The Influence of Cartoons Soundscape Irrelevant Sound Effects on young children's Auditory Processing and Working memory skills.

BACKGROUND: Irrelevant sound or speech effect (ISE) affects an individual's serial recall task of visual and auditory presentations. Cartoon soundscape mimics irrelevant sound effect hypothesis. A constant and repeated exposure to cartoons in early childhood should influence children's auditory learning or recall performance. PURPOSE: To investigate the effects of cartoons' soundscape irrelevant sound effects on young children's auditory processing and working memory skills. RESEARCH DESIGN: A cross-sectional study was used to observe the influence of the cartoon soundscape irrelevant sound effects on children. STUDY SAMPLE: Sixty young children with normal hearing in the age range 5-6years were exposed to cartoons (Indian plus Non-Indian) considered for the study. DATA COLLECTION AND ANALYSIS: Pitch Pattern Test (PPT), Duration Pattern Test (DPT), and Corsi-Block working memory apparatus were applied to the participants exposed to cartoons. The data obtained were compared statistically in terms of the groups' performances. RESULTS: There was a significant difference in PPT (p=.023) and DPT (p=.001) between the cartoon exposed and non-exposed groups. In contrast, there was no significant difference between the two groups in Corsi-Block working memory(p>0.05). CONCLUSION: Cartoon soundscape irrelevant sound or speech affects young children's auditory processing skills. The visual-spatial recall follows a different developmental pattern in young children without recoding to phonological aspects. It is predicted that our study findings might help determine the ill effects of cartoons on the auditory and language development process.

Universal Newborn Hearing Screening: An Indian Experience of Conceptualizing and Testing a Comprehensive Model.

There have been isolated attempts to implement newborn hearing screening at various setups across India. However, none of these attempts has followed a holistic model comprising of multiple components. Therefore, a need was felt to design and implement a comprehensive universal newborn hearing-screening model to, improve follow-up, and provide practically implementable solutions for developing economies. The model was conceptualized after a detailed preliminary planning level. Separate protocols for newborns from well-baby nursery and neonatal intensive care unit were implemented. Measures were implemented to improve follow-up. Knowledge, attitude, and practices survey followed by a sensitization program was carried out to highlight the importance of newborn hearing screening among the healthcare providers. A knowledge and attitude survey was also carried out among mothers. The estimated prevalence rate was 8.78 per 1000. Measures enabled an improved follow-up rate that lead to a reduced age of identification to 6 months. The surveys among mothers and healthcare providers helped to identify the lacunae in knowledge levels, which need to be filled in order to improve their attitudes. Thus, this was a successful model for universal newborn hearing screening comprising of two-stage screening, separate protocols, steps to improve follow-up, improving awareness among parents, sensitization programs, and surveys among mothers as well as healthcare providers.

Parental Perspectives on Quality of Life in Adolescents with Cerebral Palsy.

BACKGROUND: Quality of life (QoL) is an important outcome variable while evaluating intervention effectiveness during adolescence. Limited studies have addressed the issues that affect the QoL in adolescents with cerebral palsy. The present study explores the parent-reported QoL in adolescents with cerebral palsy. MATERIALS AND METHODS: Using a cross-sectional study design, parental perspectives on QoL were investigated among 35 parents of adolescents with cerebral palsy, aged between 13 and 18 years. Performance on seven domains of QoL across age and gender were explored. RESULTS: While the maximum QoL was seen in the domain of social well-being, the least QoL was noted for feelings about functioning. Across age, the early adolescence group (13-15 years) had a poorer quality of life in comparison to the late adolescence group (16-18 years). With respect to the gender, though females had a lower QoL scores, a statistically significant difference was observed only for the domain of general well-being and participation. CONCLUSIONS: From a parental perspective, the major issues of concern in adolescents with cerebral palsy were feelings about functioning, general well-being and participation, and access to services. This information will be useful when establishing management options or assessment protocols to improve their overall QoL.

Adaptation and Validation of the Kannada Singing Voice Handicap Index-10.

