Gender Attributions by Cisgender and Gender Diverse Listeners Rating Vowels, Reading, and Monologues.

OBJECTIVES: To determine if listeners' attributions of speakers' gender vary by linguistic context and/or the listeners' gender identity. METHODS: Seventeen self-identified transgender adults assigned male at birth were audio-recorded prolonging /a/, reading sentences, and saying spontaneous monologues. Eighteen adults (10 cisgender and 8 gender-diverse individuals) listened and used a 1-5 scale (1: very masculine, 2: somewhat masculine, 3: androgynous, 4: somewhat feminine, and 5: very feminine) to rate the gender attribution of each speech sample. RESULTS: The intra-rater reliability was moderate to excellent (0.62-1.00). Ratings by cisgender and gender-diverse listeners were not significantly different. Ratings were not significantly different between different speech contexts of vowel, reading, and spontaneous monologue speech samples. CONCLUSIONS: Transwomen have many variables available to consider and use in their communication. The linguistic context (eg, reading a speech versus spontaneous monologue) or listener's gender does not appear to be highly influential factors in how listeners attribute gender.

Introduction of Voice Type Component (VTC) as an Effective Acoustic Voice Analysis Method in Tele-evaluation.

OBJECTIVE: Telepractice in voice health care and evaluation services has attracted much attention in recent years. Multiple studies have proven the effectiveness of voice therapy with telepractice. However, voice evaluations are still mostly conducted in person due to the lack of sensitive acoustic analysis methods. METHODS: This study examined various acoustic analysis methods for voice evaluation in telepractice. Eighteen female elementary school teachers with self-reported voice disorders volunteered to participate in the study. Speech samples were collected before and after the interventions using two voice sampling methods concurrently. One set of data was collected using the traditional voice sample collection method by the therapist in person. The second set of data was collected on the same speech samples using the clients' own smartphones, and the collected voice samples were later sent to the researcher for further acoustic analysis. The voice type component (VTC) measurement represented the proportion of different VTCs in a voice by measuring the chaos and intrinsic dimension. RESULTS: Voice analyses were conducted on both sets of data, and the correlation between the two sampling procedures was analyzed. It appears that the VTC could be a more reliable method for producing acoustic analysis results with voice samples collected from smartphones compared to other objective voice assessment procedures. This reliability has been demonstrated via statistical analysis, including correlation coefficient, pairwise t test, d-prime, and area under the curve. The results of this study highlighted the VTC as an effective and accurate acoustic analysis method in tele-evaluation. CONCLUSIONS: This feasible voice sampling method, which utilizes participants' own smartphones, will reduce barriers to accessing limited voice specialists due to distance and will decrease the cost of care by minimizing expenses associated with travel and additional equipment for voice sampling. Ultimately, this approach will enhance the effectiveness of voice care delivered through telepractice to patients in remote and underserved areas.

Preterm oral feeding scale to assist in deciding initial oral feeding of preterm infants in neonatal intensive care units.

BACKGROUND: The inconsistency in decisions to commence oral feeding indicates that health professionals require clearer guidelines to determine when to initiate oral feeding in preterm infants. This study applied the Taiwan version of Preterm Oral Feeding Readiness Assessment Scale (TW-POFRAS) to clinical decision-making, especially for preterm infants with a birth weight less than 1,500 g or gestational age (GA) less than 32 weeks. METHODS: This was a single-center observational cross-sectional study and 81 preterm infants were recruited. Lengths of stay from admission to initial one-meal oral feeding, to one-day all-meal oral feeding, and to discharge were analyzed. Scale scores, physician orders, and smooth oral intake of 5 mL of milk were analyzed. Kappa coefficients were examined to determine concordances within the results. RESULTS: At least moderate concordance was evident (k = 0.492). Most preterm infants can begin to consume one meal of the least 5 mL of milk smoothly and proceed to consume a full day of meals with a week; they are typically discharged from the hospital within a month, except for those with a birth weight less than 1,500 g or a GA less than 32 weeks. For 17 of 81 participants, assessment results for physician orders, 5-mL milk consumption, and scale scores were inconsistent. Participants with a birth weight less than 1,500 g or GA less than 32 weeks were able to meet the 5-mL standard by the postmenstrual age of 35 weeks, at latest. CONCLUSION: We recommend that TW-POFRAS should be used in conjunction with physicians' clinical decision-making for oral feeding readiness for preterm infants in the NICU.

