Longitudinal Evaluation of Cepstral Peak Prominence in Children

OBJECTIVES

To evaluate whether the acoustic measure of cepstral peak prominence changes during typical development in children 2-7.

METHODS

Data were retrospectively analyzed from the Arizona Child Acoustic Database Repository in this longitudinal cohort study. The Repository contains longitudinal data recordings from 63 total children between 2 and 7 years of age. Thirty-one children met the inclusion criteria for the current analysis (at least five time points of usable speech data, no history of speech or language difficulties, no significant dysphonia, and were monolingual speakers of American English). Cepstral peak prominence measures were calculated in Praat for each child, at each timepoint. Additional acoustic measures of vocal fundamental frequency, vocal intensity, and stimuli length were also calculated. These measures were chosen as previous work has shown they may impact cepstral peak prominence values.

RESULTS

Linear mixed-effects regression models examined the relationship between cepstral peak prominence and age, after controlling for vocal fundamental frequency, vocal intensity, and stimuli length. Within-participant effects of age were found, indicating a trajectory change in which cepstral peak prominence increases with age in this population. This positive relationship between a cepstral peak prominence and age was nonlinear, with a steeper slope between age and cepstral peak prominence after 5 years of age.

CONCLUSIONS

This is the first study to examine the typical developmental trajectory of cepstral peak prominence children between 2 and 7 years, a critical period of vocal development. Cepstral peak prominence increased with age, suggesting an increase in periodicity of vocal fold vibration that coincides with the significant vocal fold structural changes occurring during this time. Outcomes present important normative information on vocal development, essential for effectively understanding the difference between what vocal changes are part of normative development and what changes indicate a voice disorder.

The Significant Influence of Hoarseness Levels in Connected Speech on the Voice-Related Disability Evaluated Using Voice Handicap Index-10

OBJECTIVES

This retrospective study examines the influence of voice quality in connected speech (CS) and sustained vowels (SV) on the voice-related disability in patients' daily living documented by Voice Handicap Index-10 (VHI-10).

METHODS

A total of 500 voice recordings of CS and SV samples from 338 patients with voice disturbances were included, along with the patients' age, diagnoses, maximum phonation time, and VHI-10. Dataset-1 comprised of 338 untreated patients, whereas Dataset-2 included 162 patients before and after phonosurgeries. As a preliminary study, the concurrent and diagnostic validities based on auditory-perceptual judgments were examined for cepstral peak prominence (CPP) and CPP smoothed (CPPS) for CS and SV tasks. Next, simple correlations and multivariate regression analyses (MRA) were performed to identify which of the acoustic measures for the CS or SV tasks significantly influenced the total score or improvement of VHI-10.

RESULTS

The preliminary study confirmed high correlations with hoarseness levels as well as the excellent diagnostic accuracy of CPP and CPPS for both CS and SV tasks. In Dataset-1, the simple correlations and MRA results showed that cepstral measures in both tasks demonstrated moderate correlations with, and significant contribution to the total score of VHI-10, respectively. However, in Dataset-2, the changes of cepstral measures, as well as the median pitch after phonosurgeries in the CS tasks only, showed significant contributions to the improvement of VHI-10.

CONCLUSION

The study demonstrated that the hoarseness levels in both the CS and SV tasks equivalently influenced the VHI-10 scores, and that the post-surgical change of voice quality only in the CS tasks influenced the improvement of voice-related disability in daily living.

Cepstral Measures in the Fado Voice: Gender, Age and Phonatory Tasks

Cepstral measures are sensitive to gender, age and phonatory tasks. With a cepstral measure designated as the CPP, it was possible to confirm the vulnerability of the Fado singers' voice. These were established at the vocal pathological threshold, which suggests a need for a direct clinical approach for these voice users.

OBJECTIVES/HYPOTHESIS

This study aimed to characterize cepstral peak prominence (CPP) and cepstral peak prominence smoothed (CPPS) in the Fado singing voice and to determine if there were significant differences in CPP and CPPS measures between spoken and sung tasks, as well as due to singers' gender and age.

METHODS

Forty seven males and 57 females Fado singers, ranging from 18 to 70 years participated in this study. Spoken voice tasks were sustained [a] and reading aloud the phonetically balanced text "O Sol". Sung tasks were sustained [a] of the word [ɐfinaɫ] and the Fado chorus song "Nem às paredes confesso". Acoustic measures included CPP and CPPS. CPP was measured using Analyses of Dysphonia in Speech and Voice software, of Multi-Speech program, Model 3700, by KayPENTAX. CPPS was measured using Praat software (4.2.1/2003). Statistical analysis was performed with an IBM SPSS Statistics version 22 program. CPP and CPPS mean differences of spoken and sung tasks were analyzed using paired samples t-test, with α at .05.