OBJECTIVE: The aim of the present study was to adapt and validate the English version of the Singing Voice Handicap Index-10 (SVHI-10) into Kannada language. STUDY DESIGN: Cross-sectional Comparitive study design. METHODS: The English version of SVHI-10 was translated into Kannada using standard procedure. A total of 115 singers participated in the study, including 90 singers with no voice problems (control group) and 25 singers with voice problems. The internal consistency, test-retest reliability, clinical validity, and cutoff points were calculated. RESULTS: Kannada SVHI-10 has excellent internal consistency and test-retest reliability. The singers with voice problems scored significantly higher than the singers with no voice problems (t = -14.67, df = 113, P < 0.001). The optimal cutoff point of the SVHI-10 was 9.5 with a sensitivity of 96% and specificity of 84%. CONCLUSION: The Kannada SVHI-10 is a reliable and clinically valid tool to assess the self-reported singing voice handicap among singers. It can also be used as a quick screening tool for distinguishing singers with and without voice problems as per client's perception.

Acoustic Analysis of Voice in Singers: A Systematic Review.

Purpose: Singers are vocal athletes having specific demands from their voice and require special consideration during voice evaluation. Presently, there is a lack of standards for acoustic evaluation in them. The aim of the present study was to systematically review the available literature on the acoustic analysis of voice in singers. Method: A systematic review of studies on acoustic analysis of voice in singers (PubMed/MEDLINE, CINAHL, Scopus, ProQuest, Cochrane, Ovid, Science Direct, and Shodhganga) was carried out. Key words based on PIO (population-investigation-outcome) were used to develop search strings. Titles and abstracts were screened independently, and appropriate studies were read in full for data extraction. Results: Of the 895 studies, 26 studies met the inclusion criteria. Great variability was noted in the instruments and task used. Different acoustic measures were employed, such as fundamental frequency, perturbation, cepstral, spectral, dysphonia severity index, singing power ratio, and so forth. Conclusion: Overall, a great heterogeneity was noted regarding population, tasks, instruments, and parameters. There is a lack of standardized criteria for the evaluation of singing voice. In order to implement acoustic analysis as a part of comprehensive voice evaluation exclusively for singers, there is a certain need for methodical sound studies.

Prevalence and Risk Factors of Voice Problems Among Primary School Teachers in India.

OBJECTIVES: Teachers are more prone to develop voice problems (VPs) when compared with other professional voice users. The aim of present study was to investigate the prevalence and risk factors of VPs among primary school teachers in India. STUDY DESIGN: Epidemiological cross-sectional survey. METHODS: Self-reporting questionnaire data were collected from 1082 teachers. RESULTS: Out of 1082 teachers who participated in the present study, 188 teachers reported VPs that account for a prevalence rate of 17.4%. Tired voice after long hours of talking was the most frequently reported symptom, followed by sore/dry throat, strain in voice, neck muscle tension, and difficulty in projecting voice. The adjusted odds ratio values showed number of years of teaching, high background noise levels in the classroom, experiencing psychological stress while teaching classes, improper breath management (holding breath while speaking), poor focus of the tone (clenching jaw/teeth while speaking), upper respiratory tract infection, thyroid problems, and acid reflux as significant risk factors for the development of VPs in the current cohort of teachers. CONCLUSIONS: Current results suggest that teachers develop VPs due to multiple risk factors. These factors may be either biological, psychomotor, or environment-related factors. A holistic approach (which could include educating teachers about voice care during their training, and if they develop VP during their career, then managing the VP by taking into consideration different risk factors) addressing all these factors needs to be adopted to prevent VPs in primary school teachers.

Adaptation and Validation of the Kannada Version of the Singing Voice Handicap Index.

