Are smartphones and low-cost external microphones comparable for measuring time-domain acoustic parameters?

PURPOSE: This study examined and compared the diagnostic accuracy and correlation levels of the acoustic parameters of the audio recordings obtained from smartphones on two operating systems and from dynamic and condenser types of external microphones. METHOD: The study included 87 adults: 57 with voice disorder and 30 with a healthy voice. Each participant was asked to perform a sustained vowel phonation (/a/). The recordings were taken simultaneously using five microphones AKG-P220, Shure-SM58, Samson Go Mic, Apple iPhone 6, and Samsung Galaxy J7 Pro microphones in an acoustically insulated cabinet. Acoustic examinations were performed using Praat version 6.2.09. The data were examined using Pearson correlation and receiver-operating characteristic (ROC) analyses. RESULTS: The parameters with the highest area under curve (AUC) values among all microphone recordings in the time-domain analyses were the frequency perturbation parameters. Additionally, considering the correlation coefficients obtained by synchronizing the microphones with each other and the AUC values together, the parameter with the highest correlation coefficient and diagnostic accuracy values was the jitter-local parameter. CONCLUSION: Period-to-period perturbation parameters obtained from audio recordings made with smartphones show similar levels of diagnostic accuracy to external microphones used in clinical conditions.

Effects of Speech and Language Therapists' Personality Traits and Cognitive Emotion Regulation on the Perceptual Evaluation of Dysphonia.

OBJECTIVE: As in many health care fields, it is essential to establish clinical standards for voice assessments; however, some individual characteristics of clinicians, such as their personalities, may affect assessment reliability. Therefore, this study aims to examine the relationship between the personality traits and cognitive emotion regulation strategies of speech-language therapists (SLTs) and their GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) scoring. METHOD: The study group comprised 33 SLTs and 9 women with dysphonia. The Five-Factor Personality Inventory (FFPI) and Cognitive Emotion Regulation Questionnaire (CERQ) were used to assess SLTs' psychological traits. The SLTs evaluated the acoustic recordings of sustained vowel phonation /a/ obtained from individuals with dysphonia, using the GRBAS scale. Cronbach's alpha was used to assess inter-rater reliability, and Spearman's correlation analysis was used to analyze the relationships among the variables. RESULTS: The findings revealed that the FFPI dimensions were weakly and significantly related to Grade (G) and Strain (S). In the maladaptive dimensions, with an increase in the scores of the neuroticism dimension of FPPI and the catastrophizing dimension of CERQ, the SLTs gave significantly higher scores to Grade (G). In addition, with an increase in the score of rumination or focus on thought, the SLTs perceived Strain (S) more negatively. Consistent with these findings, in the adaptive dimensions, the SLTs gave higher scores to Grade (G) as the positive refocusing and positive reappraisal scores decreased. CONCLUSION: The findings of this study showed that, as some maladaptive aspects of personality and cognitive emotion regulation increased and adaptive aspects decreased, the SLTs' perceptions of Grade (G) and Strain (S) became more negative. Additionally, these results suggested the possibility of advanced confounding variables beyond primary factors, such as training and experience in the perceptual voice assessment of the SLTs, and the importance of standardizing professional practices, such as the observation and supervision of experts.

Is Articulation Assessment via Synchronous Telepractice as Reliable as In-Person Assessment?

PURPOSE: This study aimed to determine whether articulation assessment via telepractice is as reliable as in-person assessment. METHOD: Thirty-four children aged 4-11 years with speech sound disorder (SSD) participated in the study. The Articulation Subtest (SET) of the Turkish Articulation and Phonology Test (SST) was used to assess the children's articulation skills. The study's procedures comprised two stages. First, in the Baseline Pilot Stage, five speech-language pathologists (SLPs; four graduate SLPs and one SLP with a PhD degree) conducted in-person assessments on seven children, and their agreement was examined (α for five SLPs = .950; p < .0001). In the Main Assessment Stage, four SLPs assessed 27 children synchronously on four separate days through either online (two SLPs) or in-person (the other two SLPs) clinician roles, which changed daily. Online evaluators did not use microphones and headphones to avoid any advantage. The agreement among the four raters was examined by calculating the intraclass correlation coefficient. RESULTS: The results revealed an excellent level of agreement regarding overall assessment between online and in-person clinicians (p < .0001). All articulation manners were acceptable, good, or excellent. However, some sounds' (α < .7 for /d/, /É£/, /b/; α < .8 for /p/, /ʃ/, /t/, /l/, /v/) reliability levels were relatively low compared with others. CONCLUSIONS: There may be certain restrictiveness regarding discriminating visual or auditory clues related to certain phonemes in a telepractice environment. This restrictiveness may be related with sonority and with differentiation between minimal pairs where visual clues are limited.

The Immediate and Long-Term Effects of Tube and Mask+Tube Phonation in Water Exercises and Their Duration as Measured by Electroglottographic and Nasometric Parameters.

