS, and those with unilateral/bilateral VIM DBS.Methods: We conducted a retrospective review of 133 patients with the diagnosis of ET. We analyzed the clinical speech and swallowing evaluations, and compared outcomes across four ‘DBS disposition’ groupings: no DBS, left, right, or bilateral VIM DBS.Results: Speech function was worse in bilateral group versus no DBS and unilateral groups. Orofacial (p=0.000), rate (p=0.001), and prosody (p=0.003) were significantly different between groups. No DBS and unilateral groups demonstrated either no dysarthria or mild hyperkinetic dysarthria versus exhibiting higher rates of dysarthria including an ataxic component in bilateral group. Bilateral group showed more impaired swallowing severity versus no DBS and unilateral groups, however, these differences were not statistically significant.Conclusions: The results demonstrated speech and swallowing changes in the ET patient population after VIM DBS. This data provides support for further study in order to better understand the speech and/or swallowing changes that may occur with VIM DBS.

Spectral/cepstral analyses of connected speech in parkinson’s disease as compared with sustained phonation before and after voice treatment

Purpose: The primary purpose of this study was to assess the effect of Lee Silverman Voice Treatment (LSVT®LOUD) on selected spectral/cepstral measures of voice in connected speech. Spectral/cepstral analyses also were used to descriptively compare changes in connected speech to those previously reported in sustained vowels. An additional goal was to examine individual differences in responses to LSVT across the spectral/cepstral measures.Methods: Nine adult participants with PD were examined in a pre/post treatment design. Speech recordings were obtained on three different days within one week before and one week after LSVT. Speech recordings were analyzed for cepstral peak prominence (CPP), CPP Standard Deviation (CPP-SD), Low/High Spectral Ratio (L/H SR), and Cepstral/Spectral Index of Dysphonia (CSID) using the Analysis of Dysphonia in Speech and Voice (ADSV) program.Results: CPP and CSID were the only measures that detect treatment-related changes in connected speech. Investigating individual differences demonstrated more participants exhibiting an improvement in sustained phonation than in connected speech.Conclusions: Cepstral/spectral measures have been shown to be valid measures for estimating dysphonia severity in both continuous speech and sustained vowels. In addition, it extends the use of the cepstral/spectral measures for characterizing speech and voice aspects prior to treatment and for quantifying treatment outcomes. Moreover, it supports the use of LSVT as a treatment approach for improving voice quality in addition to intensity in PD.

Cross-language comparison of long-term average speech spectrum and dynamic range for three Indian languages and British English

Purpose: The Long-Term Average Speech Spectrum (LTASS) and Dynamic Range (DR) of speech strongly influence estimates of Speech Intelligibility Index (SII), gain and compression required for hearing aid fitting. It is also known that acoustic and linguistic characteristics of a language have a bearing on its LTASS and DR. Thus, there is a need to estimate LTASS and DR for Indian languages. The present work on three Indian languages fills this gap and contrasts LTASS and DR attributes of these languages against British English.Methods: For this purpose, LTASS and DR were measured for 21 one-third octave bands in the frequency range of 0.1 to 10 kHz for Hindi, Kannada, Indian English and British English.Results: Our work shows that the DR of Indian languages studied is 7-10 dB less relative to that of British English. We also report that LTASS levels for Indian languages are 7 dB lower relative to British English for frequencies above 1 kHz. Finally, we observed that LTASS and DR attributes across genders were more or less the same.Conclusions: Given the evidence presented in this work that LTASS and DR characteristics for Indian languages analyzed are markedly different than those for BE, there is a need to determine Indian language specific SII, as well as gain and compression parameters used in hearing aids.

