Acoustic characteristics of crying in infantile laryngomalacia

The neural correlates of paternal consoling behavior and frustration in response to infant crying

Human fathers often form strong attachments to their infants that contribute to positive developmental outcomes. However, fathers are also the most common perpetrators of infant abuse, and infant crying is a known trigger. Research on parental brain responses to infant crying have typically employed passive listening paradigms. However, parents usually engage with crying infants. Therefore, we examined the neural responses of 20 new fathers to infant cries both while passively listening, and while actively attempting to console the infant by selecting soothing strategies in a video game format. Compared with passive listening, active responding robustly activated brain regions involved in movement, empathy and approach motivation, and deactivated regions involved in stress and anxiety. Fathers reporting more frustration had less activation in basal forebrain areas and in brain areas involved with emotion regulation (e.g., prefrontal cortex and the supplementary motor area). Successful consolation of infant crying activated regions involved in both action-outcome learning and parental caregiving (anterior and posterior cingulate cortex). Overall, results suggest that active responding to infant cries amplifies activation in many brain areas typically activated during passive listening. Additionally, paternal frustration during active responding may involve a combination of low approach motivation and low engagement of emotion regulation.

Laryngeal Constriction Phenomena in Infant Vocalizations

Purpose Instances of laryngeal constriction have been noted as a feature of infant vocal development. The purpose of this study was to directly evaluate the developmental occurrence of laryngeal constriction phenomena in infant crying, cooing, and babbling vocalizations. Method The cry and noncry vocalizations of 20 healthy term-born infants between the ages of 1 and 7 months were examined for instances of laryngeal constriction. Approximately 20,000 vocalization samples were acoustically evaluated, applying a combined visual (frequency spectra and melody curves) and auditory analysis; the occurrence of instances of different constriction phenomena was analyzed. Results Laryngeal constrictions were found during the production of cry and noncry vocalizations. The developmental pattern of constrictions for both vocalizations was charac-terized by an increase in constrictions followed by a decrease. During the age period of 3-5 months, when cry and noncry vocalizations were co-occurring, laryngeal constrictions were observed in 14%-22% of both types of vocalizations. An equal percentage of constrictions was found for both vocalizations at 5 months of age. Conclusions The findings confirm that the production of laryngeal constriction is a regularly occurring phenomenon in healthy, normally developing infants' spontaneous crying, cooing, and marginal babbling. The occurrence of constriction in both cry and noncry vocalizations suggests that an infant is exploiting physiological constraints of the sound-generating system for articulatory development during vocal exploration. These results lend support to the notion that the laryngeal articulator is the principal articulator that infants 1st start to control as they test and practice their phonetic production skills from birth through the 1st several months of life.

Comparison of Supervised-Learning Models and Auditory Discrimination of Infant Cries for the Early Detection of Developmental Disorders / Vergleich von Supervised-Learning Klassifikationsmodellen und menschlicher auditiver Diskriminationsfähigkeit zur Unterscheidung von Säuglingsschreien mit kongenitalen Entwicklungsstörungen

Infant cry classification can be performed in two ways: computational classification of cries or auditory discrimination by human listeners. This article compares both approaches.

An auditory listening experiment was performed to examine if various listener groups (naive listeners, parents, nurses/midwives and therapists) were able to distinguish auditorily between healthy and pathological cries as well as to differentiate various pathologies from each other.

Listeners were trained in hearing cries of healthy infants and cries of infants suffering from cleft-lip-and-palate, hearing impairment, laryngomalacia, asphyxia and brain damage. After training, a listening experiment was performed by allocating 18 infant cries to the cry groups.

Multiple supervised-learning classifications models were calculated on the base of the cries’ acoustic properties. The accuracy of the models was compared to the accuracy of the human listeners.

With a Kappa value of 0.491, listeners allocated the cries to the healthy and the five pathological groups with moderate performance. With a sensitivity of 0.64 and a specificity of 0.89, listeners were able to identify that a cry is a pathological one with higher confidence than separating between the single pathologies. Generalized linear mixed models found no significant differences between the classification accuracy of the listener groups. Significant differences between the pathological cry types were found.

Supervised-learning classification models performed significantly better than the human listeners in classifying infant cries. The models reached an overall Kappa value of up to 0.837.

Use of Audiometric Measurement for Assessment of Vocal-Fold Function in Postextubation Infants

Importance

Infants with vocal-fold motion impairment (VFMI) have an increased risk of aspiration and pulmonary complications. Flexible nasolaryngoscopy (FNL) is the gold standard for evaluation of vocal-fold mobility. Although safe, FNL causes measurable physiologic changes. Noxious stimuli, especially in neonates in the cardiovascular intensive care unit, may cause imbalance between the pulmonary and systemic circulations and potentially circulatory collapse.

Objective

To examine whether bedside measurement of infant cry volume using a smartphone application can be a screening tool for vocal-fold movement in FNL.

Design, Study, and Participants

This case-control study performed from December 1, 2013, through January 31, 2015, included 42 infants in the intensive care unit at Texas Children's Hospital, Houston.

Main Outcomes and Measures

Patient cry volume in decibels was recorded using a smartphone application placed 12 in from their mouth.

