Effects of error experience when learning to simulate hypernasality

Connecting Auditory-Perceptual Prompts Used in Voice Therapy to Anatomy and Physiology: Application to the Estill Voice Model and the Rehabilitation Treatment Specification System

PURPOSE

This clinical tutorial will present the concept of applying auditory-perceptual prompts (implicit instruction) typically used in voice therapy to the anatomy and physiology of the voice production system (explicit instruction) via the Estill Voice Model (EVM) and the Rehabilitation Treatment Specification System (RTSS).

METHODS

EVM offers an integrated implicit-explicit instructional approach to voice training allowing for isolated practice of vocal structures (explicit) that interact to produce functional voice qualities (implicit), such as modal speech and louder projected voice qualities. In EVM, voice quality is correlated with the specific anatomy and physiologic adjustments via 13 Estill Figures and Options (eg, Larynx Figure has three options: High, Mid, and Low). RTSS provides a framework to connect client change in functioning (ie, target) with clinician action (ie, ingredients). Mechanisms of action connect the target to the ingredients by hypothesizing how the treatment is expected to work.

RESULTS

Evidence is provided for connecting auditory-perpetual voice prompts with the anatomy and physiology of voice and supporting an integrated implicit-explicit approach to voice therapy. The concept of linking commonly used implicit auditory-perceptual prompts used in voice therapy (eg, humming, loud "aahh") to explicit anatomy and physiology training (eg, 13 Estill Figures and Options) is demonstrated using EVM and the RTSS framework with case studies and video examples.

CONCLUSIONS

Clinicians may choose to use anatomy and physiology of voice to define and provide explicit instruction for typically used implicit auditory-perceptual prompts. Future research is warranted to test the concept applied to voice therapy models in the literature across prevention and treatment of voice disorders.

The Role of Instructions in Motor Learning of Oral Versus Nasalized Speech Targets

PURPOSE

The purpose of this study was to investigate how general, implicit instructions with auditory-perceptual emphasis; specific, explicit instructions with biomechanical focus; or both affect learning of oral-nasal balance control in speech.

METHOD

Thirty healthy, vocally untrained participants were assigned to one of three instructional groups (i.e., implicit, explicit, and integrated) and learned to produce oral versus nasalized vowel-, syllable-, and phrase-level targets during once-weekly sessions over 4 weeks. Learning gains and performance variability were analyzed using nasometry.

RESULTS

We observed a significant main effect of instruction type on learning gains at phrase level (p = .016). Specifically, the integrated group (M = 59.8%) significantly outperformed the explicit group (M = 37.9%) and numerically outperformed the implicit group (M = 45.1%). For nasalized phrase targets, results revealed a significant main effect of instruction type on performance variability (p = .042), but pairwise comparisons between instruction groups were not significant.

CONCLUSIONS

The integration of implicit processes via auditory-perceptual modeling and explicit processes via relevant biomechanical directives resulted in larger motor learning gains, especially at higher levels of task complexity (i.e., phrase) compared to providing implicit or explicit instruction alone. The higher performance variability (i.e., less stable productions) that was sometimes induced by explicit instruction did not negatively impact learning when integrated with implicit instruction. Clinical implications for speech/voice therapy models are discussed.

Development of a Psychometric Measure of the Propensity to Consciously Control and Monitor Speech Production

Purpose A speech-specific reinvestment scale (SSRS) is a psychometric measure of the propensity to consciously control and monitor speech production. This study develops and validates an SSRS as well as examines its relationship with speech performance with the moderating effects of trait social anxieties (i.e., social interaction anxiety, public speaking anxiety, and social phobia). Method Scale development involves the following stages: (a) initial item generation based on relevant literature, (b) item evaluation through cognitive interviews with 24 healthy respondents, (c) scale reliability and validity tests using cross-sectional survey data from 498 healthy respondents, and (d) test-retest reliability assessment using longitudinal survey data from 185 healthy respondents. Respondents' speech performance is quantified using speech examination scores. Hierarchical moderated regression analyses are conducted to examine the moderating effects of trait social anxieties. Results The validated SSRS comprises 35 items, which can be categorized into four subdimensions, namely, speech movement self-consciousness, public consciousness of speech content, speech manner, and speech movement. Results show that respondents with low trait social anxieties indicate a generally positive relationship between public consciousness of speech movement and speech performance, whereas respondents with high trait social anxieties exhibit a nonsignificant relationship. Conclusions SSRS offers a reliable and valid method for assessing the predisposition for conscious speech control and monitoring, which plays a role in speech performance and is moderated by an individual's level of trait social anxiety. SSRS is a potential assessment tool for speech-language pathologists to evaluate the impacts of conscious speech control and monitoring on individuals with speech impairment.

Effects of Knowledge of Task on Control of Oral-Nasal Balance in Speech

<b><i>Introduction:</i></b> Previous research has shown that altering the nasal signal level auditory feedback changed the control of oral-nasal balance in normal speakers. The present study investigated whether knowledge of the task and the instruction not to compensate would change the participants’ response to the manipulation. <b><i>Methods:</i></b> Twenty participants (10 females) in 2 groups continuously repeated a sentence while their nasal signal level was increased or decreased and fed back to them via headphones, so the speakers heard themselves as more or less nasal, respectively. After the first recording session, participants were debriefed about the true nature of the experiment. They were instructed not to compensate in the second recording session. The outcome measures were the percentage changes of nasalance scores from the first baseline. <b><i>Results:</i></b> Statistical analysis using a repeated measures analysis of variance showed an effect of the nasal signal level, <i>F</i>(5,80) = 2.51, <i>p</i> = 0.049, and a nasal signal level by knowledge of task interaction effect, <i>F</i>(5,80) = 3.25, <i>p</i> = 0.019. Post hoc tests showed that the maximum nasal signal level auditory feedback resulted in a significant decrease of nasality from the initial baseline. <b><i>Conclusion:</i></b> Despite knowledge of the task, speakers were unable to resist compensating. As found in previous research, there was a numerically higher compensation response at the maximum than at the minimum nasal signal level auditory feedback condition.

Effects of Error Experience on Learning to Lower Speech Nasalance Level

Purpose This research aims to examine the effects of error experience when learning to speak with lowered nasalance level. Method A total of 45 typical speakers were instructed to learn to lower speech nasalance level in either an errorless (restricted possibility for committing errors) or an errorful (unrestricted possibility for committing errors) learning condition. The nasality level of the participants' speech was measured by a nasometer and quantified by nasalance scores (in percent). Errorless learners practiced producing speech with lowered nasalance level with a threshold nasalance score of 50% (the easiest target) at the beginning, which gradually decreased to a threshold of 10% (the most difficult target) at the end. The same set of threshold targets was presented to errorful learners, but in reverse order. Errors were defined by the proportion of speech, with a nasalance score exceeding the threshold. Retention and transfer tests were administered. Results Errorless learners displayed fewer errors and lower mean nasalance scores than errorful learners during the acquisition phase. Furthermore, errorless learners achieved lower mean nasalance scores than errorful learners in the retention and transfer tests. Conclusion These results suggest that errorless learning is more effective than errorful learning and that error experience has a detrimental effect on the acquisition of a novel speech motor task that requires minimization of the nasality level. Errorless learning may be a useful paradigm for the intervention and management of hypernasality in clinical settings where behavioral treatments are needed.