Effect of Two Isolated Vocal-facilitating Techniques Chant Talk and Pitch Inflections on the Phonation of Female Speech-language Pathology Students: A Pilot Study
Introduction
Chant Talk and Pitch Inflections are listed by Boone and McFarlane1 as techniques that may facilitate a more optimal vocal response in patients with dysphonia. Chant Talk is produced by reciting syllables in one continuous tone, creating a “singing monotone” (cfr. legato in singing). It is characterized by an elevation of pitch, prolongation of vowels, lack of syllable stress, and an obvious softening of glottal attack. The Pitch Inflections technique is used to stimulate pitch variability during phonation.2 Both facilitating techniques were described by Boone et al2 as being particularly beneficial for patients with hyperfunctional dysphonia. Nevertheless, a broader application can be found in the literature, more specifically in treating organic dysphonia and training professional voices.3, 4, 5, 6, 7, 8, 9, 10, 11
The existing literature is limited to defining the techniques and describing their potential benefit. Studies that investigate the underlying mechanisms and the exact reason for a possible effect are missing. Boone et al2 and Bovo et al5 mentioned obtaining relaxed voicing and elimination of hard glottal attacks, although these findings were based on clinical experience rather than evidence-based practice. Moreover, the techniques have been used for more than 20 years2 and yet effectiveness studies are rare. A summary of these studies can be found in Table 1. A first observation of the table indicates that almost all studies had a positive outcome. A less favorable result was found by De Bodt et al,12 who used fiberoptic laryngovideoendoscopy to assess the impact of vocal techniques on vocal-fold closure in young females with normal vocal quality. Remarkably, Chant Talk resulted in significantly decreased vocal-fold closure. However, an unexpected laryngeal tension or breath holding during phonation due to the use of a flexible videoendoscopic system could possibly have influenced the results.12 A second observation of the table indicates that Chant Talk and/or Pitch Inflections have nearly always been investigated as part of a broader therapy program,4, 5, 6, 7, 8, 9, 10, 11 wherefore the results cannot be attributed solely to the techniques. One exception is a study of McCabe and Titze,3 which examined the exclusive effect of Chant Talk on self-perceptive symptoms of vocal fatigue in four public school teachers. Group data on one particular vocal technique are difficult to gather because voice therapy is individualized and usually includes several techniques.2 Nevertheless, the need for effectiveness studies that exclusively investigate the facilitating techniques Chant Talk and Pitch Inflections becomes clear.
This pilot study aimed to make a first contribution to the research gap and focused on Chant Talk and Pitch Inflections as techniques that could facilitate and train the healthy voice. Previous studies investigating healthy subjects show conflicting results. Bovo et al5 and Oliveira et al11 both investigated the effect of a training program including Chant Talk and Pitchinflections in healthy professional voice users. Bovo et al5 found a positive effect, whereas Oliveira et al11 found no effect. These conflicting results are probably due to various reasons such as variations in assessment methods and training frequency, although the main reason probably remains a difference in therapy content: the techniques were never investigated in isolation and were always presented in different combinations.
The purpose of this study was to determine the effect of the isolated vocal-facilitating techniques Chant Talk and Pitch Inflections on the phonation of healthy female speech-language pathology (SLP) students. A positive effect on the SLP students' vocal capacities was hypothesized because Chant Talk and Pitch Inflections may facilitate relaxed voicing with elimination of hard glottal attacks,2, 5 and most studies that investigated the techniques as part of a broader therapy program were promising.4, 5, 6, 7, 8, 9, 10, 11
Section snippets
Material and Methods
This study was approved by the Human Subjects Committee of Ghent University Hospital.
Voice questionnaire
At the beginning of the study, each subject filled in a questionnaire based on the voice assessment protocol of the European Study Group on Voice Disorders12 to describe vocal complaints and risk factors.
Objective vocal measures
The three groups completed pre- and postobjective voice assessment measures. Data were collected by two SLPs (S.D. and L.T.) in a sound-treated room at Ghent University Hospital.
Voice questionnaire
The results of the questionnaire concerning vocal complaints and vocal risk factors are presented in Table 3. No significant differences were found between the three groups at precondition (chi-square test, P > 0.05).
Comparison of the precondition objective vocal measures
The results of the precondition voice assessment are presented in Table 4. No significant differences in precondition vocal measures were found between the three groups (One-way ANOVA, p > 0.05).
Comparison of the differences in pre- and postobjective vocal measures
Comparison of the differences in pre- and postobjective vocal measures between the
Discussion
The purpose of this study was to determine the effect of the isolated vocal-facilitating techniques Chant Talk and Pitch Inflections on the phonation of healthy females enrolled in an SLP program. A positive effect on the SLP students' vocal capacities was hypothesized because Chant Talk and Pitch Inflections may facilitate relaxed voicing with elimination of hard glottal attacks,2, 5 and most studies that investigated the techniques as part of a broader therapy program were promising.4, 5, 6, 7
Conclusions
The results of this pilot study suggest that the facilitating techniques Chant Talk and Pitch Inflections may improve the objective measure of breathiness (NHR) in healthy female SLP students. An investigation of the underlying mechanisms together with their potential effect in subjects with vocal pathology is recommended in future.
