INSTRUMENTATION FOR VOICE

ASSESSMENT
Voice : science and disorders
01 Visualization Techniques

Vocal tract visualization and imaging is the collection of procedures for

performing a detailed visual examination of the vocal tract and laryngeal and
velopharyngeal structures and gross function, including vocal fold vibration.

These procedures enable a speech-language pathologist (SLP) to further

assess and plan treatment strategies for

• Voice,
• Deglutition
• Resonance disorders.
Visualization Techniques used -

 Fibroptic endoscopic evaluation of swallowing (FEES)

 Rigid fiberoptic oral endoscopy (RFOE)
 Videolaryngoendoscopy (either RFOE or FFN)
 Videostroboscopy
 Fibroptic endoscopic evaluation
of swallowing (FEES)
 Is a portable procedure
 Done by passing an endoscope
transnasally (Langmore et al., 1988).
 FEES is used without concerns of radiation
exposure
 Can be used within therapeutic contexts
and for diagnostic therapy to assess
current progress and effectiveness of
therapy.
 to rule out the possibility of disease in the
nasal, pharyngeal, or laryngeal region.
Procedure
Procedures for FEES vary across settings and across clinicians. Clinicians
should follow guidelines from their facility and licensing body regarding
FEES procedures.

Prior to bolus delivery, the SLP may

• Educate the patient and/or caregiver regarding FEES procedures and

rationale for the examination.
• Position the patient consistent with the patient’s typical eating
posture (e.g., upright, reclined);
• Provide a topical anesthetic if appropriate
Procedure
• Select the appropriate endoscope type and size
• Insert the scope
• Identify anatomical landmarks and any abnormalities
• Administer flexible endoscopic evaluation of swallowing with
sensory testing (FEESST), if indicated, to determine laryngeal
adductor reflex (LAR) sensitivity and vocal fold dynamics
• Assess basic movement abilities of anatomical structures through
specific maneuvers (e.g., have the patient perform the Valsalva
maneuver to evaluate vocal fold closure, ask the patient to say
words with no nasal phoneme stimuli to assess velopharyngeal
closure).
The SLP can test sensation in the hypopharynx and larynx
directly with a modification of the FEES procedure.

Office or bedside method of evaluating both the motor and

sensory components of swallowing, called fiberoptic
endoscopic evaluation of swallowing with sensory testing
(FEESST).
.
 Inability of the patients
Limitations to tolerate the discomfort
Inability to visualise the
oral and esophageal
phase

Limited ability to visulaise the

pharyngeal phase

‘White out’ – passage of bolus

and movement pf pharyngeal
structures cannot be observed –
reflected light
Limitations

discomfort, vomiting, epistaxis (nosebleed), mucosal perforation,

an allergic reaction or hypersensitivity to topical anaesthesia or
nasal spray, and laryngospasm.
 Rigid Fibreoptic Oral
Endoscopy (RFOE)

• Rigid endoscopes are the oldest type on the market.

• They are used in the majority of surgical endoscopic applications

and enable endoscopists to visualize the surface of organs, their
vessels, or pathological changes without large incisions of the
body and delivering a view even more clear than with the naked
eye.
 Rigid endoscopes are made of metal tubes which contain the lenses, and the light
channel(s) and are available in a large range of external diameters, from 1 to 12
mm.

 Rigid endoscopes have a series of high-resolution optical glass rod lenses.

 Images of rigid endoscopes still surpasses that of the fiber-optic or digital images
produced by flexible scopes.
Preparation
Patient Positioning: The patient is usually seated in an upright position in a chair with a
headrest for support.

Pre-Procedure Examination: Conduct a thorough examination of the patient's medical

history, especially focusing on any allergies, bleeding disorders, or conditions that may
affect the procedure.

Anesthesia: Local anesthetic may be applied to the oropharyngeal area to minimize

discomfort. This is often done using a topical spray or gel.
Procedure
1. Insertion of the Endoscope:
1. Gently insert the rigid endoscope through the patient's mouth.
2. Advance the scope slowly and carefully to avoid causing trauma to the oral tissues.

