• Speech Sciences
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• v.8 no.1
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• pp.135-142
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• 2001

The present study was performed to investigate adequate levels of utterances which can give essential as well as useful information about the patients' voice, by examining the degrees of correlation between the levels of utterances (vowels, words, and phrase paragraph reading) and the entire utterance including all of the levels. For this purpose, a total of 10 individual utterance samples (5 vowels, 3 words, 1 phrase, 1 paragraph reading) were collected from each of the 30 subjects with voice disorder patients, and four experienced voice therapists evaluated them using GRBAS. The results showed that four therapists highly agreed upon on 'G' parameter. The coefficient of the correlation between each level of utterance and entire utterance tended to be above 0.70. Judgements of the vowel /$\varepsilon$/ as well as /o/ highly correlated with the judgement of the entire utterance. Regardless of severity, the judgement of the entire utterance highly correlated with the judgements of the vowel /u/ and the paragraph reading. These results suggest that experienced voice therapists can precisely evaluate patients' voice quality with only one sustained vowel in the clinic field, as is done with the entire utterance evaluation.

• Proceedings of the Korean Society for Emotion and Sensibility Conference
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• 2009.05a
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• pp.181-182
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• 2009

GRBAS(G : grade, R : rough, B : breathy, S : strained, A : asthenic) 음성장애평가는 성대의 이상 또는 말마비장애 등의 환자들을 평가하는 척도로 널리 사용된다. 하지만 사람에 의해 주관적인 평가로 이루어지는 방식의 문제점이 많이 제기되어, 자동화 알고리즘에 의한 객관적인 청지각적 음성장애 평가도구를 개발하려는 시도가 많이 연구되어왔다. 이러한 개발에 있어 보편적으로 선행되어야 하는 음소 분류 및 일치성 판단을 위한 객관적인 파라미터를 구하고자 함이 본 연구의 목적이다.

• The Journal of the Korea Contents Association
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• v.18 no.1
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• pp.108-116
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• 2018

The purpose of this study was to investigate the relationship between the differences in the acoustic measurements (AVQI) and the auditory-perceptual assessments (GRBAS, CAPE-V) of the normal and vocal fold nodules. For this purpose, Total 335 voice samples were analyzed acoustically and three raters performed auditory-perceptual assessments. in the results, AVQI, G, and OS scores of the normal group were lower than those of the vocal fold nodules group. The correlations between the G scale and the OS scale were highly correlated, and the correlation between the AVQI, and auditory-perceptual results (G and OS) was also high value. The threshold values for discriminating AVQI, G, and OS between the two groups were ${\leq}4.06$, ${\leq}1$, and ${\leq}26$, respectively, and the predictive diagnostic power was 0.840, 0.860, and 0.848. In conclusion, AVQI and auditory-perceptual evaluation can improve potentiality the screening of vocal fold nodules and help to determine the diagnosis and treatment plan of voice disorders.

• Phonetics and Speech Sciences
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• v.1 no.2
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• pp.37-42
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• 2009

The purpose of the present study was to determine the effect of the management program known as vocal function exercise (VFE) on voice quality. Typical VFE was modified and applied to patients with vocal nodules by controlling intensity of voice and relieving the vocal fold to solve hyperfunctional problems in VFE. Eight female subjects aged between 28 and 54 who had been diagnosed with vocal nodules took part in the study. The patients performed VFEs once a week for eight weeks. Vocal function exercises consist of voice hygiene, respiratory training, phonation training, and glide training. The subjects' voices were analyzed pre and post therapy on the aspects of acoustics, maximum phonation time (MPT), GRBAS, and voice handicap index (VHI). As a result, it was found that fundamental frequency ($F_o$) was significant increased, shimmer decreased remarkably and that noise to harmonic ratio (NHR) lowered obviously in the acoustic parameter. In addition, MPT was increased significantly. The scale of GRBAS indicated significant improvement in grade, roughness, and strained voice. VHI indicated significant improvement in an emotional part. In conclusion, VFE was effective in improving voice quality for patients with vocal nodules.