RESULTS

CPP and CPPS values of singers' voice changed according to the gender, age and phonatory tasks. There were significant differences between CPP and CPPS measures (P < 0.05). Generally, young male singers, in their sung task, presented the highest CPP and CPPS values. The highest CPP mean was obtained by older males in sustained spoken [a] and the lowest was obtained by younger males in their reading aloud task. For CPPS, the highest mean value was obtained by younger males during sung [a] and the lowest was by younger males in the reading aloud task.

CONCLUSION

Males presented higher cepstral measures than females. Young singers presented higher cepstral measures than older. Sung tasks had higher cepstral measures than spoken tasks. CPPS means are overall higher than CPP means. This study reinforces the need for a clinical prevention approach directed at potential vocal disorders in Fado singers.

Longitudinal Assessment of Singing Students

INTRODUCTION

Singers have unique vocal demands, and if the voice is impaired there can be a negative impact on their quality of life. While a variety of options exist to assess vocal health, the utilization of cepstral peak prominence (CPP) has increased due to his reliability in some situations. However, it has not been utilized commonly in the singing population. This study sought to assess vocal health in singing students using noninvasive measures such as singing voice handicap index (SVHI) and consensus auditory perceptual evaluation of voice (CAPE-V) as well as CPP to provide preliminary information on this measure.

METHODS

A prospective longitudinal study of singing students independent of year of training enrolled in a 2-credit voice lesson at an undergraduate School of Music was conducted. Non-invasive measures were used to evaluate the voice. All participants recorded the same spoken sentence at four equally spaced intervals throughout the semester using a ZOOM H4n Pro (two cardioid input microphone, Hauppauge, New Year). Participants completed SVHI at the time of each recording, and CAPE-V conducted by two speech language pathologists trained in voice. CPP was determined using running speech samples.

RESULTS

A total of 23 singers completed the study (11 male, 12 female). There was a significant difference in SVHI at the first recording compared to the final recording (10.6 ± 4.6 vs 9.3 ± 5.9, P= 0.008). Similarly, there was a significant difference in CPP at the first recording compared to the final recording (9 ± 3 vs 9.4 ± 1.1, P < 0.001). However, no significant difference was seen with CAPE-V.

CONCLUSION

Our results are similar to previous studies. There was no evidence in decline in objective and subjective vocal quality utilizing the measure included in our study.

Multiparametric analysis of voice following prolonged voice use and voice rest in teachers: evidence from discriminant analysis

PURPOSE

Even though recent investigations have used multiparametric protocol, the set of robust parameters in determining the effects of vocal fatigue and voice rest in teachers is not clear. The first objective of the study was to document the impact of prolonged voice use and voice rest on the subjective and objective voice parameters among Indian secondary school teachers. The second objective was to determine the set voice parameters sensitive to vocal changes resulting from continuous voice use and voice rest.

METHOD

The study included 15 male and 15 female secondary school teachers with a clinically normal voice and no history of voice disorders. Phonation samples were recorded in three different conditions, i.e., condition 1 (before voice use), condition 2 (following voice use), and condition 3 (following voice rest). The vocal Fatigue Index (version 2) was administered before the voice recordings in all three conditions. The objective parameters, namely fundamental frequency, range of fundamental frequency, jitter (%), shimmer (%), harmonic to noise ratio, and smoothened cepstral peak prominence, were extracted.

RESULTS

Results revealed that fundamental frequency, jitter, shimmer, Harmonic to noise ratio, and smoothened cepstral peak prominence were significantly different across the three conditions. The discriminant analysis revealed that only three parameters classified 98.3% of samples accurately between the three conditions.

CONCLUSION

Further research on the correlation between the other subjective and the objective parameters of voice after vocal fatigue would provide more penetrating and ample in-depth insights into the assessment and quantification of vocal fatigue.

Investigating the cepstral acoustic characteristics of voice in healthy children

OBJECTIVES

This study aimed to determine the cepstral acoustic parameters that vary depending on age and gender in vocally healthy children, and to establish normative data for cepstral analysis.