Effectiveness and Feasibility of Telepractice on Voice Therapy for Female Teachers in Elementary Schools with Self-Reported Voice Disorders.

PURPOSE: The purpose of this study is to explore the effectiveness of telepractice in voice intervention for female teachers in elementary schools with self-reported voice disorders. METHODS: Thirty-five female elementary school teachers with self-reported voice disorders volunteered to participate in the study. They were divided into a telepractice voice intervention group (experimental group N=18) and a face-to-face voice intervention group (control group N=17) based on their employment setting. The exact same treatment protocol was applied to both groups of subjects, except that the intervention group was seen through telepractice, and the control group was seen face-to-face. The treatment protocol includes vocal hygiene education and resonant voice therapy twice a week for a total of eight sessions. Auditory perceptual analysis, acoustic assessment, aerodynamic assessment and self-assessment protocol were conducted before the intervention and one week after the last intervention, and the differences before and after interventions within each group and between groups were compared. RESULTS: There was no significant difference in baseline data including age, working years, and voice symptoms between the two groups. Both groups showed significant improvement (P<0.05) in all voice assessment before and after the treatment sessions, except for the Voice Handicap Index-10 (VHI-10) assessment. No statistical difference was found in other pre- and post-intervention voice assessment changes between the two study groups. The control group presented higher improvement in the total score, and the two subdomain assessments of physiology and emotion. CONCLUSIONS: Telepractice voice intervention can effectively improve the voice quality of female teachers in elementary schools, and telepractice therapy can be an effective alternative to face-to-face voice intervention.

Clinical Validation of the Preterm Oral Feeding Readiness Assessment Scale in Taiwan.

PURPOSE: A successful transition from gavage to full oral feeding is a decisive indicator for discharging premature infants from the neonatal intensive care unit. A clinically useful measure of oral feeding readiness would help nurses initiate implementation of the cue-based feeding model in Taiwan. The study aimed to assess the validity and reliability of the Traditional Chinese Preterm Oral Feeding Readiness Assessment Scale (TC-POFRAS). DESIGN AND METHODS: 81 preterm infants were enrolled and assessed by TC-POFRAS regarding their oral feeding readiness. This study included two phases. Phase 1 conducted a cross language validation procedure and item-level content validity indices (I-CVIs) for content validity were estimated. In phase 2, Cronbach's alpha for internal consistency at each category and total scale levels were estimated. A receiver operating characteristic (ROC) curve was estimated to explore the scale's performance. The optimal cut-off value of TC-POFRAS was identified by the best Youden's Index [maximum (sensitivity + specificity - 1)]. RESULTS: All of the I-CVIs were 1.00. The whole Cronbach's alpha for internal consistency was 0.804 (95% CI = 0.736-0.862), and Cronbach's alpha values were between 0.538 (95% = 0.332-0.689) and 0.687 (95%CI = 0.572-0.781) for categories. The area under ROC was 92.2%, and an optimal cut-off value of TC-POFRAS was 29 (sensitivity: 0.938, specificity: 0.941). CONCLUSIONS: The TC-POFRAS has been verified to be an effective and accurate instrument to determine the initiation of oral feeding in preterm infants. PRACTICE IMPLICATIONS: The TC-POFRAS is an appropriate and complementary assessment instrument for professionals to conveniently use in clinical practice.

The Application of the First Year Inventory for ASD Screening in China.

