Clinical Validation of Feeding Handicap Index for Children (FHI-C).

Children with developmental disabilities (DD) exhibit feeding and swallowing difficulties, which can have an impact on nutritional, developmental, and psychological aspects. The existing tools assess the nature of feeding problems and behaviors only. The present study aimed to assess the physical, functional, and emotional domains in children with DD with feeding issues using Feeding handicap index for children (FHI-C). For clinical validation, FHI-C was administered on the parents/caregivers of 60 children with cerebral palsy, 61 with autism spectrum disorder, 59 with intellectual disability and 60 typically developing children in the age range of 2 to 10 years. The results revealed that the mean scores (Total FHI-C and FHI-C domain scores) were significantly higher for all three clinical groups than for the control group, which revealed good clinical validity. Also, FHI-C was found to have significantly high test-retest reliability. The study presents a valid and reliable tool for assessing the psychosocial handicapping effects of feeding problems in children with DD. FHI-C provides a holistic picture about the psychosocial impact of feeding problems in children with DD and will assist the clinicians in prioritizing the goals for feeding therapy. The scores obtained can be used as reference for pre and post therapy comparison purposes.

A Comprehensive Application for Grading Severity of Voice Based on Acoustic Voice Quality Index v.02.03.

Acoustic Voice Quality Index is a six-variable acoustic model for the multiparametric measurement developed by Maryn et al. Studies have provided evidence regarding the practical usefullness, internal consistency, external validity, diagnostic accuracy, and responsiveness to change of AVQI. Recently, researchers have been exploring the utility of AVQI in classifying the voice severity. The aim of the present study was to determine the diagnostic accuracy of the AVQI v.02.03 in discriminating across the perceptual levels of dysphonia severity in 18-40 years age range in Kannada speaking population; and to develop an application to depict the AVQI based severity of dysphonia. For the study, 163 individuals in normophonic and 134 individuals in dysphonic group were considered in the age range of 18-40 years. All participants were native speakers of Kannada language. The sustained vowel /a/ and reading of standard Kannada passage were considered as stimuli for extracting AVQI analysed using AVQI script version 02.03. The AVQI cut-off values obtained were 2.50 (AROC=0.894; Sensitivity= 84.7%; Specificity= 83.1%), 4.17 (AROC=0.953; Sensitivity= 84.4%; Specificity= 88.5%) and 6.23 (AROC=1.000; Sensitivity= 100%; Specificity= 100%) for normal vs. mild, mild vs. moderate and moderate vs. severe respectively. A user friendly application was developed which provides a simplified output for AVQI cut-off values which can be comprehendible by patients with voice disorder/ non-professionals and health professionals.

Effect of Gender on Acoustic Voice Quality Index 02.03 and Dysphonia Severity Index in Indian Normophonic Adults.

Acoustic Voice Quality Index and Dysphonia Severity Index are the two most widely used multiparametric objective measures that can successfully quantify voice quality. Latoszek et al. (2019) reported that gender had no influence on both AVQI and DSI in Dutch population. However, there is a lack of research focussed on investigating the gender effect on both DSI and AVQI and on investigating the relationship between DSI and AVQI in the Indian adult population. The present study is aimed to investigate the effect of gender on DSI and AVQI and to explore the relation between the two in the Indian adult population. 138 normophonic individuals (74 females and 64 males) were considered as participants. The phonation of /a/ and reading samples were considered as stimuli for extracting AVQI analysed using AVQI script version 02.03. The raw values of MPT, highest frequency, lowest intensity, and Jitter% were obtained from VRP module and MDVP module of Computerized Speech Lab to calculate the DSI. The results revealed that gender has significant effect on CPPs, HNR and TiltLTAS, ShimLocal, ShimdB, MPT, F0-High and Jitter%. While the overall AVQI, DSI, SlopeLTAS and I-Low were independent of gender effect. To conclude, the present study provides the reference data for AVQI v.2.03 and DSI for healthy Indian adults and discusses the influence of gender on AVQI, DSI and their constituent parameters.

Diagnostic Accuracy of Acoustic Voice Quality Index Version 02.03 in Discriminating across the Perceptual Degrees of Dysphonia Severity in Kannada Language.

