The promise of self-determination theory to study the therapist-client relationship in speech-language treatment.

This study aims at examining the therapist-client relationship in speech-language treatment and its relationships with clients' motivation from the perspective of Self-Determination Theory (SDT). It adds to the current literature by relying on observations as well as client perceptions of the therapists' interaction style and by studying three different age groups of adults (>18 years old), adolescents (12-18 years old) as well as children (<12 years). Two convenience samples: 1) 42 Speech Language Therapists (SLPs; 95.2 % female) and 72 individuals with communication disorders (ICDs) (72.2 % female;>12 years old), and 2) 21 SLPs (100 % female) and 44 ICDs (50 % girls; <12 years) were recruited for this cross-sectional study. After engaging in a treatment session, ICDs responded to a set of validated questionnaires measuring the SLPs' motivating style, their need-based experiences and motivation towards the treatment. Moreover, each treatment session was observed. Both client-reported as well as observational measures show that SLPs more strongly evince an autonomy-supportive (i.e. motivating) when compared to a controlling (i.e. demotivating) style to the benefit of their clients' motivation. The display of empathy was the most frequently observed strategy. SLPs regularly provided rationales, choices, and opportunities for clients to experiment. However, these behaviors were more frequent in younger compared to older clients. With the younger clients, SLPs frequently used effort-contingent rewards, which is considered a controlling strategy in SDT. Results showed that motivational benefits may be expected if SLPs rely on an autonomy-supportive rather than a controlling style. This study provides a valuable starting point for an SDT-driven examination of the therapist-client relationship and ICD's motivation in the context of speech-language pathology.

Effect of two isolated vocal facilitating techniques glottal fry and yawn-sigh on the phonation of female speech-language pathology students: A pilot study.

OBJECTIVE: The purpose of this study was to determine the effect of two isolated vocal facilitating techniques, glottal fry and yawn-sigh, on the phonation of vocally healthy female speech-language pathology (SLP) students. STUDY DESIGN: A multigroup pretest-posttest design was used. METHODS: A group of thirty-six healthy female SLP students with a mean age of 18.1 years were assigned into three groups: a glottal fry group (practicing the facilitating technique glottal fry across 18 weeks, n=12), a yawn-sigh group (practicing the facilitating technique yawn-sigh across 18 weeks, n=12) and a control group (receiving no facilitating techniques, n=12). To compare vocal measures before and after this training period, an identical objective voice assessment protocol (maximum performance task, acoustic analysis, voice range profile and Dysphonia Severity Index) was performed in the three groups. Groups were compared over time using linear mixed models. Within-group effects of time were determined using post hoc pairwise comparisons. RESULTS: Glottal fry resulted in a significant decrease in lowest and highest intensity. Yawn-sigh resulted in a significant increase in fundamental frequency, a significant decrease in shimmer and noise-to-harmonic ratio, and a significant increase in highest intensity. CONCLUSIONS: Yawn-sigh may have a positive effect on the phonation of female vocally healthy future SLPs, whereas results are less supportive for using glottal fry in training this population's voice.

Short-term effect of short, intensive speech therapy on articulation and resonance in Ugandan patients with cleft (lip and) palate.

OBJECTIVES: The purpose of the current study was to assess the short-term effectiveness of short and intensive speech therapy provided to patients with cleft (lip and) palate (C(L)P) in terms of articulation and resonance. METHODS: Five Ugandan patients (age: 7.3-19.6 years) with non-syndromic C(L)P received six hours of individualized speech therapy in three to four days. Speech therapy focused on correct phonetic placement and contrasts between oral and nasal airflow and resonance. Speech evaluations performed before and immediately after speech therapy, including perceptual and instrumental assessment techniques, were compared. RESULTS: Post-therapy, improvement of speech was noted for most of the patients, although to varying degrees. Clinically relevant progress of objective nasalance values and/or articulation was obtained in four patients. Overall, two patients showed normal speech intelligibility, while three patients required additional speech therapy. CONCLUSION: These preliminary short-term results demonstrate that short and intensive speech therapy can be effective for patients with C(L)P in countries with limited access to speech-language therapy. However, further research is needed on the long-term effectiveness and the advantages of applying this treatment protocol in countries with good access to speech therapy. LEARNING OUTCOMES: The reader will be able to (1) list the challenges in resource poor-countries to achieve access to speech-language therapy services, (2) describe when the application of speech therapy is appropriate in patients with C(L)P, (3) describe the speech therapy that can be applied to reduce compensatory articulation and resonance disorders in patients with C(L)P, and (4) list the (possible) advantages of short, intensive speech therapy for both resource-poor and developed countries.

