Intensive Voice Treatment following Botulinum Neurotoxin Injection for a Speaker with Abductor Laryngeal Dystonia: An Exploratory Case Study.

Abductor laryngeal dystonia (ABLD) is a rare neurological voice disorder which results in sporadic opening of the vocal folds during speech. Etiology is unknown, and to date there is no identified effective behavioral treatment for it. It is hypothesized that LSVT LOUD®, which was developed to treat dysphonia secondary to Parkinson's disease, may have application to speakers with ABLD to improve outcomes beyond that with botulinum neurotoxin (BoNT) treatment alone. The participant received one injection of BoNT in each vocal fold 2 to 3 months prior to initiating intensive voice therapy via teletherapy. Objective measures of vocal loudness (dB sound pressure level), maximum phonation time, and high/low pitch frequency (Hz) were recorded in all treatment sessions and follow-up sessions. Over the course of treatment, the participant showed steady gains in phonation time, volume, pitch range, and vocal quality with a substantial reduction in aphonic voice breaks by the end of the treatment program. Perceptual symptoms of ABLD were nearly undetectable by the participant and the clinicians up to 12 months posttreatment, with no additional BoNT injections. The results suggest that LSVT LOUD® following BoNT was effective, with long-lasting improvement in vocal function, for this speaker with ABLD.

A Case Study Using a Multimodal Approach to Melodic Intonation Therapy.

Purpose: The purpose of this study was to assess the efficacy. of increasing spontaneous expressive language using a modified melodic intonation therapy (MIT) approach with a male participant diagnosed with acquired aphasia and apraxia who was 10 years post onset. Method: A therapeutic protocol consisting of vocal and linguistic tasks was administered. The participant attended two 50-min individual sessions and a 4-hr/week socialization program for three 12-week semesters. Measures of speech and language were administered before intervention and at the completion of each of the 3 semesters. Results: At the completion of the study, the participant demonstrated reduced apraxia of speech as measured by The Apraxia Battery for Adults, Second Edition (Dabul, 2000). He also showed improvements in auditory comprehension skills as measured on the Boston Diagnostic Aphasia Evaluation (Goodglass, Kaplan, & Barresi, 2000). His spontaneous utterances were characterized by an increased number of complete sentences and questions. Several language parameters including mean length of utterance, total number of spontaneous (untrained) utterances, and number of different words spoken were also improved as revealed through language analysis. Conclusions: Integration of melodic intonation therapy through the addition of musical elements may result in improved speech and expressive language skills when administered over a 9-month period in conjunction with a group socialization program.

Prevalence of vocal fry in young adult male American English speakers.

The purpose of this study was to assess possible gender differences in the prevalence of vocal fry in the voices of young male college students. Results were compared with previously published findings derived from a matched sample of female speakers. Thirty-four male college students, native American English speakers, produced speech samples in two speaking conditions: (1) sustained isolated vowel /a/ and (2) reading task. Data analyses included perceptual evaluations by two licensed speech-language pathologists. Results showed that vocal fry was perceived significantly more frequently in sentences than in isolated vowel productions. When vocal fry occurred in sentences, it was detected significantly more often in sentence-final position than in initial- and/or mid-sentence position. Furthermore, the prevalence of vocal fry in sentences was significantly lower for male speakers than has previously been reported for female speakers. Possible physiological and sociolinguistic explanations are discussed.

Habitual use of vocal fry in young adult female speakers.

The purpose of this study was to examine the use of vocal fry in young adult Standard American-English (SAE) speakers. This was a preliminary attempt (1) to determine the prevalence of the use of this register in young adult college-aged American speakers and (2) to describe the acoustic characteristics of vocal fry in these speakers. Subjects were 34 female college students. They were native SAE speakers aged 18-25 years. Data collection procedures included high quality recordings of two speaking conditions, (1) sustained isolated vowel /a/ and (2) sentence reading task. Data analyses included both perceptual and acoustic evaluations. Results showed that approximately two-thirds of this population used vocal fry and that it was most likely to occur at the end of sentences. In addition, statistically significant differences between vocal fry and normal register were found for mean F(0) minimum, F(0) maximum, F(0) range, and jitter local. Preliminary findings were taken to suggest that use of the vocal fry register may be common in some adult SAE speakers.