Sex differences in vocal behavior in virtual rooms compared to real rooms.

This study investigates speech production under various room acoustic conditions in virtual environments, by comparing vocal behavior and the subjective experience of speaking in four real rooms and their audio-visual virtual replicas. Sex differences were explored. Males and females (N = 13) adjusted their voice levels similarly to room acoustic changes in the real rooms, but only males did so in the virtual rooms. Females, however, rated the visual virtual environment as more realistic compared to males. This suggests a discrepancy between sexes regarding the experience of realism in a virtual environment and changes in objective behavioral measures such as voice level.

Screen11: validating a screening instrument for voice disorders in accordance with the COSMIN framework.

PURPOSE: Although numerous patient-reported outcome measures have been developed and validated to quantify the impact of voice problems on different aspects of life, to our knowledge no screening instrument exists that specifically captures voice disorders in a retrospective fashion. The aim of the present study was to examine the psychometric properties and diagnostic validity of a retrospective voice screening method, Screen11, according to the COSMIN framework for health-related, patient-reported outcome measures. The items in Screen11 have been used to establish the prevalence of voice disorders in both general and occupation-specific populations in the Nordic countries. However, the instrument has not been validated. METHODS: The voice patient group (n = 54) in this study comprised of patients from the Turku University Central Hospital phoniatric outpatient clinic seeking help for their voice problems. For these voice patients, we recruited voice-healthy controls (n = 61) who matched in terms of gender, age, and occupation. The participants responded to the Screen11 questionnaire along with the VHI and the VAPP. RESULTS: The results of the initial exploratory factor analysis showed that all the Screen11 items loaded on a common underlying latent factor. Furthermore, Screen11 had high internal consistency (α = .93) and correlated sufficiently with other voice questionnaires. CONCLUSIONS: The results indicate that Screen11, which screens for possible voice disorders at an early stage, was successfully validated. With respect to its diagnostic validity, the Screen11 sum score is preferable. A threshold of ≥ 15 should be used for differentiating patients with possible voice disorders from those with healthy voices.

How older adults relate to their own voices: a qualitative study of subjective experiences of the aging voice.

AIM: The aim of this study was to investigate how otherwise healthy older adults with self-assessed voice problems relate to their voice and voice changes. METHOD: Focus groups were conducted at an activity center to identify how older adults reflect on their own voice and the aging voice in general. The interviews were audio recorded and transcribed. The analysis was done using thematic content analysis. RESULTS: The analysis resulted in three main themes: "communicational aspects of the aging voice," "consequences of deteriorating vocal and communicative capacity," and "attitudes, strategies, and ideas". The participants considered voice to be an important communication tool and presented what could be interpreted as awareness regarding their voice. Voice changes were considered a natural part of aging. This attitude was also an important reason why the participants had not sought medical care for their voice problems. The participants discussed ideas concerning extended voice use to maintain a functioning voice when aging. Simultaneously, voice changes due to aging were considered to have a negative effect on communication and social participation. CONCLUSIONS: The voice is important for older adults, and an insufficient voice can affect communication and social participation. Information about aging voice and voice exercises, for example from speech language pathologists, could be of interest among older adults. Further studies on the voice of older adults are needed regarding how they experience their voice and the general aspects of a healthy aging voice.

Virtual reality head-mounted displays affect sidetone perception.

The purpose of this study was to investigate whether head-mounted displays (HMDs) change the sidetone to an auditory perceivable extent. Impulse responses (IRs) were recorded using a dummy head wearing a HMD (IRtest) and compared to IRs measured without HMD (IRref). Ten naive listeners were tested on their ability to discriminate between the IRtest and IRref using convolved speech signals. The spectral analysis showed that the HMDs decreased the spectral energy of the sidetone around 2000-4500 Hz. Most listeners were able to discriminate between the IRs. It is concluded that HMDs change the sidetone to a small but perceivable extent.

Resonance Tube Phonation in Water-the Effect of Tube Diameter and Water Depth on Back Pressure and Bubble Characteristics at Different Airflows.

