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1.
  • Eklund, Robert, 1962-, et al. (författare)
  • An acoustic analysis of Swedish cattle calls,‘kulning’, performed outdoors at three distances
  • 2019
  • Ingår i: Proceedings from Fonetik 2019. - 9789177979845 - 9789177979852
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Kulning is a Swedish cattle call singing style with an almost mythical status inSwedish folklore. In previous studiestwo of the authors (RE, AM) studied kulning produced by a kulning singer (FP) in both indoor and outdoor settings. In this paper we report kulning as produced by a second singer (the third author, KD), recorded outdoors in a forest setting, with simultaneous recordings at 1, 11 and 22 meters. The results of amplitude, FFT and LPC analyses reported, and compared to theearlier studies reported in Eklund, McAllister and Pehrson (2013) and McAllister and Eklund (2015).
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2.
  • Rayner, Manny, et al. (författare)
  • A web-deployed Swedish spoken CALL systembased on a large shared English/Swedish feature grammar
  • 2012
  • Ingår i: Proceedings of the SLTC 2012 workshop on NLP for CALL. - : Linköping University Electronic Press. ; , s. 37-46
  • Konferensbidrag (refereegranskat)abstract
    • We describe a Swedish version of CALL-SLT,a web-deployed CALL system that allows beginner/intermediate students to practise generativespoken language skills. Speech recognitionis grammar-based, with language modelsderived, using the Regulus platform, fromsubstantial domain-independent feature grammars.The paper focusses on the Swedishgrammar resources, which were developedby generalising the existing English featuregrammar into a shared grammar for Englishand Swedish. It turns out that this can be donevery economically: all but a handful of rulesand features are shared, and English grammaressentially ends up being treated as a reducedform of Swedish. We conclude by presentinga simple evaluation which compares theSwedish and French versions of CALL-SLT.
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3.
  • Bakke, Merete, et al. (författare)
  • Development and evaluation of a comprehensive screening for orofacial dysfunction.
  • 2007
  • Ingår i: Swedish dental journal. - 0347-9994. ; 31:2, s. 75-84
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim was to develop a comprehensive screening instrument for evaluation of orofacial dysfunction that was easy to perform for different health professionals without special equipment. The Nordic Orofacial Test--Screening (NOT-S), consisting of a structured interview and clinical examination,was developed with a picture manual illustrating the different tasks in the examination. It was first tested in a Swedish version, and later translated to other Nordic languages, and to English. The interview reflected six domains, (I) Sensory function, (II) Breathing, (III) Habits, (IV) Chewing and swallowing, (V) Drooling, and (VI) Dryness of the mouth, and the examination included six domains representing (1) The face at rest, and tasks regarding (2) Nose breathing, (3) Facial expression, (4) Masticatory muscle and jaw function, (5) Oral motor function, and (6) Speech. One or more "yes" for impairment in a domain resulted in one point (maximum NOT-S score 12 points). The mean NOT-S score (+/- SD) in 120 patients (3-86 yr), referred to five centers for specialized dental care or speech and language pathology in Sweden, Norway and Denmark, was 4.1 +/- 2.6, and 0.4 +/- 0.6 in 60 control subjects (3-78 yr). The screening was easy to administer and the time spent 5-13 min. The scores from the clinic-referred sample differed significantly from the controls, and the sensitivity of the screening was 0.96 and specificity 0.63. Repeated evaluations of videotapes of 200 patients by 3 examiners, speech-language pathologists and dentists, with at least two-week intervals, showed inter- and intraexaminer agreement on the points given in the domains at respectively 83% and 92-95% which increased after recalibration to 85% and 95-99%. Kappa values for interexaminer agreement on the NOT-S scores were 0.42-0.44 (i.e. fair), and the method error was 5.3%. To conclude, NOT-S gave a reliable and valid screening for orofacial dysfunction.
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5.
  • Bergendal, Birgitta, et al. (författare)
  • Orofacial function and monitoring of oral care in amyotrophic lateral sclerosis
  • 2017
  • Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 75:3, s. 179-185
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The aim was to assess orofacial function and monitor oral care in patients with amyotrophic lateral sclerosis (ALS) to maintain oral comfort and oral health.MATERIALS AND METHODS: A case series of 14 patients newly diagnosed with ALS accepted to participate in a quality improvement project. After initial examinations, baseline oral conditions were obtained and the patients were seen every 3 months. Nordic Orofacial Test-Screening (NOT-S) was used for evaluation of orofacial function.RESULTS: Patients were grouped according to initial symptoms in a bulbar group and a spinal group with eight and six patients, respectively. The mean age at diagnosis was 62.8 years. All were dentate with a mean of 26.7 natural teeth. Most patients had very good oral and dental conditions. As expected, orofacial functions were differently affected in the two groups; at initial NOT-S registration, the mean total score was 5.6 (range 3-8 domains) in the bulbar group and 0.7 (0-2 domains) in the spinal group. At final registration, the corresponding figures were 6.1 and 3.2. Oral and dental aids were introduced according to need.CONCLUSIONS: In the bulbar group, several orofacial functions became impaired at an early stage of disease development, and at final registrations many vital orofacial functions were severely compromised. The spinal group was less severely affected orally. However, all individuals irrespective of type of initial symptoms needed assistance in performing oral hygiene measures in the latter part of the disease period. Good oral health and oral comfort could be maintained in all participants and no other dental treatment was needed.
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6.
  • Bergendal, Birgitta, et al. (författare)
  • Profiles of orofacial dysfunction in different diagnostic groups using the Nordic Orofacial Test (NOT-S)-A review
  • 2014
  • Ingår i: Acta Odontologica Scandinavica. - : Informa Healthcare. - 0001-6357 .- 1502-3850. ; 72:8, s. 578-584
  • Forskningsöversikt (refereegranskat)abstract
    • Objective. The Nordic Orofacial Test-Screening (NOT-S) was developed as a comprehensive method to assess orofacial function. Results from the screening protocol have been presented in 11 international publications to date. This study reviewed these publications in order to compile NOT-S screening data and create profiles of orofacial dysfunction that characterize various age groups and disorders. Materials and methods. NOT-S results of nine reports meeting the inclusion criteria were reviewed. Seven of these studies not only provided data on the mean and range of total NOT-S scores, but also on the most common domains of orofacial dysfunction (highest rate of individuals with dysfunction scores), allowing the construction of orofacial dysfunction profiles based on the prevalence of dysfunction in each domain of NOT-S. Results. The compiled data comprised 669 individuals, which included healthy control subjects (n = 333) and various patient groups (n = 336). All studies reported differences between individuals with diagnosed disorders and healthy control subjects. The NOT-S data could measure treatment effects and provided dysfunction profiles characterizing the patterns of orofacial dysfunction in various diagnoses. Conclusions. This review corroborates previous results that the NOT-S differentiates well between patients and healthy controls and can also show changes in individuals after treatment. NOT-S could be used as a standard instrument to assess orofacial dysfunction, evaluate the outcomes of oral habilitation and rehabilitation and improve comparability in clinical practice and research.
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8.
  • Contardo, Ivonne, et al. (författare)
  • Real-time registration of listener reactions to unintelligibility in misarticulated child speech
  • 2014
  • Ingår i: Proceedings from FONETIK 2014. - Stockholm. ; , s. 127-132
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • This study explores the relation between misarticulations and their impact on intelligibility. 30 listeners (17 clinicians and 13 untrained listeners) were given the task of clicking a button whenever they perceived something unintelligible during playback of misarticulated child speech samples. No differences were found between the clinicians and the untrained listeners regarding clicking frequency. The distribution of listener clicks correlated strongly with the clinical evaluations of the same samples. The distribution of clicks was also related to manually annotated speech errors, allowing examination of links between events in the speech signal and reactions evoked in listeners. Hereby, we demonstrate a viable approach to ranking speech error types with regards to their impact on intelligibility in conversational speech.
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9.
  • Eklund, Robert, 1962-, et al. (författare)
  • An acoustic analysis of ‘kulning’ (cattle calls) recorded in an outdoor setting on location in Dalarna (Sweden)
  • 2015
  • Ingår i: Proceedings of ICPhS 2015. - Glasgow, Scotland, UK : International Phonetic Association. - 9780852619414
  • Konferensbidrag (refereegranskat)abstract
    • The Swedish cattle call singing style ‘kulning’ issurprisingly understudied, despite its almostmythical status in Swedish folklore. While somephysiological-productive aspects of kulning havebeen treated in previous work, acoustic propertiesare still much lacking description. This paper addsto and extends the results presented in a previousstudy [7], where kulning and head voice (“falsetto”)was acoustically analysed in two indoor settings:a normal room and an anechoic chamber. In thepresent study, the same singer, singing the samekulning in the same two modes (kulning and headvoice), was recorded in an outdoor setting (close tothe singer’s home), thus allowing for a comparisonbetween “clinical” and more ecologically valid data.
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10.
  • Eklund, Robert, 1962-, et al. (författare)
  • An acoustic comparison of voice characteristics in ‘kulning’, head and modal registers.
