Advertisement

Analyses of Sustained Vowels in Down Syndrome (DS): A Case Study Using Spectrograms and Perturbation Data to Investigate Voice Quality in Four Adults With DS

Published:September 21, 2017DOI:https://doi.org/10.1016/j.jvoice.2017.08.004

      Summary

      Objectives

      Automatic acoustic measures of voice quality in people with Down syndrome (DS) do not reliably reflect perceived voice qualities. This study used acoustic data and visual spectral data to investigate the relationship between perceived voice qualities and acoustic measures.

      Study design

      Participants were four young adults (two males, two females; mean age 23.8 years) with DS and severe learning disabilities, at least one of whom had a hearing impairment.

      Methods

      Participants imitated sustained /i/, /u/, and /a/ vowels at predetermined target pitches within their vocal range. Medial portions of vowels were analyzed, using Praat, for fundamental frequency, harmonics-to-noise ratio, jitter, and shimmer. Spectrograms were used to identify the presence and the duration of subharmonics at onset and offset, and mid-vowel. The presence of diplophonia was assessed by auditory evaluation.

      Results

      Perturbation data were highest for /a/ vowels and lowest for /u/ vowels. Intermittent productions of subharmonics were evident in spectrograms, some of which coincided with perceived diplophonia. The incidence, location, duration, and intensity of subharmonics differed between the four participants.

      Conclusions

      Although the acoustic data do not clearly indicate atypical phonation, diplophonia and subharmonics reflect nonmodal phonation. The findings suggest that these may contribute to different perceived voice qualities in the study group and that these qualities may result from intermittent involvement of supraglottal structures. Further research is required to confirm the findings in the wider DS population, and to assess the relationships between voice quality, vowel type, and physiological measures.