BACKGROUND: Acoustic Voice Quality Index (AVQI) has been reported to be a sensitive tool for discriminating between the normal and dysphonic voices, however, there is a dearth of research focused on investigating the diagnostic accuracy of AVQI in discriminating across the perceptual categories of dysphonia severity ie, slight, moderate, and severe. Hence, the present study is a preliminary attempt to document the AVQI across the degrees of dysphonia severity and to verify whether the AVQI can discriminate across these degrees of perceptual dysphonia severity. METHOD: A total of 71 dysphonic samples extracted from the clinical database of the institute and 19 prospectively recorded normophonic samples consisting of sustained vowel /a/ and a sentence from a standardized Kannada passage served as input data. These 90 samples were categorized into four categories based on the overall grade of perceptual dysphonia (G) as normal, slight, moderate, or severe by three experienced speech language pathologists in a randomized and double-blinded manner, which served as the ground truth. The AVQI was calculated from the samples using Praat version 6.0.40 and the AVQI script version 2.03. RESULTS: The Spearman's correlation test revealed a positive correlation between the G and the AVQI (r = 0.67; P < 0.001). The Receiver Operating Characteristics analysis revealed that the AVQI could accurately discriminate across the perceptual subcategories of dysphonia. CONCLUSIONS: The results of the present study revealed that AVQI is a robust multiparametric measure which can accurately discriminate across the subcategories of the perceptual dysphonia severity with reasonable precision. Further, the AVQI is also shown to be promising in evaluating the signals with higher levels of aperiodicity such as severe hoarse voice quality.

Acoustic and Aerodynamic Characteristics of Choral Singers.

OBJECTIVES: The study aimed to investigate and compare the acoustic and aerodynamic characteristics of choral singers and nonsingers. METHOD: Twenty choral singers and 20 nonsingers in the age range of 20-30 years with no vocal pathology participated in the study. For acoustic analysis, the voice sample was recorded and analyzed using Praat software (Phonetic Sciences, University of Amsterdam, Amsterdam, Netherlands) version 6.0.33 and for aerodynamic evaluation, Helios 401 PC based spirometer (Recorders & Medicare System Pvt. Ltd., Panchkula, Haryana, India) was used. RESULTS: The results from acoustic analysis of female groups revealed higher F0 in singers than nonsingers; higher jitter, shimmer, and noise-to-harmonics ratio (NHR) values were obtained for nonsingers compared to singers. Results from acoustic analysis of male groups revealed significantly higher F0 in singers than nonsingers and significantly higher shimmer and NHR values for nonsingers compared to singers. Results from aerodynamic analysis for both male and female groups revealed higher vital capacity, forced vital capacity, and slow vital capacity in singers than nonsingers. CONCLUSION: The results revealed better control over phonatory and respiratory subsystems among singers compared to nonsingers, although the singers were untrained. This could be possible due to the fact that long-term singing practices involving vocal modulation and changes in the breathing pattern, better respiratory control during the expiratory phase among singers. However, as the participants of the singing group are untrained, further studies are required to compare the acoustic and the aerodynamic characteristics with trained singers.

Dysphonia Severity Index in Typically Developing Indian Children.

BACKGROUND: Dysphonia is a variation in an individual's quality, pitch, or loudness from the voice characteristics typical of a speaker of similar age, gender, cultural background, and geographic location. Dysphonia Severity Index (DSI) is a recognized assessment tool based on a weighted combination of maximum phonation time, highest frequency, lowest intensity, and jitter (%) of an individual. Although dysphonia in adults is accurately evaluated using DSI, standard reference values for school-age children have not been studied. AIM: This study aims to document the DSI scores in typically developing children (8-12 years). METHOD: A total of 42 typically developing children (8-12 years) without complaint of voice problem on the day of testing participated in the study. DSI was computed by substituting the raw scores of substituent parameters: maximum phonation time, highest frequency, lowest intensity, and jitter% using various modules of CSL 4500 software. RESULTS: The average DSI values obtained in children were 2.9 (1.23) and 3.8 (1.29) for males and females, respectively. DSI values are found to be significantly higher (P = 0.027) for females than those for males in Indian children. This could be attributed to the anatomical and behavioral differences among females and males. Further, pubertal changes set in earlier for females approximating an adult-like physiology, thereby leading to higher DSI values in them. CONCLUSION: The mean DSI value obtained for male and female Indian children can be used as a preliminary reference data against which the DSI values of school-age children with dysphonia can be compared.