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  • 1.
    Enflo, Laura
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Royal Inst Technol KTH, Dept Speech Mus & Hearing, Stockholm, Sweden; Boston Univ, Dept Speech Language & Hearing Sci, Boston, MA 02215 USA.
    Herbst, Christian T.
    Dept. of Cognitive Biology, University of Vienna, Vienna, Austria; Palacky Univ Olomouc, Fac Sci, Dept Biophys, Voice Res Lab, Olomouc, Czech Republic.
    Sundberg, Johan
    Dept. of Speech, Music and Hearing, Royal Institute of Technology (KTH), Stockholm, Sweden.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Dept CLINTEC, Stockholm, Sweden.
    Comparing vocal fold contact criteria derived from audio and electroglottographic signals2016In: Journal of Voice, ISSN 0892-1997, E-ISSN 1873-4588, Vol. 30, no 4, 381-388 p.Article in journal (Refereed)
    Abstract [en]

    Collision threshold pressure (CTP), i.e., the lowest subglottal pressure producing vocal fold contact during phonation, is a parameter likely to reflect relevant vocal fold properties. The amplitude of an electroglottographic (EGG) signal or the amplitude of its first derivative (dEGG) has been used as the criterion of such contact. Manual measurement of CTP is time-consuming, making the development of a simpler, alternative method desirable. In this investigation we compare CTP values automatically derived from the dEGG signal to values measured manually, and to values derived from a set of alternative parameters, some obtained from audio and some from EGG signals. One of the parameters was the novel EGG wavegram, which visualizes sequences of EGG or dEGG cycles, normalized with respect to period and amplitude. Raters with and without previous acquaintance with EGG analysis marked the disappearance of vocal fold contact in dEGG and in wavegram displays of /pa:/-sequences produced with continuously decreasing vocal loudness by seven singer subjects. Vocal fold contact was equally accurately identified in displays of dEGG amplitude as of wavegram. Automatically derived CTP values showed high correlation with those measured manually, and with those derived from the ratings of the visual displays. Seven other parameters were tested as criteria of such contact. Mainly due to noise in the EGG signal, most of them yielded CTP values differing considerably from those derived from the manual and the automatic methods, while the EGG spectrum slope showed a high correlation. The possibility of measuring CTP automatically seems promising for future investigations.

  • 2.
    Enflo, Laura
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Sundberg, Johan
    Department of Speech, Music and Hearing, KTH, Royal Institute of Technology, Stockholm, Sweden.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Collision and phonation threshold pressures before and after loud, prolonged vocalization in trained and untrained voices2013In: Journal of Voice, ISSN 0892-1997, E-ISSN 1557-8658, Vol. 27, no 5, 527-530 p.Article in journal (Refereed)
    Abstract [en]

    The phonation threshold pressure (PTP) is defined as the lowest subglottal pressure needed for obtaining and sustaining vocal fold oscillation. It has been found to increase during vocal fatigue. In the present study, PTP is measured together with the threshold pressure needed for vocal fold collision; henceforth, the collision threshold pressure (CTP). PTP and CTP are compared before and after loud, prolonged vocalization in singer and nonsinger voices. Ten subjects repeated the vowel sequence /a, e, i, o, u/ at a Sound Pressure Level of at least 80 dB at 0.3 m for 20 minutes. Audio and electroglottography signals were recorded before and after this exercise. At the same time, oral pressure was registered while the subjects produced a diminuendo repeating the syllable /pa:/, thus acquiring an approximate of the subglottal pressure. CTP and PTP increased significantly after the vocal loading in the nonsinger subjects. On the other hand, singers reported no substantial effect of the exercise, and most singers had a mean after-to-before ratio close to 1 for both CTP and PTP.

