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

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

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

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References

  1. Hunter EJ, Cantor-Cutiva LC, van Leer E, van Mersbergen M, Nanjundeswaran CD, Bottalico P et al (2020) Toward a consensus description of vocal effort, vocal load, vocal loading, and vocal fatigue. J Speech Lang Hear Res 63(2):509–532

    Article  PubMed  PubMed Central  Google Scholar 

  2. Nanjundeswaran C, Jacobson B, Verdolini Abbott K, Nanjundeswaran C, Jacobson BH, Gartner-Schmidt J et al (2015) Vocal fatigue index (VFI): development and validation. J Voice 29(4):433–440

    Article  PubMed  Google Scholar 

  3. Casper J, Leonard R (2006) Understanding voice problems: a physiological perspective for diagnosis and treatment. Lippincott Williams & Wilkins, Baltimore, MD

    Google Scholar 

  4. Gotaas C, Starr CD (1993) Vocal fatigue among Teachers. Folia Phoniatr Logop 45(3):120–129

    Article  CAS  Google Scholar 

  5. Kitch JA, Oates J (1994) The perceptual features of vocal fatigue as self-reported by a group of actors and singers. J Voice. Sep 1;8(3):207–14

  6. Welham N, Maclagan M (2003) Vocal fatigue: current knowledge and future directions. J Voice 17(1):21–30

    Article  PubMed  Google Scholar 

  7. Hillman R, Holmberg E, Perkell J, Walsh M, Vaughan C (1989) Objective assessment of vocal hyperfunction: an experimental framework and initial results. J Speech Lang Hear Res 32(2):373–392

    Article  CAS  Google Scholar 

  8. Kostyk BE, Rochet AP (1998) Laryngeal airway resistance in teachers with vocal fatigue: A preliminary study. J Voice. Jan 1;12(3):287–99

  9. McCabe D, Titze I (2002) Chant therapy for treating vocal fatigue among public school teachers: a preliminary study. Am J Speech-Language Pathol 11:356–369

    Article  Google Scholar 

  10. Solomon N (2008) Vocal fatigue and its relation to vocal hyperfunction. Int J Speech Lang Pathol 10(4):254–266

    Article  PubMed  Google Scholar 

  11. Anand S, Bottalico P, Gray C (2021) Vocal fatigue in prospective vocal professionals. J Voice 35(2):247–258

    Article  PubMed  Google Scholar 

  12. Awan SN, Roy N, Dromey C (2009 Nov) Estimating dysphonia severity in continuous speech: application of a multi-parameter spectralcepstral model estimating dysphonia severity in continuous speech. Clin Linguist Phonetics 23(11):825–841

  13. Bielamowicz S, Kreiman J, Gerratt BR, Dauer MS, Berke GS (1996) Comparison of voice analysis systems for perturbation measurement. J Speech Lang Hear Res 39(1):126–134

    Article  CAS  Google Scholar 

  14. Carding PN, Steen IN, Webb A, Mackenzie K, Deary IJ, Wilson JA (2004 Oct) The reliability and sensitivity to change of acoustic measures of voice quality. Clin Otolaryngol Allied Sci 29(5):538–544

  15. Kumar B, Bhat J, Prasad N (2010) Cepstral analysis of voice in persons with vocal nodules. J Voice 24(6):651–653

    Article  Google Scholar 

  16. Heman-Ackah Y, Michael D, Goding G Jr (2002) The relationship between cepstral peak prominence and selected parameters of dysphonia. Elsevier 16(1):20–27

    Google Scholar 

  17. Hillenbrand J, Cleveland RA, Erickson RL (1994) Acoustic correlates of breathy vocal quality. J Speech Hear Res 37(4):769–778

    Article  CAS  PubMed  Google Scholar 

  18. Awan S, Roy N (2005) Acoustic prediction of voice type in women with functional dysphonia. J Voice 19(2):268–282

    Article  PubMed  Google Scholar 

  19. Maryn Y, Roy N, De Bodt M, Van Cauwenberge P, Corthals P (2009 Nov) Acoustic measurement of overall voice quality: a meta-analysis. J Acoust Soc Am 126(5):2619–2634

