Effects on Voice Quality of Thyroidectomy: A Qualitative and Quantitative Study Using Voice Maps.

OBJECTIVES: This study aims to explore the effects of thyroidectomy-a surgical intervention involving the removal of the thyroid gland-on voice quality, as represented by acoustic and electroglottographic measures. Given the thyroid gland's proximity to the inferior and superior laryngeal nerves, thyroidectomy carries a potential risk of affecting vocal function. While earlier studies have documented effects on the voice range, few studies have looked at voice quality after thyroidectomy. Since voice quality effects could manifest in many ways, that a priori are unknown, we wish to apply an exploratory approach that collects many data points from several metrics. METHODS: A voice-mapping analysis paradigm was applied retrospectively on a corpus of spoken and sung sentences produced by patients who had thyroid surgery. Voice quality changes were assessed objectively for 57 patients prior to surgery and 2months after surgery, by making comparative voice maps, pre- and post-intervention, of six acoustic and electroglottographic (EGG) metrics. RESULTS: After thyroidectomy, statistically significant changes consistent with a worsening of voice quality were observed in most metrics. For all individual metrics, however, the effect sizes were too small to be clinically relevant. Statistical clustering of the metrics helped to clarify the nature of these changes. While partial thyroidectomy demonstrated greater uniformity than did total thyroidectomy, the type of perioperative damage had no discernible impact on voice quality. CONCLUSIONS: Changes in voice quality after thyroidectomy were related mostly to increased phonatory instability in both the acoustic and EGG metrics. Clustered voice metrics exhibited a higher correlation to voice complaints than did individual voice metrics.

Pragmatic De-Noising of Electroglottographic Signals.

In voice analysis, the electroglottographic (EGG) signal has long been recognized as a useful complement to the acoustic signal, but only when the vocal folds are actually contacting, such that this signal has an appreciable amplitude. However, phonation can also occur without the vocal folds contacting, as in breathy voice, in which case the EGG amplitude is low, but not zero. It is of great interest to identify the transition from non-contacting to contacting, because this will substantially change the nature of the vocal fold oscillations; however, that transition is not in itself audible. The magnitude of the cycle-normalized peak derivative of the EGG signal is a convenient indicator of vocal fold contacting, but no current EGG hardware has a sufficient signal-to-noise ratio of the derivative. We show how the textbook techniques of spectral thresholding and static notch filtering are straightforward to implement, can run in real time, and can mitigate several noise problems in EGG hardware. This can be useful to researchers in vocology.

Effects of Speech Characteristics on Electroglottographic and Instrumental Acoustic Voice Analysis Metrics in Women With Structural Dysphonia Before and After Treatment.

PURPOSE: Literature suggests a dependency of the acoustic metrics, smoothed cepstral peak prominence (CPPS) and harmonics-to-noise ratio (HNR), on human voice loudness and fundamental frequency (F0). Even though this has been explained with different oscillatory patterns of the vocal folds, so far, it has not been specifically investigated. In the present work, the influence of three elicitation levels, calibrated sound pressure level (SPL), F0 and vowel on the electroglottographic (EGG) and time-differentiated EGG (dEGG) metrics hybrid open quotient (OQ), dEGG OQ and peak dEGG, as well as on the acoustic metrics CPPS and HNR, was examined, and their suitability for voice assessment was evaluated. METHOD: In a retrospective study, 29 women with a mean age of 25 years (± 8.9, range: 18-53) diagnosed with structural vocal fold pathologies were examined before and after voice therapy or phonosurgery. Both acoustic and EGG signals were recorded simultaneously during the phonation of the sustained vowels /ɑ/, /i/, and /u/ at three elicited levels of loudness (soft/comfortable/loud) and unconstrained F0 conditions. RESULTS: A linear mixed-model analysis showed a significant effect of elicitation effort levels on peak dEGG, HNR, and CPPS (all p < .01). Calibrated SPL significantly influenced HNR and CPPS (both p < .01). Furthermore, F0 had a significant effect on peak dEGG and CPPS (p < .0001). All metrics showed significant changes with regard to vowel (all p < .05). However, the treatment had no effect on the examined metrics, regardless of the treatment type (surgery vs. voice therapy). CONCLUSIONS: The value of the investigated metrics for voice assessment purposes when sampled without sufficient control of SPL and F0 is limited, in that they are significantly influenced by the phonatory context, be it speech or elicited sustained vowels. Future studies should explore the diagnostic value of new data collation approaches such as voice mapping, which take SPL and F0 effects into account.