2. Visualization:
1. As the endoscope is advanced, visualize the structures of the oral cavity, including the
tongue, palate, and tonsils.
2. Continue to the oropharynx and larynx, inspecting for any abnormalities such as lesions,
swelling, or anatomical anomalies.
1. Manipulation and Examination:
1. Use the endoscope to manipulate tissues gently if needed to get a better view of certain
areas.
2. If necessary, use additional instruments through the endoscope’s working channel to collect
tissue samples (biopsy) or remove foreign objects.
 Advantages Disadvantages

• high illumination • interference with normal speech

• wide field of view
production
• excellent image reproduction • minor patient discomfort
• smaller diameter rigid endoscopes are • equipment expense
available for pediatric populations or • possible difficulties with gag reflex
those with a smaller oral cavity
Videolaryngoendoscopy
● Video laryngoscopy is an essential
tool in a full-service voice clinic.
● Involves insertion of either a rigid
rod deeply into the mouth, or a
flexible cable through the nostrils
into the pharynx, the procedure is
sufficiently invasive (and not
without risk of discomfort or minor
injury) to require medical
supervision.
Since the captured image is in the form of a movie, both time resolution and
space resolution need to be considered in acquisition of a system.

Time resolution is usually described by the frame rate, the number of

frames (images) captured per second.

Space resolution is described by the two-dimensional pixel array

(eg. 480 x 320 pixels). The expense of the system is directly
related to the time and space resolution

Another dimension added to the system is colour. If adjusted

carefully, some diagnostic information about lesion type,
vascularity, and general tissue health can be gleaned from the
colour images.
Videostroboscopy

• It is the most commonly used clinical method of

visualization of the vocal folds.
• The process of using a pulsing light to simulate
movement at a rate slower than the actual rate of
movement of the object being imaged.
• Stroboscopy, particularly when connected to video
recording equipment, provides the viewer with the
ability to visualize mucosal wave vibration—not
the actual vibration, but a visual estimate of the
vibration.
 Videostroboscopy

• The basic principle of Stroboscopy is based on Talbot law.

• It takes into account the physical reality that images on the human retina
linger for 0.2 seconds after exposure. Therefore, sequential images
produced at interval less than 0.2 seconds produce the illusion of
continuous images.
• It is a special method of examination of a vibrating or fast-moving object,
such as the vocal folds.
 Videostroboscopy

Stroboscopy works because of two visual perceptual features.

• First, the image must be illuminated uniformly without perception of

variation (e.g., flicker).
• Second, motion is perceived from sampling (illuminating briefly)
images at specific points in time (Mehta, Deliyski, & Hillman, 2010)
Instrumentation
• It consists of an endoscope can be made of rigid or flexible material.
They contain a fiberoptic system that conveys light from an external
source into the body, and a lens system which transmits the reflected
image of the internal body surfaces. An eyepiece at one end of the scope
allows the examiner to see the reflected image or allows for the
attachment of a camera for capturing and recording of the image.
• Current technology uses a xenon bulb to generate a very brief and intense
pulse of light. Because the strobe light is the only source of illumination in
an otherwise dark vocal tract, we can see the vocal folds only when they
are illuminated by the brief light pulse. The flash of the light is triggered
by the fundamental frequency as measured by a microphone.
 Instrumentation

• The flash illuminates the vocal folds at a moment in time in the

vibratory cycle. The next flash again illuminates the vocal folds at
another moment in time. The stroboscope can be placed through either
the mouth or the nose. If placed through the mouth, the individual is
limited to sustaining a vowel especially /i/. If the endoscope is placed
through the nose, the individual can speak as he or she would
normally.
 2 Aerodynamic Analysis
Objective measurement of aerodynamic forces driving phonation, which can
include one or more parameters of volume, flow, pressure, and/or vocal
efficiency.
Aerodynamic assessments :