BACKGROUND

Cepstral measurements are among the strongest predictors of auditory-perceptual evaluation of voice and differentiate between healthy and dysphonic voices. More spesificially, ceptral peak prominence is accepted to be as a strong acoustic predictor of breathiness and overall severity of dysphonia. Cepstral measures determine voice quality reliably not only in sustained vowel samples but also in running speech samples. Determining the parameters related to the acoustic profile of children with normal voices can lead us to a better understanding of the effect of changes in the larynx and vocal fold structure during growth and development. There is a limited number of norm studies examining the cepstral acoustic properties of pediatric voice. Determining norm-specific values and clinical guidelines of cepstral acoustics according to the age and gender in vocally healthy children are utmost important.

METHODS

A total of 160 vocally healthy children were divided into the following four age groups: Group-I included children within the age range of 4-7 years, Group-II included 7-11 years, Group-III 11-14 years, and Group-IV included children within the age range of 14-18 years. An equal number of male and female participants were assigned to each group. PENTAX Medical CSL Model 4500 was used for recording all tasks. For acoustic analysis, Multi-Dimensional Voice Program and Analysis of Dysphonia in Speech and Voice were used.

RESULTS

Cepstral Peak Prominence (CPP), Cepstral Peak Prominence Standard Deviation (CPP SD), and Low-To-High Spectral Ratio (L/H Ratio) increased with age. It is found that the CPP parameter of all-voiced sentences and nasal-weighted sentences increased with age in boys, while no significant pattern was observed in any sample for girls. For L/H ratio, it can be said that there is a general increase with age in all speech samples, except for the vowel-weighted and voiceless plosive sentence samples, evident especially in the group above the age of 15 years. This study concluded that the CPP SD parameter in the vowel-weighted sentences increased with age in boys. It was also noticed in this study that CPP F0 standard deviation (SD) intervals were narrower in vowel-weighted, easy onset, and voiceless plosive sentence samples than in all-voiced, hard glottal attack and nasal-weighted sentence samples.

CONCLUSION

This study established cepstral acoustic normative values for a wide age range of the pediatric population. It is thought that age and gender specific cepstral acoustic findings presented in this study contributed to the related literature. In addition, to our knowledge, this is the first study that provides a normative cepstral acoustic database of the CAPE-V/Turkish sentences in the pediatric population.

Cultural Competency in Voice Evaluation: Considerations of Normative Standards for Sociolinguistically Diverse Voices

AIM

Significant differences exist in anatomical, acoustic, and aerodynamic parameters for nonspeech tasks between culturally and linguistically diverse sample populations. There is a need for expansion of the normative acoustic data to include sociolinguistically diverse groups to ensure that clinical objective measurements are accurately classifying the voice quality of all individuals. This study examined objective measures of voice quality assessment of monolingual speakers of Standard American English (SAE) with sequential bilingual, native (L1) French and Spanish speakers on perturbation, noise, spectral/cepstral analyses, and compared ratings on auditory-perceptual assessment with acoustic data secondary to degree of accentedness.

METHOD

Thirty speakers with normal voice quality were rated on the Consensus Auditory-Perceptual Evaluation of Voice scale. Voice quality measures were analyzed using the Multi-Dimensional Voice Program and Analysis of Dysphonia in Speech and Voice. A measure of accentedness of SAE was calculated using an informal task by two evaluators.

RESULTS

Objective acoustic measures of jitter and all-voiced cepstral peak prominence were statistically significant between SAE speakers and L1 Spanish and French speakers. SAE speakers demonstrated significantly higher group mean cepstral peak prominence for the all-voiced sentence ("We were away a year ago.") than native French and Spanish speakers. There were no significant differences in perception of voice quality and acoustic measures secondary to degree of accentedness of the non-native SAE speakers.

CONCLUSION

It is important to engage and strengthen voice diagnostic measures to support culturally competent service delivery for the diversifying clinical population. Normative databases established on SAE speakers should reflect the statistically significant differences evidenced between diverse sociolinguistic populations in anatomical, auditory-perceptual, aerodynamic, and acoustical parameters.

Performance of Different Acoustic Measures to Discriminate Individuals With and Without Voice Disorders

The goal of this study is to compare and combine different acoustic features in discriminating subjects with and without voice disorders. A database of 484 adult patients participated in the research. All subjects recorded a sustained vowel /Ɛ/ and underwent a laryngoscopic examination of the larynx. From the results of the laryngeal examination performed by a physician and the auditory-perceptual judgment performed by a Speech-Language Pathologist, the subjects were allocated to the group with (n = 52) and without (n = 432) voice disorder. Four types of acoustic features were used: traditional measures, cepstral measures, nonlinear measures, and recurrence quantification measures. Recordings comprised the emission of the vowel /ε/. Quadratic discriminant analysis was used as classifier. Individual features in the context of traditional, cepstral, and recurrence quantification measures achieved an acceptable performance of ≥70%. Combination of measures improved the classifier performance. The best classification result (86.43% accuracy) was obtained by combining traditional linear and recurrence quantification measures. Results shown that Traditional, Cepstral, and recurrence quantification measures are promising features that capture meaningful information about voice production, which provides good classification performances. The findings of this study can be used to develop a computational tool for voice disorders diagnosis and monitoring.

