A Comparison of the Dysphonia Severity Index and Singing Voice Handicap Index Between Trained and Untrained Male Iranian Traditional Singers.

OBJECTIVES: This study aimed to compare trained and untrained Iranian traditional singers on the Dysphonia Severity Index (DSI) and the Singing Voice Handicap Index. The second objective was to examine the relationship between the DSI and Persian version of the Singing Voice Handicap Index (P-SVHI) scores in each group of trained and untrained Iranian traditional singers. STUDY DESIGN: This study is a comparative cross-sectional study. METHODS: This study included 17 trained male Iranian traditional singers who were compared with 17 untrained ones who were matched in terms of age. The P-SVHI was completed by trained and untrained Iranian traditional singers. Measures of jitter, lowest intensity, highest phonational frequency, and maximum phonation time (MPT) were obtained from each participant. The DSI scores were calculated using these values. RESULTS: Trained male traditional singers had an average age of 33.76 ± 7.45 years, 3.24 ± 1.85 hours of daily practice, 5.24 ± 3.78 years of training, 3.06 ± 2.65 no. of professional performances, and untrained singers had an average age of 32.76 ± 12.92 years, 1.53 ± 1.17 hours of daily practice, and 0.88 ± 1.65 no. of professional performances. Trained singers had lower P-SVHI scores and sub-scores, longer MPT, higher F0 high, lower jitter, and lower I low, resulting in higher DSI values (P < 0.05). There was no significant correlation between P-SVHI scores and DSI values in each group of trained and untrained Iranian traditional singers (P > 0.05). CONCLUSIONS: The results of this study show that the vocal abilities of professional vocalists are enhanced through voice training (higher DSI scores in trained singers vs untrained ones). Voice training can also help to lessen the perception of a handicap related to the singing voice. Hence, it may be necessary to consider alternative norms for the DSI and P-SVHI when administering them to patients who have undergone guided vocal training, such as voice/singing lessons. The current research indicates that the perception of singing voice handicap and DSI values are two distinct characteristics that do not have a significant correlation.

Validation of the Persian Version of the Palin Parent Rating Scales.

INTRODUCTION: The Palin Parent Rating Scales (Palin PRS) is a structured questionnaire filled out by parents of children who stutter. It is designed to assess the effects of stuttering on both the children and their parents. The goal of this study was to translate the Palin PRS into Persian and to evaluate its validity and reliability for application in preschool children who stutter. METHODS: This research was conducted from August 2021 to December 2022, involving 139 parents of children who stutter. The parents completed the Palin PRS and provided their demographic data. Descriptive statistics were used to examine the floor and ceiling effects on all subscales of the Palin PRS. The internal consistency of the scale was assessed using Cronbach's alpha method, while the Intraclass Correlation Coefficient (ICC) was calculated to determine its test-retest reliability. An Exploratory Factor Analysis was also performed to clarify the factor structure of the scale. RESULTS: The Exploratory Factor Analysis results were highly consistent with the factor structure found in the original version. No floor or ceiling effects were observed for the factors of the Palin PRS. The three factors of the Persian version of the Palin PRS (P-Palin PRS) showed good internal consistency (Cronbach's alpha>0.8) and excellent test-retest reliability (ICC>0.9). Additionally, normative scores were derived by converting raw scores into Stanine scores. CONCLUSION: The P-Palin PRS showed strong reliability, thereby establishing it as a suitable instrument for evaluating how parents perceive the effects of stuttering on their children and themselves. Further research may explore its application in diverse clinical settings and populations.

Development and psychometric evaluation of an Azerbaijani-Turkish grammar comprehension test.