OBJECTIVE: This study investigated the immediate effects and their persistence (at 15 minutes) of various durations of semi-occluded vocal tract exercise (SOVTE) (standard tube into water and modified mask+tube into water exercises) as measured by electroglottographic (EGG) and nasometric parameters. METHODS: The study included 30 women aged 19 through 28 years with healthy voices, and it comprised five randomly implemented procedures (Ps): P1-tube phonation into water for 5 minutes; P2-tube phonation into water for 10 minutes; P3-tube+ventilation mask phonation into water for 5 minutes; P4-tube+ventilation mask phonation into water for 10 minutes; P5-phonation with ventilation mask for 5 minutes. Fifteen-minute voice rest breaks were provided between each procedure. Nasometric and electroglottographic measurements were taken before, during, immediately after and at 5, 10, and 15 minutes after the exercises, and the recorded measurements were analyzed. RESULTS: The immediate effects of P3 and P4 on voice quality showed better performance than the other procedures. Among all the procedures, P1 had the smallest effect on voice quality in terms of nasometric and EGG parameters and the least degree of effect permanence. In all the fluctuating SOVTE procedures except P1, the nasalance scores decreased (P1, P2, P3, and P4: fluctuating SOVTE; P5: steady SOVTE). CONCLUSION: The tube phonation exercises modified by the addition of a ventilation mask were highly advantageous in terms of EGG parameters. In addition to this, regardless of the mode of application of the retention time, it was observed that the positive effect (ie, lower vertical laryngeal position) of the exercises applied for 10 minutes was higher than the exercises applied for 5 minutes.

Receiver operating characteristic analysis of acoustic and electroglottographic parameters with different sustained vowels.

OBJECTIVE: To examine the power of the parameters obtained from different sustained vowels used in acoustic and electroglottographic (EGG) voice evaluation protocols to discriminate between dysphonic and non-dysphonic voice quality. METHODS: Sixty non-dysphonic participants and 30 dysphonic participants were included in the study. In addition to the time domain amplitude and frequency perturbation parameters obtained from the sustained phonation of /ʌ/-/ɛ/-/i/-/u/ vowels, several frequency-domain spectral/cepstral parameters and EGG parameters were evaluated. The classification performance of the acoustic and electroglottographic measures was quantified using analysis and receiver operating characteristic (ROC) curve analysis. RESULTS: As a result of ROC analysis, the discriminative diagnostic performance (area under the curve, AUC) of the test for low-vowel (/ʌ/-/ɛ/) phonation was higher than values obtained from high-vowel (/i/-/u/) phonation. For /ʌ/ and /ɛ/ sustained vowels, the parameters exhibiting the highest discrimination were fundamental frequency standard deviation (fo/STD), cepstral peak prominence (CPP), relative average perturbation (RAP), pitch perturbation quotient (PPQ), and jitter percent (JITT). In the EGG parameters, on the other hand, average jitter and periodicity parameters obtained from front vowels (/ɛ/-/i/) were found to have higher AUC values compared to back vowels (/ʌ/-/u/). CONCLUSIONS: In acoustic analyses, /ʌ/ and /ɛ/ sustained vowels give the highest diagnostic performance. In the electroglottographic evaluation, on the other hand, /ɛ/ and /i/ vowels, when the position of the tongue is forward, have better classification performance compared to /ʌ/ and /u/ vowels, when the position of the tongue is back.

Stuttering therapy through telepractice in Turkey: A mixed method study.

PURPOSE: The effectiveness of telepractice in stuttering therapy in Turkey may be unclear, but there is good evidence for the efficaciousness of it from other countries, e.g., Australia. The purpose of the present study is to compare the outcomes of telepractice and in-person therapy delivery on traditional stuttering treatment and explore telepractice stuttering therapy experience in Turkey. METHODS: 20 adults who stutter participated in the study. Half the participants received treatment via telepractice, while the others were provided with services in-clinic. Based on a convergent parallel mixed-method research, quantitative (Study 1) and qualitative data (Study 2) were collected in parallel, analyzed separately, and then combined. Study 1 included a non-inferiority controlled trial, repeated measures, quasiexperimental design. Within the scope of the quantitative research, the objective clinical data, including the scale and assessment scores, were collected from two groups in three stages. Study 2 used the phenomenology approach to assess the qualitative aspects of our study. RESULTS: According to the quantitative findings in Study 1, the effectiveness of telepractice and in-person in the post-test and follow up is not significantly different. The following themes emerged out of the qualitative data analysis in Study 2: expectation, telepractice-participant suitability and advantages of telepractice, technology, therapy techniques and clinician skills, therapeutic components, satisfaction, and preference. CONCLUSION: The triangulation of quantitative and qualitative findings indicated that these data sets were compatible in general. The results show that telepractice is equally effective as the in-person method as a service delivery method for adults who stutter.