Folia Phoniatrica et Logopaedica

<b><i>Objective:</i></b> To observe the possible differential effects of 8 different semi-occluded vocal tract exercises on glottal contact quotient (CQ) as a measure of vocal fold impact stress. <b><i>Patients and Methods:</i></b> Eighty participants were divided into two groups: an experimental group with hyperfunctional dysphonia and a control group of vocally healthy subjects. The participants were recorded before, during and after the exercises. Electroglottographic samples were analyzed to obtain CQ. <b><i>Results:</i></b> For the experimental group, all exercises, except lip trills and tongue trills, had an overall significant effect when conditions before, during and after the exercises were compared. The CQ presented differently across the 8 semi-occluded postures during exercise for both groups. For the experimental group, most exercises increased the CQ during practice. Only lip and tongue trills demonstrated lower CQ during exercise. <b><i>Conclusions:</i></b> Different semi-occluded exercises differentially affect vocal fold adduction. Lip and tongue trills produced the lowest CQ. Therefore, they may be recommended for decreasing glottal adduction. A straw submerged 10 cm below the water surface presented the greatest CQ. A shallower depth led to a lower CQ, while deeper submersion produced a higher CQ.

<i>Aims:</i> One of the objectives of our study on voice and vocal health was to find out whether there is a relation between the reactivity to stress and voice problems in teachers. <i>Materials and Methods:</i> For this, we used a sample of 447 individuals amongst future teachers and teachers in active service, since they form a group with both a high index of voice problems and stress. In order to gather the necessary information for the study, we applied the Voice Handicap Index and the ‘índice de reactividad al estrés’ (IRE; Stress Reactivity Index). <i>Results:</i> The results indicate that those individuals with voice problems have a greater reactivity to stress. It was observed that some items of the IRE show a relatively great difference between the groups with and without voice problems. The majority of these items concern vegetative signs that are linked to aspects of voice emission. <i>Conclusion:</i> Reactivity to stress is a useful factor to bear in mind in teachers with voice problems.

<i>Objective:</i> Constructing an internationally applicable short-scale of the Voice Handicap Index (VHI). <i>Methods:</i> Subjects were 1,052 patients with 5 different types of voice disorder groups from Belgium, France, Sweden, Germany, Italy, The Netherlands, Portugal, and the USA. Different 9- and 12-item subsets were selected from the 30 VHI items using (1) the first factor of an unrotated factor analysis (narrow range subsets) and (2) the first three factors after promax rotation (broad range subsets). Country-specific subsets were selected to test deviations from the international subsets. For all subsets, reliability was investigated using Cronbach’s alphas and correlations with the total VHI. Validity was investigated using regression on voice disorder groups. All analyses were performed for the total and for all country-specific subject samples. <i>Results:</i> Reliability was high for all item subsets. It was lower for the international compared to the country-specific subsets and for the broad range compared to the narrow range subsets. Validity was best for the broad range subsets. Validity was better for the international than for the country-specific subsets. For all statistics the 12-item subsets were not essentially better than the 9-item subsets. <i>Conclusion:</i> The international broad range 9-item subset forms a scale which approximates well the total VHI.

<i>Objective:</i> We aimed to assess the equivalence of translations of the Voice Handicap Index (VHI). <i>Patients and Methods:</i> Confirmatory factor analysis was used to assess equivalence of the US version and several translations including (1) Dutch, (2) Flemish Dutch (Belgium), (3) UK English, (4) French, (5) German, (6) Italian, (7) Portuguese and (8) Swedish. VHI questionnaires were gathered from 1,281 subjects. Patients were classified into 11 voice lesion categories. Patients with incomplete response (4%) and patients within voice lesion categories with small numbers were excluded from further analyses, leaving a cohort of 1,052 patients from 8 countries. <i>Results:</i> The internal consistency of the VHI proved to be good. Confirmatory factor analysis across countries revealed that a 3-factor fixed measurement model best fitted the data; the 3 subscales appeared to highly intercorrelated, especially in the US data. The underlying structure of the VHI was also equivalent regarding various voice lesions, but distinct groups were recognized with respect to the height of the VHI scores, indicating that various voice lesions lead to a diversity of voice problems in daily life. <i>Conclusion:</i> The US VHI and the translations appeared to be equivalent, which means that the results from studies from the various included countries can be compared.

In order to assess voice complaints and absence from work due to voice problems among teachers of primary and secondary education, as well as among a control group, 2,117 questionnaires were analysed. The total group consisted of 1,878 teachers and 239 controls. Female teachers more frequently reported voice complaints and absence from work due to voice problems than their male colleagues. No unequivocal relationship between age on the one hand and voice complaints and absence from work due to voice problems on the other hand was observed. Therefore, the percent of cases was corrected for gender but not for age. More than half of the teachers reported voice problems during their career and about one fifth had a history of absence from work due to voice problems. These numbers are relatively high compared to those of the controls with as well as to those without a vocally demanding profession. More than 20% of the teachers sought medical help or had been treated for a voice problem. Remarkably, more than 12% of the teachers had experienced voice problems during their training and this group reported significantly more voice complaints and absence from work due to voice problems in their career than the colleagues without voice problems during the training. The results of the Voice Handicap Index scores followed these trends. These findings point at voice problems during education as a risk factor for getting voice problems during the career. The results of this study clearly demonstrate that teaching is a high-risk profession for the development of voice problems, which is in accordance with other studies and support the contention that voice is a worldwide problem in the teaching profession. Furthermore, this study indicates the importance of voice care not only during training for the profession but also during the career.

<b><i>Objective:</i></b> Previous studies of English-speaking esophageal (SE) and tracheoesophageal (TE) speakers revealed a significantly lower voice fundamental frequency (F0) than normal laryngeal (NL) speakers. Studies of SE and TE speakers of a tone language, however, indicated discrepant findings. Tonal SE and TE speakers could produce comparable or even higher F0 than NL speakers. The present study examined the F0 characteristics associated with speech and nonspeech tasks produced by Cantonese SE and TE speakers. <b><i>Subjects and Methods:</i></b> Speech produced by 15 superior SE, 15 superior TE and 15 NL speakers was recorded while each was reading a short passage and performing a pitch scaling task. F0 values were calculated from the speech samples. <b><i>Results:</i></b> SE speakers had higher average F0 in reading tasks than TE and NL speakers, while the NL speakers exhibited the highest average F0 values followed by SE and TE speakers during pitch scaling. In addition, pitch scaling (nonspeech) tasks were associated with higher average F0 than passage reading tasks regardless of speaker type. <b><i>Conclusion:</i></b> The findings point to the fact that, despite the use of the new sound source, SE and TE speakers were still able to change F0 for specific speech tasks.

Fundamental frequency (F&#8320;), F&#8320; contours, vowel duration, and intensity associated with Cantonese alaryngeal speech, and their relation to the perception of meaning were studied. Thirty adult male native Cantonese speakers participated in the study: 10 esophageal, 10 electrolaryngeal, and 10 laryngeal speakers. Results indicated that perceptually, listeners were able to identify what the Cantonese esophageal speakers were saying, particularly for words associated with high-level, low-falling and high-rising tonal contours. Acoustic analysis of the speech signals of the esophageal speakers indicated that intensity and durational data did not contribute to the perception of meaning. The F&#8320; contours appeared to be the acoustic cues associated with the signal that contributed most to the perception of meaning.