● Allow clinicians to measure respiratory function, laryngeal function,

respiratory–laryngeal coordination, and whether impairment exists in
any of those three domains.
● Allow clinicians to objectively quantify physiological substrates of
phonation.
● Are simple to employ as part of the clinical process and can serve as a visual
biofeedback tool.
● Can be repeated over time to objectively measure changes in phonation
physiology subsequent to voice treatment.
Common clinical aerodynamic measures obtained during
the process of voice evaluation

Pressure
• Mean subglottal pressure (Ps): The average (over time) tracheal air pressure
immediately below the vocal folds which initiates and maintains oscillation.
Measured in cm H2O
• Peak subglottal pressure (Ps): The peak subglottal pressure from a narrow
(in milliseconds) analysis window within a larger temporal frame (total
selected analysis range). Measured in cm H2O
• Phonation threshold pressure (PtP): The minimum Ps required to oscillate
the vocal folds. Measured in cm H2O
Common clinical aerodynamic measures obtained during
the process of voice evaluation

Flow
• Mean transglottal airflow rate (MTAR): The average volume of air flowing
through the glottis over a specific period of time. Measured in L/s or mL/s
• Peak transglottal airflow rate (PTAR): The peak flow rate from a narrow (in
milliseconds) analysis window within a larger temporal frame (total selected
analysis range). Peak flow is greatest at the release of the plosive preceding
onset of the vowel. Measured in L/s or mL/s
• Phonation quotient (PQ): An estimate of transglottal airflow. The ratio of
vital capacity to maximum phonation time (VC/MPT). Measured in mL/s
Common clinical aerodynamic measures obtained during
the process of voice evaluation

Volume

• Vital capacity (VC): The quantity of air that can be exhaled from the
lungs following as deep an inhalation as possible. Measured in L or
mL
• Phonation volume: The quantity of air that can be exhaled from the
lungs while voicing (e.g., sustained vowel) following as deep an
inhalation as possible. Measured in L or mL
 Common clinical aerodynamic measures obtained during
the process of voice evaluation

Efficiency

• S/Z ratio: An estimate of aerodynamic efficiency. The ratio of maximum

phonation time for /s/ to maximum phonation time for /z/. Measured in
seconds
• Laryngeal resistance: An indicator of the degree of resistance applied to
the air supply by the vocal folds. The ratio of Ps to airflow (Ps/flow),
measured in cm H2O / mL/s
• Maximum phonation time (MPT): The maximum duration of sustained
vowel production following as deep an inhalation as possible. Measured
in seconds
Aerodynamics and Phonation

Voice production is accomplished by converting aerodynamic

energy (pressure and flow) into acoustic energy (sound).
The aerodynamic energy of voice production originates from
differential pressures between the lower vocal tract (lungs and
trachea) and upper vocal tract (larynx and supraglottal spaces),
resulting in airflow. The larynx acts as a valve that applies
varying degrees of resistance to this airflow. Pressure, airflow,
and resistance are related to each other.
Aerodynamics and Phonation
A number of physical impairments can cause inefficiencies or
ineffectiveness of phonation and the accompanying aerodynamic
characteristics. Impairments that result in measurable changes to
aerodynamic forces in phonation include, among other things:
● Restricted lung capacity due to disease or muscular weakness.
● Hypokinesia or hyperkinesia of the respiratory and/or intrinsic
laryngeal muscles resulting from neurological or functional etiologies.
● Lesions affecting the vocal fold tissue.
● Ineffective posturing of the supraglottal structures and spaces.
Aerodynamics and Phonation
These conditions may result in ineffective respiratory support for
phonation, altered vibratory dynamics creating irregularities and
inefficiencies in vocal fold oscillation, or both. In addition to altered
aerodynamic measurements, clinical signs and symptoms related to these
impairments include

● Short phrase lengths (few words in one breath).