  • 2013
  • Ingår i: Robert Eklund (ed.), <em>Proceedings of Fonetik 2013, the XXVIth Swedish Phonetics Conference, Studies in Language and Culture, no. 21</em>, ISBN 978-91-7519-582-7, eISBN 978-91-7519-579-7, ISSN 1403-2570, pp. 21–24.. - 9789175195827 - 9789175195797 ; , s. 21-24
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • The Swedish folk singing style ‘kulning’ issurprisingly understudied, despite its almostmythical status in Swedish folklore. While somephysiological–productive aspects of kulninghave been treated in previous work, acousticproperties are still much lacking description.This paper compares kulning, head (‘falsetto’)and modal voice from an acoustic perspective.
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11.
  • Enflo, Laura, et al. (författare)
  • Collision and Phonation Threshold Pressures Before and After Loud, Prolonged Vocalization in Trained and Untrained Voices
  • 2013
  • Ingår i: Journal of Voice. - : Elsevier BV. - 0892-1997 .- 1873-4588. ; 27:5, s. 527-530
  • Tidskriftsartikel (refereegranskat)abstract
    • The phonation threshold pressure (PTP) is defined as the lowest subglottal pressure needed for obtaining and sustaining vocal fold oscillation. It has been found to increase during vocal fatigue. In the present study, PTP is measured together with the threshold pressure needed for vocal fold collision; henceforth, the collision threshold pressure (CTP). PTP and CTP are compared before and after loud, prolonged vocalization in singer and nonsinger voices. Ten subjects repeated the vowel sequence /a, e, i, o, u/ at a Sound Pressure Level of at least 80 dB at 0.3 m for 20 minutes. Audio and electroglottography signals were recorded before and after this exercise. At the same time, oral pressure was registered while the subjects produced a diminuendo repeating the syllable /pa:/, thus acquiring an approximate of the subglottal pressure. CTP and PTP increased significantly after the vocal loading in the nonsinger subjects. On the other hand, singers reported no substantial effect of the exercise, and most singers had a mean after-to-before ratio close to 1 for both CTP and PTP.
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12.
  • Enflo, Laura (författare)
  • Collision Threshold Pressure : A novel measure of voice function Effects of vocal warm-up, vocal loading and resonance tube phonation in water
  • 2013
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The phonation threshold pressure (PTP), i.e., the smallest amount of subglottal pressure needed to initiate and sustain vocal fold oscillation, is frequently difficult to measure due to the difficulty for some subjects to produce extremely soft phonation. In addition, PTP values are often quite scattered. Hence, the collision threshold pressure (CTP), i.e., the smallest amount of subglottal pressure needed for vocal fold collision, was explored as a possible complement or alternative to PTP. Effects on CTP and PTP of vocal warm-up (Paper 1), resonance tube phonation with the tube end in water (Paper 2), and vocal loading (Paper 3) were investigated. With the aim to accelerate the CTP measurement process, comparisons were made between CTP values derived manually and those derived by several automatic or semi-automatic parameters (Paper 4).Subjects were recorded at various F0 while phonating /pa:/-sequences, starting at medium loudness and continuing until phonation ceased. Subglottal pressure was estimated from oral pressure signals during the /p/ occlusion. Vocal fold contact was determined manually from the amplitude of the electroglottographic (EGG) signal (Papers 1 and 3) or its first derivative (dEGG) (Papers 2 and 4).Recordings were made before and after exercise: (Paper 1) Vocal warm-up was carried out in the 13 singers’ own habitual way. (Paper 2) Twelve mezzo-sopranos phonated on /u:/ at various pitches for two minutes before post-recording, and 15 seconds before each additional F0, into a glass tube (l=27 cm, id=9 mm) at a water depth of 1-2 cm.(Paper 3) Five trained singers and five untrained subjects repeated the vowel sequence /a,e,i,o,u/ at a Sound Pressure Level of at least 80 dB at 0.3 m for 20 minutes.Statistically significant results: (Paper 1) CTP and PTP decreased after warm-up in the five female voices. CTP was found to be higher than PTP (about 4 H2O). Also, CTP had a lower coefficient of variation, suggesting that CTP is a more reliable measure than PTP. (Paper 2) CTP increased on average six percent after resonance tube phonation in water.(Paper 3) CTP and PTP increased after the vocal loading in the untrained voices, with an average after-to-before ratio of 1.26 for CTP and 1.33 for PTP.(Paper 4) Automatically derived CTP values showed high correlation with those obtained manually, from EGG spectrum slope, and from the visual displays of dEGG and of dEGG wavegram.
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13.
  • Enflo, Laura, et al. (författare)
  • Comparing vocal fold contact criteria derived from audio and electroglottographic signals
  • 2016
  • Ingår i: Journal of Voice. - : Elsevier. - 0892-1997 .- 1873-4588. ; 30:4, s. 381-388
  • Tidskriftsartikel (refereegranskat)abstract
    • Collision threshold pressure (CTP), i.e., the lowest subglottal pressure producing vocal fold contact during phonation, is a parameter likely to reflect relevant vocal fold properties. The amplitude of an electroglottographic (EGG) signal or the amplitude of its first derivative (dEGG) has been used as the criterion of such contact. Manual measurement of CTP is time-consuming, making the development of a simpler, alternative method desirable. In this investigation we compare CTP values automatically derived from the dEGG signal to values measured manually, and to values derived from a set of alternative parameters, some obtained from audio and some from EGG signals. One of the parameters was the novel EGG wavegram, which visualizes sequences of EGG or dEGG cycles, normalized with respect to period and amplitude. Raters with and without previous acquaintance with EGG analysis marked the disappearance of vocal fold contact in dEGG and in wavegram displays of /pa:/-sequences produced with continuously decreasing vocal loudness by seven singer subjects. Vocal fold contact was equally accurately identified in displays of dEGG amplitude as of wavegram. Automatically derived CTP values showed high correlation with those measured manually, and with those derived from the ratings of the visual displays. Seven other parameters were tested as criteria of such contact. Mainly due to noise in the EGG signal, most of them yielded CTP values differing considerably from those derived from the manual and the automatic methods, while the EGG spectrum slope showed a high correlation. The possibility of measuring CTP automatically seems promising for future investigations.
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14.
  • Enflo, Laura, 1980-, et al. (författare)
  • Effects of Tube Phonation on Collision and Phonation Threshold Pressures in Mezzo-soprano Voices
  • 2011
  • Ingår i: Pan European Voice Conference (PEVOC9).
  • Konferensbidrag (refereegranskat)abstract
    • Tube phonation is a voice therapy method widely used in Scandinavia and Germany. Invented by Sovijärvi (1965 & 1969) in the sixties, it is now used to treat several kinds of voice pathologies but also to solve passaggio and speech problems among singers. The subject phonates into a 26-28 cm long tube, typically made of glass, with the other end placed a few cm under water in a bowl. The resulting bubbling causes a modulation of intraoral pressure. Tube phonation is supposed to contribute to the development of appropriate combinations of air flow and subglottal pressure needed for a healthy voice control and/or vocal skill.  The present study is part of a project aiming at exploring the potentials of the collision threshold pressure (CTP) (Enflo and Sundberg, 2009; Enflo et al., 2009), defined as the lowest subglottal pressure needed for vocal fold collision. This pressure may be a valuable complement to the commonly used phonation threshold pressure (PTP), defined as the lowest subglottal pressure needed to obtain and sustain vocal fold vibration. In the present investigation we analysed the effects of tube phonation on these threshold pressures. Twelve mezzo-sopranos with differing levels of singing training participated in the experiment, six highly advanced classically trained singers with daily  singing practise, and six modestly experienced choir singers without daily  singing practise. Subglottal pressure, EGG and audio were recorded before and after a tube phonation exercise. The tube phonation induced intraoral pressure modulation amplitude of about five cm H2O. Perceptual effects of the tube phonation in these subjects was assessed by a listening test. On average across singers CTP tended to rise, particularly in the less well trained singers. The listening test indicated that tube phonation was associated with a clearly audible improvement of voice function, at least in the less well-trained singers.
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15.
  • Enflo, Laura, et al. (författare)
  • Effects of vocal warm-up, vocal loading, and tube phonation on phonation and collision threshold pressures
  • 2012
  • Ingår i: The Voice Foundation's 41st annual Symposium. - Philadelphia : The Voice Foundation.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Collision threshold pressure (CTP) is defined as the lowest subglottal pressure producing vocal fold collision. It has been measured in three studies, to analyze the effects of (1) vocal warm-up, (2) vocal loading and (3) the voice therapy method resonance tube phonation, which implies phonation into a tube, the end of which is placed a few cm under water. Also, phonation threshold pressure (PTP) was determined. This threshold pressure, however, although more commonly used, is often difficult to measure; the coefficient of variation has been found mostly to be higher for PTP than for CTP.                      Before and after data for CTP and PTP were determined from audio, electroglottographic (EGG) and pressure signals. Subjects repeated the syllable /pa:/ with gradually decreasing vocal loudness at several fundamental frequencies. Subglottal pressure was estimated from oral pressure during the p-occlusion. CTP was determined using EGG or dEGG spike amplitude as criteria of vocal fold collision, while vocal fold vibration for PTP measurement was determined from the audio signal.The first investigation, with 15 amateur singers, suggested that vocal warm-up tended to lower both CTP and PTP. The effect of vocal loading, studied in seven subjects two of whom had trained voices, was that CTP and PTP rose, especially in the untrained voices. Resonance tube phonation exercise (tube length 27 cm, Æ 8 mm) caused an increase of CTP and PTP in 12 mezzo-soprano voices, with different levels of voice training. The effect on both CTP and PTP was greater in less trained singers, and was perceived as an improvement in a pair-wise comparison listening test with seven voice experts.The three studies support the conclusion that CTP can be used as a valuable complement to or replacement of PTP.