      Key Words

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

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

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

      References

        • Moran M.J.
        Identification of Down's syndrome adults from prolonged vowel samples.
        J Commun Disord. 1986; 19: 387-394https://doi.org/10.1016/0021-9924(86)90028-6
        • Moran M.J.
        • Gilbert H.R.
        Selected acoustic characteristics and listener judgments of the voice of Down syndrome adults.
        Am J Ment Defic. 1982; 86: 553-556
        • Benda C.E.
        Mongolism.
        in: Carter C.H. Medical Aspects of Mental Retardation. Springfield, Illinois1965
        • Novak A.
        The voice of children with Down's syndrome.
        Folia Phoniatr (Basel). 1972; 24: 182-194
        • Pentz Jr, A.L.
        • Gilbert H.R.
        Relation of selected acoustical parameters and perceptual ratings to voice quality of Down syndrome children.
        Am J Ment Defic. 1983; 2: 203-210
        • Montague Jr, J.C.
        • Hollien H.
        • Hollien P.A.
        • et al.
        Perceived pitch and fundamental frequency comparisons of institutionalized Down's syndrome children.
        Folia Phoniatr et Logop. 1978; 30: 245-256
        • Montague J.C.
        • Hollien H.
        Perceived voice quality disorders in Down's syndrome children.
        J Commun Disord. 1973; : 76-87
        • Beckman D.A.
        • Wold D.C.
        • Montague J.C.
        A noninvasive acoustic method using frequency perturbations and computer-generated vocal-tract shapes.
        J Speech Hear Res. 1983; 26: 304-314
        • Moura C.P.
        • Cunha L.M.
        • Vilarinho H.
        • et al.
        Voice parameters in children with Down Syndrome.
        J Voice. 2008; 22: 34-42https://doi.org/10.1016/j.jvoice.2006.08.011
        • Lee M.T.
        • Thorpe J.
        • Verhoeven J.
        Intonation and phonation in young adults with Down Syndrome.
        J Voice. 2009; 23: 82-87https://doi.org/10.1016/j.jvoice.2007.04.006
        • Albertini G.
        • Bonassi S.
        • Dall'Armi V.
        • et al.
        Spectral analysis of the voice in Down Syndrome.
        Res Dev Disabil. 2010; 31: 995-1001https://doi.org/10.1016/j.ridd.2010.04.024
        • Rodger R.
        Voice quality of children and young people with Down's Syndrome and its impact on listener judgement.
        (Queen Margaret University, Edinburgh, Scotland, Unpublished PhD dissertation; Available at:)
        • Seifpanahi S.
        • Bakhtiar M.
        • Salmalian T.
        Objective vocal parameters in Farsi-speaking adults with Down syndrome.
        Folia Phoniatr et Logop. 2011; 63: 72-76
        • 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: 324-333https://doi.org/10.1177/000348940311200406
        • Pryce M.
        The voice of people with Down's syndrome: an EMG biofeedback study.
        Down Syndr Res Pract. 1994; 2: 106-111https://doi.org/10.3104/reports.39
        • Beck J.M.
        Organic variation of the vocal apparatus.
        (In: The Handbook of Phonetic Sciences: Second Edition, 153–201)2010https://doi.org/10.1002/9781444317251.ch5
        • Titze I.R.
        Workshop on acoustic voice analysis.
        Natl Cent Voice Speech Am. 1994; : 1-36https://doi.org/10.1016/j.jvoice.2009.04.002
        • Cavalli L.
        • Hirson A.
        Diplophonia reappraised.
        J Voice. 1999; 13: 542-556https://doi.org/10.1016/S0892-1997(99)80009-5
        • Dejonckere P.H.
        • Lebacq J.
        An analysis of the diplophonia phenomenon.
        Speech Commun. 1983; 2: 47-56https://doi.org/10.1016/0167-6393(83)90063-8
        • Aronson A.E.
        • Bless D.
        Clinical Voice Disorders.
        Thieme, Stuttgard2011
        • Fawcus M.
        The physiology of phonation.
        in: Freeman M. Fawcus M. Voice disorders and their management. 3rd ed. Whurr, London1990: 1-17
        • Bailly L.
        • Henrich N.
        • Pelorson X.
        Vocal fold and ventricular fold vibration in period-doubling phonation: physiological description and aerodynamic modeling.
        J Acoust Soc Am. 2010; 127: 3212-3222https://doi.org/10.1121/1.3365220
        • Sakakibara K.I.
        • Imagawa H.
        • Yokonishi H.
        • et al.
        Physiological observations and synthesis of subharmonic voices.
        APSIPA ASC. 2011; : 1079-1085
        • Stager S.
        The role of the supraglottic area in voice production.
        Otolaryngol. 2011; S1: 1-7
        • Fourcin A.
        • Abberton E.
        Hearing and phonetic criteria in voice measurement: clinical applications.
        Logoped Phoniatr Vocol. 2008; 33: 35-48https://doi.org/10.1080/14015430701251574
        • Schaeffler F.
        • Beck J.M.
        • Jannetts S.
        Phonation Stabilisation Time as an Indicator of Voice Disorder.
        ICPhS, Glasgow2015
        • Yin R.K.
        Designing Case Studies.
        Fifth ed. Sage, London2003
        • Dunn L.M.
        • Dunn D.M.
        The British Picture Vocabulary Scale.
        GL Assessment Limited, Windsor, Berkshire1992
        • Shipley K.G.
        • McAfee J.
        Assessment in Speech-language Pathology.
        Delmar Learning, USA2009
        • Teixeira J.P.
        • Fernandes P.O.
        Acoustic analysis of vocal dysphonia.
        Procedia Comput Sci. 2015; 64: 466-473https://doi.org/10.1016/j.procs.2015.08.544
        • Boersma P.
        • Weenink D.
        Praat: Doing phonetics by computer (Version 5.3.14.) [Computer program].
        (Available at:)
        http://www.fon.hum.uva.nl/praat/
        Date accessed: January 10, 2015
        • Yan Y.
        • Damrose E.
        • Bless D.
        Functional analysis of voice using simultaneous high-speed imaging and acoustic recordings.
        J Voice. 2007; 21: 604-616
        • Fuks L.
        Computer-aided musical analysis of extended vocal techniques for compositional applications.