Body motion of choral singers.

Recent investigations on music performances have shown the relevance of singers' body motion for pedagogical as well as performance purposes. However, little is known about how the perception of voice-matching or task complexity affects choristers' body motion during ensemble singing. This study focussed on the body motion of choral singers who perform in duo along with a pre-recorded tune presented over a loudspeaker. Specifically, we examined the effects of the perception of voice-matching, operationalized in terms of sound spectral envelope, and task complexity on choristers' body motion. Fifteen singers with advanced choral experience first manipulated the spectral components of a pre-recorded short tune composed for the study, by choosing the settings they felt most and least together with. Then, they performed the tune in unison (i.e., singing the same melody simultaneously) and in canon (i.e., singing the same melody but at a temporal delay) with the chosen filter settings. Motion data of the choristers' upper body and audio of the repeated performances were collected and analyzed. Results show that the settings perceived as least together relate to extreme differences between the spectral components of the sound. The singers' wrists and torso motion was more periodic, their upper body posture was more open, and their bodies were more distant from the music stand when singing in unison than in canon. These findings suggest that unison singing promotes an expressive-periodic motion of the upper body.

Treatment of Hypophonia in Parkinson's Disease Through Biofeedback in Daily Life Administered with A Portable Voice Accumulator.

OBJECTIVES: The purpose of this study was to assess the outcome following continuous tactile biofeedback of voice sound level administered, with a portable voice accumulator to individuals with Parkinson's disease (PD). METHOD: Nine out of 16 participants with PD completed a 4-week intervention program where biofeedback of voice sound level was administered with the portable voice accumulator VoxLog during speech in daily life. The feedback, a tactile vibration signal from the device, was activated when the wearer used a voice sound level below an individually predetermined threshold level, reminding the wearer to increase voice sound level during speech. Voice use was registered in daily life with the VoxLog during the intervention period as well as during one baseline week, one follow-up week post intervention and 1 week 3 months post intervention. Self-to-other ratio (SOR), which is the difference between voice sound level and environmental noise, was studied in multiple noise ranges. RESULTS: A significant increase in SOR across all noise ranges of 2.28 dB (SD: 0.55) was seen for participants with scores above the cut-off for normal function (>26 points) on the cognitive screening test Montreal Cognitive Assessment (MoCA) (n = 5). No significant increase was seen for the group of participants with MoCA scores below 26 (n = 4). Forty-four percent ended their participation early, all which scored below 26 on MoCA (n = 7). CONCLUSIONS: Biofeedback administered in daily life regarding voice level may help individuals with PD to increase their voice sound level in relation to environmental noise in daily life, but only for a limited subset. Only participants with normal cognitive function as screened by MoCA improved their voice sound level in relation to environmental noise.

Quantitative and Qualitative Electroglottographic Wave Shape Differences in Children and Adults Using Voice Map-Based Analysis.

Purpose The purpose of this study is to identify the extent to which various measurements of contacting parameters differ between children and adults during habitual range and overlap vocal frequency/intensity, using voice map-based assessment of noninvasive electroglottography (EGG). Method EGG voice maps were analyzed from 26 adults (22-45 years) and 22 children (4-8 years) during connected speech and vowel /a/ over the habitual range and the overlap vocal frequency/intensity from the voice range profile task on the vowel /a/. Mean and standard deviations of contact quotient by integration, normalized contacting speed, quotient of speed by integration, and cycle-rate sample entropy were obtained. Group differences were evaluated using the linear mixed model analysis for the habitual range connected speech and the vowel, whereas analysis of covariance was conducted for the overlap vocal frequency/intensity from the voice range profile task. Presence of a "knee" on the EGG wave shape was determined by visual inspection of the presence of convexity along the decontacting slope of the EGG pulse and the presence of the second derivative zero-crossing. Results The contact quotient by integration, normalized contacting speed, quotient of speed by integration, and cycle-rate sample entropy were significantly different in children compared to (a) adult males for habitual range and (b) adult males and adult females for the overlap vocal frequency/intensity. None of the children had a "knee" on the decontacting slope of the EGG slope. Conclusion EGG parameters of contact quotient by integration, normalized contacting speed, quotient of speed by integration, cycle-rate sample entropy, and absence of a "knee" on the decontacting slope characterize the wave shape differences between children and adults, whereas the normalized contacting speed, quotient of speed by integration, cycle-rate sample entropy, and presence of a "knee" on the downward pulse slope characterize the wave shape differences between adult males and adult females. Supplemental Material https://doi.org/10.23641/asha.15057345.