● Fatigue with prolonged speaking.
● Perceptions of excessive effort when speaking
01 Hand-Held Spirometer

 Calibrate the spirometer as per manufacturer’s specifications or using a

known volume of air.
 Attach a new flow tube onto the spirometer.
 Place a nose clip on the speaker’s nares.
 Instruct the speaker as follows: “Take two comfortable breaths, inhaling
and exhaling. On the third breath, inhale as deeply as you can, place
your mouth and lips completely around the flow tube, and exhale
forcefully into the tube. Keep exhaling until you completely run out of
air.”
 The clinician should make sure the speaker’s lips are sealed around the
flow tube and that air does not leak around the tube during the task.
01 Hand-Held Spirometer

A number of factors can influence measures of VC, including the speaker’s

Gender, age, body mass, and height. These factors have been accounted
for in equations which can be used to estimate VC in a normal, healthy
speaker against which a patient’s VC can be compared. Many different
reference formulas have been generated based on various population
samples. As an example, the following formulas have been used as
estimates of predicted VC and referenced in a number of publications
associated with voice production
 VC (mL) Males: [27.63 – (0.112 × Age)] × Height (cm).
 VC (mL) Females: [27.78 – (0.101 × Age)] × Height (cm).
 02 Wet Spirometer
Wet spirometer is a device used in pulmonary function testing (PFT) to measure lung
volumes and capacities by directly displacing water.
A wet spirometer operates on the principle of Boyle's Law, which states that the volume
of gas varies inversely with the pressure at a constant temperature. As the
subject breathes into the spirometer, the volume of air displaced causes water levels
in a chamber or bell to rise or fall.
A wet spirometer consists of a bell or chamber partially filled with water. As the subject
exhales or inhales into the spirometer, the displacement of air causes the water level
to move, thereby measuring the volume of air moved.
The volume of air displaced is calculated based on the movement of the water level
in the spirometer chamber. The device is calibrated to convert the movement of
water into an accurate measurement of lung volume.
02 Wet Spirometer

Application
 Wet spirometry is used to measure various lung volumes, including
tidal volume, inspiratory reserve volume, expiratory reserve
volume, and residual volume.
 It helps calculate vital capacity (the maximum amount of air that can
be exhaled after a maximum inhalation) and total lung capacity (the
total volume of air in the lungs at the end of maximal inhalation).
02 Wet Spirometer

Advantages:
• Provides direct measurement of lung volumes by displacement of
water, making it a simple yet effective method for basic lung function
assessment.
• Compared to more advanced spirometry devices, wet spirometers are
typically more affordable and require minimal maintenance.
02 Wet Spirometer

Limitations:
• Depending on the design and calibration, wet spirometers may have
limitations in accuracy compared to modern digital spirometry
devices.
• Requires manual recording and calculation of results, which can be
time-consuming and prone to human error.
03 Dry Spirometer

A dry spirometer is a type of spirometer used in pulmonary function testing

(PFT) to measure lung volumes and capacities without the use of
water displacement.
Dry spirometers measure lung volumes based on the displacement of air
through a flow sensor or pneumotachometer. The device detects the
flow rate and integrates it over time to calculate the volume of air
moved during inhalation and exhalation.
03 Dry Spirometer

Components:
Flow Sensor: A key component that measures the rate of airflow during breathing.
Electronic Interface: Typically includes a display screen to show real-time flow
rates and volumes, as well as data storage capabilities.
Mouthpiece and Tubing: Used for the subject to breathe through, ensuring that all
exhaled and inhaled air passes through the flow sensor.
Measurement Process: The subject performs a series of breathing manoeuvres as
instructed by the technician or healthcare provider. The flow sensor detects
the speed and volume of air passing through it, providing real-time
measurements of lung volumes and flow rates.
03 Dry Spirometer

Parameters measured include tidal volume, inspiratory and expiratory reserve

volumes, vital capacity, and forced expiratory volume in one second (FEV1),
among others.
03 Dry Spirometer

