ABSTRACT
PURPOSE: The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) was developed to provide a protocol and form for clinicians to use when assessing the voice quality of adults with voice disorders (Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kramer, & Hillman, 2009). This study examined the reliability and the empirical validity of the CAPE-V when used by experienced voice clinicians judging normal and disordered voices. METHOD: The validity of the CAPE-V was examined in 2 ways. First, we compared judgments made by 21 raters of 22 normal and 37 disordered voices using the CAPE-V and the GRBAS (grade, roughness, breathiness, asthenia, strain; see Hirano, 1981) scales. Second, we compared our raters' judgments of overall severity to a priori consensus judgments of severity for the 59 voices. RESULTS: Intrarater reliability coefficients for the CAPE-V ranged from .82 for breathiness to .35 for strain; interrater reliability ranged from .76 for overall severity to .28 for pitch. CONCLUSIONS: Although both CAPE-V and GRBAS reliability coefficients varied across raters and parameters, this study reports slightly improved rater reliability using the CAPE-V to make perceptual judgments of voice quality in comparison to the GRBAS scale. The results provide evidence for the empirical (concurrent) validity of the CAPE-V.
Subject(s)
Dysphonia/diagnosis , Speech Production Measurement/methods , Speech Production Measurement/standards , Voice Quality , Adolescent , Adult , Consensus , Female , Humans , Male , Middle Aged , Observer Variation , Reproducibility of Results , Speech Production Measurement/statistics & numerical data , Young AdultABSTRACT
PURPOSE: To provide the first detailed information about native language abilities of children who are or had been institutionalized. METHOD: The language of ten 30-month-old children raised in Romanian orphanages was compared with that of 30 chronological-age-matched peers: 10 children who had moved recently from orphanages to foster care, 10 children in foster families for at least 1 year, and 10 children raised in their biological families. Ten language measures were obtained from communication during play and from parent/caregiver report. RESULTS: Children who were institutionalized and children in foster care for a brief time showed substantial language delays, with some of these children not yet producing intelligible words. Children in foster care for at least 1 year approximated the expressive output and receptive language of children who had never been institutionalized; however, they showed lower expressive grammatical abilities. Within the group of children who were institutionalized, the presence of a preferred caregiver and a measure of development, greater height, were associated with greater language output. Although children in orphanages produced fewer complex forms than children in biological families, there were no systematic qualitative differences in language structure across groups. CONCLUSION: Foster care facilitated language growth after substantial language delays associated with institutionalization.
Subject(s)
Child, Institutionalized , Foster Home Care , Language Development , Body Height , Caregivers , Child, Preschool , Cohort Studies , Humans , Language Development Disorders/physiopathology , Language Development Disorders/psychology , Romania , SpeechABSTRACT
Voice disorders, specifically vocal fatigue, are more commonly reported by women than by men. Previously, 4 women with normal untrained voices read loudly for 2 hours in an attempt to fatigue the voice. Vocal function deteriorated, as indicated by increases in phonation threshold pressure (PTP) and self-perceived phonatory effort. The increase in PTP was delayed or attenuated to some degree in 3 of the women when they drank ample amounts of water before the experiment. The current study examined the same vocal-loading task and water-drinking condition in 4 vocally normal men. PTP increased after the loud-reading task. Although 2 of the men appeared to benefit from increased systemic hydration (PTP increased more when they were underhydrated than well-hydrated), the other 2 men's data changed in the opposite direction. Phonatory effort correlated well with PTP; this varied across subject and pitch. Laryngeal endoscopy revealed an anterior glottal gap in two men after the loud-reading task. Amplitude of vocal fold vibration was judged to be reduced after the loud-reading task in three subjects when underhydrated and one subject when well hydrated. The high between-subject variability prohibits a conclusion that drinking water is beneficial to vocal function in men, but all subjects studied to date demonstrated detrimental vocal effects of prolonged loud talking.
