Objective Dysphonia Measures in the Program Praat: Smoothed Cepstral Peak Prominence and Acoustic Voice Quality Index

  • Youri Maryn
    Address correspondence and reprint requests to Youri Maryn, Sint-Jan General Hospital, Speech-Language Pathology and Audiology, Ruddershove 10, 8000 Bruges, Belgium.
    Department of Otorhinolaryngology and Head & Neck Surgery, Speech-Language Pathology, Sint-Jan General Hospital, Bruges, Belgium

    Department of Speech-Language Therapy and Audiology, Faculty of Education, Health and Social Work, University College Ghent, Ghent, Belgium

    Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
    Search for articles by this author
  • David Weenink
    Institute of Phonetic Sciences, Faculty of Humanities, University of Amsterdam, Amsterdam, The Netherlands
    Search for articles by this author
Published:December 09, 2014DOI:https://doi.org/10.1016/j.jvoice.2014.06.015



      A version of the “smoothed cepstral peak prominence” (ie, CPPS) has recently been implemented in the program Praat. The present study therefore estimated the correspondence between the original CPPS from the program SpeechTool and Praat's version of the CPPS. Because the CPPS is the main factor in the multivariate Acoustic Voice Quality Index (AVQI), this study also investigated the proportional relationship between the AVQI with the original and the second version of the CPPS.

      Study Design

      Comparative cohort study.


      Clinical recordings of sustained vowel phonation and continuous speech from 289 subjects with various voice disorders were analyzed with the two versions of the CPPS and the AVQI. Pearson correlation coefficients and coefficients of determination were calculated between both CPPS-methods and between both AVQI-methods.


      Quasi-perfect correlations and coefficients of determination approaching hundred percent were found.


      The findings of this study demonstrate that the outcomes of the two CPPS-methods and the two AVQI-methods are highly comparable, increasing the clinical feasibility of both methods as measures of dysphonia severity.

