Ms. Noid's Vocal Roughness

Summary of Interpretation: Given the information provided in Interpretation A, the clinician diagnosed Kara-Lynn with a severe phonological disorder. This diagnosis was made based on evidence provided by testing results, clinician observations, and speech analyses. Kara-Lynn demonstrated phoneme collapses into /d/ in place of stops (/p/, /t/, /k/, /g/), fricatives (/s/, /z/, /θ/, /ð/), and some consonant clusters (/tr/, /gr/) across all word positions. For example, Kara-Lynn produced /diə/ for “seal,” /dædɚ/ for “treasure,” and /dədudɚ/ for “computer.” Kara-Lynn also presented with active phonological processes of final consonant deletion (/fɪ/ for “fish”), cluster reduction (/tul/ for “school”), vocalization (/ɛləkə/ for “helicopter”), and deaffrication (/ʃi/ for “cheese”). She also presented with inconsistent patterns of initial-consonant deletion (/ɑʊps/ for “house”, /ɪʒ/ for “bridge”). In most instances, Kara-Lynn presented with both final consonant deletion and another phonological process, which markedly impacted her speech intelligibility, as when she produced /lɑʊ/ for “clown,” demonstrating both final consonant deletion and cluster reduction. She also expressed a high percentage of CV (27%) and CVC (29%) syllable and word shapes, with little other variation. Analysis of Kara-Lynn’s speech sample revealed similar errors exhibited during formal assessment, including phoneme collapse into /d/, high occurrences of initial and final consonant deletion and cluster

The vocal note produced by the vibrations of the vocal folds is complex and made up of periodic (regular and repetitive) and aperiodic (irregular and non-repetitive) sound waves. The aperiodic waves are random noise introduced into the vocal signal owing to irregular or asymmetric adduction (closing) of the vocal folds. Noise impairs the clarity of the vocal note and too much noise is perceived as hoarseness.

c. Isolate and pronounce initial, medial vowel, and final sounds (phonemes) in spoken single‐syllable words.(1.RF.2.c)

This study includes the results from the three participants, Mathew, Mark and Luke. The figures will be represented by the X- axis, which will show the sessions, and the Y-axis, which will display the number of times the participant engaged in the vocal stereotypy during the sessions. All data from the IOA agreement was calculated for 25% of each participant and will be included within the recoding. The ESE teacher was the second observer and was trained in all aspects of the study to assist with procedural fidelity. Social validity was taken into consideration by the results rendered from the parent’s observation and recordings.

They was appropriate because, the frequency is 30 and the mean is 14.63, they are used to describe the data.

Additionally, the oro-motor assessment reports that Jane can accurately copy speech sounds in isolation and vary her volume and pitch accordingly. It also states that her

Meister, J., Hagen, R., Shehata-Dieler, W., Kuhn, H., Kraus, F., & Kleinsasser, N. (2017). Pitch elevation in male-to-female transgender persons—the Wurzburg approach. Journal of Voice, 31(2), 244.e1-244.e5. doi:10.1016/j.jvoice.2016.07.018

With healthy ageing, there could be several changes in an older adult’s vocal mechanism, in particular, the larynx. One of the main changes is the increase in the concentration of collagen fibres, causing vocal folds to become more rigid which in turn results in the instability of vocal fold vibrations (Hammond, Gray, & Butler, 2000). Another normal age-related voice change is the degeneration of vocal muscles which could have been a result of programmed cell death (apoptosis) (Malmgren, Jones, & Bookman, 2001; Martins et al., 2015). This is directly associated with presbyphonia which could contribute to a shortness of breath and troubles increasing one’s voice (Martins et al., 2015). Presbyphonia is the biological modification to one’s voice as a result of structural deterioration in the coverage mucosa, muscle and cartilage due to aging (Ford, 2004). The extent of the decline is associated with an individual’s physical and mental well-being, lifestyle, race and genes (Martins et al., 2015)

Unilateral vocal fold paralysis (UVFP) is the complete immobility of one vocal fold. According to Sapienza and Ruddy (2013), “90% of vocal fold paralysis that occurs is unilateral and caused by damage to the peripheral nervous system” (p. 189). Vocal fold paralysis is typically considered a symptom of a disease or neurologic disruption. In one study, it was found that vocal fold paralysis was caused by surgical trauma, tumors or neoplasms, unknown or idiopathic factors, trauma, central nervous system dysfunction, radiation, inflammatory, cardiovascular, and other causes (Chen, Jen, Wang, Lee, & Lin, 2007). Symptoms of unilateral vocal fold paralysis may include: aphonia, abnormal vocal quality (breathy, hoarse, and/or strained), and dysphagia. Onset of UVFP may be life altering as the individual has to find compensatory strategies for voicing or even alternative methods of communication. The individual is also left susceptible to aspiration due to the lack of airway protection. These factors make it critical to diagnose the impairment so as to provide the appropriate treatment.

Ibrahim, Kilpatrick, Reilly, and Vogel (2009) performed a comparative study of the acoustic measures of hypernasality in the speech of school-aged children aged 2-14 years, some with cleft lip/palate and others without cleft lip/palate. Ibrahim, Kilpatrick, Reilly, and Vogel (2009) provided perceptual ratings of the hyper/hyponasality of vowel production in the children’s speech. Any child who was sick or had acquired an upper respiratory infection was excluded from the study, as was any child with cleft lip/palate who also had any other disorders or comorbidities. The study included a perceptual assessment in which two speech therapists were required to agree upon the perception of the phonemes the child produced. Each child held and sustained two vowels, followed by production of two CVC words without nasal phonemes. This process was repeated five times with each child. The

In the first experiment, the effects of motor response interruption and redirection, and vocal response interruption and redirection on vocal stereotypy and appropriate vocalizations were compared for two of the participants. In the second experiment, the effects of both RIRD procedures on both vocal and motor stereotypy and appropriate vocalizations were compared. In conclusion, the researchers found response interruption and redirection to be effective regardless of the procedural variation or topography of the stereotypy and vocal response interruption and redirection as a

Participant 1 (P1) was a male of the age seven diagnosed with spastic quadriparesis due to Cerebral Palsy and secondary seizure disorder. His parent reported speech and voice concerns describing a breathy, quiet voice with weak breath support. His observed speech and voice signs were reduced loudness, monotone, intermittent hypernasality, intermittent

The aging process impacts the vocal mechanism as it does any other system of the body. In one of the few studies that reviewed vocal disorders in the geriatric population, the incidence of vocal disorders in people 65 years or older was between 12% and 35%. (Davids, Klein, Johns, 2012). Of that population, 25% had vocal fold atrophy as the cause of their disorder. (Davids, et al., 2012). A 2006 study conducted on 100 assisted-living residents found the incidence of age-related dysphonia to be around 20% (Golub, Chen, Otto, Hapner, Johns, 2006). It further found that the impact of this disorder had a percieved negative impact on quality of life in 13% of the test poplutation (Golub et al., 2006). An inability, or a limited ability to

Respiratory: Lung sounds are clear on auscultation without rales, rhonchi, or wheezes. Respiration unlabored with

The last option is surgical voice restoration which was introduced by Singer & Blom in 1980(Blom,1995) Not all patients are suitable for this however, It involves a tracheoesophageal speaking valve, a small fistula is surgically created through the tracheal wall into the oesophagus. A small, one way valve is inserted into the fistula and it allows air to be shunted from the trachea to the oesophagus and up through the pharyngo-oesophageal segment creating an acoustic wave form and voice. A longer flow of voice can be achieved as pulmonary air is used as the initiator for voice.