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16.
  • Enflo, Laura, et al. (författare)
  • Effects on Vocal Fold Collision and Phonation Threshold Pressure of Resonance Tube Phonation With Tube End in Water
  • 2013
  • Ingår i: Journal of Speech, Language and Hearing Research. - : American Speech Language Hearing Association. - 1092-4388 .- 1558-9102. ; 56:5, s. 1530-1538
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Resonance tube phonation in water (RTPW) or in air is a voice therapy method successfully used for treatment of several voice pathologies. Its effect on the voice has not been thoroughly studied. This investigation analyzes the effects of RTPW on collision and phonation threshold pressures (CTP and PTP), the lowest subglottal pressure needed for vocal fold collision and phonation, respectively. Method: Twelve mezzo-sopranos phonated into a glass tube, the end of which was placed under the water surface in a jar. Subglottal pressure, electroglottography, and audio signals were recorded before and after exercise. Also, the perceptual effects were assessed in a listening test with an expert panel, who also rated the subjects' singing experience. Results: Resonance tube phonation significantly increased CTP and also tended to improve perceived voice quality. The latter effect was mostly greater in singers who did not practice singing daily. In addition, a more pronounced perceptual effect was found in singers rated as being less experienced. Conclusion: Resonance tube phonation significantly raised CTP and tended to improve perceptual ratings of voice quality. The effect on PTP did not reach significance.
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17.
  • Ericsson, Elisabeth, 1959-, et al. (författare)
  • Child Behavior and Quality of Life Before and After Tonsillotomy versus Tonsillectomy
  • 2008
  • Ingår i: Swedish Sleep Medicine Congress.
  • Konferensbidrag (refereegranskat)abstract
    • Objective: to compare two techniques for tonsil surgery with respect to postoperative pain and morbidity and changes in sleep, behavior, health related quality of life (HRQL) and benefit due to  surgery. Methods: 67 pre-school children  with  tonsillar hypertrophy were randomized to regular tonsillectomy (TE)  or tonsillotomy (TT) with Radiofrequency surgical technique. The parents completed a validated quality of life  survey, Obstructive Sleep Apnea-18 (OSA18) , assessed the children’s behavior  with the Child Behavior Checklist (CBCL) before and six month after surgery and evaluated the post-operative  health related benefits using the Glasgow Children’s Benefit Inventory (GCBI). Results: TT-children recorded less pain from the first day, and were pain-free 3 days earlier than TE-children. Six months post-surgery, there was no difference between TT and TE with regard to snoring and ENT-infections. The total scores in all the individual domains between the initial OSA-18 and post-surgery scores differed (p<0.0001). Improvement in CBCL score was also significant (p<0.01) . There were no differences between TT- and TE-children. GCBI indicated a significant health benefit of both methods. Conclusions: Tonsillar hypertrophy  shows  impact on HRQL and behavior. After  tonsillar operation, improvements occur as much after TT as after TE.  TT should be first choice for treatment.
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19.
  • Ericsson, Elisabeth, 1959-, et al. (författare)
  • Child behavior and quality of life before and after tonsillotomy versus tonsillectomy
  • 2008
  • Ingår i: International conference in pediatric otorhinolaryngology, 2008. ; , s. 40-40
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction: The objective of the present investigation was to compare two techniques for pediatric tonsil surgery with respect to postoperative pain and morbidity and changes in sleep behavior, health related quality of life (HRQL) and benefit due to surgery. Methods: 67 children (4,5-5,5 years) with tonsillar hypertrophy and obstructive sleep related distress with or without recurrent tonsillitis were randomized to either regular tonsillectomy (TE)(n=32) or intracapsular tonsillectomy/tonsillotomy (TT) (n=35) with Radiofrequency surgical technique (Ellman Int) Before TT/TE, the parents completed a validated Quality of Life survey of pediatric obstructive sleep apnea, the OSA18 (Obstructive Sleep Apnea-18) and a standardized assessment of their children-s behavior with the Child Behavior Checklist (CBCL). Six months after surgery, the parents repeated these measurements, and assessed the health related benefits of the surgery using the Glasgow Children´s Benefit Inventory (GCBI). Results: In the TT group, the children recorded less pain from the first day after surgery onwards, used fewer doses of painkillers and were pain-free 3 days earlier than the children in the TE group. Six months after surgery, there was no significant difference between TT and TE with regard to snoring and ENT-infections. The differences were all significant in the total scores and in all the individual domains between the initial OSA-18 and post-surgery scores (p<0.0001). The improvement in the total problem score measured with CBCL was also significant (p<0.01) and there were no differences between the TT and TE children. The improvements in all sub scores of the GCBI indicated a significant health benefit of both TT and TE. Conclusions: TT with RF-surgery is a safe method, which causes less pain and postoperative morbidity than regular TE and has a similar effect on snoring and recurrent infections. Young children with tonsillar hypertrophy and different degrees of obstructive sleep related distress all show an impact on HRQL and behavior. All improve dramatically after a tonsillar operation-improving just as much after TT as after TE. Based on these results, TT should be the first choice for treatment of these small children. Support: Financial support from the Research Council of South East Sweden (FORSS).
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20.
  • Ericsson, Elisabeth, et al. (författare)
  • Oralmotorik, artikulation och livskvalitet : Sexmånadersuppföljning efter tonsillotomi respektive tonsillektomi
  • 2007
  • Ingår i: Medicinska Riksstämman, Stockholm 28-30 nov 2007.
  • Konferensbidrag (refereegranskat)abstract
    • Bakgrund: Barn med stora halsmandlar har oftare problem med näsandning, dregling, tal, röst och bettfysiologi. Kliniska rapporter har visat positiva resultat när det gäller dessa svårigheter efter tonsillektomi (TE). Barn med obstruktionsbesvär har mer beteende- och emotionella problem, studier har visat att barnets grundbeteende förbättras efter TE. Frågan är om partiellt borttagande, tonsillotomi (TT), av de förstorade delarna av halsmandlarna ger samma positiva långsiktiga resultat. Ingreppet ”tonsillotomi”( TT) påverkar barnet mycket mindre när det gäller smärta och blödningsrisk, och har ett snabbare läkningsförlopp än när hela tonsillen tas bort (TE). Syfte med studien att utröna om tonsillotomi förbättrar förutsättningarna för normal utveckling beträffande oralmotorik, tal och bett (artikulatorisk-, oralmotorisk- och bettutveckling) och därmed ger opererade barn en bättre livskvalitet. Metod: Prospektiv studie med 67 barn 4,5-5,5 år med tonsillhypertrofi samt med eller utan återkommande halsinfektioner  har randomiserats till  TT (n=35) med RF-teknik (Ellman international)  och sedvanlig TE (n=32). Före ingreppet bedömdes barnens oralmotorik och tal av logoped med Nordic Orofacial Test (NOT-S) och fonologisk test. Föräldrarna besvarade frågor om oralmotorik i allmänhet och tugg- och sväljfunktion i synnerhet. Tandläkare bedömer bett och gjorde cefalometri (rtg). Livskvalitetinstrument med OSA18 samt beteendeinstrument Child Behavior Checklist (CBCL) ifylldes av föräldrarna. Sex månader efter ingreppet upprepas samtliga bedömningar utom bettanalysen vilket görs först två år efter ingreppet. Resultat: Samtliga 66 barn har genomfört sexmånadersuppföljning av oralmotorik, tal och livskvalitet. Båda grupperna var signifikant förbättrade vad gäller obstruktionsbesvär, infektioner, aptit och ork/energi. Livskvaliteten skattades signifikant bättre beträffande sömnstörning, dagtidsfunktion, hälsa, fysiska och emotionella symtom. Logopedbedömningarna visar tydlig förbättring beträffande tugg - svälj- och andningsfunktion. Rapporterad dreglingsproblematik har helt försvunnit. Perceptuell analys av barnens röst och tal visar på att flera av barnen hade en tydlig förbättring postoperativt beträffande röst (talklang) och artikulation. Försenad fonologisk utveckling som upptäcktes preoperativt på barnen kvarstod vid sexmånaderskontrollen. Sammanfattning: Sexmånadersuppföljningens resultat visar att effekten är densamma efter TT som TE vid oralmotorisk dysfunktion inklusive artikulationsproblem och hälsa/livskvalitet, mycket är vunnit i både lidande, "sjukskrivningstid" och logopediska behandlingsinsatser. Tonsillotomi bör övervägas som rutinmetod vid samtliga ÖNH-kliniker vid denna indikation, även på barn med kombinerade funktionshandikapp vilka ofta lider av oraldysmotorik.
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21.