Facial transplantation: history and update.

BACKGROUND: Composite tissue allografting (CTA) represents the essence of reconstructive surgery, combining principles of solid organ transplantation (SOT) and modern plastic surgery techniques. The purpose of this article is to give a review of the history of facial CTA and an update of the cases that have been operated so far worldwide. METHODS: A systematic review of the medical literature was performed. Ten relevant publications were selected and analyzed for clinical data of the patients, surgical aspects of transplantation, complications and outcome. RESULTS: The past 9 years, 31 face transplants have been performed worldwide. The main indication was posttraumatic deformity. In all cases standard triple drug immunosuppression as used in SOT was successfully used and at least 1 period of acute rejection was seen in all patients, controllable with conventional immunosuppressive regimens. Overall functional outcomes are good and satisfaction rate is high, surpassing initial expectations. The main complications are opportunistic infections; 4 deaths occurred. CONCLUSIONS: Facial CTA is a life changing procedure and has led to new treatment options for patients with complex, devastating and otherwise unreconstructable facial deformities to restore appearance and overall wellbeing in a single operation. The key to success lies in the selection of the appropriate patient, who is stable, well-motivated and therapy compliant. Thorough screening and follow-up by a multidisciplinary team, well prepared surgical approach and intensive, early rehabilitation are all crucial factors for minimizing complications and a safe and rapid recovery.

Nasalance and nasality in children with cochlear implants and children with hearing aids.

OBJECTIVES: In prelingually deaf children, many speech production aspects including resonance, are known to be problematic. This study aimed to investigate nasality and nasalance in two groups of prelingually hearing impaired children, namely deaf children with a cochlear implant (CI) and moderate-to-severely hearing impaired hearing aid (HA) users. The results of both groups are compared with the results of normal hearing children. Besides, the impact of the degree of hearing loss was determined. METHODOLOGY: 36 CI children (mean age: 9;0y), 25 HA children (mean age: 9;1y) and 26 NH children (mean age: 9;3y) were assessed using objective assessment techniques and perceptual evaluations in order to investigate the nasal resonance of the three groups. Ten HA children had thresholds above 70dB (range: 91dB-105dB) and fifteen below 70dB (range: 58dB-68dB). The Nasometer was used for registration of the nasalance values and nasality was perceptually evaluated by two experienced speech therapists using a nominal rating scale (consensus evaluation). RESULTS: For nasal stimuli, both CI children and HA children showed lower nasalance values in comparison with NH children. The opposite was observed for the oral stimuli. In both hearing impaired groups, cul-de-sac-resonance was observed on a significantly larger scale than in the NH group, and the HA children were judged to be significantly more hypernasal in comparison with NH children. CONCLUSIONS: Despite the fact that a substantial number of the CI and HA children demonstrate normal (nasal) resonance quality, this aspect of speech production is still at risk for hearing impaired children.

Articulation and oromyofunctional behavior in children seeking orthodontic treatment.

OBJECTIVES: The purpose of this controlled study is to document articulation and oromyofunctional behavior in children seeking orthodontic treatment. In addition, relations between malocclusions, articulation, and oromyofunctional behavior are studied. MATERIALS AND METHODS: The study included 56 children seeking orthodontic treatment. The control group, consisting of 54 subjects matched for age and gender, did not undergo orthodontic intervention. To determine the impact of the occlusion on speech, the Oral Health Impact Profile was used. Speech characteristics, intelligibility and several lip and tongue functions were analyzed using consensus evaluations. RESULTS: A significant impact of the occlusion on speech and more articulation disorders for/s,n,l,t/were found in the subjects seeking orthodontic treatment. Several other phenomena were seen more often in this group, namely more impaired lip positioning during swallowing, impaired tongue function at rest, mouth breathing, open mouth posture, lip sucking/biting, anterior tongue position at rest, and tongue thrust. Moreover, all children with a tongue thrust showed an anterior tongue position at rest. CONCLUSIONS: Children seeking orthodontics have articulatory and oromyofunctional disorders. To what extent a combined orthodontic and logopaedic treatment can result in optimal oral health (i.e. perfect dentofacial unit with perfect articulation) is subject for further multidisciplinary research.

Speech characteristics in a Ugandan child with a rare paramedian craniofacial cleft: a case report.