  20. Hillenbrand J, Houde RA (1996) Acoustic correlates of breathy vocal quality: dysphonic voices and continuous speech. J Speech Lang Hear Res 39(2):311–321

    Article  CAS  Google Scholar 

  21. Hartl DM, Hans S, Vaissière J, Brasnu DF (2003) Objective acoustic and aerodynamic measures of breathiness in paralytic dysphonia. Eur Arch Oto-Rhino-Laryngology 260(4):175–182

    Article  Google Scholar 

  22. Hasanvand A, Salehi A, Ebrahimipour M (2017) A cepstral analysis of normal and pathologic voice qualities in iranian adults: a comparative study. J Voice 31(4):508e17–508e23

    Article  Google Scholar 

  23. Heman-Ackah YD, Heuer RJ, Rubin A, Sataloff RT, Laureyns G, Lurie D et al (2014) Quantifying the cepstral peak prominence, a measure of dysphonia. J Voice 28(6):783–788

    Article  PubMed  Google Scholar 

  24. Heman-Ackah Y (2004) Reliability of calculating the cepstral peak without linear regression analysis. J Voice 18(2):203–208

    Article  PubMed  Google Scholar 

  25. Heman-Ackah YD, Heuer RJ, Michael DD, Ostrowski R, Horman M, Baroody MM et al (2003) Cepstral peak prominence: A more reliable measure of dysphonia. Ann Otol Rhinol Laryngol. Apr 1;112(4):324–33

  26. Mahalingam S, Boominathan P, Arunachalam R (2021) Cepstral measures to analyze vocal fatigue in individuals with hyperfunctional voice disorder. J Voice 35(6):815–821

    Article  PubMed  Google Scholar 

  27. Narasimhan S, Soumya M (2020) Spectral and cepstral measures of vocal fatigue in indian Heavy Metal Vocalists. J Indian Speech Lang Hear Assoc 34(2):241–246

    Article  Google Scholar 

  28. Thomas S, Maruthy S (2022) Comparison of habitual and high pitch phonation in teachers with and without vocal fatigue. J Voice 36(1):141. e1-141.e9

    Article  Google Scholar 

  29. Oates J (2009) Auditory-perceptual evaluation of disordered voice quality. Folia Phoniatr Logop 61(1):49–56

    Article  PubMed  Google Scholar 

  30. Eadie T, Baylor C (2006) The effect of perceptual training on inexperienced listeners’ judgments of dysphonic voice. J Voice 20(4):527–544

    Article  PubMed  Google Scholar 

  31. Shrivastav R (2003) The use of an auditory model in predicting perceptual ratings of breathy voice quality. J Voice 17(4):502–512

    Article  PubMed  Google Scholar 

  32. Shrivastav R, Sapienza CM, Nandur V (2005 Apr) Application of psychometric theory to the measurement of voice quality using rating scales. J Speech Lang Hear Res 48(2):323–335

  33. Phadke KV, Laukkanen A-M, Ilomäki I, Kankare E, Geneid A, Švec JG (2020) Cepstral and perceptual investigations in female teachers with functionally healthy voice. J Voice 34(3):485e33–485e43

    Article  Google Scholar 

  34. Maryn Y, Weenink D (2015) Objective dysphonia measures in the program Praat: smoothed cepstral peak prominence and acoustic voice quality index. J Voice 29(1):35–43

    Article  PubMed  Google Scholar 

  35. Salary Majd N, Khoddami SM, Drinnan M, Kamali M, Amiri-Shavaki Y, Fallahian N (2014) Validity and rater reliability of Persian version of the Consensus Auditory Perceptual evaluation of Voice. Audiology 23(3):65–74

    Google Scholar 

  36. Yamasaki R, Madazio G, Leão S, Padovani M, Azevedo R, Behlau M (2017) Auditory-perceptual evaluation of normal and dysphonic voices using the voice deviation scale. J Voice 31(1):67–71