  • Gauffin, Helena, et al. (författare)
  • Cognitive problems in young adults with epilepsy : Language deficits correlate to brain activation and self-esteem
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • People with epilepsy often display cognitive decline. Language function in epilepsy has been most thoroughly studied in temporal lobe epilepsy, but the impact of language deficits in epilepsy is not fully understood. The aim of this study was to evaluate the effect of epilepsy on language function with functional magnetic resonance imaging of brain activation, with behavioral methods and to relate language performance to demographic data, self-esteem and Quality of life. We specifically aimed to investigate if variation in epilepsy origin would relate to differences in language performance and if these differences could be associated with specific language activation patterns in the brain. We recruited people with epilepsy (29 in total), with focal onset seizures in either the left or right hemispheres or with generalized epilepsy; and 27 matching healthy controls. The participants’ language skills were measured with a phonemic word fluency test and a broader test measuring higher language functions. Functional magnetic resonance images of the brain were obtained during a word fluency and a sentence reading paradigm. Questionnaires on self-esteem and quality of life were collected. People with epilepsy of both focal and generalized origin had impaired function in semantic and verbal fluency tasks compared to the controls. The causes of language impairment were multifactorial; the most important determinants were education and onset age of epilepsy. Impaired language function was correlated to low self-esteem for participants with focal onset seizures; however Quality of life did not seem to be affected by language impairment. The functional magnetic resonance imaging investigation demonstrated altered functional activity during language tasks for participants with epilepsy compared to healthy controls. In epilepsy with focal seizures originating in the left hemisphere we found increased bilateral  activation of supporting areas in the anterior mid-cingulate cortex and the left anterior ventral insula, indicating a compensational functional reorganization. In generalized epilepsy, the functional language network showed an imbalance expressed as an inadequate  suppression of activation in the left anterior temporal lobe during semantic processing. Our study shows not only that reduced language functioning is present in people with epilepsy other than in the temporal lobe, but also that frequency of convulsive seizures correlates to language impairment. For patients with focalized seizures, low self esteem correlated also to language impairment. Our results highlight the importance of addressing the negative consequences of language decline in people with epilepsy of both focal and generalized origin.
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22.
  • Gauffin, Helena, et al. (författare)
  • Impaired language function in generalized epilepsy : Inadequate suppression of the default mode network
  • 2013
  • Ingår i: Epilepsy & Behavior. - : Elsevier. - 1525-5050 .- 1525-5069. ; 28:1, s. 26-35
  • Tidskriftsartikel (refereegranskat)abstract
    • We aimed to study the effect of a potential default mode network (DMN) dysfunction on language performance in epilepsy. Language dysfunction in focal epilepsy has previously been connected to brain damage in language-associated cortical areas. In this work, we studied generalized epilepsy (GE) without focal brain damage to see if the language function was impaired. We used functional magnetic resonance imaging (fMRI) to investigate if the DMN was involved. Eleven persons with GE and 28 healthy controls were examined with fMRI during a sentence-reading task. We demonstrated impaired language function, reduced suppression of DMN, and, specifically, an inadequate suppression of activation in the left anterior temporal lobe and the posterior cingulate cortex, as well as an aberrant activation in the right hippocampal formation. Our results highlight the presence of language decline in people with epilepsy of not only focal but also generalized origin.
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23.
  • Gauffin, Helena, et al. (författare)
  • Similar Profile and Magnitude of Cognitive Impairments in Focal and Generalized Epilepsy : A Pilot Study
  • 2022
  • Ingår i: Frontiers in Neurology. - Lausanne, Switzerland : Frontiers Media S.A.. - 1664-2295. ; 12
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Cognitive impairments in epilepsy are not well-understood. In addition, long-term emotional, interpersonal, and social consequences of the underlying disturbances are important to evaluate.Purpose: To compare cognitive function including language in young adults with focal or generalized epilepsy. In addition, quality of life and self-esteem were investigated.Patients and Methods: Young adults with no primary intellectual disability, 17 with focal epilepsy and 11 with generalized epilepsy participated and were compared to 28 healthy controls. Groups were matched on age (mean = 26 years), sex, and education. Participants were administered a battery of neuropsychological tasks and carried out self-ratings of quality of life, self-esteem, and psychological problems.Results: Similar impairments regarding cognitive function were noted in focal and generalized epilepsy. The cognitive domains tested were episodic long-term memory, executive functions, attention, working memory, visuospatial functions, and language. Both epilepsy groups had lower results compared to controls (effect sizes 0.24-1.07). The total number of convulsive seizures was predictive of episodic long-term memory function. Participants with focal epilepsy reported lower quality of life than participants with generalized epilepsy. Lowered self-esteem values were seen in both epilepsy groups and particularly in those with focal epilepsy. Along with measures of cognitive speed and depression, the total number of seizures explained more than 50% of variation in quality of life.Conclusion: Interestingly, similarities rather than differences characterized the widespread cognitive deficits that were seen in focal and generalized epilepsy, ranging from mild to moderate. These similarities were modified by quality of life and self-esteem. This study confirms the notion that epilepsy is a network disorder.
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24.
  • Geneid, Ahmed, et al. (författare)
  • Kulning: A study of the physiological basis for long-distance sound propagation in Swedish cattle calls
  • 2018
  • Ingår i: Proceedings of FONETIK 2016, KTH Royal Institute of TechnologyStockholm, Sweden8-10 June 2016. - Stockholm : Royal Institute of Technology. ; , s. 25-30
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • The Swedish cattle call song, kulning, is an example of very marked and far-reaching sound propagation of vocal communication. While earlier studies have investigated the acoustic characteristics of kulning, the present study focuses on its physiological basis from the point of view of vocal fold functionand supralaryngeal posture by applying electroglottography and stroboscopy to two types singing: falsetto (head voice)and kulning. It is shown that kulning, ascompared to falsetto, exhibits a better contact of the vocal folds and a longer glottal closure in the phonation cycle. Nasofiberendoscopy also showedmedial and anteroposterior narrowing of the laryngeal inlet and approximation of the false vocal folds in kulning.
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25.
  • Geneid, Ahmed, et al. (författare)
  • Kulning (Swedish Cattle Calls) : Acoustic, EGG, Stroboscopic and High-Speed Video Analyses of an Unusual Singing Style
  • 2016
  • Ingår i: Interspeech 2016, 8-12 Sep 2016, San Francisco. - : International Speech Communication Association. ; , s. 1132-1135
  • Konferensbidrag (refereegranskat)abstract
    • The Swedish cattle call singing style ‘kulning’ is surprisingly understudied, despite its mythical status in folklore. While some acoustic and physiological aspects have been addressed previously [1,2], a more detailed analysis is still lacking. Previous work [2] showed that sound pressurelevel (SPL) in kulning tapered off less than in head register as a function of distance, which warrants a study of underlying physiological mechanisms responsible for this. In the present paper, the same singer, singing the same song – in kulning and in head register (“falsetto”) mode – was recorded indoors.Electroglottographic (EGG), stroboscopic, high-speed endoscopic and audio registrations were made. Analyses examined differences between kulning and head register. Results show somewhat higher SPL in kulning than in head register confirming the previous findings. EGG showed longer relative glottal closed time and higher amplitude of the signalin kulning. This suggests better vocal fold contact in kulning. Flexible nasofiberoscopy and high-speed recordings during kulning showed medial and antero-posterior narrowing of the laryngeal inlet, a clear approximation of the false vocal folds and marked adduction of the vocal folds.
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26.
  • Hefele, Anna-Maria, et al. (författare)
  • Polyphonic Overtone Singing : an acoustic and physiological (MRI) analysis and a first-person description of aunique mode of singing
  • 2019
  • Ingår i: Proceedings from Fonetik 2019. - 9789177979845 - 9789177979852
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • This paper describes a unique singing mode, tentatively labeled “polyphonic overtone singing”. In overtone singingthe vocal harmonics of a stabile fundamental frequency are filtered by the singer in such a way that specific upper harmonics are amplified, and heard clearly, as a second musical voice. In the “throat singing” of Tuva (Mongolia) moving overtones usually occur over astable drone. In polyphonic overtone singing not only the pitch of the overtonesare changed and moving, but also the fundamental which results in two-voice singing.
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27.
  • Hengen, Johanna, et al. (författare)
  • Patient characteristics and intervention effect as measured by Voice Handicap Index
  • 2017
  • Ingår i: Logopedics, Phoniatrics, Vocology. - : TAYLOR & FRANCIS LTD. - 1401-5439 .- 1651-2022. ; 42:2, s. 93-98
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To analyze patients with a confirmed voice disorder in order to identify patterns regarding age, gender, and occupation compared to the general public. To explore effects of voice therapy according to the Voice Handicap Index (VHI) score pre- and post-therapy in relation to the number of sessions, age, and gender. Design: Prospective cohort study. Materials and methods: This study was conducted as a collaborative project between Linkoping University and hospitals in the south-east health care region in Sweden. Six voice clinics participated by asking their patients voluntarily to complete the Swedish version of the VHI at the beginning and end of therapy. Results and conclusions: The two most prevalent diagnoses were dysphonia (43%) and phonasthenia (25%). Among the working population, the three most common occupational fields were education, health care, and child-care. The majority of the patients were women (74.3%), and the mean age of all patients was 55 years. A significant improvement in VHI scores was found after therapy, with an average decrease of 19 median points in total score and a substantial effect size (0.55). The number of sessions did not significantly correlate with the mean VHI score difference but had a weak correlation to the start and end scores. Increasing age correlated with a higher median VHI score both at the start and end of therapy but did not affect the average decrease between the two measurements.