The purpose of this study is to describe the speech characteristics in an English-speaking Ugandan boy of 4.5 years who has a rare paramedian craniofacial cleft (unilateral lip, alveolar, palatal, nasal and maxillary cleft, and associated hypertelorism). Closure of the lip together with the closure of the hard and soft palate (one-stage palatal closure) was performed at the age of 5 months. Objective as well as subjective speech assessment techniques were used. The speech samples were perceptually judged for articulation, intelligibility and nasality. The Nasometer was used for the objective measurement of the nasalance values. The most striking communication problems in this child with the rare craniofacial cleft are an incomplete phonetic inventory, a severely impaired speech intelligibility with the presence of very severe hypernasality, mild nasal emission, phonetic disorders (omission of several consonants, decreased intraoral pressure in explosives, insufficient frication of fricatives and the use of a middorsum palatal stop) and phonological disorders (deletion of initial and final consonants and consonant clusters). The increased objective nasalance values are in agreement with the presence of the audible nasality disorders. The results revealed that several phonetic and phonological articulation disorders together with a decreased speech intelligibility and resonance disorders are present in the child with a rare craniofacial cleft. To what extent a secondary surgery for velopharyngeal insufficiency, combined with speech therapy, will improve speech intelligibility, articulation and resonance characteristics is a subject for further research. The results of such analyses may ultimately serve as a starting point for specific surgical and logopedic treatment that addresses the specific needs of children with rare facial clefts.

Impact of fixed implant prosthetics using the 'all-on-four' treatment concept on speech intelligibility, articulation and oromyofunctional behaviour.

The purpose of this case control study is to determine the impact of screw-retained fixed cross-arch prostheses, supported by four osseointegrated implants, on articulation and oromyofunctional behaviour. Objective (acoustic analysis) and subjective assessment techniques were used to determine the overall intelligibility, phonetic characteristics and oromyofunctional behaviour at an average period of 7.3 months after placement of the fixed implant prosthesis in 15 patients and 9 age-matched controls with intact dentition and without prosthetic appliances. Overall satisfaction with the prosthesis was 87%, but 53% of the subjects mentioned an impact on speech. 87% of the subjects presented with one or more distortions of the consonants. The most common distortions were distortions of the sound /s/ (sigmatismus simplex, 40% and sigmatismus stridens, 33%), simplex /z/ (27%), insufficient frication of /f/ (20%), /[symbol in text]/ (20%), addental production of /d/ (20%), /t/ (20%) or /s/ sound (13%) and devoiced /d/ (7%). In the control group, no articulation disorders were noted. Oromyofunctional behaviour in both groups was normal. To what extent motor-oriented speech therapy (with focus on tongue function) immediately after periodontal treatment (after wound healing) would decrease the persistent phonetic distortions is a subject for further research.

Normative nasalance data in Ugandan english-speaking children.

AIMS: The aim of this study was to obtain normative nasalance values for typically developing Ugandan English-speaking children as a reference point for clinical practice and further research. METHODS: Sixty-nine typically developing Ugandan children (35 males and 34 females, 2.7-13.5 years of age) participated in the study. Nasalance scores were obtained with the Nasometer while children repeated 4 sustained sounds, 14 repeated syllables, 15 sentences (12 oral, 3 nasal) and 2 texts ('Rainbow Passage' and 'Zoo Passage'). Data were analyzed for gender and age dependence. RESULTS: No significant effects of age or gender on nasalance values were obtained; hence, normative values for the overall group were reported. The average nasalance scores for Ugandan English-speaking children were 17 and 64% for the oral and nasal sentences and 33 and 14% for the oronasal and oral text, respectively. CONCLUSION: The normative values are important as a reference point to assess the impact of several surgical procedures and several surgical timing strategies on speech in Uganda.

Comparison of speech intelligibility, articulation and oromyofunctional behaviour in subjects with single-tooth implants, fixed implant prosthetics or conventional removable prostheses.

The purpose of this controlled study was to determine the impact of a single-tooth implant, fixed implant prosthesis and completely removable dental prosthesis on intelligibility, articulation and oromyofunctional behaviour. Additionally, the self-perceived overall satisfaction of the dental replacements and the effect on speech was questioned. Objective (acoustic analysis) as well as subjective assessment techniques (perceptual evaluation) were used. The satisfaction of single-tooth implant group was very high (100%) followed by a satisfaction of 87% for the fixed implant prosthesis group and 68% for the removable prosthesis group. The results of the phonetic analyses revealed a normal intelligibility and oromyofunctional behaviour in the three groups of dental replacements. Only one type of articulation disorders was observed in the single-tooth implant group, followed by three types of disorders in the removable prosthesis group and six types of disorders in the fixed implant prosthesis group. In this last group, not only 87% of the subjects showed distortions of one or more consonants but also most consonants of the Dutch language were disturbed in comparison with the single-tooth implant and removable prosthesis users. Special attention must be paid to the fricative /s/ because in more than 50% of all groups, this sound is disturbed.