Due to the lack of appropriate developmental language tests in the Azerbaijani-Turkish language, the present study aimed to develop the Azerbaijani-Turkish grammar comprehension test (ATGCT) for children aged 4-6 years and determine its validity and reliability. This study was conducted in three phases. First, the target grammatical structures were extracted during the item generation phase. Second, item reduction and content validity ratio (CVR) were calculated. The content validity index (CVI) was determined after designing the items. This test was administered to typically developing children (TD) (N = 30). Face validity was confirmed and modifications were applied. The second version of the test was performed on 170 TD and 60 children with developmental language disorder (DLD) aged 4-6 years were selected using the random cluster method. Third, item analysis was performed, and eight items were removed. The construct validity, reliability, and ROC analysis of the final form of the test were evaluated. The psychometric properties considered in the study included construct validity (group, gender, and age discriminative validity) and reliability (test-retest, inter-rater, and internal consistency). The final test version contained 56 items and confirmed face validity. The Scale Content Validity was .91, and the Item Content Validity was between .8 and 1. The test showed a content validity ratio of .96, indicating that it assesses appropriate content. The construct validity analysis revealed significant differences between the TD and DLD groups and among the four age groups. Test-retest and inter-rater reliability were significantly correlated. Furthermore, the high correlation between test items (ICC= .90) demonstrated that the ATGCT had excellent internal consistency. The receiver operating characteristic (ROC) analysis results indicated that the test had high sensitivity and specificity in all four age groups and effectively distinguished children with TD and those with DLD. In conclusion, based on the psychometric assessment of the test, it appears that the ATGCT has appropriate values for reliability and validity measures, and it can be used as the first suitable and quick test by researchers and clinicians.

Cepstral and Perceptual Investigations of Voice in Speech and Language Pathologists with Vocal Fatigue.

Vocal fatigue is known as a hyperfunctional voice disorder that can lead to other conditions, such as muscle tension dysphonia (MTD). Speech and language pathologists (SLPs) are professional voice users who may suffer from vocal fatigue due to heavy vocal demands. This study aimed at investigating the cepstral and perceptual dimensions of voice and their correlation in the SLPs with vocal fatigue. Twenty-six SLPs and senior speech therapy students (mean age = 27.11 ± 6.8 yrs), including men (n = 5) and women (n = 21), participated in this descriptive cross-sectional study. They had vocal fatigue according to the Vocal Fatigue Index (VFI). In acoustic assessment, cepstral analysis (CPP and CPPS) was performed using Praat software. The Persian version of Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) was used to evaluate the overall severity of dysphonia. The correlation between these two evaluations was also investigated using IBM SPSS Statistics software version 23. Results revealed that the mean CPPS (13.716 ± 2.084) was lower than the cutoff point. Perceptual findings indicated that the mean overall severity (10.557 ± 11.210) fell in the normal variability of voice quality (NVVQ) range. In addition, cepstral and perceptual evaluations had no significant correlation (P > 0/05). The findings showed that auditory-perceptual evaluation considered the gold standard method of voice evaluation, cannot solely identify vocal fatigue. However, cepstral measures can help provide a more objective profile of vocal function in SLPs with vocal fatigue. Therefore, both of these evaluations are recommended for voice assessment of vocal fatigue.

Multidimensional Voice Assessment After Management of Early Laryngeal Cancer: A Comparative Study.

Laryngeal Squamous Cell Carcinoma is one of the most common head and neck cancers, and patients experience dysphonia after treatment with transoral laser microsurgery (TLM) or radiotherapy (RT). This study aimed to investigate the multidimensional assessment of voice, based on objective and subjective evaluation. In this cross-sectional study, a group of 120 patients (mean = 57.59 years, SD = 4.87), including men (n = 116) and women (n = 4) with early laryngeal carcinoma, were divided into two groups; Patients who had undergone TLM (n = 60) or RT (n = 60). The multidimensional assessment of voice was conducted using the acoustic analysis, the dysphonia severity index (DSI), the Persian versions of Consensus Auditory Perceptual Evaluation of Voice, and the voice handicap index (VHI). Results revealed that objective voice assessment only shows differences (P < 0.001) in the DSI between TLM and RT groups, despite there being no significant differences (P = 0.196) in overall severity of voice disorder in comparison between them. Also, there is a significant difference (P < 0.05) based on the Emotional subscale of VHI, between irradiated and TLM-treated patients. This finding showed that TLM-treated patients with early laryngeal carcinoma had severe voice disorder compared to irradiated patients. In addition, radiotherapy has a greater impact on the emotions of patients with early glottic cancer.