PURPOSE: The First Year Inventory (FYI) is a parent-report instrument, and is developed to assess behaviors of 12-month-old infants that could suggest risk for an eventual diagnosis of autism. This study was designed to examine the application of the FYI in the Chinese community. DESIGN AND METHODS: FYIs were completed at a community health center by 541 families during the child's physical examination at 12 months of age from 2013 to 2015. The weighted risk scores used in this study were based on US norms, and compared the FYI differences between China and the U.S. RESULTS: The total risk scores ranged from 5 to 42 points; the 95th percentile cutoff was 27.00(9.8 points higher than the 95th percentile cutoff in the US), the 98th percentile cutoff was 29.66(7.04 points higher than the 98th percentile cutoff in the US), and the 99th percentile cutoff was 31.83. Higher risk scores were found for boys than girls. Mothers with a junior college education reported significantly higher FYI risk scores than other three groups including high school, college graduates and post-graduates. CONCLUSIONS: There were no significant effects of birth parity, investigator, or investigation year on risk scores. Large-scale longitudinal research is encouraged in the future to develop an early detection model of autism in China.

Research of cerebral activation in Uygur-speaking and Chinese-speaking participants during verb generation task with functional magnetic resonance imaging.

The aims are to investigate and compare the activated cerebral regions of Uygur-speaking and Chinese-speaking participants during verb generation task.A total of 31 cases of Uygur and 28 cases of Han healthy volunteers were enrolled. They were requested to take verb generation tasks. Blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI) was performed. The fMRI images were collected and activated brain regions were analyzed.In Chinese-speaking participants, the main activated cerebral regions were as follows: the left caudate nucleus, the left occipital gyrus, the left fusiform gyrus, bilateral supplementary motor area (BA8/ 6), the left BA32, left precuneus, the left superior parietal lobule, the left inferior parietal lobule (BA7), the left angular gyrus, the right side of the central gyrus (BA9), the left inferior frontal gyrus triangular section, the right pars opercularis gyri frontalis inferiorista, and bilateral cerebellum. In Uygur-speaking subjects, the main activated cerebral regions included left precentral gyrus (BA9 region), inferior frontal gyrus of left opercular part, inferior frontal gyrus of left triangle part, and left cerebellum. Left caudate nucleus, left orbital frontal gyrus, right caudate nucleus, and bilateral anterior cingulate gyrus (BA32 region) of Chinese group were significantly activated compared with Uygur group. By contrast, Uygur group showed no region that was more activated than Chinese group.The present study demonstrates that activated brain regions in verb generation tasks are different between Uygur and Chinese languages. Processing of Uygur characters is mainly in the left hemisphere of the brain, while the processing of Chinese characters needs more participation by the right hemisphere of the brain.

Evaluating autism in a Chinese population: the Clinical Autism Diagnostic Scale.

BACKGROUND: The purpose of this study was to report on the psychometric measures and discriminatory function of a new diagnostic test for autism spectrum disorders, the Clinical Autism Diagnostic Scale (CADS). METHODS: The CADS was used to test 216 children in the study, including 86 with low-functioning autism spectrum disorders (ASD), 16 children with high-functioning ASD, 16 with pervasive developmental disorder, not otherwise specified, 7 with Asperger syndrome, 65 with typical development, 11 children with language impairments and 15 with intellectual disabilities. Ages ranged from 38-73 months. Behaviors for the groups were compared across seven domains. RESULTS: The results indicated the instrument was reliable, valid, and successfully differentiated the different groups of children with and without autism. All ASD groups were found to display difficulties in the domains of sensory behaviors and stereotyped behaviors. The play and social domains were found to measure similar underlying concepts of behaviors, while the receptive language and expressive language domains were also found to measure similar underlying-language concepts. The group of children diagnosed as having low-functioning autism performed less well on all tested domains in the instrument than did the other three groups of children with ASD, and these other three groups each also presented unique patterns of behaviors and differed on individual domains. CONCLUSIONS: CADS is a reliable and valid test. It successfully differentiates the abilities of children with ASD at different levels of functioning.

Detecting anticipatory effects in speech articulation by means of spectral coefficient analyses.

