Citations

Computer-based analysis systems are increasingly available for the clinical assessment of speech and voice functions. These systems have the potential to provide immediate quantitative information to assist clinical assessment and treatment. The Multi-Dimensional Voice Program (MDVP) is a computer program that can calculate as many as 33 acoustic parameters from a voice sample. The MDVP appears to have potential for rapid quantitative assessments of voice in both research and clinical applications. This report evaluates the robustness and reliability of MDVP for vocal analyses of 32 individuals with dysarthria of various etiologies. It is concluded that the reliability is generally very good and that MDVP has potential as a tool for the semi-automatic analysis of voice samples in dysarthria. Some parameters appear to hold particular value in the description of voice qualities in these speech disorders.

The purpose of this investigation was to determine the relationships among frontal lisping, protrusive lingual force, and lingual diadochokinetic rates when subjects are grouped according to severity of lisping. Results revealed that when compared to normal speaking counterparts: (1) lispers in each severity subgroup exhibited significantly weaker protrusive lingual forces and that the significance of such differences increased with the severity of lisping; and (2) all but the moderately severe lispers displayed significantly slower lingual diadochokinetic rates. These findings suggest that clustering lispers into homogeneous severity subgroups before examining the relationships between their misarticulations and the lingual factors studied may offer important information regarding the diagnosis, treatment, and prognosis of their articulatory problems.

The exact nature of ipsilateral auditory pathway suppression under dichotic stimulation remains controversial. To help resolve this controversy, the distinctive feature confusions (blend vs nonblend errors) made on a dichotic listening CV test by two hemispherectomees were analyzed. Results support ipsilateral auditory pathway suppression under dichotic CV stimulation. Ipsilateral auditory pathway suppression is discussed in terms of stimulus specificity, subject, and task difference.

Adductor spastic dysphonia may not be one disorder but a voice sign of several different neurologic and psychiatric syndromes. This study evaluates whether rhythmic voice arrests, often components of "spastic dysphonia," are signs of essential tremor, a neurologic disorder. Data on 22 patients originally diagnosed as having spastic dysphonia, who had tremor-like or rhythmic voice arrests, were compared with data on two groups of patients who had essential (voice) tremor. The frequency of voice arrests on vowel prolongation in the group labeled spastic dysphonia was compared with the frequency of voice tremor in the groups with essential tremor. The median frequencies of 5.7, 5.0, and 5.5 Hz were not significantly different among the three groups. Patients in all three groups had tremor in other parts of the body, other scattered neurologic signs, and histories of life stress associated with the onset of their voice disorders. Although the results do not prove conclusively that the patients diagnosed as having spastic dysphonia in this study actually had essential tremor, the similarities to that disorder strongly suggest a linkage.

Case history and voice data for 17 patients who presented with intermittent moments of breathy dysphonia (IBD) in contextual speech were analyzed. From recorded samples of vowel prolongation four variants of phonation were identified. Of 13 patients examined neurologically, 10 (77%) had positive neurologic signs. Psychiatric and physical illnesses were often associated with onset of the voice disorder. Sex ratio of the patients in this study was nearly the same as that for adductor spastic dysphonia. Age at onset was similar to that which has been described for "functional" voice disorders. Different therapies were generally ineffective in alleviating the disorder. Although not conclusive, patients presenting with IBD in connected speech may have an underlying neurologic or psychologic disorders.

Twelve patients (6 men and 6 women), ages 21–79 years, who, as far as it could be determined from their case histories, began to stutter for the first time in adulthood were classified by examining physicians and speech-language pathologists as having psychogenic stuttering. The case histories of these patients were examined to determine the details of their speech and allied complaints, the course and duration of stuttering, and if any psychologically stressful events surrounded the onset and development of the disorder. Minnesota Multiphasic Personality Inventory (MMPI) data on 10 of the 12 patients were analyzed independently. The main findings were (a) stuttering was the chief complaint of 11 patients; (b) all 12 patients had additional neurologic-like complaints that turned out to be nonorganic; (c) duration of stuttering from onset to examination ranged from 4 hr to 1.5 years; (d) the stuttering of most patients was variable in severity and returned to normal either spontaneously or as a result of speech therapy or psychotherapy; (e) psychologic stress was associated with the onset in 10 patients: the stress was chronic in 4 patients and acute in 6; (t) MMPI profiles of 9 of 1O patients were abnormal, with four profiles reflective of a conversion reaction; (g) differentiating neurologic from psychogenic stuttering and the need for interdisciplinary collaboration were essential in all 12 cases; and (h) speech therapy and psychotherapy are justified when psychogenic stuttering is diagnosed.