• Phonetics and Speech Sciences
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• v.3 no.4
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• pp.109-115
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• 2011

The purposes of this study were to identify acoustic parameters of connected speech and to contribute to acoustic analysis of dysphonic voice about patient's natural speech voice as well as sustained phonation of vowels. Acoustic parameters of sentences included LTAS (long-term average spectrum) mean and spectral slope over frequence ranges such as 0-4kHz, 0-6kHz, 0-8kHz, 0-12.5kHz as well as HNR. Acoustic parameters of the vowel 'a' included jitter, RAP, shimmer, NHR, and HNR. Based on 'G' of GRBAS for the severity of dysphonia, two experienced raters judged and classified as four groups including controls, mild, moderate and severe dysphonic group. Connected speech was two sentences extracted from 'stroll' passage. Parameters of the vowel and LTAS mean of the sentences were measured by CSL. The spectral slope of the sentences and HNR of the vowel and the sentences were measured by Praat. Data were statistically analyzed by Spearman correlation and Kruskal-Wallis test using SPSS 12.0. The results of this study are as follows: First, jitter, RAP, shimmer and NHR were significantly different between the groups. Second, for several frequencies, LTAS mean and spectral slope of the sentences were significantly different between the groups. Third, the HNR of the sentences were significantly different between the groups. Forth, there was a presence of correlation between HNR and NHR of the vowel and HNR of the sentences. Accordingly, this study concluded that LTAS, spectral slope, and HNR were predictive parameters of connected speech voice for dysphonic voice.

• Phonetics and Speech Sciences
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• v.9 no.4
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• pp.99-106
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• 2017

Clinical data about vocal nodules have seldom been reported, even though vocal nodules are commonly diagnosed in outpatient speech and voice clinic. This study aims to investigate clinical characteristics of the patients who are diagnosed with vocal nodules. This study analyzed the data for 10 years from the 319 patients diagnosed with vocal nodules (45 males and 274 females with the mean age of 39.4 ranging from 2 to 83) in terms of gender, age, occupation, voice change initiation pattern, change with time, throat clearing, smoking history, type of voice abuse, acoustic analysis, maximum phonation time, GRBAS, and VHI. Thirteen patients (4.08%) had unilateral vocal nodule and 306 patients (95.9%) had bilateral vocal nodule, the majority of which had a pattern of asymmetry (73.9%). The glottal closure pattern was hourglass in 72.1% of patients, posterior chink in 17.9% of patients, and irregular in 7.9% of patients. The most common occupational category was professional voice users (43.4%). The voice abuse pattern included excessive talking in 96 patients (76.8%), loud voice in 78 (62.4%) patients, and excessive singing in 17 patients (21.6%). The patients showed worse scores in G, B, and S than in R and A for the GRBAS evaluation. The most recommended treatment for vocal nodules was voice therapy. The current clinical data will be helpful for treatment planning for the patients of vocal nodule.

• Phonetics and Speech Sciences
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• v.9 no.4
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• pp.129-136
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• 2017

This study investigates the effect of voice quality on speech intelligibility and the relationship between voice quality and intelligibility for children with spastic CP. We recruited 36 children with spastic CP (mean age 10.43 year, 17 girls, 19 boys, spastic type 34, mixed 2) from a special school and a rehabilitation hospital. Voice samples for the perceptual analysis of voice quality were extracted from a sustained vowel /a/ and were rated on the GRBAS scales by two experienced speech language pathologists. Ten adult subjects with no hearing problems evaluated speech intelligibility for the 37 words listed in the Assessment of Phonology and Articulation for Children on a 7-point interval scale. The children with spastic CP were divided into three groups according to the rated G scores on the GRBAS scales (G1(n)=10, G2(n)=13, G3(n)=13). Analyses of ANCOVA and Pearson correlation showed that there was a significant difference in speech intelligibility among three groups. There was also a significant correlation in G scale (grade), A scale (asthenia), B scale (breathy) score, and speech intelligibility. These findings suggest that poor speech intelligibility of spastic CP might be related to asthenia and breathiness. Vocal intensity should be increased and vocal functioning should be improved for speech therapy to improve speech intelligibility of the children with spastic CP.