References (41)
- et al.
Vocal problems among teachers: evaluation of a preventive voice program
J Voice
(2007) - et al.
Outcome of laryngeal manual therapy in four Dutch adults with persistent moderate-to-severe vocal hyperfunction: a pilot study
J Voice
(2004) - et al.
Acoustic analysis findings in objective laryngopharyngeal reflux patients
J Voice
(2007) - et al.
Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge
J Voice
(2011) - et al.
Muscle tension dysphonia in Vietnamese female teachers
J Voice
(2009) - et al.
Comparison of neck tension palpation rating systems with surface electromyographic and acoustic measures in vocal hyperfunction
J Voice
(2011) - et al.
The frequency of hard glottal attacks in patients with muscle tension dysphonia, unilateral benign masses and bilateral benign masses
J Voice
(2000) - et al.
Current and emerging concepts in muscle tension dysphonia: a 30-month review
J Voice
(2005) - et al.
Toward improved ecological validity in the acoustic measurement of overall voice quality: combining continuous speech and sustained vowels
J Voice
(2010) - et al.
The Voice and Voice Therapy
(1994)
The Voice and Voice Therapy
Chant therapy for treating vocal fatigue among public school teachers: a preliminary study
Am J Speech Lang Pathol
Telehealth: voice therapy using telecommunications technology
Am J Speech Lang Pathol
Combination of voice therapy and antireflux therapy rapidly recovers voice-related symptoms in laryngopharyngeal reflux patients
Otolaryng Head Neck
Effectiveness of voice therapy in reflux-related voice disorders
Dis Esophagus
The effect of a “voice course” on the voices of people with and without pathologies: preliminary observations
Logop Phoniatr Voco
The impact of phonation mode and vocal technique on vocal fold closure in young females with normal voice quality
J Voice
Vocal symptoms in telemarketers: a random and controlled field trial
Folia Phoniatr Logop
Research work of the Belgian Study Group on voice disorders
Acta Otorhinolaryngol Belg
Evaluation of the vocal performance of children using a voice range profile index
J Speech Lang Hear Res
Cited by (8)
Voice Quality of Choir Singers and the Effect of a Performance on the Voice
2022, Journal of VoiceVocal Training in Healthy Individuals: A Scoping Review
2022, Journal of VoiceCitation Excerpt :It is possible to quantify and characterize noninvasive sound signal49 from different analysis models, such as linear models, based on the source-filter model, and nonlinear models, based on voice production as a chaotic system, as in dysphonic vocal signals.48 The results presented in the analyzed studies pointed mainly to the decrease in the harmonic–noise ratio and improvement of jitter,40,50,51 which represent as the main results in evaluating the effects of interventions on healthy voice. Jitter and harmonic–noise ratio are traditional measures (linear models) and are related, respectively, to the measurement of the disturbance of the frequency variability of glottic cycles in the short term and the presence of the additive noise in vocal emission.45
A Study of Vocal Facilitating Techniques Compared to Manual Circumlaryngeal Therapy in Teachers With Muscle Tension Dysphonia
2020, Journal of VoiceCitation Excerpt :The voice facilitating techniques (VFTs) proposed by Boone (1971) are based on the principles of behavioral therapy aimed to improve voice characteristics through manipulation of articulatory, respiratory, phonatory, and resonatory systems.27–29 Although these techniques have been used effectively in the treatment of voice disorders and also were able to improve vocal measures in healthy population,30–33 little evidence is available regarding their effectiveness in teachers31 and patients with MTD.24,34 It is supposed that laryngeal muscle tension imbalance is one possible cause of voice disturbances.35,36
Measuring the Dysphonia Severity Index (DSI) in the Program Praat
2017, Journal of VoiceCitation Excerpt :The DSI is a well-established, objective, and multivariable method to measure dysphonia severity. The vocological research group of the University of Ghent, eg, has used it extensively to evaluate the outcomes of various treatment techniques and methods.18–22 However, having to use its original materials and methods to rule out intersystem variability,2 it cannot be applied by all voice clinicians due to organizational (ie, financial or otherwise) constraints.
Effect of two isolated vocal facilitating techniques glottal fry and yawn-sigh on the phonation of female speech-language pathology students: A pilot study
2017, Journal of Communication DisordersCitation Excerpt :Above findings clearly highlights the potential and the need to optimize SLP students’ voice. A similar trend of using identical techniques for both rehabilitation and training can be seen in multiple studies (D’haeseleer, Claeys, & Van Lierde, 2013; Meerschman et al., 2016a, 2016b; Santos, Borrego, & Behlau, 2015; Timmermans, De Bodt, Wuyts, & Van de Heyning, 2004; Timmermans et al., 2011; Van Lierde et al., 2011). This is no surprise keeping in mind the common goal of both interventions, namely improving vocal capacities (De Bodt et al., 2008).
The comparison between vocal facilitating techniques, manual circumlaryngeal therapy, and combined voice therapy in teachers with muscle tension dysphonia: a randomized clinical trial
2023, European Archives of Oto-Rhino-Laryngology