Feature Maps of the Acoustic Spectrum of the Voice.

The change in the spectrum of sustained /a/ vowels was mapped over the voice range from low to high fundamental frequency and low to high sound pressure level (SPL), in the form of the so-called voice range profile (VRP). In each interval of one semitone and one decibel, narrowband spectra were averaged both within and across subjects. The subjects were groups of 7 male and 12 female singing students, as well as a group of 16 untrained female voices. For each individual and also for each group, pairs of VRP recordings were made, with stringent separation of the modal/chest and falsetto/head registers. Maps are presented of eight scalar metrics, each of which was chosen to quantify a particular feature of the voice spectrum, over fundamental frequency and SPL. Metrics 1 and 2 chart the role of the fundamental in relation to the rest of the spectrum. Metrics 3 and 4 are used to explore the role of resonances in relation to SPL. Metrics 5 and 6 address the distribution of high frequency energy, while metrics 7 and 8 seek to describe the distribution of energy at the low end of the voice spectrum. Several examples are observed of phenomena that are difficult to predict from linear source-filter theory, and of the voice source being less uniform over the voice range than is conventionally assumed. These include a high-frequency band-limiting at high SPL and an unexpected persistence of the second harmonic at low SPL. The two voice registers give rise to clearly different maps. Only a few effects of training were observed, in the low frequency end below 2 kHz. The results are of potential interest in voice analysis, voice synthesis and for new insights into the voice production mechanism.

Effects of the Lung Volume on the Electroglottographic Waveform in Trained Female Singers.

OBJECTIVES: To determine if in singing there is an effect of lung volume on the electroglottographic waveform, and if so, how it varies over the voice range. STUDY DESIGN: Eight trained female singers sang the tune "Frère Jacques" in 18 conditions: three phonetic contexts, three dynamic levels, and high or low lung volume. Conditions were randomized and replicated. METHODS: The audio and EGG signals were recorded in synchrony with signals tracking respiration and vertical larynx position. The first 10 Fourier descriptors of every EGG cycle were computed. These spectral data were clustered statistically, and the clusters were mapped by color into a voice range profile display, thus visualizing the EGG waveform changes under the influence of fo and SPL. The rank correlations and effect sizes of the relationships between relative lung volume and several adduction-related EGG wave shape metrics were similarly rendered on a color scale, in voice range profile-style 'voice maps.' RESULTS: In most subjects, EGG waveforms varied considerably over the voice range. Within subjects, reproducibility was high, not only across the replications, but also across the phonetic contexts. The EGG waveforms were quite individual, as was the nature of the EGG shape variation across the range. EGG metrics were significantly correlated to changes in lung volume, in parts of the range of the song, and in most subjects. However, the effect sizes of the relative lung volume were generally much smaller than the effects of fo and SPL, and the relationships always varied, even changing polarity from one part of the range to another. CONCLUSIONS: Most subjects exhibited small, reproducible effects of the relative lung volume on the EGG waveform. Some hypothesized influences of tracheal pull were seen, mostly at the lowest SPLs. The effects were however highly variable, both across the moderately wide fo-SPL range and across subjects. Different singers may be applying different techniques and compensatory behaviors with changing lung volume. The outcomes emphasize the importance of making observations over a substantial part of the voice range, and not only of phonations sustained at a few fundamental frequencies and sound levels.