OBJECTIVES: Resonance tube phonation with tube end in water is a voice therapy method in which the patient phonates through a glass tube, keeping the free end of the tube submerged in water, creating bubbles. The purpose of this experimental study was to determine flow-pressure relationship, flow thresholds between bubble types, and bubble frequency as a function of flow and back volume. METHODS: A flow-driven vocal tract simulator was used for recording the back pressure produced by resonance tubes with inner diameters of 8 and 9 mm submerged at water depths of 0-7 cm. Visual inspection of bubble types through video recording was also performed. RESULTS: The static back pressure was largely determined by the water depth. The narrower tube provided a slightly higher back pressure for a given flow and depth. The amplitude of the pressure oscillations increased with flow and depth. Depending on flow, the bubbles were emitted from the tube in three distinct types with increasing flow: one by one, pairwise, and in a chaotic manner. The bubble frequency was slightly higher for the narrower tube. An increase in back volume led to a decrease in bubble frequency. CONCLUSIONS: This study provides data on the physical properties of resonance tube phonation with the tube end in water. This information will be useful in future research when looking into the possible effects of this type of voice training.

Real-Time Visual Feedback of Airflow in Voice Training: Aerodynamic Properties of Two Flow Ball Devices.

OBJECTIVES: Flow ball devices have been used as teaching tools to provide visual real-time feedback of airflow during singing. This study aims at exploring static back pressure and ball height as function of flow for two devices, marketed as flow ball and floating ball game. STUDY DESIGN: This is a comparative descriptive study. METHODS: A flow-driven vocal tract simulator was used to investigate the aerodynamic properties of these two devices, testing them for four different ball sizes. The flow range investigated was between 0 and 0.5 L/s. Audio, flow, pressure, and ball height were recorded. RESULTS: The flow pressure profiles for both tested devices were similar to those observed in previous studies on narrow tubes. For lifting the ball, both devices had a flow and a pressure threshold. The tested floating ball game required considerably higher back pressure for a given flow as compared with the flow ball. CONCLUSIONS: Both tested devices have similar effects on back pressure as straws of 3.7 and 3.0 mm in diameter for the flow ball and the floating ball game, respectively. One might argue that both devices could be used as tools for practicing semi-occluded vocal tract exercises, with the additional benefit of providing real-time visual feedback of airflow during phonation. The flow threshold, combined with the flow feedback, would increase awareness of flow, rather than of pressure, during exercises using a flow ball device.

Vertical laryngeal position and oral pressure variations during resonance tube phonation in water and in air. A pilot study.

Resonance tube phonation in water (RTPW) is commonly used in voice therapy, particularly in Finland and Sweden. The method is believed to induce a lowering of the vertical laryngeal position (VLP) in phonation as well as variations of the oral pressure, possibly inducing a massage effect. This pilot study presents an attempt to measure VLP and oral pressure in two subjects during RTPW and during phonation with the free tube end in air. VLP is recorded by means of a dual-channel electroglottograph. RTPW was found to lower VLP in the subjects, while it increased during phonation with the tube end in air. RTPW caused an oral pressure modulation with a bubble frequency of 14-22 Hz, depending mainly on the depth of the tube end under the water surface. The results indicate that RTPW lowers the VLP instantly and creates oral pressure variations.

The Flow and Pressure Relationships in Different Tubes Commonly Used for Semi-occluded Vocal Tract Exercises.

This experimental study investigated the back pressure (P(back)) versus flow (U) relationship for 10 different tubes commonly used for semi-occluded vocal tract exercises, that is, eight straws of different lengths and diameters, a resonance tube, and a silicone tube similar to a Lax Vox tube. All tubes were assessed with the free end in air. The resonance tube and silicone tube were further assessed with the free end under water at the depths from 1 to 7 cm in steps of 1 cm. The results showed that relative changes in the diameter of straws affect P(back) considerably more compared with the same amount of relative change in length. Additionally, once tubes are submerged into water, P(back) needs to overcome the pressure generated by the water depth before flow can start. Under this condition, only a small increase in P(back) was observed as the flow was increased. Therefore, the wider tubes submerged into water produced an almost constant P(back) determined by the water depth, whereas the thinner straws in air produced relatively large changes to P(back) as flow was changed. These differences may be taken advantage of when customizing exercises for different users and diagnoses and optimizing the therapy outcome.