The impact of menopause and hormone therapy on voice and nasal resonance.

In an initial study it was shown that (without hormonal influences) middle-aged (premenopausal) women show a smaller frequency and intensity range and a lower fundamental frequency of the voice compared to young women. To investigate the impact of menopause on voice and nasal resonance a cross-sectional non-randomized study design was used. Vocal characteristics and nasal resonance in premenopausal and postmenopausal women without hormone therapy (HT) were compared. Postmenopausal women without HT showed a significantly lower speaking fundamental frequency (SFF) and were able to phonate lower compared to postmenopausal women with HT. The mean difference in SFF was 14 Hz. HT can also counteract the menopausal changes in SFF. The lower SFF did not result in vocal complaints. Further research about the impact of menopause and HT on voice should concentrate on elite professional voice users.

Impact of tongue reduction on overall speech intelligibility, articulation and oromyofunctional behavior in 4 children with Beckwith-Wiedemann syndrome.

OBJECTIVE: The purpose of this study was to determine the impact of partial glossectomy (using the keyhole technique) on speech intelligibility, articulation, resonance and oromyofunctional behavior. PATIENTS AND METHODS: A partial glossectomy was performed in 4 children with Beckwith- Wiedemann syndrome between the ages of 0.5 and 3.1 years. An ENT assessment, a phonetic inventory, a phonemic and phonological analysis and a consensus perceptual evaluation of speech intelligibility, resonance and oromyofunctional behavior were performed. RESULTS: It was not possible in this study to separate the effects of the surgery from the typical developmental progress of speech sound mastery. Improved speech intelligibility, a more complete phonetic inventory, an increase in phonological skills, normal resonance and increased motor-oriented oral behavior were found in the postsurgical condition. The presence of phonetic distortions, lip incompetence and interdental tongue position were still present in the postsurgical condition. CONCLUSION: Speech therapy should be focused on correct phonetic placement and a motor-oriented approach to increase lip competence, and on functional tongue exercises and tongue lifting during the production of alveolars. Detailed analyses in a larger number of subjects with and without Beckwith-Wiedemann syndrome may help further illustrate the long-term impact of partial glossectomy.

Parent and child ratings of satisfaction with speech and facial appearance in Flemish pre-pubescent boys and girls with unilateral cleft lip and palate.

The purpose of this controlled study is to determine satisfaction with speech and facial appearance in Flemish pre-pubescent children with unilateral cleft lip and palate. Forty-three subjects with unilateral cleft lip and palate and 43 age and gender matched controls participated in this study. The Cleft Evaluation Profile was used to assess the perceived satisfaction for individual features related to cleft care. Both the cleft palate subjects and their parents were satisfied with the speech and facial appearance. The Pearson χ(2) test revealed significant difference between the cleft palate and the control group regarding hearing, nasal aesthetics and function, and the appearance of the lip. An in depth analysis of well specified speech characteristics revealed that children with clefts and their parents significantly more often reported the presence of an articulation, voice and resonance disorder and experienced /s/ /r/ /t/ and /d/ as the most difficult consonants. To what extent the incorporation of specific motor oriented oral speech techniques regarding the realisation of specific consonants, attention to vocal and ear care, and the recommendation of secondary velopharyngeal surgery, with the incorporation of primary correction of the cleft nose deformity simultaneously with primary lip closure, will aid these patients are future research subjects.

Impact of anterior single-tooth implants on quality of life, articulation and oromyofunctional behaviour: a pilot study.

The main purpose of this study is to determine the impact (one and a half year after implantation) of a single-tooth implant on articulation and oromyofunctional behaviour. This information is important for dentists, orthodontists or stomatologists who treat professional speakers. Objective (acoustic analysis) as well as subjective (questionnaire, phonetic inventory, phonetic analysis, oromyofunctional assessment of lip and tongue function, blowing, sucking and swallowing) assessment techniques were used to determine the quality of life, articulation and oromyofunctional behaviour. Fourteen subjects who received a single-tooth implant and a control group of nine subjects participated in this study. The mean overall satisfaction of single-implant users was 95%. The subjects who received a single-tooth implant were capable of producing all Dutch vowels and consonants. The phonetic analysis revealed a sigmatism in 57% of the cases. Sigmatisms (stridens sigmatism followed by simplex sigmatism) were the most frequently observed phonetic disorders. There was interobserver agreement about normal lip and tongue functions. Moreover, blowing, sucking and swallowing patterns were normal (concordance value 96%). Detailed analyses 1 or 2 years after implantation of an anterior single-tooth implant revealed normal speech intelligibility and oromyofunctional behaviour. Articulation was characterised by the presence of a persistent phonetic disorder. Further research involving more subjects with an anterior single-tooth implant is needed.