Voice Use in Daily Life Studied With a Portable Voice Accumulator in Individuals With Parkinson's Disease and Matched Healthy Controls.

Purpose The purpose of this work was to study how voice use in daily life is impacted by Parkinson's disease (PD), specifically if there is a difference in voice sound level and phonation ratio during everyday activities for individuals with PD and matched healthy controls. A further aim was to study how variations in environmental noise impact voice use. Method Long-term registration of voice use during 1 week in daily life was performed for 21 participants with PD (11 male, 10 female) and 21 matched healthy controls using the portable voice accumulator VoxLog. Voice use was assessed through registrations of spontaneous speech in different ranges of environmental noise in daily life and in a controlled studio recording setting. Results Individuals with PD use their voice 50%-60% less than their matched healthy controls in daily life. The difference increases in high levels of environmental noise. Individuals with PD used an average voice sound level in daily life that was 8.11 dB (female) and 6.7 dB (male) lower than their matched healthy controls. Difference in mean voice sound level for individuals with PD and controls during spontaneous speech during a controlled studio registration was 3.0 dB for the female group and 4.1 dB for the male group. Conclusions The observed difference in voice use in daily life between individuals with PD and matched healthy controls is a 1st step to objectively quantify the impact of PD on communicative participation. The variations in voice use in different levels of environmental noise and when comparing controlled and variable environments support the idea that the study of voice use should include methods to assess function in less controlled situations outside the clinical setting.

Normalized time-domain parameters for electroglottographic waveforms.

The electroglottographic waveform is of interest for characterizing phonation non-invasively. Existing parameterizations tend to give disparate results because they rely on somewhat arbitrary thresholds and/or contacting events. It is shown that neither are needed for formulating a normalized contact quotient and a normalized peak derivative. A heuristic combination of the two resolves also the ambiguity of a moderate contact quotient, with regard to vocal fold contacting being firm versus weak or absent. As preliminaries, schemes for electroglottography signal preconditioning and time-domain period detection are described that improve somewhat on similar methods. The algorithms are simple and compute quickly.

Long-term effects of Lee Silverman Voice Treatment on daily voice use in Parkinson's disease as measured with a portable voice accumulator.

This study examines the effects of an intensive voice treatment focusing on increasing voice intensity, LSVT LOUD® Lee Silverman Voice Treatment, on voice use in daily life in a participant with Parkinson's disease, using a portable voice accumulator, the VoxLog. A secondary aim was to compare voice use between the participant and a matched healthy control. Participants were an individual with Parkinson's disease and his healthy monozygotic twin. Voice use was registered with the VoxLog during 9 weeks for the individual with Parkinson's disease and 2 weeks for the control. This included baseline registrations for both participants, 4 weeks during LSVT LOUD for the individual with Parkinson's disease and 1 week after treatment for both participants. For the participant with Parkinson's disease, follow-up registrations at 3, 6, and 12 months post-treatment were made. The individual with Parkinson's disease increased voice intensity during registrations in daily life with 4.1 dB post-treatment and 1.4 dB at 1-year follow-up compared to before treatment. When monitored during laboratory recordings an increase of 5.6 dB was seen post-treatment and 3.8 dB at 1-year follow-up. Changes in voice intensity were interpreted as a treatment effect as no significant correlations between changes in voice intensity and background noise were found for the individual with Parkinson's disease. The increase in voice intensity in a laboratory setting was comparable to findings previously reported following LSVT LOUD. The increase registered using ambulatory monitoring in daily life was lower but still reflecting a clinically relevant change.

Prediction of three articulatory categories in vocal sound imitations using models for auditory receptive fields.

Vocal sound imitations provide a new challenge for understanding the coupling between articulatory mechanisms and the resulting audio. In this study, the classification of three articulatory categories, phonation, supraglottal myoelastic vibrations, and turbulence, have been modeled from audio recordings. Two data sets were assembled, consisting of different vocal imitations by four professional imitators and four non-professional speakers in two different experiments. The audio data were manually annotated by two experienced phoneticians using a detailed articulatory description scheme. A separate set of audio features was developed specifically for each category using both time-domain and spectral methods. For all time-frequency transformations, and for some secondary processing, the recently developed Auditory Receptive Fields Toolbox was used. Three different machine learning methods were applied for predicting the final articulatory categories. The result with the best generalization was found using an ensemble of multilayer perceptrons. The cross-validated classification accuracy was 96.8% for phonation, 90.8% for supraglottal myoelastic vibrations, and 89.0% for turbulence using all the 84 developed features. A final feature reduction to 22 features yielded similar results.