Development and usability of biofeedback system for water resistance therapy using sensor

Purpose: The purpose of this study was to develop a water cup device for voice therapy as a biofeedback device for water resistance therapy (WRT), one of the semi-occluded vocal tract exercises (SOVTEs) using sensors. In addition, we explore the usefulness of the system for training in voice therapy by implementing water resistance phonation through newly developed devices.Methods: Using Arduino, the water resistance value was measured using a water level sensor, and a system was developed to visually implement the water resistance value and duration of exhalation and vocalization according to the change in water level caused by bubbles. Visual feedback was provided using LED sensors that represent colors according to the height of the water level. The WRT step was performed on six normal adults (male 3 and female 3) to implement changes in water level change amplification rate according to tube diameter and depth, and quantitatively analyzed.Results: The experiment showed that different LED colors were displayed depending on the resistance value of the water level. The LED’s brightness decreased as the width of the silicone tube diameter became larger in the bubble according to the tube diameter. Moreover, compared to 5 mm or 7 mm, a tube diameter of 10 mm showed the lowest amplification rate, regardless of with or without phonation. A depth of 2 cm, with the tube tip submerged in water, demonstrated the lowest amplification rate with or without phonation, compared to 4, 7, and 10 cm.Conclusions: The newly developed cup device for water resistance therapy was easy to give visual feedback according to changes in water level and helped to identify objectively by quantifying the performance of the target. This system may help clinicians and patients not only in clinical situations but also in practice at home during voice training.

Acoustic characteristics of resyllabification process in Korean

Purpose: This study aims to analyze acoustic characteristics of Korean words and nonwords according to resyllabification and meaningfulness.Methods: The experimental data consisted of 10 homonyms and 10 corresponding words. Computerized Speech Lab (CSL) 4150B was used in a quiet place for recording. Moreover, the randomized word list was presented to 20 subjects, and they were asked to read naturally as if they were talking comfortably to the subjects. The analysis program was Praat 6151 win 64bit (Boersma & Weenink, 2021). Pitch, intensity, and duration of the words and the first and the second syllables were measured, and the resyllabification liaison rules and resyllabification influenced them. To investigate acoustic characteristics according to resyllabification, independent sample t-test and multivariate test were conducted using SPSS 26 for the statistical processing of a syllable’s pitch, intensity, and duration changes.Results: First, there was a significant difference between the groups in post-syllable pitch ratio in words and nonwords, which was 40s–50s pitch change was greater than that of 20s–30s. Second, the post-syllable pitch ratio was a significant difference between gender groups and according to the effect of the liaison rule. Third, the post-syllable duration ratio showed a significant difference between age groups. The post-syllable pitch ratio was a significant difference according to the effect of the liaison rule.Conclusions: Therefore, when resyllabifications are generated by the liaison rule, the change of the post-syllable pitch can be explained by the focus prosody, and further research will be needed to establish a solid basis for this study.

Impact of COVID-19 on hearing aid users

Purpose: An unexpected pandemic ‘COVID-19’ has arisen in the world which affected many lives either directly and/or indirectly. Coronavirus disease 2019 (COVID-19) is an acute respiratory illness caused by the newly identified β-coronavirus SARS-CoV-2 virus.Methods: COVID-19 has proven challenging to the public health system. Taking into account thehearing healthcare, an internet based survey was conducted to understand the effect COVID-19 has on the usage of hearing aid among its users during the pandemic and conditions such as lockdowns arise due to it. This study was carried out by the Department of Audiology, MAA Institute of Speech and Hearing, India, during the period of June-August 2020. The questionnaire consisted of 13 questions, developed and presented via “Google forms”. The questions in the questionnaire was based on the presumptive but common problems faced by the hearing aid users. The nature of the questions was specifically focused on the effect that pandemic and the resultant lockdowns have on the hearing aid usage. The survey was self-administered and the time taken would be 5-10 minutes. The respondents were asked to answer the survey with the best of their experience.Results: Overall, survey results showed that respondents faced variety of problems with their hearing aid usage during the pandemic and conditions arose due to it.Conclusions: COVID-19 has negatively affected the lives of many people with hearing loss in variety of ways. Further research is needed to provide effective solutions and make global strategies to tackle hearing aid usage related problems in these.