  • 3. Ihre, E
    et al.
    Zetterström, Olle
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Allergy Centre . Linköping University, Department of Clinical and Experimental Medicine, Allergy Centre .
    Ihre, E
    Hammarberg, B
    Voice problems as side effects of inhaled corticosteroids in asthma patients - A prevalence study2004In: Journal of Voice, ISSN 0892-1997, Vol. 18, no 3, 403-414 p.Article in journal (Refereed)
    Abstract [en]

    Voice disturbances in asthma patients may be caused by inhaled corticosteroids. In order to study the prevalence of such voice disturbances, a questionnaire was delivered to asthma patients at three asthma and allergy departments in Stockholm. The questionnaire consisted of 25 questions concerning the asthma disease symptoms, medication, voice function, and voice disturbances. A total of 350 questionnaires were delivered. Response frequency was 80%. There was a significant positive correlation between inhalation of cortison and voice disturbances. Most of the patients complained about hoarseness, followed by throat clearing, a lump in the throat, loss of voice, and less frequently, throat pain. There were no significantly differences between men and women. Elderly had more voice problems than young persons. Patients with voice-demanding professions had more problems than patients who used their voice to a lesser extent during the working day. There was a significant positive correlation between high cortison doses and voice problems as well as between voice problems and acid regurgitation.

  • 4.
    Johansson, Kerstin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Strömbergsson, Sofia
    Karolinska Institute, Sweden.
    Robieux, Camille
    Karolinska Institute, Sweden; Aix Marseille University, France.
    McAllister, Anita
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Perceptual Detection of Subtle Dysphonic Traits in Individuals with Cervical Spinal Cord Injury Using an Audience Response Systems Approach2017In: Journal of Voice, ISSN 0892-1997, E-ISSN 1873-4588, Vol. 31, no 1, UNSP 126.e7Article in journal (Refereed)
    Abstract [en]

    Objectives. Reduced respiratory function following lower cervical spinal cord injuries (CSCIs) may indirectly result in vocal dysfunction. Although self-reports indicate voice change and limitations following CSCI, earlier efforts using global perceptual ratings to distinguish speakers with CSCI from noninjured speakers have not been very successful. We investigate the use of an audience response system-based approach to distinguish speakers with CSCI from noninjured speakers, and explore whether specific vocal traits can be identified as characteristic for speakers with CSCI. Methods. Fourteen speech-language pathologists participated in a web-based perceptual task, where their overt reactions to vocal dysfunction were registered during the continuous playback of recordings of 36 speakers (18 with CSCI, and 18 matched controls). Dysphonic events were identified through manual perceptual analysis, to allow the exploration of connections between dysphonic events and listener reactions. Results. More dysphonic events, and more listener reactions, were registered for speakers with CSCI than for noninjured speakers. Strain (particularly in phrase-final position) and creak (particularly in nonphrase-final position) distinguish speakers with CSCI from noninjured speakers. Conclusions. For the identification of intermittent and subtle signs of vocal dysfunction, an approach where the temporal distribution of symptoms is registered offers a viable means to distinguish speakers affected by voice dysfunction from non-affected speakers. In speakers with CSCI, clinicians should listen for presence of final strain and nonfinal creak, and pay attention to self-reported voice function and voice problems, to identify individuals in need for clinical assessment and intervention.

  • 5.
    Lundeborg Hammarström, Inger
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Ericsson, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Acoustic and perceptual aspects of vocal function in children with adenotonsillar hypertrophy —effects of surgery2012In: Journal of Voice, ISSN 0892-1997, E-ISSN 1557-8658, Vol. 26, no 4, 480-487 p.Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate outcome of two types of tonsil surgery (tonsillectomy+adenoidectomy or tonsillotomy +adenoidectomy) on vocal function perceptually and acoustically.

    Study Design: Sixty-seven children, aged 50-65 months, on waiting list for tonsil surgery were randomized to tonsillectomy (n=33) or tonsillotomy (n=34). Fifty-seven age and gender matched healthy pre-school children were controls. Twenty-eight of them, aged 48-59 months, served as control group before surgery, and 29, aged 60-71 months, after surgery

    Methods: Before surgery and six months postoperatively, the children were recorded producing three sustained vowels (/A, u, i/) and 14 words. The control groups were recorded only once.

    Three trained speech and language pathologists performed the perceptual analysis using Visual Analogue Scales (VAS) for eight voice quality parameters. Acoustic analysis from sustained vowels included average fundamental frequency, jitter percent, shimmer percent, noise-to-harmonic ratio and the centre frequencies of formants 1-3

    Results: Before surgery the children were rated to have more hyponasality and compressed/throaty voice (p<0,05) and  lower mean pitch (p<0,01) in comparison to the control group. They also had higher perturbation measures and lower frequencies of the second and third formant. After surgery there were no differences perceptually. Perturbation measures decreased but were still higher compared to the control group’s, p<0, 05. Differences in formant frequencies for /i/ and /u/ remained. No differences were found between the two surgical methods.