A comparison of electroglottographic and glottal area waveforms for phonation type differentiation in male professional singers.

This study compares the use of electroglottograms (EGGs) and glottal area waveforms (GAWs) to study phonation in different vibratory states as produced by professionally trained singers. Six western classical tenors were asked to phonate pitch glides from modal to falsetto phonation, or from modal to their stage voice above the passaggio (SVaP). For each pitch glide the sample entropy (SampEn) of the EGG signal was calculated to detect the occurrence of phonatory instabilities and establish a "ground truth" for the performed phonation type. The cycles before the maximum SampEn were labeled as modal, and the cycles after the peak were labeled as either falsetto, or SVaP. Three automatic categorizations of vibratory state were performed using clustering: one based only on the EGG, one based on the GAW, and one based on their combination. The error rate (clustering vs ground truth) was, on average, lower than 10% for all of the three settings, revealing no special advantage of the GAW over EGG, and vice versa. Modal voice cycles exhibited a larger contact quotient, larger normalized derivative peak ratio, and lower rise time, compared to SVaP and falsetto. The GAW-based normalized maximum area declination rate was larger in SVaP compared to modal voice.

Vocal Behavior in Environmental Noise: Comparisons Between Work and Leisure Conditions in Women With Work-related Voice Disorders and Matched Controls.

OBJECTIVES: This study aimed to assess vocal behavior in women with voice-intensive occupations to investigate differences between patients and controls and between work and leisure conditions with environmental noise level as an experimental factor. METHODS: Patients with work-related voice disorders, 10 with phonasthenia and 10 with vocal nodules, were matched regarding age, profession, and workplace with 20 vocally healthy colleagues. The sound pressure level of environmental noise and the speakers' voice, fundamental frequency, and phonation ratio were registered from morning to night during 1 week with a voice accumulator. Voice data were assessed in low (≤55 dBA), moderate, and high (>70 dBA) environmental noise levels. RESULTS: The average environmental noise level was significantly higher during the work condition for patients with vocal nodules (73.9 dBA) and their controls (73.0 dBA) compared with patients with phonasthenia (68.3 dBA) and their controls (67.1 dBA). The average voice level and the fundamental frequency were also significantly higher during work for the patients with vocal nodules and their controls. During the leisure condition, there were no significant differences in average noise and voice level nor fundamental frequency between the groups. The patients with vocal nodules and their controls spent significantly more time and used their voices significantly more in high-environmental noise levels. CONCLUSIONS: High noise levels during work and demands from the occupation impact vocal behavior. Thus, assessment of voice ergonomics should be part of the work environmental management. To reduce environmental noise levels is important to improve voice ergonomic conditions in communication-intensive and vocally demanding workplaces.

Perceptual and Acoustic Analyses of Good Voice Quality in Male Radio Performers.

OBJECTIVES: Good voice quality is an asset to professional voice users, including radio performers. We examined whether (1) voices could be reliably categorized as good for the radio and (2) these categories could be predicted using acoustic measures. PARTICIPANTS AND METHODS: Male radio performers (n = 24) and age-matched male controls performed "The Rainbow Passage" as if presenting on the radio. Voice samples were rated using a three-stage paired-comparison paradigm by 51 naive listeners and perceptual categories were identified (Study 1), and then analyzed for fundamental frequency, long-term average spectrum, cepstral peak prominence, and pause or spoken-phrase duration (Study 2). RESULTS: Study 1: Good inter-judge reliability was found for perceptual judgments of the best 15 voices (good for radio category, 14/15 = radio performers), but agreement on the remaining 33 voices (unranked category) was poor. Study 2: Discriminant function analyses showed that the SD standard deviation of sounded portion duration, equivalent sound level, and smoothed cepstral peak prominence predicted membership of categories with moderate accuracy (R2 = 0.328). CONCLUSIONS: Radio performers are heterogeneous for voice quality; good voice quality was judged reliably in only 14 out of 24 radio performers. Current acoustic analyses detected some of the relevant signal properties that were salient in these judgments. More refined perceptual analysis and the use of other perceptual methods might provide more information on the complex nature of judging good voices.