    Article  PubMed  Google Scholar 

  37. Leong K, Hawkshaw M, Dentchev D, Gupta R, Lurie D, Sataloff R (2013) Reliability of objective voice measures of normal speaking voices. J Voice 27(2):170–176

    Article  PubMed  Google Scholar 

  38. Brinca L, Batista A, Tavares A, Gonçalves I, Moreno M (2014) Use of cepstral analyses for differentiating normal from dysphonic voices: a comparative study of connected speech versus sustained vowel in european portuguese. J Voice 28(3):282–286

    Article  PubMed  Google Scholar 

  39. Lowell SY, Kelley RT, Awan SN, Colton RH, Chan NH (2012) Spectral- and cepstral-based acoustic features of dysphonic, strained voice quality. Ann Otol Rhinol Laryngol 121(8):539–548

    Article  PubMed  Google Scholar 

  40. Murton O, Hillman R, Mehta D (2020) Cepstral peak prominence values for clinical voice evaluation. Am J Speech-Language Pathol. Aug 1;29(3):1596–607

  41. Stemple J, Roy N, Klaben B (2014) Pathologies of the laryngeal mechanism. Clinical voice pathology: theory and management, 5th edn. Plural Publishing

  42. Antonetti A, Siqueira L, Gobbo M (2020) Relationship of cepstral peak prominence-smoothed and long-term average spectrum with auditory–perceptual analysis. Appl Sci. ;10(23)

  43. Núñez-Batalla F, Cartón-Corona N, Vasile G, García-Cabo P, Fernández-Vañes L, Llorente-Pendás J (2019) Validation of the measures of cepstral peak prominence as a measure of dysphonia severity in spanish-speaking subjects. Acta Otorrinolaringol (English Ed 70(4):222–228

    Article  Google Scholar 

  44. Karnell M, Melton S, Childes J, Coleman T, Dailey S, Hoffman H (2007) Reliability of clinician-based (GRBAS and CAPE-V) and patient-based (V-RQOL and IPVI) documentation of voice disorders. J Voice 21(5):576–590

    Article  PubMed  Google Scholar 

  45. Zraick R, Kempster G, Connor N, Thibeault S, Klaben B, Bursac Z et al (2011) Establishing validity of the Consensus Auditory perceptual evaluation of Voice (CAPE-V). Am J Speech-Language Pathol 20(1):14–22

    Article  Google Scholar 

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Acknowledgements

This study is a part of the Master’s Degree Thesis at the University of Social Welfare and Rehabilitation Sciences. The authors highly appreciate the Speech and Language Pathologists and students who participated in this research.

Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

    Rezvane Nayebian, Akbar Darouie & Arezoo Hasanvand

  2. Department of Biostatistics and Epidemiology, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

    Mohsen Vahedi

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  1. Rezvane Nayebian
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  2. Akbar Darouie
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  3. Arezoo Hasanvand
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  4. Mohsen Vahedi
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Contributions

The manuscript entitled “Cepstral and Perceptual Investigations of Voice in Speech and Language Pathologists with Vocal Fatigue” is written by RN, AD, AH, and MV. This manuscript is original and has not been published before; it is also not being considered for publication somewhere else. All authors have read and approved the manuscript, attest to the validity and legitimacy of the data and its interpretation, and agree to its submission to the Indian Journal of Otolaryngology and Head & Neck Surgery.

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Correspondence to Akbar Darouie.

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The authors declare that they have no conflict of interest.

Ethics Approval

Approval was obtained from the ethics committee of the University of Social Welfare and Rehabilitation Sciences (No. IR.USWR.REC.1401.186). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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Nayebian, R., Darouie, A., Hasanvand, A. et al. Cepstral and Perceptual Investigations of Voice in Speech and Language Pathologists with Vocal Fatigue. Indian J Otolaryngol Head Neck Surg 75, 3696–3702 (2023). https://doi.org/10.1007/s12070-023-04048-x

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