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28.
  • Hengen, Johanna, 1989-, et al. (författare)
  • Röstbehandling : Kartläggning av patienter och utvärdering av interventionseffekt med Rösthandikappindex
  • 2014
  • Ingår i: Norsk tidsskrift for logopedi. - 0332-7256. ; :2, s. 26-30
  • Tidskriftsartikel (refereegranskat)abstract
    • Denna studie är ett samarbetsprojekt mellan Linköpings Universitet och fyra landsting i sydöstra och södra sjukvårdsregionen. Syftet är att kartlägga patienter i röstbehandling samt jämföra patienternas RHI-skattningar före och efter genomgången röstbehandling för att undersöka huruvida ålder, kön samt antalet behandlingstillfällen påverkar resultatet. Studien bygger på 350 patienters självskattningar. Wilcoxon teckenrangtest visar en signifikant skillnad i RHI-poäng före och efter behandling med en minskning av 19 medianpoäng i RHI-index med stor effektstyrka (0,55). Kvinnor utgjorde en majoritet av patienterna (74,3 %) och medelåldern totalt var 55 år. Äldre patienter hade högre medianvärde på RHI vid behandlingsstart och behandlingsslut. En högre ålder påverkade dock inte den observerade skillnaden mellan skattningarna.
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29.
  • Johansson, Kerstin, et al. (författare)
  • Perceptual Detection of Subtle Dysphonic Traits in Individuals with Cervical Spinal Cord Injury Using an Audience Response Systems Approach
  • 2017
  • Ingår i: Journal of Voice. - : MOSBY-ELSEVIER. - 0892-1997 .- 1873-4588. ; 31:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives. Reduced respiratory function following lower cervical spinal cord injuries (CSCIs) may indirectly result in vocal dysfunction. Although self-reports indicate voice change and limitations following CSCI, earlier efforts using global perceptual ratings to distinguish speakers with CSCI from noninjured speakers have not been very successful. We investigate the use of an audience response system-based approach to distinguish speakers with CSCI from noninjured speakers, and explore whether specific vocal traits can be identified as characteristic for speakers with CSCI. Methods. Fourteen speech-language pathologists participated in a web-based perceptual task, where their overt reactions to vocal dysfunction were registered during the continuous playback of recordings of 36 speakers (18 with CSCI, and 18 matched controls). Dysphonic events were identified through manual perceptual analysis, to allow the exploration of connections between dysphonic events and listener reactions. Results. More dysphonic events, and more listener reactions, were registered for speakers with CSCI than for noninjured speakers. Strain (particularly in phrase-final position) and creak (particularly in nonphrase-final position) distinguish speakers with CSCI from noninjured speakers. Conclusions. For the identification of intermittent and subtle signs of vocal dysfunction, an approach where the temporal distribution of symptoms is registered offers a viable means to distinguish speakers affected by voice dysfunction from non-affected speakers. In speakers with CSCI, clinicians should listen for presence of final strain and nonfinal creak, and pay attention to self-reported voice function and voice problems, to identify individuals in need for clinical assessment and intervention.
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30.
  • Lagerberg, Tove B, et al. (författare)
  • Measuring intelligibility in spontaneous speech using syllables perceived as understood
  • 2021
  • Ingår i: Journal of communication disorders. - : Elsevier BV. - 1873-7994 .- 0021-9924. ; 92
  • Tidskriftsartikel (refereegranskat)abstract
    • Intelligibility, the ability to convey a message by speech, is one of the most important variables in speech-language pathology. The assessment of intelligibility is a challenge especially when it comes to spontaneous speech. The aim of the study was to investigate validity and reliability of a method for assessment of intelligibility, syllables perceived as understood (SPU); a method that is more time-efficient than previous methods based on transcription, as it does not require a master transcript for reference.A group of 20 adult listeners transcribed stimuli consisting of spontaneous speech from 16 children (14 with speech sound disorder and two with typical speech and language development, age 4:4 to 8:1, M=6:0). Intelligibility was calculated based on these orthographic transcripts, as a) proportion of syllables perceived as understood (SPU) and b) proportion of syllables correctly understood (SCU), with reference to a master transcript. Validity was checked through investigation of the correlation and difference between these two measures. Reliability was analysed with inter-listener reliability by intra-class correlation.The correlation between SPU and SCU (the gold standard intelligibility score) was strong and statistically significant, with SPU being consistently higher than SCU. Inter-listener reliability for single measures of intra-class correlation of the assessment by syllables perceived as understood was moderate to low, whereas the inter-listener reliability for average measures of intra-class correlation was high.The method based on SPU might be used for assessment of intelligibility if the median from several listeners is used or when comparing results from the same listener over time. The SPU method might therefore be a valuable tool in a clinical and research context as a more valid option than rating scales and a more time-efficient method than the gold standard SCU method. However, it should be noted that the reliability of the SPU is not as high as for the SCU.
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31.
  • Larsby, Birgitta, 1950-, et al. (författare)
  • The influence of female versus malespeakers’ voice on speech recognitionthresholds in noise: Effects of low and high-frequency hearing impairment
  • 2015
  • Ingår i: Speech, Language and Hearing. - : W.S. Maney & Son Ltd. - 2050-571X. ; 18:2, s. 84-90
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To investigate the effect of female versus male speakers’ voice on the ability to recognize speech innoise in two groups of sensorineural hearing-impaired listeners, one group with impairment at lowfrequencies and the other at high frequencies.Method: Eight participants with high-frequency hearing impairments (Hf-HI) and seven with low-frequencyhearing impairments (Lf-HI) participated. Sixteen normal hearing (NH) participants served as reference.The sentences from the hearing in noise test, read by a female or a male speaker, were presentedmonaurally with a background noise. In an adaptive procedure, the mean speech recognition threshold,for 50% correctly recognized sentences, was calculated for the female and male voice and each test subject.Results: The Hf-HI group had significantly greater difference in signal-to-noise ratio (SNR) results betweenfemale and male voices. Irrespective of hearing impairment, the female voice required 2.1 dB better SNR.In addition, the NH group showed a small but significant difference in favor of the male voice.Conclusions: Results indicate that speaker gender matters for hearing impaired and NH individuals’ ability torecognize speech in noise.
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32.
  • Lindström, Fredric, 1974, et al. (författare)
  • Observations of the Relationship Between Noise Exposure and Preschool Teacher Voice Usage in Day-Care Center Environments
  • 2011
  • Ingår i: Journal of Voice. - : Elsevier BV. - 0892-1997 .- 1873-4588. ; 25:2, s. 166-172
  • Tidskriftsartikel (refereegranskat)abstract
    • Although the relationship between noise exposure and vocal behavior (the Lombard effect) is well established, actual vocal behavior in the workplace is still relatively unexamined. The first purpose of this study was to investigate correlations between noise level and both voice level and voice average fundamental frequency (F-0) for a population of preschool teachers in their normal workplace. The second purpose was to study the vocal behavior of each teacher to investigate whether individual vocal behaviors or certain patterns could be identified. Voice and noise data were obtained for female preschool teachers (n = 13) in their workplace, using wearable measurement equipment. Correlations between noise level and voice level, and between voice level and F-0, were calculated for each participant and ranged from 0.07 to 0.87 for voice level and from 0.11 to 0.78 for F-0. The large spread of the correlation coefficients indicates that the teachers react individually to the noise exposure. For example, some teachers increase their voice-to-noise level ratio when the noise is reduced, whereas others do not.
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33.
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34.
  • Lohmander, Anette, et al. (författare)
  • Kommunikations- och sväljstörningar genom hela livet : ett logopediskt ståndpunktsdokument
  • 2017
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Den forskning som bedrivs inom logopedi i Sverige idag spänner över ett brett spektrum av medfödda, utvecklingsrelaterade och förvärvade kommunikationsstörningar på grund av röst-, tal- och språksvårigheter samt sväljstörningar. Precis som i andra länder pågår en snabb utveckling både mot en breddning av det urval av områden som det forskas kring och ett ökat fokus på nationellt samarbete. Även om de framsteg som görs inom respektive fält kan mätas genom de forskningsrapporter som publiceras av respektive forskargrupper, finns det ett behov av att granska vilka forskningsinsatser som bedrivs jämte det demografiska sammanhanget. I detta ståndpunktsdokument ger vi en översikt över logopediämnet och den forskning som bedrivs i Sverige. I en kubmodell illustreras hur kommunikations- och sväljstörningar kan beskrivas. Stratifierade (per åldersintervall) uppskattningar av prevalensen av kommunikations- och sväljstörningar ges baserat på 2016 års befolkningsstruktur. Genom att presentera dessa två komponenter identifieras forskningsområden och riktningar inom logopedi som behöver ges ökad uppmärksamhet i det kommande forskningsarbetet.
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35.