      Key Words

      To read this article in full you will need to make a payment


      Subscribe to Journal of Voice
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Buder E.H.
        Acoustic analysis of voice quality: a tabulation of algorithms 1902–1990.
        in: Kent R.D. Ball M.J. Voice Quality Measurement. Singular Publishing Group, San Diego, CA2000: 119-244
        • Parsa V.
        • Jamieson D.G.
        Acoustic discrimination of pathological voice: sustained vowels versus continuous speech.
        J Speech Lang Hear Res. 2001; 44: 327-339
        • Portney L.G.
        • Watkins M.P.
        Foundations of Clinical Research: Applications to Practice.
        3rd ed. Prentice-Hall, Upper Saddle River, NJ2000
        • Maryn Y.
        • Corthals P.
        • Van Cauwenberge P.
        • Roy N.
        • De Bodt M.
        Toward improved ecological validity in the acoustic measurement of overall voice quality: combining continuous speech and sustained vowels.
        J Voice. 2010; 24: 540-555
        • Askenfelt A.G.
        • Hammarberg B.
        Speech waveform perturbation analysis: a perceptual-acoustical comparison of seven measures.
        J Speech Hear Res. 1986; 29: 50-64
        • Zraick R.I.
        • Wendel K.
        • Smith-Olinde L.
        The effect of speaking task on perceptual judgment of the severity of dysphonic voice.
        J Voice. 2005; 19: 574-581
        • de Krom G.
        Consistency and reliability of voice quality ratings for different types of speech fragments.
        J Speech Hear Res. 1994; 37: 985-1000
        • Revis J.
        • Giovanni A.
        • Wuyts F.
        • Triglia J.
        Comparison of different voice samples for perceptual analysis.
        Folia Phoniatr Logop. 1999; 51: 108-116
        • Wolfe V.
        • Cornell R.
        • Fitch J.
        Sentence/vowel correlation in the evaluation of dysphonia.
        J Voice. 1995; 9: 297-303
        • De Bodt M.
        A framework for voice assessment: the relation between subjective and objective parameters in the judgement of normal and pathological voice.
        ([doctoral thesis]) University of Antwerp, Faculty of Medicine, Antwerp, Belgium1997
        • Maryn Y.
        • Roy N.
        Sustained vowels and running speech in the auditory-perceptual evaluation of dysphonia severity.
        J Soc Bras Fonoaudiol. 2012; 24: 107-112
        • Kreiman J.
        • Vanlancker-Sidtis D.
        • Gerratt B.R.
        Perception of voice quality.
        in: Pisoni D.B. Remez R.E. The Handbook of Speech Perception. Blackwell Publishing, Malden, MA2005: 338-362
        • Kreiman J.
        • Gerratt B.R.
        Validity of rating scale measures of voice quality.
        J Acoust Soc Am. 1998; 104: 1598-1608
        • Maryn Y.
        • Roy N.
        • De Bodt M.
        • Van Cauwenberge P.
        • Corthals P.
        Acoustic measurement of overall voice quality: a meta-analysis.
        J Acoust Soc Am. 2009; 126: 2619-2634
        • Eskenazi L.
        • Childers D.G.
        • Hicks D.M.
        Acoustic correlates of vocal quality.
        J Speech Hear Res. 1990; 33: 298-306
        • Giovanni A.
        • Robert D.
        • Estublier N.
        • Teston B.
        • Zanaret M.
        • Cannoni M.
        Objective evaluation of dysphonia: preliminary results of a device allowing simultaneous acoustic and aerodynamic measurements.
        Folia Phoniatr Logop. 1996; 48: 175-185
        • Wolfe V.
        • Fitch J.
        • Martin D.
        Acoustic measures of dysphonic severity across and within voice types.
        Folia Phoniatr Logop. 1997; 49: 292-299
        • Piccirillo J.F.
        • Painter C.
        • Fuller D.
        • Haiduk A.
        • Fredrickson J.M.
        Assessment of two objective voice function indices.
        Ann Otol Rhinol Laryngol. 1998; 107: 396-400
        • Wuyts F.L.
        • De Bodt M.S.
        • Molenberghs G.
        • et al.
        The dysphonia severity index: an objective measure of vocal quality based on a multiparameter approach.
        J Speech Lang Hear Res. 2000; 43: 796-809
        • Yu P.
        • Ouaknine M.
        • Revis J.
        • Giovanni A.
        Objective voice analysis for dysphonic patients: a multiparametric protocol including acoustic and aerodynamic measurements.
        J Voice. 2001; 15: 529-542
        • Bhuta T.
        • Patrick L.
        • Garnett J.D.
        Perceptual evaluation of voice quality and its correlation with acoustic measurement.
        J Voice. 2004; 18: 299-304
        • Awan S.N.
        • Roy N.
        Toward the development of an objective index of dysphonia severity: a four-factor acoustic model.
        Clin Linguist Phon. 2006; 20: 35-49
        • Ma E.
        • Yiu E.
        Multiparametric evaluation of dysphonic severity.
        J Voice. 2006; 20: 380-390
        • Maryn Y.
        • Dick C.
        • Vandenbruaene C.
        • Vauterin T.
        • Jacobs T.
        Spectral, cepstral, and multivariate exploration of tracheoesophageal voice quality in continuous speech and sustained vowels.
        Laryngoscope. 2009; 119: 2384-2394
        • Awan S.N.
        • Solomon N.P.
        • Helou L.B.
        • Stojadinovic A.
        Spectral-cepstral estimation of dysphonia severity: external validation.
        Ann Otol Rhinol Laryngol. 2013; 122: 40-48
        • Lowell S.Y.
        • Colton R.H.
        • Kelley R.T.
        • Mizia S.A.
        Predictive value and discriminant capacity of cepstral- and spectral-based measures during continuous speech.
        J Voice. 2013; 27: 393-400
        • Hillenbrand J.
        • Cleveland R.A.
        • Erickson R.
        Acoustic correlates of breathy vocal quality.
        J Speech Hear Res. 1994; 37: 769-778
        • Hillenbrand J.
        • Houde R.A.
        Acoustic correlates of breathy vocal quality: dysphonic voices and continuous speech.
        J Speech Hear Res. 1996; 39: 311-321
        • Wolfe V.
        • Martin D.
        Acoustic correlates of dysphonia: type and severity.
        J Commun Disord. 1997; 30: 403-415
        • Heman-Ackah Y.D.
        • Michael D.D.
        • Goding G.S.
        The relationship between cepstral peak prominence and selected parameters of dysphonia.
        J Voice. 2002; 16: 20-27
        • Heman-Ackah Y.D.
        • Heuer R.J.
        • Michael D.D.
        • et al.
        Cepstral peak prominence: a more reliable measure of dysphonia.
        Ann Otol Rhinol Laryngol. 2003; 112: 324-333
        • Halberstam B.
        Acoustic and perceptual parameters relating to connected speech are more reliable measures of hoarseness than parameters relating to sustained vowels.
        ORL J Otorhinolaryngol Relat Spec. 2004; 66: 70-73
        • Eadie T.L.
        • Baylor C.R.
        The effect of perceptual training on inexperienced listeners' judgments of dysphonic voice.
        J Voice. 2006; 20: 527-544
        • Maryn Y.
        • De Bodt M.
        • Roy N.
        The acoustic voice quality index: toward improved treatment outcomes assessment in voice disorders.
        J Commun Disord. 2010; 43: 161-174
        • Lowell S.Y.
        • Colton R.H.
        • Kelley R.T.
        • Hahn Y.C.
        Spectral- and cepstral-based measures during continuous speech: capacity to distinguish dysphonia and consistency within a speaker.
        J Voice. 2011; 25: e223-e232
        • Moers C.
        • Möbius B.
        • Rosanowski F.
        • Nöth E.
        • Eysholdt U.
        • Haderlein T.
        Vowel- and text-based cepstral analysis of chronic hoarseness.
        J Voice. 2012; 26: 416-424
        • Samlan R.A.
        • Story B.H.
        • Bunton K.
        Relation of perceived breathiness to laryngeal kinematics and acoustic measures based on computational modeling.
        J Speech Lang Hear Res. 2013; 56: 1209-1223
        • Reynolds V.
        • Buckland A.
        • Bailey J.
        • et al.
        Objective assessment of pediatric voice disorders with the acoustic voice quality index.
        J Voice. 2012; 26: 672.e1-672.e7
        • Barsties B.
        • Maryn Y.
        HNO. 2012; 60: 715-720
        • Maryn Y.
        • De Bodt M.
        • Barsties B.
        • Roy N.
        The value of the acoustic voice quality index as a measure of dysphonia severity in subjects speaking different languages.
        Eur Arch Otorhinolaryngol. 2014; 271: 1609-1619
        • Van de Weijer J.C.
        • Slis I.H.
        Nasaliteitsmeting met de nasometer. [Nasality measurement with the nasometer].
        Tijdschrift voor Logopedie en Foniatrie. 1991; 63: 97-101
      1. Weenink D. Implementation of the cepstral peak prominence measure in Praat. In preparation.