Fundamental Frequency and Intensity Effects on Cepstral Measures in Vowels from Connected Speech of Speakers with Voice Disorders

OBJECTIVE

Cepstral peak prominence (CPP) and smoothed CPP (CPPS) have been described as reliable parameters to detect overall dysphonia in standardized connected speech samples. Recent studies indicate that vocal intensity (sound pressure level, SPL) and fundamental frequency (f_o) changes may influence cepstral measurement results in healthy speakers. The main aim of the present work was to investigate the effects of prosody related SPL and f_o variations on cepstral measures in speech of adults with voice disorders.

STUDY DESIGN

Retrospective cross-sectional study.

METHODS

Recordings of CAPE-V sentences from 27 voice disordered Brazilian Portuguese speakers (19 women, eight men) with a mean age of 45 years (SD = 13) were investigated. Five /a/ vowels were manually extracted from stressed syllables in different positions. Voice f_o (Hz), SPL (dBA), CPP (dB), and CPPS (dB) were computed using PRAAT. Statistical analysis included Linear Mixed Models with ANCOVA and Bonferroni post hoc tests.

RESULTS

Voice SPL as single factor and combined with f_o had a highly significant effect (P ≤ 0.001), while f_o alone had no significant impact on both CPP and CPPS (P ≥ 0.77). Voice f_o, SPL, CPP, and CPPS of the first vowel were all significantly lower than of the last vowel (P ≤ 0.03).

CONCLUSION

In vowel samples from connected speech of adults with voice disorders, we observed better CPP and CPPS in higher voice SPL alone and combined with higher f_o. Further, the vowel position influenced the present results. A larger clinical study should confirm how prosody related SPL and f_o and vowel position effects could be controlled for in connected speech samples.

Use of cepstral analysis for differentiating dysphonic from normal voices in children

OBJECTIVES

Cepstral measures have mainly been evaluated by studies conducted on dysphonic and healthy adults, and many of these studies have reported the advantages of using cepstral measures for the evaluation of dysphonia however there is a paucity regarding to the cepstral analyses' results in dysphonic children. In this present study, it is hypothesized that cepstral peak prominence (CPP) and some other parameters of cepstral analysis would differ in children with vocal nodules when compared with the same parameters of cepstral analysis of healthy children.

METHODS

In this present study, totally 54 children aged between 5 years old to 12 years and 7 months participated. The study group consisted of 20 males and 7 females diagnosed with vocal nodules. The control group consisted of an equal number of age- and gender-matched healthy peers. Analysis of Dysphonia in Speech and Voice software (CSL Model 4500 equipment, Kay Elemetrics Group) was used to gather speech sample recordings according to the Consensus Auditory-Perceptual Evaluation of Voice/Turkish protocol. Cepstral measures of all the six CAPE-V sentences and sustained/a/sample were calculated. CPP, CPP fundamental frequency, CPP standard deviation (CPP SD), Low_high spectral ratio (L/H ratio), L/H ratio standard deviation parameters were taken into account when statistical analyses were completed. In addition to the descriptive statistics of ceptral measures for both groups, the differences between the study and control groups according to the gender were documented.

RESULTS

It was found that for both genders CPP and CPP SD values were significantly higher for the control group for vowel-weighted sample, all voiced-weighted sample, glottal attack-weighted sample, nasal weighted sample, and voiceless-weighted sample. In the vowel-weighted sample, CPP and CPP SD were significantly higher for the control group in males. In females, a difference was only observed on the CPP parameter for the same sentence. In terms of the CPP value of the sustained phonation sample, a significant difference was only detected for males, whereas no difference was detected for females.

CONCLUSIONS

In conclusion, present study found that cepstral analysis can be used to determine the difference between dysphonic and healthy voices of children and indicated that cepstral analysis should be a compulsory component of routine clinical voice evaluation of children. In addition, this present study indicates that of the cepstral analysis of sentences appear to be more sensitive to dysphonia than the analysis of vowel samples. In future studies, normative values of the CAPE-V/Turkish sentences and cutoff values for differentiating dysphonia from normal voice should be evaluated using a larger sample size.