The Auditory Perception of Consonant Contrasts in Cochlear Implant Children.

Background and ObjectivesA major part of speech perception is based on understanding and distinguishing between vocal cues in the speaker's speech. Consonants and vowels are vocal cues that can be affected by hearing impairment and their perception may thus be reduced or distorted. The present study aims to investigate the auditory perception of consonant contrasts in cochlear implant children. Materials and Methods The present cross-sectional, descriptive-analytical study was conducted on 24 cochlear implant children aged 9-13 selected through convenience sampling from schools and cochlear implant centers. A test of non-word pairs based on a study conducted by Khavar-Ghazlani was carried out to measure contrast in consonants, place of and manner of articulation and voicing. Results The results of the test showed that cochlear implant children scored lower in the perception of voicing compared to the other two features. No significant differences were observed between their perceptions of place of articulation and manner of articulation. Conclusion Cochlear implant children appear to have a poorer perception of voicing contrast compared to the other features, which may be due to the greater reliance of this feature on auditory signs.

A comparison of the performance of Persian speaking children who do and do not stutter on three nonwords repetition tasks.

PURPOSE: The purpose of the study was to examine the performance of Persian speaking children who stutter (CWS) and children who do not stutter (CWNS) on three nonword repetition tasks, while also focusing on which task and scoring method best differentiates the two groups of children. METHOD: Thirty CWS and 30 CWNS between the ages of 5;0 to 6;6 completed three nonword repetition tasks that varied in complexity. Each task was scored using two methods: nonwords correct and phonemes correct. Between-group differences in performance on each task were examined, along with disfluencies for CWS and the task and scoring method that best differentiated the CWS and CWNS. RESULTS: The findings revealed that, across all three nonword repetition tasks, the CWS consistently produced fewer nonwords correct and phonemes correct than the CWNS group at virtually all syllable lengths. The CWS produced more disfluencies on longer nonwords than shorter nonwords in all three nonword repetition tasks. The nonword repetition task with lower wordlikeness and more phonologically complex items best differentiated the two groups of children. Findings further revealed that discriminative accuracy was highest for scoring based on the number of phonemes produced correctly. CONCLUSION: Findings provide further evidence to suggest that CWS may have difficulty with phonological working memory and/or phonological processing.

Development of the Farsi Hearing in Noise Test.

Objectives: Develop sentences in Farsi for use in the Hearing In Noise Test (HINT); equalise the difficulty of the sentences; form twelve 20-sentence lists; and determine the reliability and norms for these materials.Design: The same study design as used in the development of HINT in other languages was followed. Sentences were sampled from elementary school reading materials. Sentence difficulty was matched by scaling sentence levels. Equivalent sentence lists were formed. Speech reception thresholds were measured under headphones in quiet and in three noise conditions that differed in the spatial locations of the speech and noise sources. Spatial locations were simulated using head-related transfer functions.Study sample: Subjects were 24 adult native speakers of Farsi with pure-tone thresholds ≤25 dB HL at audiometric frequencies from 0.25 to 8.00 kHz.Results: Reliability, the variability of test-retest score differences, was 1.28 dB in quiet and 1.08 dB in noise. Average speech reception thresholds in Quiet = 19.4 dB(A). Average signal/noise ratios at threshold were Noise Front = -5.4 dB, Noise Right = -13.7 dB, and Noise Left = -13.7.Conclusions: The reliability and norms for the Farsi HINT are comparable to those for other languages, enabling comparison of test results across languages.

Maternal Perception of Self-Efficacy and Involvement in Young Children with Prelingual Hearing Loss.

