Fidelity to the Consensus Auditory-Perceptual Analysis of Voice (CAPE-V): A Pilot Study.

OBJECTIVES: Auditory-perceptual measurements of voice are among the most common diagnostic tools used during a voice evaluation and are considered a gold standard for documenting voice disorders. The goal of this pilot study was to examine the fidelity of clinicians in the administration of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and its published protocol. This investigation aimed to determine how the CAPE-V is being used by clinicians and researchers and the extent to which users deviate from the published procedure. STUDY DESIGN: Survey METHODS: Data were collected by surveying a group (N = l7) of speech-language pathologists who regularly evaluate and treat patients with voice disorders. Survey results revealed that few of the sampled speech-language pathologists follow exactly the standardized instructions for administering the CAPE-V. Considerable variability in CAPE-V administration, including tasks and stimuli examined, was found across respondents. CONCLUSIONS: This exploratory project may be used to develop a larger national survey study investigating fidelity to the CAPE-V and to motivate recommendations for possible revisions to the instrument and its protocol for administration.

Vocal and Neural Responses to Unexpected Changes in Voice Pitch Auditory Feedback During Register Transitions.

OBJECTIVE/HYPOTHESIS: It is known that singers are able to control their voice to maintain a relatively constant vocal quality while transitioning between vocal registers; however, the neural mechanisms underlying this effect are not understood. It was hypothesized that greater attention to the acoustical feedback of the voice and increased control of the vocal musculature during register transitions compared with singing within a register would be represented as neurological differences in event-related potentials. STUDY DESIGN/METHODS: Nine singers sang musical notes at the high end of the modal register (the boundary between the modal and the head/falsetto registers) and at the low end (the boundary between the modal and the fry/pulse registers). While singing, the pitch of the voice auditory feedback was unexpectedly shifted either into the adjacent register ("toward" the register boundary) or within the modal register ("away from" the boundary). Singers were instructed to maintain a constant pitch and ignore any changes to their voice feedback. RESULTS: Vocal response latencies and magnitude of the accompanying N1 and P2 event-related potentials were greatest at the lower (modal-to-fry) boundary when the pitch shift carried the subjects' voices into the fry register as opposed to remaining within the modal register. CONCLUSIONS: These findings suggest that when a singer lowers the pitch of his or her voice such that it enters the fry register from the modal register, there is increased sensory-motor control of the voice, reflected as increased magnitude of the neural potentials to help minimize qualitative changes in the voice.

Event related potentials study of aberrations in voice control mechanisms in adults with attention deficit hyperactivity disorder.

OBJECTIVE: The present study was designed to test for neural signs of impulsivity related to voice motor control in young adults with ADHD using EEG recordings in a voice pitch perturbation paradigm. METHODS: Two age-matched groups of young adults were presented with brief pitch shifts of auditory feedback during vocalization. Compensatory behavioral and corresponding bioelectrical brain responses were elicited by the pitch-shifted voice feedback. RESULTS: The analysis of bioelectrical responses showed that the ADHD group had shorter peak latency and onset time of motor-related bioelectrical brain responses as compared to the controls. CONCLUSIONS: These results were interpreted to suggest differences in executive functions between ADHD and control participants. SIGNIFICANCE: We hypothesize that more rapid motor-related bioelectrical responses found in the present study may be a manifestation of impulsiveness in adults with ADHD at the involuntary level of voice control.

Understanding the mechanisms underlying voluntary responses to pitch-shifted auditory feedback.

Previous research has shown that vocal errors can be simulated using a pitch perturbation technique. Two types of responses are observed when subjects are asked to ignore changes in pitch during a steady vowel production, a compensatory response countering the direction of the perceived change in pitch and a following response in the same direction as the pitch perturbation. The present study investigated the nature of these responses by asking subjects to volitionally change their voice fundamental frequency either in the opposite direction ("opposing" group) or the same direction ("following" group) as the pitch shifts (±100 cents, 1000 ms) presented during the speaker's production of an /a/ vowel. Results showed that voluntary responses that followed the stimulus directions had significantly shorter latencies (150 ms) than opposing responses (360 ms). In addition, prior to the slower voluntary opposing responses, there were short latency involuntary responses that followed the stimulus direction. These following responses may involve mechanisms of imitation or vocal shadowing of acoustical stimuli when subjects are predisposed to respond to a change in frequency of a sound. The slower opposing responses may represent a control strategy that requires monitoring and correcting for errors between the feedback signal and the intended vocal goal.