• Phonetics and Speech Sciences
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• v.8 no.2
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• pp.73-80
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• 2016

The purpose of this study was to analyze perceptual and spectral/cepstral measurements in patients with adductor spasmodic dysphonia(ADSD). Sixty participants with gender and age matched individuals(30 ADSD and 30 controls) were recorded in reading a sentence and sustained the vowel /a/. Acoustic data were analyzed acoustically by measuring CPP, L/H ratio, mean CPP F0 and CSID, and auditory-perceptual ratings were measured using GRBAS. The main results can be summarized as below: (a) the CSID for the connected speech was significantly higher than for the sustained vowel (b) the G, R and S for the connected speech were significantly higher than for the sustained vowel (c) Spectral/cepstral parameters were significantly correlated with the perceptual parameters, and (d) the ROC analysis showed that the threshold of 13.491 for the CSID achieved a good classification for ADSD, with 86.7% sensitivity and 96.7% specificity. Spectral and cepstral analysis for the connected speech is especially meaningful on cases where perceptual analysis and clinical evaluation alone are insufficient.

• Phonetics and Speech Sciences
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• v.8 no.2
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• pp.49-56
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• 2016

The study examined that parents and teachers were aware of what extents behavioral characteristics were related to the children's voice problems. The voice samples of 89 children in the ages of 3 to 5 were collected and their voice quality were graded by G scale of GRBAS. The parents and teachers of the children were asked to complete the questionnaire composed of the pediatric Voice Handicap Index (pVHI) and the psycho- and voice behavioral characteristics of their children. The results are as follows. First, there were no significant differences in both pVHI and behavioral characteristics of their children by G scale. However, significant differences were shown in the behavioral characteristics between parents and teachers, but no difference in pVHI between them. In addition, there was a significant correlation between the psycho-behavioral characteristics and the voice behavioral characteristics in both parents and teachers. These results represent that parents and teachers are not aware of the presence of their children's voice problems and such voice problems are affected by behavioral characteristics associated with the use of voice.

• Phonetics and Speech Sciences
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• v.15 no.4
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• pp.81-90
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• 2023

Auditory perceptual assessment and acoustic analysis are commonly used in clinical practice for voice evaluation. This study aims to explore the effects of speech task context on auditory perceptual assessment and acoustic measures in patients with voice disorders. Sustained vowel phonations (/a/, /e/, /i/, /o/, /u/, /ɯ/, /ʌ/) and connected speech (a standardized paragraph 'kaeul' and nine sub-sentences) were obtained from a total of 22 patients with voice disorders. GRBAS ('G', 'R', 'B', 'A', 'S') and CAPE-V ('OS', 'R', 'B', 'S', 'P', 'L') auditory-perceptual assessment were evaluated by two certified speech language pathologists specializing in voice disorders using blind and random voice samples. Additionally, spectral and cepstral measures were analyzed using the analysis of dysphonia in speech and voice model (ADSV).When assessing voice quality with the GRBAS scale, it was not significantly affected by the vowel type except for 'B', while the 'OS', 'R' and 'B' in CAPE-V were affected by the vowel type (p<.05). In addition, measurements of CPP and L/H ratio were influenced by vowel types and sentence positions. CPP values in the standard paragraph showed significant negative correlations with all vowels, with the highest correlation observed for /e/ vowel (r=-.739). The CPP of the second sentence had the strongest correlation with all vowels. Depending on the speech stimulus, CAPE-V may have a greater impact on auditory-perceptual assessment than GRBAS, vowel types and sentence position with consonants influenced the 'B' scale, CPP, and L/H ratio. When using vowels in the voice assessment of patients with voice disorders, it would be beneficial to use not only /a/, but also the vowel /i/, which is acoustically highly correlated with 'breathy'. In addition, the /e/ vowel was highly correlated acoustically with the standardized passage and sub-sentences. Furthermore, given that most dysphonic signals are aperiodic, 2nd sentence of the 'kaeul' passage, which is the most acoustically correlated with all vowels, can be used with CPP. These results provide clinical evidence of the impact of speech tasks on auditory perceptual and acoustic measures, which may help to provide guidelines for voice evaluation in patients with voice disorders.