  • Lundeborg Hammarström, Inger, 1956-, et al. (författare)
  • Acoustic and perceptual aspects of vocal function in children with adenotonsillar hypertrophy : effects of surgery
  • 2012
  • Ingår i: Journal of Voice. - New York, USA : Mosby-Elsevier. - 0892-1997 .- 1873-4588. - 9789173933339 ; 26:4, s. 480-487
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To evaluate outcome of two types of tonsil surgery (tonsillectomy [TE] + adenoidectomy or tonsillotomy [TT] + adenoidectomy) on vocal function perceptually and acoustically.Study Design: Sixty-seven children, aged 50–65 months, on waiting list for tonsil surgery were randomized to TE (n = 33) or TT (n = 34). Fifty-seven age- and gender-matched healthy preschool children were controls. Twenty-eight of them, aged 48–59 months, served as control group before surgery, and 29, aged 60–71 months, served as control group after surgery.Methods:  Before surgery and 6 months postoperatively, the children were recorded producing three sustained vowels (/ɑ/, /u/, and /i/) and 14 words. The control groups were recorded only once. Three trained speech and language pathologists performed the perceptual analysis using visual analog scale for eight voice quality parameters. Acoustic analysis from sustained vowels included average fundamental frequency, jitter percent, shimmer percent, noise-to-harmonic ratio, and the center frequencies of formants 1–3.Results: Before surgery, the children were rated to have more hyponasality and compressed/throaty voice (P < 0.05) and lower mean pitch (P < 0.01) in comparison to the control group. They also had higher perturbation measures and lower frequencies of the second and third formants. After surgery, there were no differences perceptually. Perturbation measures decreased but were still higher compared with those of control group (P < 0.05). Differences in formant frequencies for /i/ and /u/ remained. No differences were found between the two surgical methods.Conclusion: Voice quality is affected perceptually and acoustically by adenotonsillar hypertrophy. After surgery, the voice is perceptually normalized but acoustic differences remain. Outcome was equal for both surgical methods.
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36.
  • Lundeborg Hammarström, Inger, 1956-, et al. (författare)
  • Effects of tonsil surgery on speech and oral motor function
  • 2008
  • Ingår i: The 12th Congress of the International Clinical Phonetics and Linguistics association. ; , s. 119-119
  • Konferensbidrag (refereegranskat)abstract
    • Large tonsils decrease the upper airways and cause oral breathing in children. If oral breathing persists, it leads to muscular and postural alterations, which, in turn cause dentoskeletal changes. In Sweden 6% of all children, have tonsil surgery performed. The indications are usually recurrent tonsillitis or severe snoring and/or sleep apneoa. Oral motor dysfunction including swallowing problems , disordered speech and aberrant dentofacial growth are less recognized problems as indications for treatment. We report results from a project aiming at comparing oral motor function and speech in children trated with two different surgical methods, tonsillectomy (TE) and partial tonsil resection, tonsillotomy (TT). 67 children aged 4-5 years old on ordinary waiting list for tonsil surgery were randomized to either TE or TT. They were assessed with the Swedish version of Nordic Orofacial Test (NOT-S) and a Swedish phonological test. A voice recording was also made. The assessment was repeated 6 months after surgery. The results were compared to a control group without tonsil problems. No significant differences were found between the children operated with TE or TT. Both groups performed significantly better on the oral motor test at the postoperative assessment, and voice quality had improved. However, compared to the control group, the children with enlarged tonsils had a delay in phonological development, preoperatively that remained at the 6-month postoperative control   
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37.
  • Lundeborg Hammarström, Inger, 1956-, et al. (författare)
  • Influence of adenotonsillar hypertrophy on /s/-articulation in children-effects of surgery
  • 2011
  • Ingår i: Logopedics, Phoniatrics, Vocology. - New York, USA : Informa Healthcare. - 1401-5439 .- 1651-2022. ; 36:3, s. 100-108
  • Tidskriftsartikel (refereegranskat)abstract
    • Tonsillar hypertrophy is common in young children and affects several aspects of the speech such as distortions of the dento-alveolar consonants. The study objective was to assess s-articulation, perceptually and acoustically in children with tonsillar hypertrophy and compare effects of two types of surgery, total tonsillectomy and tonsillotomy. Sixty-seven children, 50-65 months, on waiting list for surgery, were randomized to tonsillectomy or tonsillotomy. The speech material was collected pre-operatively and six months post-operatively.  Two groups of age-matched children were controls. /S/-articulation was affected acoustically with lower spectral peak locations and perceptually with less distinct /s/-production before surgery, in comparison to controls.  After surgery /s/-articulation was normalized perceptually, but acoustic differences remained. No significant differences between surgical methods were found.
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38.
  • Lundeborg Hammarström, Inger, 1956- (författare)
  • Oral Motor Function, Voice, Speech and Language in Children with Tonsillar Hypertrophy in Relation to Surgical Outcome
  • 2010
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aim of this thesis was two-fold: first, to evaluate four different functional aspects of the speech and language spectrum; oral-motor function, voice, /s/-articulation and phonology in preschool children with tonsillar hypertrophy before and after surgical treatment. The second aim was to investigate weather the outcome of surgery was equal for two surgical techniques; tonsillectomy or tonsillotomy combined with adenoidectomy when necessary. In all included publications (I-IV), 67 children on waiting list for tonsil surgery and randomized to either tonsillectomy (33) or tonsillotomy (34) participated. The children were assessed and audio-recorded within a month before surgery and six months postoperatively. Results were compared to age-matched control groups.In the first study, oral motor function was assessed using the Nordic Orofacial Test-Screening, NOT-S, consisting of a structured interview and a clinical examination. Before surgery, the children in the study group differed in all domains of the structured interview in comparison to age-matched controls and in the clinical examination regarding the parameters deviant lip position and trouble nose-breathing. Postoperatively oral motor functions were normalized in both surgical groups and no differences to age matched controls were observed. In study two, recordings of three sustained vowels (/α , u, i/) and 14 words elicited by picture naming were analysed both perceptually and acoustically. Compared to the controls, significant differences were found in the study group preoperatively with higher ratings on Visual Analogue Scales (VAS) for the voice quality parameters “hyponasality” and “compressed/throaty” and also lower for pitch. Significantly higher values on all studied perturbation measures (jitter, shimmer and Noise to Harmonics Ratio) were found. Regarding center frequencies of formants, the study groups had lower F3 values for /u / and also lower F2 and F3 for / i / compared to age-matched controls. After surgery there were no significant differences between the perceptual ratings of voice quality of the two surgical groups and there were no significant differences between the children in the surgical groups and the corresponding controls. The acoustic analyses showed a decrease in all the measures of perturbation for the study group after surgery with a slight difference between the two surgical groups. The children in the tonsillotomy group had higher shimmer value for /u/ and higher NHR for /α/. In comparison to the older controls significantly higher values were found an all perturbation measures and the difference seen regarding formant frequencies for the /i/-sound in comparison to controls still remained. The significantly lower third formant (F3) of the /u/-sound also remained. When comparing pre- versus postoperative results for the surgical group as a whole, a decrease was found on all perturbation measures postoperatively, however the differences were not statistically significant. A significant increase was found in formant 3 for /α/ and /u/ was found.The material used in the third study were speech samples containing the /s/-sound and elicited by picture naming and sentence repetition. Before surgery the study group was rated to have more indistinct /s/-sounds than agematched controls. The acoustic analyses showed that the study group had lower spectral peak values for the /s/-sound than controls. After surgery the operated children’s /s/-production did not differ perceptually from the older controls, neither as a whole group nor when divided according to surgical methods. Regarding the acoustic analyses however, the study groups differed from the age-matched control group showing that noise duration was longer and the peak location higher in the study groups.In study four, a Swedish phonology test was performed and transcribed phonetically. The transcription of each child was analyzed in terms of phonological processes and categorized into one of six developmental stages according to the model developed by Nettelbladt (1983) and adapted by Sahlén, Reuterskiold-Wagner, Nettelbladt & Radeborg (1999). A majority of the children in the study group (62.7 %) showed a slowed phonological development preoperatively (developmental stages 0-4), compared to the age-matched control group. Postoperatively the children in both surgical groups had improved their phonological skills. However, they were still behind in comparison to age-matched controls and the difference was even larger than before surgery.The results of this thesis project have clinical relevance for both speech and language pathologists (SLP’s) and ear-nose and throat-surgeons (ENT-surgeons). SLP’s must be aware of the potential impact of tonsillar hypertrophy on oral-motor function and the speech and language spectrum to be able to help affected children adequately and ENT- surgeons should include oral motor and speech and language problems as additional indications for tonsillar surgery.
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39.
  • Lundeborg Hammarström, Inger, 1956-, et al. (författare)
  • Oral sensorimotor function in typically developing children 3 to 8 years old as assessed by the Nordic orofacial test, NOT-S
  • 2014
  • Ingår i: Journal of medical speech-language pathology. - 1065-1438. ; 21:1, s. 51-59
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Oral senorimotor development is the basis for several vital functions for the child, hence orofacial dysfunction may be severely disabling. Recently, a comprehensive screening instrument assessing different aspects of orofacial function in adults and children age three and up was developed, the Nordic Orofacial Test-Screening (NOT-S). The aim of the present study was to establish developmental profiles of orofacial function for children 3 to 7:11 years old using NOT-S methods: A total of 231  typically developing children 3:0 to 7:11 years old were included. Data were compiled from previous investigations. Comparisons across ages and gender were made.Results: The total NOT-S score was below two for 58% (133) of all children in the study.There was a clear trend of lower total NOT-S score with  increased age according to a best linear fit regression, R2= .81, p = .014. The number of children without any score on NOT-S increases dramatically for the seven-year-old children, 44% compared to 20% or lower for the other age groups. Boys had statistically significant higher scores than girls on the total NOT-S score and also for the clinical examination according to a Mann-Whitney U-test, p<.000 for both cases.