A comparison of vowel productions in prelingually deaf children using cochlear implants, severe hearing-impaired children using conventional hearing aids and normal-hearing children.

OBJECTIVE: The purpose of this study was to compare vowel productions by deaf cochlear implant (CI) children, hearing-impaired hearing aid (HA) children and normal-hearing (NH) children. PATIENTS AND METHODS: 73 children [mean age: 9;14 years (years;months)] participated: 40 deaf CI children, 34 moderately to profoundly hearing-impaired HA children and 42 NH children. For the 3 corner vowels [a], [i] and [u], F(1), F(2) and the intrasubject SD were measured using the Praat software. Spectral separation between these vowel formants and vowel space were calculated. RESULTS: The significant effects in the CI group all pertain to a higher intrasubject variability in formant values, whereas the significant effects in the HA group all pertain to lower formant values. Both hearing-impaired subgroups showed a tendency toward greater intervowel distances and vowel space. CONCLUSION: Several subtle deviations in the vowel production of deaf CI children and hearing-impaired HA children could be established, using a well-defined acoustic analysis. CI children as well as HA children in this study tended to overarticulate, which hypothetically can be explained by a lack of auditory feedback and an attempt to compensate it by proprioceptive feedback during articulatory maneuvers.

Speech intelligibility of children with unilateral cleft lip and palate (Dutch cleft) following a one-stage Wardill-Kilner palatoplasty, as judged by their parents.

This study determined the intelligibility (words, sentences and story telling) of 43 children (mean age 4.9 years) with unilateral cleft lip and palate who received a Wardill-Kilner palatoplasty, as judged by their parents and determined the influence of age and gender. A comparison with normative data for intelligibility of 163 Dutch speaking children was made. Each child and the parents completed The Dutch intelligibility test. Measures reported include group mean intelligibility percentages for words, sentences and story telling for children aged 2.5-5.0 and 5.0-7.6 years. A significant correlation between age of the children and intelligibility was measured. No significant gender-related differences were found. An interesting finding is the absence of significant difference in intelligibility percentage between the children with cleft palate and the normative data for story telling. The reported intelligibility percentages provide important prognostic reference information for surgeons who perform palatoplasty and speech pathologists who assess the speech production of children with cleft palate.

Long-term impact of tongue reduction on speech intelligibility, articulation and oromyofunctional behaviour in a child with Beckwith-Wiedemann syndrome.

The purpose of the present case study was to determine the long-term impact of partial glossectomy (using the keyhole technique) on overall speech intelligibility and articulation in a Dutch-speaking child with Beckwith-Wiedemann syndrome (BWS). Furthermore the present study is meant as a contribution to the further delineation of the phonation, resonance, articulation and language characteristics and oral behaviour in a child with BWS. Detailed information on the speech and language characteristics of children with BWS may lead to better guidance of pediatric management programs. The child's speech was assessed 9 years after partial glossectomy with regard to ENT characteristics, overall intelligibility (perceptual consensus evaluation), articulation (phonetic and phonological errors), voice (videostroboscopy, vocal quality), resonance (perceptual, nasometric assessment), language (expressive and receptive) and oral behaviour. A class III malocclusion, an anterior open bite, diastema, overangulation of lower incisors and an enlarged but normal symmetric shaped tongue were present. The overall speech intelligibility improved from severely impaired (presurgical) to slightly impaired (5 months post-glossectomy) to normal (9 years postoperative). Comparative phonetic inventory showed a remarkable improvement of articulation. Nine years post-glossectomy three types of distortions seemed to predominate: a rhotacism and sigmatism and the substitution of the alveolar /z/. Oral behaviour, vocal characteristics and resonance were normal, but problems with expressive syntactic abilities were present. The long-term impact of partial glossectomy, using the keyhole technique (preserving the vascularity and the nervous input of the remaining intrinsic tongue muscles), on speech intelligibility, articulation, and oral behaviour in this Dutch-speaking child with congenital macroglossia can be regarded as successful. It is not clear how these expressive syntactical problems demonstrated in this child can be explained. Certainly they are not part of a more general developmental delay, hearing problems or cognitive malfunctioning. To what extent the presence of expressive syntactical problems is a possible aspect of the phenotypic spectrum of children with BWS is subject for further research. Multiple variables, both known and unknown can affect the long-term outcome after partial glossectomy in a child with BWS. The timing and type of the surgical technique, hearing and cognitive functioning are known variables in this study. But variables such as children's motivation, the contribution of the motor-oriented speech therapy, the parental articulation input and stimulation and other family, school and community factors are unknown and are all factors which can influence speech outcome after partial glossectomy. Detailed analyses in a greater number of subjects with BWS may help further illustrate the long-term impact of partial glossectomy.