Appropriate intervention needs to support families and consider them as a part of rehabilitation program. Parents who have high self-efficacy are more likely to put their knowledge and skills into action and have positive interactions with their children. In addition, there has been a positive relation between parental involvement and child educational success. The aim of present study was evaluating maternal perception of both self-efficacy and involvement between mothers of children with hearing aid and cochlear implant via Scale of Parental Involvement and Self Efficacy (SPISE) and exploring relationship between maternal self-efficacy and parental involvement and child factors. 100 mothers of children with hearing loss were available. 49 mothers participated in study, filled SPISE, and return it on time. SPISE consisted of three sections (1) demographic information, (2) maternal self-efficacy, (3) parental involvement. All cases had received at least 6 months auditory training and speech therapy. Participants included 30 (61.2%) mothers of children with hearing aid, 19 (38.8%) mothers of children with cochlear implant. ANOVA analysis showed that there is no significant difference between hearing aid (HA) and cochlear implant (CI) groups in term of self-efficacy and parent-involvement except for question 21 (comfortable in participating in individualized program) that score in HA group was significantly higher than CI group. Results of present study has practical implications for early interventionists working with families. Every early intervention program should consider families to reach maximum outcome. Early interventionists can use SPISE to evaluate parental selfefficacy and involvement and work on parents with low score to achieve the best results.

The Design and Assessment of a Multiparametric Model for the Dysphonia Severity Index for Persian-speaking Populations.

OBJECTIVES: In instrumental voice assessment, multiparametric models reflect the multidimensional nature of voice and are therefore better than models that reflect only a single dimension of voice. The Dysphonia Severity Index (DSI) is one of the most common multiparametric models. In voice assessment, race, language, and structural and physiological features affect the acoustic, aerodynamic, and voice range profile measures. Given these differences, this study was conducted to design and evaluate a multiparametric and objective model for assessing the severity of dysphonia in Persian-speaking populations. MATERIAL AND METHODS: This study examined 300 participants with several types of dysphonia (104 women and 196 men) and 100 healthy individuals (63 women and 37 men). Five acoustic parameters, three aerodynamic parameters, and seven voice range profile parameters were measured for designing the model. Perceptual evaluation was performed using the grade, roughness, breathiness, asthenia, strain scale. The logistic regression analysis was used to determine the factors affecting the DSI and each component's coefficient. RESULTS: Of the 15 parameters assessed, shimmer, vital capacity, semitone range, and voice onset time of /pa/ remained in the model with their coefficients. This section presents the DSI model for the examined population. The discriminant analysis showed that this combination corresponds to 47.8 of the perceptual assessment: DSI = 0.289 (shimmer) + 0.0001 (VC) - 0.059 (STR) - 13.278 (VOT_Pa). CONCLUSION: In this study, the DSI corresponded to the physiological, linguistic, and racial characteristics of the Persian-speaking population with or without voice disorder.

The Relationship Between the Aerodynamic Parameters of Voice and Perceptual Evaluation in the Iranian Population With or Without Voice Disorders.

OBJECTIVES: Aerodynamic evaluations can provide useful information about the interaction between the respiratory and the phonation systems. The present study was conducted to investigate the relationship of maximum phonation time (MPT), vital capacity (VC), and phonation quotient (PQ) with perceptual evaluation in different types of dysphonia. The relationship between these parameters and the type of dysphonia was also examined. MATERIALS AND METHODS: The study participants consisted of 300 individuals with different types of dysphonia (104 women and 196 men) and 100 healthy samples (63 women and 37 men). A professional speech-language pathologist conducted the perceptual evaluation based on the G (grade) component of the GRBAS scale, which stands for grade, roughness, breathiness, asthenia, and strain. VC was measured using a spirometer and MPT using a stopwatch. PQ was calculated as the ratio of VC to MPT. RESULTS: The difference between the mean ± standard deviation of PQ, VC, and MPT were found to be significant at all the four degrees of dysphonia severity (P < 0.001). There was a significant difference in mean MPT and VC between the genders (P < 0.001), but no significant gender differences were observed in terms of the mean PQ (P = 0.346). The study participants were classified into four groups, including the organic dysphonia group, neurologic dysphonia and functional dysphonia groups, and the normal group; the study variables measured were found to be significantly different between all the four groups (P < 0.001). CONCLUSION: As MPT and PQ were correlated with the perceptual G (grade) and differentiated dysphonic from healthy individuals, clinicians are recommended to take account of them in their instrumental evaluations.