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40.
  • Lundeborg Hammarström, Inger, et al. (författare)
  • Voice onset time in Swedish children and adults
  • 2012
  • Ingår i: Logopedics, Phoniatrics, Vocology. - : Informa Healthcare. - 1401-5439 .- 1651-2022. ; 37:3, s. 117-122
  • Tidskriftsartikel (refereegranskat)abstract
    • Voice onset time (VOT) is a temporal acoustic parameter, which reflects the timing of speech motor control. The objective of the work was to obtain normative VOT data in Swedish children. Thus, 150 children aged 8-11 years old and 36 adults were audio-recorded when producing the plosives in minimal pairs. Measures were made using waveforms and spectro-grams. Results show that Swedish children developed adult-like VOT values between 9 and 10 years. By the age of 10 years prevoicing was also found to be completely adultlike in length. The results indicate that all Swedish adults do not produce voiced plosives with prevoicing. No evident gender differences were found. The obtained VOT values can be used as normative data when assessing children with speech and language disorders.
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41.
  • Lundeborg Hammarström, Inger, et al. (författare)
  • Voice onset time in Swedish children with phonological impairment
  • 2015
  • Ingår i: Logopedics, Phoniatrics, Vocology. - : TAYLOR & FRANCIS LTD. - 1401-5439 .- 1651-2022. ; 40:4, s. 149-155
  • Tidskriftsartikel (refereegranskat)abstract
    • Mastering spatial and temporal co-ordination in speech production is a challenge for children. Voice onset time (VOT) reflects timing in speech. The objective was to study VOT in Swedish children with a diagnosed phonological impairment and compare results with normative data. Thus 38 children, aged 4-11 years, in three age-groups were audio-recorded when producing minimal pairs with the plosives /p b t d k g/. Waveforms and spectrograms were analysed. Results show that children with phonological impairment produced plosives with deviant VOT values and greater variability compared to normative data. No developmental trend was seen with increasing age. Also, no relationship was found between VOT values and degree of impairment measured by percentage phonemes correct. Furthermore no relation was found between number of errors on auditory discrimination of nine minimal pairs with the different plosives and number of deviant VOT. Findings were interpreted as displaying motor co-ordination difficulties.
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42.
  • Lundeborg, Inger, et al. (författare)
  • Effects of tonsil surgery on speech and oral-motor function
  • 2007
  • Ingår i: 27th World Congress International Association of Logopedics and Phonoiatrics, Köpenhamn, Danmark.
  • Konferensbidrag (refereegranskat)abstract
    • Large tonsils decrease the oropharyngeal airspace and cause upper respiratory obstruction and consequently mouth breathing in children. If mouth breathing is prolonged, it leads to muscular and postural alterations which, in turn cause dentoskeletal changes. In Sweden 6% of all children are surgically treated for hypertrophy of the tonsils. The indications for surgery are recurrent tonsillitis or severe obstructive-sleep-disorder. Oral motor dysfunction including swallowing problems, disordered speech and aberrant dentofacial growth are less recognized problems as indications for treatment. We report preliminary results from an ongoing project aiming at comparing outcome of oral motor function and speech in children treated with two different surgical methods, tonsillectomy (TE)and partial tonsil resection, tonsillotomy (TT). 67 children aged 4-5 years old on waiting list for tonsil surgery were randomized to either TE or TT. They were assessed before surgery with the Swedish version of Nordic Orofacial Test (NOT-S) and a Swedish phonological test. A voice recording was also made. The assessment was repeated 6 months after surgery. The results were compared with the assessment of a control group.No significant differences were found between the TE and the TT group. Both groups performed significantly better on the oral motor test at the postoperative assessment, and voice quality had improved. However the delay in the phonological development that was found preoperatively in the children with enlarged tonsils still remained at the 6-month postoperative control
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43.
  • Lundeborg, Inger, et al. (författare)
  • Oral Motor Dysfunction in Children with adenotonsillar hypertrophy : effects of Surgery
  • 2009
  • Ingår i: Logopedics, Phoniatrics, Vocology. - New York, USA : Informa Healthcare. - 1401-5439 .- 1651-2022. ; 34:3, s. 111-116
  • Tidskriftsartikel (refereegranskat)abstract
    • Adenotonsillar hypertrophy is associated with a wide range of problems. The enlargement causes obstructive symptoms and affects different functions such as chewing, swallowing, articulation, and voice. The objective of this study was to assess oral motor function in children with adenotonsillar hypertrophy using Nordic Orofacial Test-Screening (NOT-S) before and 6 months after surgery consisting of adenoidectomy combined with total or partial tonsil removal. A total of 67 children were assigned to either tonsillectomy (n33) or partial tonsillectomy, ‘tonsillotomy’ (n34); 76 controls were assessed with NOT-S and divided into a younger and older age group to match pre- and post-operated children. Most children in the study groups had oral motor problems prior to surgery including snoring, open mouth position, drooling, masticatory, and swallowing problems. Post-surgery oral motor function was equal to controls. Improvement was independent of surgery method.
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44.
  • Lundeborg, Inger, et al. (författare)
  • Phonological Development in Children with Obstructive Sleep Disordered Breathing
  • 2009
  • Ingår i: Clinical Linguistics & Phonetics. - Oxon, United Kingdom : Taylor & Francis. - 0269-9206 .- 1464-5076. ; 23:10, s. 751-61
  • Tidskriftsartikel (refereegranskat)abstract
    • Adeno-tonsillar hypertrophy with obstructive sleep disordered breathing (OSDB) is known to affect oral-motor function, behaviour, and academic performance. Adeno-tonsillectomy is the most frequently performed operation in children, with total tonsillectomy (TE) being more common than partial resection, ‘tonsillotomy’ (TT). In the present study 67 children, aged 50–65 months, with OSBD were randomized to TE or TT. The children’s phonology was assessed pre-operatively and 6 months post-operatively. Two groups of children served as controls. Phonology was affected in 62.7% of OSBD children before surgery, compared to 34% in the control group (p < .001). Also, OSBDchildren had more severe phonological deficits than the controls (p < .001). Phonology improved 6 months equally after both surgeries. Despite improvement post-operatively, the gap to the controls increased. Other functional aspects, such as oral motor function, were normalized regardless of surgical method—TE or TT. The impact of OSBD should be considered as one contributing factor in phonological impairment.
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45.
  • Lundeborg, Inger, et al. (författare)
  • Treatment with a combination of intra-oral sensory stimulation and electropalatography in a child with severe developmental dyspraxia
  • 2007
  • Ingår i: Logopedics, Phoniatrics, Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022. ; 32:2, s. 71-9
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper describes the use of a combination of intra-oral sensory stimulation and electropalatography (EPG) in the treatment of a case with severe developmental verbal dyspraxia. A multiple-baseline design was used. The treatment duration was 11 months and started when the subject was 5 years old. The efficacy of the treatment was assessed by calculations of percentage of correctly articulated words, percentage of consonants correct, percentage of phonemes correct and percentage of words correct. Intelligibility assessments were conducted by both naïve and expert listeners. The experts also assessed visual deviances in articulatory gestures from video recordings. Qualitative analysis of EPG data was made. The subject's speech was significantly improved by the treatment in all aspects. The results and their generalization to other cases of developmental verbal dyspraxia are discussed.
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46.
  • Malmenholt, Ann, et al. (författare)
  • Childhood apraxia of speech: A survey of praxis and typical speech characteristics
  • 2017
  • Ingår i: Logopedics, Phoniatrics, Vocology. - : TAYLOR & FRANCIS LTD. - 1401-5439 .- 1651-2022. ; 42:2, s. 84-92
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The purpose of this study was to investigate current knowledge of the diagnosis childhood apraxia of speech (CAS) in Sweden and compare speech characteristics and symptoms to those of earlier survey findings in mainly English-speakers. Method: In a web-based questionnaire 178 Swedish speech-language pathologists (SLPs) anonymously answered questions about their perception of typical speech characteristics for CAS. They graded own assessment skills and estimated clinical occurrence. Results: The seven top speech characteristics reported as typical for children with CAS were: inconsistent speech production (85%), sequencing difficulties (71%), oro-motor deficits (63%), vowel errors (62%), voicing errors (61%), consonant cluster deletions (54%), and prosodic disturbance (53%). Motor-programming deficits described as lack of automatization of speech movements were perceived by 82%. All listed characteristics were consistent with the American Speech-Language-Hearing Association (ASHA) consensus-based features, Strands 10-point checklist, and the diagnostic model proposed by Ozanne. The mode for clinical occurrence was 5%. Number of suspected cases of CAS in the clinical caseload was approximately one new patient/year and SLP. Conclusions: The results support and add to findings from studies of CAS in English-speaking children with similar speech characteristics regarded as typical. Possibly, these findings could contribute to cross-linguistic consensus on CAS characteristics.