OBJECTIVE: The present study aimed to adapt and validate the Singing Voice Handicap Index (SVHI) into Kannada language using standard procedures. STUDY DESIGN: This is a cross-sectional study. METHODS: The original English version of SVHI was translated into Kannada. It was administered on 106 Indian classical singers, of whom 22 complained of voice problems. Its internal consistency was determined using Cronbach's alpha coefficient (α), test-retest reliability using Pearson's product moment correlation and paired t test, and the difference in mean scores by independent sample t test. RESULTS: The results revealed that the Kannada SVHI exhibited an excellent internal consistency (α = 0.96) with a high item-to-total correlation. Further, excellent test-retest reliability (r = 0.99) and significant differences in SVHI scores were also obtained by singers with and without a voice problem (t = 12.93, df = 104, P = 0.005). CONCLUSION: The Kannada SVHI is a valid and reliable tool for self-reported assessment of singers with voice problems. It will provide a valuable insight into the singing-related voice problems as perceived by the singers themselves.

Exploring Attitudes of Indian Classical Singers Toward Seeking Vocal Health Care.

OBJECTIVE: The attitude of Indian classical singers toward seeking vocal health care is a dimension yet to be explored. The current study was aimed to determine the attitudes of these singers toward seeking vocal health care and further understand the influence of age and gender. STUDY DESIGN: Cross-sectional. METHOD: A 10-item self-report questionnaire adapted from a study on contemporary commercial music singers was used. An additional question was added to ask if the singer was aware about the profession and role of speech-language pathologists (SLPs). The questionnaire was administered on 55 randomly selected self-identified trained Indian classical singers who rated the items using a five-point Likert scale. Demographic variables were summarized using descriptive statistics and t test was used to compare the mean scores between genders and age groups. RESULTS: Of the singers, 78.2% were likely to see a doctor for heath-related problems, whereas 81.8% were unlikely to seek medical care for voice-related problems; the difference was statistically significant (P < 0.001). Responses for the questions assessing the attitudes toward findings from medical examination by a specialist revealed a statistically significant difference (P = 0.02) between the genders. Age did not have a significant influence on the responses. Only 23.6% of the respondents were aware about the profession and the role of SLPs. CONCLUSION: The findings are in tune with western literature reporting hesitation of singers toward seeking vocal health care and draws attention of SLPs to promote their role in vocal health awareness and management.

Acoustic Analysis of Madhya and Taar Saptak/Sthayi in Indian Classical Singers.

OBJECTIVES: We aimed to compare the acoustic parameters of voice between Madhya Saptak/Sthayi (MS) and Taar Saptak/Sthayi (TS) in trained Indian classical singers and between males and females. PARTICIPANTS AND METHOD: Sixty-five adult trained Indian classical singers were instructed to produce MS and TS; the acoustic parameters were analyzed with the Multidimensional Voice Program. Descriptive statistics were used for analysis across tasks and gender. Two-way random-effects ANOVA was used to test the effect of gender and task. RESULTS: Male participants had a restricted range of fundamental frequency (F0), especially at high pitches. The acoustic analysis showed a statistically significant difference for F0 measures, range of F0, jitter and pitch perturbation quotient between males and females during MS and TS. CONCLUSION: The use of TS, that is, high-pitch phonation, during the clinical evaluation of singers enables an understanding of their vocal behavior in the higher scales of singing.

Acoustic analysis of voice in normal and high pitch phonation: a comparative study.

OBJECTIVES: Comparison of acoustic parameters of voice between normal and high pitch phonation in normal adults, and comparison between genders. PARTICIPANTS AND METHODS: A total of 48 normal laryngeal speakers were considered for this study. The acoustic parameters were analyzed using the Multi-Dimensional Voice Program. Descriptive statistics were used for analysis of the acoustic parameters across tasks and genders. Paired-samples t tests were used to compare measures between tasks. Independent-samples t tests were used to compare parameters between genders. RESULTS: Significant differences were found across tasks in the range of fundamental frequency and average fundamental frequency. Females showed a significant difference in the frequency perturbation measures ­ percent jitter and relative average perturbation, while males demonstrated a significant difference in the noise-to-harmonic ratio. While comparing mean differences between genders, significant differences were observed in fundamental frequency, range of the fundamental frequency, and smoothed pitch perturbation quotient during both phonation tasks. CONCLUSION: Comparison of acoustic parameters between normal and high pitch phonation would facilitate understanding the effect of high pitch phonation on voice parameters. Subsequently, this would help clinicians to focus on important acoustic parameters while assessing professional voice users who are at risk of developing voice problems.