Investigation of the relationship between electroglottogram waveform, fundamental frequency, and sound pressure level using clustering.

Although it has been shown in previous research (Orlikoff, 1991; Henrich et al, 2005; Kuang et al, 2014; Awan, 2015) that there exists a relationship between the electroglottogram (EGG) waveform and the acoustic signal, this relationship is still not fully understood. To investigate this relationship, the EGG and acoustic signals were measured for four male amateur choir singers who each produced eight consecutive tones of increasing and decreasing vocal intensity. The EGG signals were processed cycle-synchronously to obtain the discrete Fourier transform, and the data were used as an input to a clustering algorithm. The acoustic signal was analyzed in terms of sound pressure level (dB SPL) and fundamental frequency (fo) of vibration, and the results of both EGG and acoustic analysis were depicted on a two-dimensional plane with fo on the x-axis and SPL on the y-axis. All the subjects were seen to have a weak, near-sinusoidal EGG waveform in their lowest SPL range, whereas increase in SPL coincided with progressive enrichment in harmonic content of the EGG waveforms. The results of the clustering were additionally used to classify waveforms across subjects to enable inter-subject comparisons and assessment of individual strategies of exploring the fo-SPL dimensions. In these male subjects, the EGG waveform shape appeared to vary with SPL and to remain essentially constant with fo over one octave.

Motor-Learning-Based Adjustment of Ambulatory Feedback on Vocal Loudness for Patients With Parkinson's Disease.

OBJECTIVES: To investigate how the direct biofeedback on vocal loudness administered with a portable voice accumulator (VoxLog) should be configured, to facilitate an optimal learning outcome for individuals with Parkinson's disease (PD), on the basis of principles of motor learning. STUDY DESIGN: Methodologic development in an experimental study. METHODS: The portable voice accumulator VoxLog was worn by 20 participants with PD during habitual speech during semistructured conversations. Six different biofeedback configurations were used, in random order, to study which configuration resulted in a feedback frequency closest to 20% as recommended on the basis of previous studies. RESULTS: Activation of feedback when the wearer speaks below a threshold level of 3 dB below the speaker's mean voice sound level in habitual speech combined with an activation time of 500 ms resulted in a mean feedback frequency of 21.2%. CONCLUSIONS: Settings regarding threshold and activation time based on the results from this study are recommended to achieve an optimal learning outcome when administering biofeedback on vocal loudness for individuals with PD using portable voice accumulators.

Natural Voice Use in Patients With Voice Disorders and Vocally Healthy Speakers Based on 2 Days Voice Accumulator Information From a Database.

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, Umeå, 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.

Analysis of vibratory states in phonation using spectral features of the electroglottographic signal.

The vocal folds can oscillate in several different ways, manifest to practitioners and clinicians as "registers" or "mechanisms," of which the two most often considered are modal voice and falsetto voice. Here these will be taken as instances of different "vibratory states," i.e., distinct quasi-stationary patterns of vibration of the vocal folds. State transitions are common in biomechanical nonlinear oscillators, and they are often abrupt and impossible to predict exactly. Therefore, vibratory states are a source of confounding variation, for instance when acquiring a voice range profile (VRP). In the quest for a state-based, non-invasive VRP, a semi-automatic method based on the short-term spectrum of the electroglottographic (EGG) signal was developed. The method identifies rapid vibratory state transitions, such as the modal-falsetto switch, and clusters the EGG data based on their similarities in the relative levels and phases of the lower frequency components. Productions of known modal and falsetto voice were accurately clustered by a Gaussian mixture model. When mapped into the VRP, this EGG-based clustering revealed connected regions of different vibratory sub-regimes in both modal and falsetto.