    Conclusion: Voice quality is affected perceptually and acoustically by adenotonsillar hypertrophy. After surgery the voice is perceptually normalized but acoustic differences remain. Outcome was equal for both surgical methods.

  • 6.
    McAllister, Anita
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Brandt, Signe Kofoed
    Habilitation Services, Kullbergska Hospital, Katrineholm, Sweden.
    A Comparison of Recordings of Sentences and Spontaneous Speech: Perceptual and Acoustic Measures in Preschool Children's Voices.2012In: Journal of Voice, ISSN 0892-1997, E-ISSN 1557-8658, Vol. 26, no 5, 13- p.Article in journal (Refereed)
    Abstract [en]

    A well-controlled recording in a studio is fundamental in most voice rehabilitation. However, this laboratory like recording method has been questioned because voice use in a natural environment may be quite different. In children's natural environment, high background noise levels are common and are an important factor contributing to voice problems. The primary noise source in day-care centers is the children themselves. The aim of the present study was to compare perceptual evaluations of voice quality and acoustic measures from a controlled recording with recordings of spontaneous speech in children's natural environment in a day-care setting. Eleven 5-year-old children were recorded three times during a day at the day care. The controlled speech material consisted of repeated sentences. Matching sentences were selected from the spontaneous speech. All sentences were repeated three times. Recordings were randomized and analyzed acoustically and perceptually. Statistic analyses showed that fundamental frequency was significantly higher in spontaneous speech (P<0.01) as was hyperfunction (P<0.001). The only characteristic the controlled sentences shared with spontaneous speech was degree of hoarseness (Spearman's rho=0.564). When data for boys and girls were analyzed separately, a correlation was found for the parameter breathiness (rho=0.551) for boys, and for girls the correlation for hoarseness remained (rho=0.752). Regarding acoustic data, none of the measures correlated across recording conditions for the whole group.

  • 7.
    McAllister, Anita
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology . Linköping University, Faculty of Health Sciences.
    Granqvist, Svante
    Royal Institute of Technology (KTH).
    Sjölander, Peta
    Royal Institute of Technology (KTH).
    Sundberg, Johan
    Royal Institute of Technology (KTH).
    Child Voice and Noise: A Pilot Study of Noise in Day Cares and the Effects on 10 Children's Voice Quality According to Perceptual Evaluation2009In: Journal of Voice, ISSN 0892-1997, ISSN 0892-1997, Vol. 23, no 5, 587-593 p.Article in journal (Refereed)
    Abstract [en]

    The purpose of this investigation was to study children's exposure to background noise at the ears during a normal day at the day care center and also to relate this to a perceptual evaluation of voice quality. Ten children, from three day care centers, with no history of hearing and speech problems or frequent infections were selected as subjects. A binaural recording technique was used with two microphones placed on both sides of the subject's head, at equal distance from the mouth. A portable digital audio tape (DAT) recorder (Sony TCD-D 100, Stockholm, Sweden) was attached to the subject's waist. Three recordings were made for each child during the day. Each recording was calibrated and started with three repetitions of three sentences containing only sonorants. The recording technique allowed separate analyses of the background noise level and of the sound pressure level (SPL) of each subjects' own voice. Results showed a mean background noise level for the three day care centers at 82.6dBA Leq, ranging from 81.5 to 83.6dBA Leq. Day care center no. 2 had the highest mean value and also the highest value at any separate recording session with a mean background noise level of 85.4dBA Leq during the noontime recordings. Perceptual evaluation showed that the children attending this day care center also received higher values on the following voice characteristics: hoarseness, breathiness, and hyperfunction. Girls increased their loudness level during the day, whereas for boys no such change could be observed.