Applications:
 Diagnostic Testing: Used to assess lung function and diagnose
respiratory conditions such as asthma, chronic obstructive pulmonary
disease (COPD), and restrictive lung diseases.
 Monitoring: Helps monitor disease progression, response to
treatment, and overall lung health over time.
 Screening: Used in occupational health assessments, pre-operative
evaluations, and general health screenings.
03 Dry Spirometer

Advantages:
• Provides accurate and precise measurements of lung volumes and
flow rates.
• Allows immediate assessment and interpretation of results during
testing.
• Data can be stored electronically for easy retrieval, analysis, and
comparison over time.
• Dry spirometers are often portable and can be used in various clinical
settings, including clinics, hospitals, and research laboratories.
03 Dry Spirometer

Limitations:
• Initial cost and maintenance of dry spirometers may be higher
compared to older types of spirometers such as wet spirometers.
• Proper training is required for technicians and healthcare providers to
ensure accurate testing and interpretation of results.
• Requires good patient cooperation and effort to perform the breathing
maneuvers correctly for accurate measurements.
03 Acoustic analysis
• The acoustic spectrogram gives much information about vocal fold oscillations.
• It is the acoustic equivalent of an x-ray, an MRI, or a video image in terms of revealing
"structure" but it relates to time and frequency structure instead of spatial structure.
 01
PRAAT
It is a free scientific computer software package for the analysis of speech in
phonetics. It was developed by Paul Boersma and David Weenik.
It is easily downloadable and widely used in the field of phonetics. A speech sample
can be recorded and analysed in praat.

The basic Praat program has five analysis options:

• Spectrum
• Pitch
• Intensity
• Formants
• Pulses.
 01
PRAAT
While analyzing the speech sample, there will be a speech waveform as well as a
spectrograph. Speech waveform gives information about the duration (horizontal
axis) and loudness (vertical axis) at each part of the recording. In Spectrogram it
is possible to see the energy (shade of grey and black) at each point in time
(horizontal axis) and the frequency (vertical axis).

Pitch curve of the utterance can also be obtained and the exact pitch height at any
part of the recording can also be displayed. Formants can also be displayed. It is
also possible to get a complete report on all the formant values at the selected
location of the signal. Formants, pitch curve, intensity curve and spectrogram can
also be turned off if needed.
 01
PRAAT