The vocal quality in female student teachers during the 3 years of study.

The purpose of the present cross-sectional study was to determine the objective vocal quality and the vocal characteristics (vocal risk factors, vocal and corporal complaints) in 143 female student teachers during the 3 years of study. The objective vocal quality was measured by means of the Dysphonia Severity Index (DSI). Perceptual voice assessment, the Voice Handicap Index, questionnaires addressing vocal risks, and vocal and corporal complaints during and/or after voice usage were performed. Student teachers have a normal perceptual and objective vocal quality corresponding with a DSI% of 76. The analysis of variance revealed a significant improvement of the vocal quality between the first and the third year of study. No psychosocial handicapping effect of the voice was observed, though there are some vocal complaints and almost all student teachers reported the presence of corporal pain during and/or after speaking. Especially sore throat and headache were mentioned as the most present corporal pain symptoms. Due to the decreased awareness and the multifactorial genesis of the potential vocal risk factors, the student teachers are at risk for developing an occupational dysphonia during their teaching career. Because teaching is a high-risk profession for the development of voice problems, the incorporation of a direct vocal training technique to increase vocal endurance during teaching together with a vocal hygiene program, dietetics, and a stress management training program during the 3 years of study is needed to prevent occupational dysphonia.

Speech intelligibility of Flemish children as judged by their parents.

OBJECTIVE: Reduced intelligibility is a central concern in speech-impaired children, especially for parents. The main purpose of this study was to develop normative data for the intelligibility of Flemish-speaking boys and girls (age 2;06-5;0 years) as judged by their parents. Additionally, the influence of familiarity, gender and age of the child was determined. PATIENTS AND METHODS: Word, sentence and story productions of 163 healthy children (83 boys and 80 girls) between 2;06 and 5;0 years were transcribed by their own parents. Speech intelligibility was determined according to the intelligibility index described by Shriberg. Additionally, a panel of 12 unfamiliar judges listened to the recordings of a subgroup of 24 randomly selected children. RESULTS: Speech intelligibility improved with increasing age and was around 90% for children aged 4;6-5;0 years. Boys and girls performed equally on the task. For the intelligibility of words, mothers scored significantly better than unfamiliar listeners did. CONCLUSION: The reported normative speech intelligibility data provide important reference information for speech pathologists who assess child speech. Moreover, it enables them to measure the effect of a specific therapeutic approach and the spontaneous transfer to daily speech.

Vocal quality in university teachers: a pilot study.

OBJECTIVE: The main purpose of this study was to determine the vocal quality of 20 male and 9 female university teachers using a multi-parameter approach. Secondly, the effect of an academic lecture on the voice profiles of the university teachers was measured. METHODOLOGY: All groups underwent subjective voice evaluations (perceptual evaluation, Voice Handicap Index, anamnesis of vocal complaints and vocal abuse) and objective voice evaluations (aerodynamic and acoustic parameters, vocal performance, and the Dysphonia Severity Index). The same voice assessment was performed after an academic lecture with a mean length of one and a half hours. RESULTS: The mean DSI score was + 2.2 for the male teachers and + 4.0 for the female teachers. The mean VHI score was 13. Perceptually, all voice parameters were rated as normal. The questionnaire revealed a relatively high amount of vocal abuse. No changes in the objective vocal parameters were found after the lecture. Perceptually, however, the voices of the university teachers were significantly less instable after the lecture. Although no negative changes in objective vocal quality were observed, 48% of the university teachers experienced subjective vocal changes. CONCLUSION: The authors concluded that university teachers are professional voice users with good vocal quality who suffer no handicapping effect from possible voice disorders. No important changes in the vocal profile after a teaching activity of one and a half hours were found, despite the high prevalence of voice complaints.