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47.
  • Malmenholt, Ann, et al. (författare)
  • Childhood Apraxia of Speech (CAS): a survey of knowledge and experience of Swedish Speech-Language Pathologists
  • 2012
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Children with Childhood Apraxia of Speech (CAS) are seen by many speech and language pathologists (SLPs) in Sweden. It is commonly believed that these patients are difficult to diagnose and treat due to the absence of a validated list of diagnostic features (American Speech-Language-Hearing Association, 2007) and lack of evidence for a wide range of treatment approaches reported (Morgan & Vogel, 2009). Speech-language pathologists’ perspectives on assessment of CAS have been studied by Forrest (2003). She asked SLPs about which three characteristics they thought were crucial for diagnosing CAS. The diversity of SLPs view on CAS diagnostic markers was documented. Not less than 50 different characteristics were listed, making inconsistent productions the most frequently noted feature (14.1%).  Experience and knowledge about the typical symptoms of CAS among Swedish SLPs would be a valuable first step towards a common routine for diagnosis of this group of patients in Sweden. Aim: The aim of this paper was to perform a survey among Swedish clinical SLPs regarding symptoms, praxis for clinical diagnosis and description of patients with CAS. Methods & Procedures: A web-based questionnaire was sent to Swedish SLPs working with pre- and primary school-aged children asking 25 questions about the clinicians background, years of clinical experience, skills of assessment and intervention, estimation of own competence and opinion about need for further education concerning this particular group. The SLPs were asked to estimate the prevalence for CAS based on their own clinical experience.Outcomes & Results: One hundred-seventy-five clinical SLPs with varying experience responded, which equals a response rate of 60%. About half of them usually diagnosed CAS. In the rating of typical symptoms of CAS 85% suggested inconsistent errors as the core feature of the disorder, 82% noticed difficulties with automaticity and 71% difficulties with sequence maintenance. In 88 % of answers children with CAS were considered to make slow progress in treatment and 80% estimated that these children typically had persisting difficulties and constraints even in primary school. There was a wide range of estimated prevalence figures for CAS from less than 1% to around 50%. Almost all SLPs who answered the questionnaire reported a need for further education about CAS.Conclusions: Although Swedish SLPs rated their own knowledge about CAS as insufficient, the rating of the key classification criterion for the disorder was high, as was the view that these children make slow progress in treatment. Estimation of prevalence for CAS was highly diverse, reflecting the difficulties with the broad definition and large variation within this disorder. The collected data of the Swedish clinical SLPs experience and knowledge about CAS revealed an important consensus on the core diagnostic features but also a vagueness regarding best treatment. This reflects the current knowledge in this field and will be taken into account in continuing work towards a common and evidence based practice.ReferencesAmerican Speech-Language-Hearing Association. Childhood Apraxia of Speech [Position Statement] 2007. Available from www.asha.org/policy.)Forrest, K. (2003). Diagnostic criteria of developmental apraxia of speech used by clinical speech-language pathologists. American Journal of Speech-Language Pathology, 12, 376–380.Morgan & Vogel. Cochrane review of treatment for childhood apraxia of speech. Eur J Phys Rehabil Med. 2009 Mar;45(1):103-10.)
  •  
48.
  • McAllister, Anita, et al. (författare)
  • A Comparison of Recordings of Sentences and Spontaneous Speech : Perceptual and Acoustic Measures in Preschool Children's Voices.
  • 2012
  • Ingår i: Journal of Voice. - : Elsevier. - 0892-1997 .- 1873-4588. ; 26:5, s. 13-
  • Tidskriftsartikel (refereegranskat)abstract
    • A well-controlled recording in a studio is fundamental in most voice rehabilitation. However, this laboratory like recording method has been questioned because voice use in a natural environment may be quite different. In children's natural environment, high background noise levels are common and are an important factor contributing to voice problems. The primary noise source in day-care centers is the children themselves. The aim of the present study was to compare perceptual evaluations of voice quality and acoustic measures from a controlled recording with recordings of spontaneous speech in children's natural environment in a day-care setting. Eleven 5-year-old children were recorded three times during a day at the day care. The controlled speech material consisted of repeated sentences. Matching sentences were selected from the spontaneous speech. All sentences were repeated three times. Recordings were randomized and analyzed acoustically and perceptually. Statistic analyses showed that fundamental frequency was significantly higher in spontaneous speech (P<0.01) as was hyperfunction (P<0.001). The only characteristic the controlled sentences shared with spontaneous speech was degree of hoarseness (Spearman's rho=0.564). When data for boys and girls were analyzed separately, a correlation was found for the parameter breathiness (rho=0.551) for boys, and for girls the correlation for hoarseness remained (rho=0.752). Regarding acoustic data, none of the measures correlated across recording conditions for the whole group.
  •  
49.
  • McAllister, Anita, 1955- (författare)
  • A comparison of studio recordings and recordings of spontaneous speech: assessments of voice quality in pre-school children
  • 2011
  • Ingår i: Pan European Voice Conference (PEVOC9), Marseille, France. - Marseille.
  • Konferensbidrag (refereegranskat)abstract
    • A well controlled recording in a studio is the basis for voice rehabilitation. However, this laboratory like recording method can be questioned since voice use in a natural environment may be quite different. In children’s natural environment high background noise levels are common and an important factor contributing to voice problems. The noise exposure often occurs in day-care centers with the children themselves as the primary noise source (McAllister, Granqvist, Sjölander, Sundberg 2009). The aim of the present study was to compare perceptual evaluations of voice quality from a controlled recording to recordings of spontaneous speech in children’s natural environment in a day-care setting. Ten five-year-old children were recorded three times during a day at the day-care. The controlled speech material consisted of repeated sentences. Matching sentences were selected from the spontaneous speech. All sentences were repeated times three. The recordings were randomized and analyzed acoustically and evaluated perceptually by three expert listeners. Statistic analyses of all recordings showed that the laboratory sentences represent spontaneous speech characteristics regarding degree of hoarseness (r=.52) and to a lesser extent also for breathiness (r=. 401). For boys a correlation was found only for the parameter breathiness (r=.539) and for girls only for hoarseness (r=.648).     References McAllister, A., Granqvist, S. Sjölander, P. Sundberg, J. (2009). Child voice and noise: A pilot study of the effect of a day at the day-care on ten children’s voice quality according to perceptual evaluation. J Voice, Sep;23(5):587-93.
  •  
50.
  • McAllister, Anita (författare)
  • Acoustic, perceptual and physiological studies of ten-year-old children's voices
  • 1997
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aim of the present investigation was to study hoarseness and its perceptual, acoustic and physiological characteristics in ten-year-old children's voices. Fifty-eight children's voices were perceptually evaluated along 15 voice parameters. The rank ordered means of each parameter revealed a discontinuity in the distribution for all parameters except pitch, breathiness and vocal fry. This discontinuity was used as an operational borderline between normal and deviant voice characteristics. Statistical analysis showed that hyperfunction, breathiness and roughness are the main predictors of hoarseness. Pitch and intensity ranges of 60 children were recorded in voice range profiles (VRP). Vocal fold status was determined by video-microlaryngoscopy and, when possible, also by stroboscopy. Six children, all boys had vocal nodules. Twenty-five children had incomplete glottal closure. The children had somewhat compressed VRP contours reflecting a more restricted pitch range and dynamics than adults. The occurrence of register transitions in children's voices was studied in an experiment Five voice experts perceptually identified such transitions from a tape made of the VRP recording sessions. On this tape the stimuli occurred in ascending pitch order. One transition was identified in most voices at a mean fundamental frequency (F0) of A#4. A second transition was identified in four voices at a mean F0 of A#5. SPL and subglottal pressure were measured at different pitch and loudness levels in nine children. At phonation threshold and at normal conversational loudness the children's subglottal pressures were similar to those of adult female voices. Acoustic correlations to perceptual voice characteristics were analyzed in two investigations For the first, six children representing different degrees of hoarseness were selected. The voice sample was running speech. Two perturbation measures were examined but no correlation was found between the perceptual evaluation and these two measures. For the second investigation 50 children were chosen. The material consisted of sustained vowels. The acoustic measures were period perturbation quotient (PPQ), amplitud perturbation quotient (APQ) and two harmonics-to-noise ratio measures, NNEa and NNEb, operating in different frequencies. The results showed that hoarseness, breathiness and roughness correlated with the acoustic measures PPQ and NNEa at the p 001 Ievel of significance. Hyperfunction and instability did not correlate with any of these measurements. Conclusions: Hoarseness in children's voices is a stable concept consisting of three main predictors; hyperfunction, breathiness and roughness. Children generally had somewhat compressed VRP recording as compared to adults. Register transitions could be identified in most children's voices, approximately 25% higher in F0 than for adults Incomplete glottal closure may be regarded as a normal finding in ten- year-old children. Subglottal pressure values in these children's voices were similar to those of adult females. In children's sustained vowel phonation hoarseness, breathiness and roughness correlated with the acoustic measures PPQ and NNEa.
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