Results

Forty-two infants were identified at the intensive care unit (median age, 33 days; 20 [48%] female and 22 [52%] male), 21 with VFMI and 21 without, based on FNL findings. A statistically significant difference was found in the mean cry volume of infants with (76.60 dB) and without (85.72 dB) VFMI. The absolute difference in the mean cry volume was 9.12 dB (95% CI, 2.74-15.50 dB). A cry volume of 90 dB or greater had a sensitivity of 90.4% (95% CI, 71%-97%) for identification of normal vocal-fold mobility. A cry volume of 75 dB or less had a specificity of 90.5% (95% CI, 71%-97%) for the identification of VFMI. The mean (SE) area under the receiver operating characteristic curve was 0.721 (0.080) (95% CI, 0.565-0.877). The cry volume, however, was not a good screen for aspiration.

Conclusions and Relevance

Bedside measurement of the cry volume with a smartphone application can be used by untrained health care professionals to screen patients for further evaluation of vocal-fold mobility using FNL.

A classification model for infant cries with hearing impairment and unilateral cleft lip and palate

OBJECTIVE

The aim of the study was to examine the acoustic features of infant cries in order to find differences between infants with normal development, hearing impairment (HI) and unilateral cleft lip and palate (UCLP). The study focused on two issues: (1) are differences in acoustic cry parameters specific of a certain pathological development, and (2) do these differences allow for a reliable classification of infant cries?

PATIENTS AND METHODS

In total, 128 spontaneous cries of infants up to 12 months of age were recorded. The mean values of acoustic cry parameters were statistically analyzed by one-way analysis of variance and Sheffé post hoc tests. A C5.0 decision tree was trained to classify infant cries by their acoustic parameters.

RESULTS

Significant differences in cry duration, fundamental frequency, formants 2 and 4, intensity, jitter, shimmer and harmonics-to-noise ratio were found between the groups. The C5.0 decision tree was able to predict an infant's membership to the healthy, UCLP or HI groups with a probability of 89.2%.

CONCLUSION

We conclude that C5.0 decision trees are suited to reliably classify healthy infants as well as infants with HI and UCLP by acoustic parameters.

Long-term average spectral characteristics of Cantonese alaryngeal speech

OBJECTIVE

In Hong Kong, esophageal (SE), tracheoesophageal (TE), electrolaryngeal (EL), and pneumatic artificial laryngeal (PA) speech are commonly used by laryngectomees as a means to regain verbal communication after total laryngectomy. While SE and TE speech has been studied to some extent, little is known regarding the EL and PA sound quality. The present study examined the sound quality associated with SE, TE, EL, and PA speech, and compared with that associated with laryngeal (NL) speech by using long-term average speech spectra (LTAS).

METHODS

Continuous speech samples of reading a 136-word passage were obtained from NL, SE, TE, EL, and PA speakers of Cantonese. The alaryngeal speakers were all superior speakers selected from the New Voice Club of Hong Kong, which is a self-help organization for the laryngectomees in Hong Kong. TE speakers were fitted with Provox valve, and EL speakers used Servox-type electrolarynx. Speech samples were digitized at 20kHz and 16bits/sample by using Praat, based on which LTAS contours were developed. First spectral peak (FSP), mean spectral energy (MSE), and spectral tilt (ST) derived from the LTAS contours associated with different speaker groups were compared.

RESULTS

Data revealed all speakers generally exhibited similar LTA contours. However, PA speakers exhibited the lowest average FSP value and the greatest average MSE value. NL phonation was associated with a significantly greater ST value than alaryngeal speech of Cantonese.

CONCLUSION

The differences in FSP, MSE, and ST values in different speaker groups may be related to the different sound sources being used by the laryngectomees, and the difference in the way the sound source is coupled with the vocal tract system.

The effect of positioning on infant cries: implications for sudden infant death syndrome

OBJECTIVE

A definitive cause for sudden infant death syndrome (SIDS) has not yet been identified, but some theories point to laryngeal or respiratory causes, in addition to theories of reduced arousal or reduced autonomic response. The occurrence of SIDS has dropped since the movement to place newborns to sleep in the supine position; however, some research has found a respiratory disadvantage for infants in this position. The current paper studied acoustic characteristics of infant pain cries to determine the potential differences related to prone versus supine positioning.

METHODS

Fifty-one newborn infant cries were recorded during and following a blood draw screening procedure, with infants placed either in the supine or prone position. All infants were healthy, full-term infants. Complete crying episodes were audio-recorded, and results were based on compositional analysis and long-time average spectrum analysis across each crying episode.

RESULTS

Spectral analysis revealed acoustic differences related to infant positioning, and acoustic analysis also revealed that there were no respiratory differences between supine-positioned and prone-positioned infants. Overall, the acoustic differences suggest decreased arousal and/or a decreased response to pain for healthy infants recorded in the prone position.

CONCLUSIONS

As decreased arousal and prone positioning have been seen as possible causative factors for SIDS, the current results are seen as a successful step in evaluating the possibility of using acoustic analysis of infant cries as a means of evaluating SIDS risk for healthy infants.