     

  • 8. Nienkerke-Springer, Anke
    et al.
    Mc Allister, Anita
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Speech and Language Pathology. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Sundberg, Johan
    Effects of family therapy on children's voices2005In: Journal of Voice, ISSN 0892-1997, Vol. 19, no 1, 103-113 p.Article in journal (Refereed)
    Abstract [en]

    The families of nine children with deviant voice qualities were selected for family treatment according to the SYGESTI model. Recordings of the children's speech were made before and after therapy. Perceptual evaluation of their voice quality showed significant improvement in various perceptual parameters after the therapy. Acoustical analysis confirmed changes of voice quality and mean fundamental frequency in speech. The therapy also was found to improve relations between family members, conflict management and other aspects of communication. The results suggest that these children's deviant voices were related to family conditions. © 2005 The Voice Foundation.

  • 9.
    Nygren, Mariana
    et al.
    Umeå University, Sweden .
    Tyboni, Mikaela
    Umeå University, Sweden .
    Lindstrom, Fredric
    University of Gothenburg, Sweden .
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    van Doorn, Jan
    Umeå University, Sweden .
    Gender Differences in Childrens Voice Use in a Day Care Environment2012In: Journal of Voice, ISSN 0892-1997, E-ISSN 1557-8658, Vol. 26, no 6Article in journal (Refereed)
    Abstract [en]

    Background. The prevalence of dysphonia is higher in boys than in girls before puberty. This could be because of the differences in boys and girls voice use. Previous research on gender differences in prepubescent childrens voice parameters has been contradictory. Most studies have focused on examining fundamental frequency. Objectives. The purpose of this study was to investigate voice use in boys and girls in a day care environment based on the voice parameters fundamental frequency (Hz), vocal intensity (dB SPL), and phonation time (%) and to ascertain whether there were any significant gender differences. Study Design. Prospective comparative design. Method. The study was conducted in a day care environment where 30 children (17 boys and 13 girls aged 4-5 years) participated. The participants voices were measured continuously for 4 hours with a voice accumulator that registered fundamental frequency, vocal intensity level, phonation time, and background noise. Results. Mean (standard deviation) fundamental frequency was 310 (22) and 321 (16) Hz, vocal intensity was 93 (4) and 91 (3) dB SPL, and phonation time was 7.7 (2.0)% and 7.6 (2.5)% for boys and girls, respectively. No differences between genders were statistically significant. Conclusion. The finding of no statistically significant gender differences for measurements of voice parameters in a group of children aged 4-5 years in a day care environment is an important finding that contributes to increased knowledge about young boys and girls voice use.

  • 10.
    Sodersten, Maria
    et al.
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Lais Salomao, Glaucia
    Karolinska Institute, Sweden; KTH Royal Institute Technology, Sweden.
    Mcallister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Ternstrom, Sten
    KTH Royal Institute Technology, Sweden.
    Natural Voice Use in Patients With Voice Disorders and Vocally Healthy Speakers Based on 2 Days Voice Accumulator Information From a Database2015In: Journal of Voice, ISSN 0892-1997, E-ISSN 1873-4588, Vol. 29, no 5Article in journal (Refereed)
    Abstract [en]

    Objectives and Study Design. Information about how patients with voice disorders use their voices in natural communicative situations is scarce. Such long-term data have for the first time been uploaded to a central database from different hospitals in Sweden. The purpose was to investigate the potential use of a large set of long-term data for establishing reference values regarding voice use in natural situations. Methods. VoxLog (Sonvox AB, Umea, Sweden) was tested for deployment in clinical practice by speech-language pathologists working at nine hospitals in Sweden. Files from 20 patients (16 females and 4 males) with functional, organic, or neurological voice disorders and 10 vocally healthy individuals (eight females and two males) were uploaded to a remote central database. All participants had vocally demanding occupations and had been monitored for more than 2 days. The total recording time was 681 hours and 50 minutes. Data on fundamental frequency (F0, Hz), phonation time (seconds and percentage), voice sound pressure level (SPL, dB), and background noise level (dB) were analyzed for each recorded day and compared between the 2 days. Variations across each day were measured using coefficients of variation. Results. Average F0, voice SPL, and especially the level of background noise varied considerably for all participants across each day. Average F0 and voice SPL were considerably higher than reference values from laboratory recordings. Conclusions. The use of a remote central database and strict protocols can accelerate data collection from larger groups of participants and contribute to establishing reference values regarding voice use in natural situations and from patients with voice disorders. Information about activities and voice symptoms would supplement the objective data and is recommended in future studies.

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