        • Howard D.M.
        • Murphy D.T.
        Voice Science, Acoustics and Recording.
        Plural Publishing, San Diego, CA2008
        • Deliyski D.D.
        • Shaw H.S.
        • Evans M.K.
        Adverse effects of environmental noise on acoustic voice quality measurements.
        J Voice. 2005; 19: 15-28
        • Deliyski D.D.
        • Shaw H.S.
        • Evans M.K.
        • Vesselinov R.
        Regression tree approach to studying factors influencing acoustic voice analysis.
        Folia Phoniatr Logop. 2006; 58: 274-288
        • Winholtz W.S.
        • Titze I.R.
        Miniature head-mounted microphone for voice perturbation analysis.
        J Speech Lang Hear Res. 1997; 40: 894-899
        • Vogel A.P.
        • Morgan A.T.
        Factors affecting the quality of sound recording for speech and voice analysis.
        Int J Speech Lang Pathol. 2009; 11: 431-437
        • Švec J.G.
        • Granqvist S.
        Guidelines for selecting microphones for human voice production research.
        Am J Speech Lang Pathol. 2010; 19: 356-368
        • Titze I.R.
        • Winholtz W.S.
        Effect of microphone type and placement on voice perturbation measurements.
        J Speech Hear Res. 1993; 36: 1177-1190
        • Deliyski D.D.
        • Shaw H.S.
        • Evans M.K.
        Influence of sampling rate on accuracy and reliability of acoustic voice measures.
        Logoped Phoniatr Vocol. 2005; 30: 55-62