Praat has a unique feature which allows the transcription of the utterance to be
displayed below the spectrogram. It offers a general extremely flexible tool to
visualize, play and extract information from a sound object.
Pulse: The user can choose the ‘pulse’ for voice analysis which lists out the frequency
and intensity perturbation measures. This menu contains a number of measures for
quantifying irregularities in the duration (jitter) and amplitude (shimmer) of individual
cycles in voicing.
 02
Multi-Dimensional voice profile (MDVP)
MDVP extracts objective quantitative values on sustained phonation, which are
displayed graphically and numerically in comparison to a built-in normative database.
These are useful in profiling a patient’s voice before and after surgery or voice
therapy and complement stroboscopic, aerodynamic, and other methods used to
assess the patient’s [Link] are totally 33 parameters assessed using MDVP.
Some of the important parameters used for acoustic analysis of speech include:
 02
Multi-Dimensional voice profile (MDVP)
1. Amplitude Perturbation Quotient (APQ) – relative evaluation of period to period
variability of peak to peak amplitude within the analysed voice indicating inability
of cords to support periodic vibrations within a defined period and with presence
of turbulent noise in voice signal.
2. Amplitude tremor intensity index (ATRI) – average ratio of most intense low
frequency amplitude modulating component to the total amplitude of analysed
voice signal indicating magnitude of tremor, which had bot frequency and
amplitude modulation of voice.
3. Degree of sub- harmonic components (%)- estimate relative evaluation of sub
harmonic to f0 components in voice samples indicating presence of double or
triple pitch periods seen in Diplophonia, Glottal fry, Functional dysphonia or
Neurogenic voice disorders
 02
Multi-Dimensional voice profile (MDVP)
4. Degree of voiceless(DUV)(%) – estimated relative evaluation of non – harmonic
areas ( where f0 cannot be detected) in the voice sample
 Checks ability of voice to sustain uninterrupted voicing
 Normative 0 as there are no pauses in normal during sustained voicing
 Indicates pauses before, after or between voiced areas
5. Degree of voice breaks(DVB)- indicates ratio of total length of areas representing
voice breaks to time of complete voice sample. Normative – 0
6. Amplitude tremor frequency (FATR) (Hz) – indicating modulating component in
specified amplitude, it is the frequency of most intensive low frequency amplitude
 02
Multi-Dimensional voice profile (MDVP)
7. Tremor frequency (FFTR)(Hz) – frequency of most intensive low frequency indicating
modulating component in specified frequencies
8. Highest fundamental frequency (FHI)- greatest of all extracted period to period
fundamental frequency of values.
9. Lowest fundamental frequency (FLO) – lowest of all extracted period to period
fundamental frequencies of values
10. Average fundamental frequencies (F0)- average value of all extracted period to
period frequency values.
11. Frequency tremor intensity index (FTRI)(%) – determines strongest periodic
frequency and amplitude modulation of voices.
 02
Multi-Dimensional voice profile (MDVP)
12. Absolute jitter (JITA) – measures in Nsec, evaluation of period to period variability
of pitch period within analysed sample indicating inability of vocal cord to support a
periodic vibration for a defined period and Hoarseness in voice
13. Jitter (%) (JITT) – relative evaluation of very short term period to period variability
of the pitch within analysed sample
14. Noise to harmonic ratio (HNR) – measures noise in a signal indicating amplitude
and frequency variations and turbulent noise, voice breaks
15. Number of sub – harmonic segments (NSH) – pitch found to be sub harmonic of f0.
normative – 0 indicating diplophonia, glottal fry, increasing in voices where double or
triple pitch period replaces fundamental in certain segments over analysis length
 02
Multi-Dimensional voice profile (MDVP)
16. Number of unvoiced segments (NUV) – normative – 0. measures ability of voice to
sustain uninterrupted voicing indicating before and after or between voiced areas.
17. Number of voice breaks (NUB) – number of times fundamental period was
interrupted indicating pauses between voiced areas.
18. Periodic Energy Ratio (PER) – number of pitch periods dictated during voice
sample, It can aid in analyzing prosodic features like pitch contours, intonation
patterns, and rhythm by segmenting speech into appropriate units.
19. Phonatory fundamental frequency range (PFR) – range between FHI and FLO
expressed in number of semi tones
20. Pitch period perturbation quotient (PPQ) – irregularity of pitch period indicating
inability of vocal folds to support periodic vibration within a defined period. Increased
PPQ indicates hoarseness / breathiness.
 02 Multi-Dimensional voice profile (MDVP)
21. Relative average perturbation(RAP)(%)- indicates variability of pitch
22. Smoothed amplitude perturbation quotient (SAPQ)(%)- evaluates amplitude
tremor in voice indicating high smoothening factor and spasmodic dysphonia.
23. Total number of segments (SCG)- Counting segments can help in studying the
distribution and characteristics of phonetic units (e.g., vowels, consonants, syllables)
within the speech signal.
24. ShdB - Measures very short term irregularity of peak to peak amplitude of voice
indicating inability of vocal folds to support periodic vibration, presence of turbulence
noise, harmonic and breathy noise
25. Shimmer % (SHIM) – period to period variability of peak to peak amplitude within
sample
26. Soft phonation index (SPI) – average ratio of low frequency harmonic energy in
range of 70-1600Hz to higher frequency harmonic energy in range of 1600- 4500Hz
indicating tight adduction of vocal folds. Increased value indicates
loosely/incompletely adducted folds.
 02 Multi-Dimensional voice profile (MDVP)
Seen in glottal chinks psychological stress.
27. Smoothed pitch period perturbation (SPPQ)(%) – indicates variability of pitch
period within analysed sample
28. Standard deviation of fundamental frequency (STD)(Hz)- statistical measure that
quantifies the variability or dispersion of the fundamental frequency (F0) values
across a segment of speech.
29. Average pitch period (msec) – average value of all extracted
30. Length of analysed voice data sample (Tsam)-Assessing voice quality and
characteristics over a specific duration
31. Co-efficient of amplitude variation(%) – reveals variations in cycle to cycle
amplitude of voice
32. co-efficient of fundamental frequency (VF0)- indicates variation of F0, indicating
frequency tremors
33. Voice turbulence index (VTF) – average ratio of spectral in harmonic high
frequency energy in range of 2800-5800Hz to spectral harmonic in range of 70-
4500Hz in areas of signal indicating breathiness and incomplete or loose adduction of
 02
Multi-Dimensional voice profile (MDVP)