        (Paper presented at VI Simpósio Brasileiro de Computaçäo Música, Rio de Janeiro; Available at:)
        http://compmus.ime.usp.br/sbcm/1999/papers/Leonardo_Fuks.pdf
        Date: 1999
        Date accessed: December 18, 2016
        • Kramer E.
        • Linder R.
        • Schönweiler R.
        A study of subharmonics in connected speech material.
        J Voice. 2013; 27: 29-38https://doi.org/10.1016/j.jvoice.2012.08.005
        • Fourcin A.
        • McGlashan J.
        • Blowes R.
        Measuring voice in the clinic-Laryngograph® Speech Studio analyses.
        (In Proceedings 6th Voice Symposium of Australia)2002
        • Jannetts S.
        • Schaeffler F.
        Cepstral peak prominence-based phonation stabilisation time as an indicator of voice disorder.
        (In: PEVOC & MAVEBA, 31st August - 4th September 2015, Florence, Italy; Available at:)
        http://eresearch.qmu.ac.uk/3922/
        Date: 2015
        Date accessed: July 2, 2016
        • Blomgren M.
        • Chen Y.
        • Ng M.L.
        • et al.
        Acoustic, aerodynamic, physiologic, and perceptual properties of modal and vocal fry registers.
        J Acoust Soc Am. 1998; 103: 2649-2658
        • Panfili L.
        The physiological underpinnings of vowel height and voice quality.
        J Acoust Soc Am. 2016; 139: 2221
        • Fourcin A.
        Aspects of voice irregularity measurement in connected speech.
        Folia Phoniatr Logop. 2009; 61: 126-136https://doi.org/10.1159/000219948
        • Strik H.
        • Boves L.L.B.-E.
        Control of fundamental frequency, intensity and voice quality in speech.
        J Phon. 1992; 20: 15-25
        • Maryn Y.
        • Corthals P.
        • Van Cauwenberge P.
        • et al.
        Toward improved ecological validity in the acoustic measurement of overall voice quality: combining continuous speech and sustained vowels.
        J Voice. 2010; 24: 540-555https://doi.org/10.1016/j.jvoice.2008.12.014
        • Baken R.J.
        • Orlikoff R.F.
        Clinical Measurement of Speech and Voice.
        Cengage Learning, New York2000
        • Fraile R.
        • Godino-Llorente J.I.
        Cepstral peak prominence: a comprehensive analysis.
        Biomed Signal Process Control. 2014; 14: 42-54https://doi.org/10.1016/j.bspc.2014.07.001
        • Carding P.N.
        • Steen I.N.
        • Webb A.
        • et al.
        The reliability and sensitivity to change of acoustic measures of voice quality.
        Clin Otolaryngol. 2004; 29: 538-544
        • Leong K.
        • Hawkshaw M.J.
        • Dentchev D.
        • et al.
        Reliability of objective voice measures of normal speaking voices.
        J Voice. 2013; 27: 170-176https://doi.org/10.1016/j.jvoice.2012.07.005
        • Parsa V.
        • Jamieson D.G.
        Acoustic discrimination of pathological voice: sustained vowels versus continuous speech.
        J Speech Hearing Res. 2001; 44: 327-339
        • Núñez B.F.
        • Suárez N.C.
        • Muñoz P.C.
        • et al.
        Spectrographic study of voice disorders: subharmonics.
        Acta Otorrinolaringol Esp. 2000; 51 (Available at:): 52-56
        • Aichinger P.
        Diplophonic voice—definitions, models, and detection.
        (Graz University of Technology, Vienna, Austria; Unpublished PhD thesis; Available at:)
        • Aichinger P.
        • Hagmüller M.
        • Roesner I.
        • et al.
        Diplophonia disturbs jitter and shimmer measurement.
        Folia Phoniatr Logop. 2016; 68: 22-28
        • Bailly L.
        • Müller N.H.B.F.
        • Rohlfs A.-K.
        • et al.
        Ventricular-fold dynamics in human phonation.
        J Speech Lang Hear Res. 2014; 57: 1679-1691https://doi.org/10.1044/2014
        • Sakakibara K.-I.
        • Fuks L.
        • Imagawa H.
        • et al.
        Growl voice in ethic and pop styles.
        (In: Proceedings of the International Symposium on Musical Acoustics (ISMA 2004))2004
        • Keating P.
        • Garellek M.
        • Kreiman J.
        Acoustic properties of different kinds of creaky voice.
        (In Proceedings of the 18th International Congress of Phonetic Sciences, Glasgow; Available at:)
        http://www.icphs2015.info/pdfs/Papers/ICPHS0821.pdf
        Date: 2015
        Date accessed: May 30, 2016
        • Braunschweig T.
        • Flaschka J.
        • Schelhorn-Neise P.
        • et al.
        High-speed video analysis of the phonation onset, with an application to the diagnosis of functional dysphonias.
        Med Eng Phys. 2008; 30: 59-66
        • Lee E.K.
        • Son Y.I.
        Muscle tension dysphonia in children: voice characteristics and outcome of voice therapy.
        Int J Pediatr Otorhinolaryngol. 2005; 69: 911-917https://doi.org/10.1016/j.ijporl.2005.01.030
        • Coelho A.C.
        • Medved D.M.
        • Brasolotto A.G.
        Chapter 6 hearing loss and the voice in update on hearing loss.
        in: Bahmad F. Hearing Loss and the Voice, Update on Hearing Loss. INTECH, Croatia2015https://doi.org/10.5772/61217 (Available at:)
        • Das B.
        • Chatterjee I.
        • Kumar S.
        Laryngeal aerodynamics in children with hearing impairment versus age and height matched normal hearing peers.
        ISRN Otolaryngol. 2013; https://doi.org/10.1155/2013/394604
        • Dehqan A.
        • Scherer R.C.
        Objective voice analysis of boys with profound hearing loss.
        J Voice. 2015; 25: e61-e65
        • Alexander M.
        • Petri H.
        • Ding Y.
        • et al.
        Morbidity and medication in a large population of individuals with Down syndrome compared to the general population.
        Dev Med Child Neurol. 2015; 58: 246-254
        • Sun X.
        Pitch determination and voice quality analysis using Subharmonic-to-Harmonic Ratio.
        (In: 2002 IEEE International Conference on Acoustics, Speech, and Signal Processing. Vol 1.; I - 333 - I - 336)2002https://doi.org/10.1109/ICASSP.2002.5743722