Few acoustic studies have attempted to examine anticipatory effects in the earliest part of the release of stop consonants. We investigated the ability of spectral coefficients to reveal anticipatory coarticulation in the burst and early aspiration of stops in monosyllables. Twenty American English speakers produced stop (/k,t,p/) - vowel (/æ,i,o/) - stop (/k,t,p/) sequences in two phrase positions. The first four spectral coefficients (mean, standard deviation, skewness, kurtosis) were calculated for one window centered on the burst of the onset consonant and two subsequent, non-overlapping windows. All coefficients showed an influence of vowel-to-consonant anticipatory coarticulation. Which onset consonant showed the strongest vowel effect depended on the specific coefficient under consideration. A context-dependent consonant-to-consonant anticipatory effect was observed for onset /p/. Findings demonstrate that spectral coefficients can reveal subtle anticipatory adjustments as early as the burst of stop consonants. Different results for the four coefficients suggest that comprehensive spectral analyses offer advantages over other approaches. Studies using these techniques may expose previously unobserved articulatory adjustments among phonetic contexts or speaker populations.

Treatment of spasmodic dysphonia with homeopathic medicine: a clinical case report.

Botulinum toxin (Botox) injection is the only conventional medical treatment available for patients with spasmodic dysphonia (SD). Some patients are reluctant to receive Botox treatment due to concerns about unknown long-term side effects, expense, and dependence on repeated injections. The purpose of the study was to report the perceptual and physiological changes in the vocal functions of an SD patient treated with classical homeopathy. The results were similar to a previous case report: classical homeopathy seems to be capable of amelioratiny SD symptoms beyond the short-term effects of Botox injections. Although the physiological mechanism of homeopathic healing is not fully accounted for by the current bio-medical models, it may be an effective therapeutic alternative for some SD patients.

Volumetric measurements of vocal tracts for male speakers from different races.

Research examining physiologic and acoustic characteristics of culturally diverse populations is sorely needed, but rarely reported. The major aim of this study was to quantify vocal tract dimensional parameters (oral length, oral volume, pharyngeal length, pharyngeal volume, total vocal tract length and total vocal tract volume) of adult male speakers from three different racial populations (White American, African American, and Chinese). It also attempted to investigate if volumetric differences in the speakers' vocal tracts, like length differences, would contribute to the acoustic characteristics of these speakers from different races. The findings of this study support the hypothesis that speakers from different races may have morphological differences in their vocal tract dimensions, and these morphological differences (especially volumetric differences) could be partially responsible for the formant frequency differences in a vowel sound void of specific language/dialectal impacts. The study has provided speech scientists, speech-language pathologists, linguists and other health professionals with a new and preliminary acoustic and physiological database for adult male speakers from these three different races.

Changes in the human vocal tract due to aging and the acoustic correlates of speech production: a pilot study.

This investigation used a derivation of acoustic reflection (AR) technology to make cross-sectional measurements of changes due to aging in the oral and pharyngeal lumina of male and female speakers. The purpose of the study was to establish preliminary normative data for such changes and to obtain acoustic measurements of changes due to aging in the formant frequencies of selected spoken vowels and their long-term average spectra (LTAS) analysis. Thirty-eight young men and women and 38 elderly men and women were involved in the study. The oral and pharyngeal lumina of the participants were measured with AR technology, and their formant frequencies were analyzed using the Kay Elemetrics Computerized Speech Lab. The findings have delineated specific and similar patterns of aging changes in human vocal tract configurations in speakers of both genders. Namely, the oral cavity length and volume of elderly speakers increased significantly compared to their young cohorts. The total vocal tract volume of elderly speakers also showed a significant increment, whereas the total vocal tract length of elderly speakers did not differ significantly from their young cohorts. Elderly speakers of both genders also showed similar patterns of acoustic changes of speech production, that is, consistent lowering of formant frequencies (especially F1) across selected vowel productions. Although new research models are still needed to succinctly account for the speech acoustic changes of the elderly, especially for their specific patterns of human vocal tract dimensional changes, this study has innovatively applied the noninvasive and cost-effective AR technology to monitor age-related human oral and pharyngeal lumina changes that have direct consequences for speech production.