Perturbation related parameters:

• Absolute Jitter (Jitta)
• Jitter Percent (Jitt)
• Relative Average Perturbation (RAP)
• Pitch Perturbation Quotient (PPQ)
• Smoothed Pitch Perturbation Quotient (sPPQ),
• Shimmer in dB (ShdB),
• Shimmer Percent (Shim)
• • Smoothed Amplitude Perturbation Quotient (sAPQ).
 03
VAGHMI
2. Off-Line measurements:

In Off-Line measurements, tests are made and a report is prepared.

Off-Line measurements are:

• F0 and Intensity
• Jitter and Shimmer
• LTAS and HNR
• EGG
• Dysfluency Analysis
 04
DR SPEECH
• It is a voice activated software device. It is a game like tool to provide real time
reinforcement of a client's attempts to produce in pitch, loudness, voiced/unvoiced
phonation, voicing onset and MPD.
• Vocal assessment: It allows the user to record, analyse and display the
acoustic and EGG signal in real time. The program will automatically compute
statistical information and plot a voice profile from a sustained vowel.
• Capturing the subject’s video image and recording progress from 1 session to
another session can easily be obtained.
• Vocal assessment provides objective, non-invasive, measures from acoustic and EGG
signals comparison can be made with a normative database. Based on the
comparison preliminary vocal function, harshness, regularity of vocal fold
vibration and glottal closure time.
 05
CSL (Computerized Speech Lab)

• The Computerized Speech Lab (CSL) is a comprehensive system developed by

KayPENTAX (formerly Kay Elemetrics) for the analysis and assessment of speech
and voice. It is widely used in clinical and research settings within the fields of
speech-language pathology, otolaryngology (ENT), and phonetics
• CSL is a computer-based system developed by KayPENTAX (formerly Kay
Elemetrics) for the acoustic analysis of speech and voice.
 05
CSL (Computerized Speech Lab)

Components of CSL

1. Hardware

• Microphones and Headsets: High-quality microphones and headsets are used to capture speech and voice
signals with accuracy.
• Analog-to-Digital Converters: These devices convert analog speech signals into digital format for
computer analysis.
• Computer Interface: CSL systems are connected to a computer or workstation equipped with specialized
software for data acquisition, analysis, and display.
 05 CSL (Computerized Speech Lab)

2. Software:

• Data Acquisition: CSL software allows real-time acquisition of speech and voice signals, capturing
various parameters such as pitch, intensity, duration, and spectral characteristics.
• Analysis Tools: Provides a range of tools for acoustic analysis, including:
• Fundamental Frequency (Pitch): Measures the frequency of vocal fold vibration during speech.
• Intensity (Loudness): Quantifies the amplitude of the speech signal.
• Jitter and Shimmer: Assess variations in frequency and amplitude, respectively, which can indicate
vocal fold irregularities.
• Harmonic-to-Noise Ratio (HNR): Evaluates the ratio of harmonics to noise in the voice signal,
indicating voice quality.
• Generates detailed reports summarizing findings from the acoustic analysis for diagnostic and treatment
planning purposes.
 05
CSL (Computerized Speech Lab)
Advantages of CSL

