Development and Evidence of Content Validity of the Spectrographic Vocal Assessment Protocol (SVAP)

Water Resistance Therapy in Individuals with Parkinson's Disease: A Session-by-Session Analysis of the Vocal Quality

OBJECTIVES

Verify session-by-session effects of the water resistance therapy (WRT) on the vocal quality of individuals with Parkinson's disease (PD).

METHODS

This is a retrospective analytical study. Then, the samples were acquired from a database composed of 10 men aged between 50 and 90 years old diagnosed with PD. The participants underwent WRT with a resonance tube; then, they were guided to perform the following phonatory tasks: comfortable pitch and loudness, high pitch, low pitch, ascending and descending glissandos, and sentence uttering. Furthermore, tube depth ranged from 2 cm to 9 cm. Finally, WRT was implemented twice per week, totaling eight sessions, each lasting 45 minutes. Participants were assessed before and after each therapy session. Hence, the data were assessed with spectrographic analysis, vocal intensity, cepstral peak prominence-smoothed, alpha ratio, L1-L0, oscillatory frequency, and auditory-perceptual assessment of overall degree, roughness, breathiness, and instability. One-way repeated measures analysis of variance and Friedman tests were applied (P < 0.05). Furthermore, Holm-Sidak and Tukey tests were used as posthoc tests.

RESULTS

After the sixth session, the spectrographic analysis revealed that the tracing color intensity of medium frequencies darkened, whereas a better result could be observed after the eighth session. Regarding vocal intensity, the improvement could be observed from the third session. Additionally, L1-L0 followed the same results. The overall degree auditory-perceptual assessment revealed the best results only after the second, third, and fourth sessions; however, after the eighth session, the instability increased.

CONCLUSIONS

WRT allowed better results from the third session, with some improvements in the sixth session. However, the instability increased after the eighth session; thus, it is important to review the phonatory tasks and session numbers to avoid an overload in the phonatory system.

Development of the Digital Speech Assessment Instrument

OBJECTIVE

This study aimed to develop a Digital Speech Assessment Instrument to evaluate the phonological and motor speech skills of Brazilian Portuguese-speaking children and adolescents through six tasks: (a) word naming, (b) word imitation, (c) pseudoword imitation, (d) word repetition, (e) pseudoword repetition, and (f) diadochokinesis.

METHOD

The assessment instrument was developed and validated in a seven-step process, beginning with stimulus selection and ending with Pilot Study 1 (involving children and adolescents with typical speech development) and Pilot Study 2 (involving children and adolescents with speech sound disorders [SSDs]). Participants of the study included expert and nonexpert judges, children, and adolescents.

RESULTS

The Digital Speech Assessment Instrument contains 91 real words (61 in the naming task, 51 in the imitation task, and five in the repetition task), 26 pseudowords (26 in the imitation task and four in the repetition task), and six stimuli for diadochokinesis. The test contains stimuli in the form of images as well as audio and video recordings and allows for the analysis and storage of participant data in a virtual database.

CONCLUSIONS

This study described the development of the Digital Speech Assessment Instrument, available in Brazilian Portuguese for the evaluation of several aspects of speech production (including word and pseudoword naming, imitation, and repetition and diadochokinesis). The test was developed for children aged 2;0 (years;months) to 17;11 and is administered fully online. In the future, the instrument can be used to provide a timely and accurate diagnosis of SSDs.

An Open Access Standardised Voice Evaluation Protocol

PURPOSE

A comprehensive protocol to evaluate voice quality can support a full characterisation of voice disorders and be used to plan voice interventions. The purpose of this study was to develop and validate a standardised protocol for voice assessment, contributing with a comprehensive and valuable tool for clinician practice and research.

METHOD

The initial structure and content of the protocol was based on an extensive literature review of existing voice assessment tools. The content validity was then assessed by a panel of voice specialist, using a modified Bland and Altman graphical method and the intraclass correlation coefficient (ICC). A group of participants with vocal pathology was finally assessed by two voice specialists on the same day (inter-rater reliability), and, on a second day, by a single evaluator (intra-rater reliability). Inter and intra-reliability were evaluated through Cohen's kappa (k) for nominal variables, and Spearman's Correlation Coefficient (ρ) for quantitative and ordinal variables.

RESULTS

The Bland and Altman analysis, revealed a reasonable agreement between the experts and the ICC values were lower than expected, but the confidence intervals were very wide. The intra-rater reliability of the protocol's nominal variables was almost perfect, with a mean k of 0.977; inter-rater reliability of nominal variables was also almost perfect, with a mean k of 0.893. The ordinal and quantitative variables revealed a very good to excellent relationship, with a mean ρ of 0.912.

CONCLUSIONS

Evidence of content validity, high intra and inter-rater reliability of a standardised protocol for voice assessment, have been shown. This protocol can be used to assess and collect data from patients, to train voice specialists and to develop reference voice databases. It has been designed to serve voice experts with diverse backgrounds and assessment needs.

Spectrographic Vocal Characteristics in Female Teachers: Finger Kazoo Intensive Short-term Vocal Therapy

OBJECTIVE

Verify the results from intensive short-term vocal therapy using the Finger Kazoo technique about the spectrographic vocal measurements of teachers.

METHODS

Controlled and randomized trial. Spectrographic vocal assessment was performed by judges before and after intensive short-term vocal therapy with Finger Kazoo. Sample was composed of 41 female teachers. There were two study groups (with vocal nodules and without structural affection of the vocal folds) and the respective control groups. For the statistical analysis of the data, nonparametric tests were used (Mann-Whitney test and Wilcoxon test).

RESULTS

After intensive short-term vocal therapy with Finger Kazoo, improvement in voice spectral parameters, such as improvement in tracing (color intensity and regularity), greater definition of formants and harmonics, increased replacement of harmonics by noise, and a greater number of harmonics, mainly in the group without structural affection of the vocal folds.

CONCLUSION

There was an improvement in the spectrographic vocal parameters, showing greater stability, quality, and projection of the emission, especially in female teachers without structural affection of the vocal folds.