• Objective Measurements: Provides precise and objective measurements of speech and voice parameters,
enhancing diagnostic accuracy.
• Real-time Analysis: Enables real-time observation and analysis of speech signals during assessments.
• Quantitative Data: Generates quantitative data that can be compared longitudinally to track progress and
treatment outcomes.
• Educational Tool: Used in educational settings to teach students about acoustic analysis and speech
pathology.
 05 CSL (Computerized Speech Lab)

Applications of CSL:
• Voice Assessment: CSL is used to evaluate voice disorders such as vocal nodules, polyps,
laryngeal tension, and dysphonia (voice disorders).
• Provides objective measurements of voice quality and characteristics, helping clinicians
make accurate diagnoses and monitor treatment outcomes.
• Speech Analysis: Helps assess speech production, articulation, fluency, and prosody (rhythm
and intonation). Useful in diagnosing speech disorders such as stuttering, dysarthria, and
apraxia of speech.
• Research: CSL systems are extensively used in research studies within fields such as
phonetics, speech science, and voice physiology. Facilitates the investigation of speech
production mechanisms, acoustic correlates of speech disorders, and effectiveness of
therapeutic interventions.
 06 lingWAVES
• An international acknowledged and leading system for acoustic voice assessment. A
complete system with tested and standardized hardware.
• The system consists of different modules managed by the lingWAVES basis user
interface. A client manager allows a patient/client based analysis and
documentation with the benefit of comparing and tracking results over time.
• The modular character of lingWAVES allows to offer different module
combinations (suites) so that a wide range of professional users can use the system,
starting from speech and language therapy, over Otolaryngology /ENT up to
services for professional singers and speakers.
 06 lingWAVES
• different acoustic suites available - each suite can be upgraded with a nasality
and/or electroglottography module - using the same client management.
• lingWAVES offer a complete system with software and tested and standardized
hardware. On request it’s also deliver a pre-configured and ready-to-run
computer/notebook.
• lingWAVES Sets and Suites: here are some special collections of modules that
focus on different needs of our customers. Suites and upgrades can be combined
using one user interface and client management.
 06 lingWAVES
Available suites
• lingWAVES Voice Clinic Suite Pro
• lingWAVES SLP Suite Pro VPR
• lingWAVES Voice Protocol (VPR)
• lingWAVES TheraVox
Upgrades for suites, also usable stand alone:
• lingWAVES Nasality
• lingWAVES Electroglottography (EGG)

A continuous and highly productive development and maintenance is not common for
speech and voice assessment tools.
06 lingWAVES
04 Surface Measures On The Skin
To Detect Vibration

When vocal fold vibration occurs, energy is transmitted to the

surface of the body; this vibrational energy can be felt with
manual contact on the neck, checks, or chest. It can also be picked
up with an accelerometer or a contact microphone. The signal
represents tissue movement produced by acoustic
pressures in the airways.
 01 ELECTROGLOTTOGRAPHY

Electroglottography provides a waveform that has been shown to correspond to the

relative contact of the vocal folds during vibration (Childers & Krishnamurthy,
1985; Colton & Conture, 1990; Scherer, Drucker, & Titze, 1988).
 00 Instrumentation
The Electroglottography, produces the EGG waveform, it consists of a pair of surface
electrodes that are placed on the outside of the neck over the left and right sides of the
thyroid cartilage.
• The electrodes are connected to a signal generator that supplies a very high-
frequency (300 kHz to 5 MHz), low-voltage (approximately 0.5 V) current
through the electrodes.
• The electrical current that flows across the neck from one electrode to the other
does not harm the tissue and is not felt by the individual being tested.
• This is because of the combination of very high frequency and very low voltage
of the signal.
 00 Instrumentation
• Tissue is generally an excellent conductor of electricity, whereas air is a very poor
conductor of electricity.
• If the vocal folds are open, the air gap across the glottis offers considerable
resistance to the flow of electricity. If the vocal folds are in contact, then the
resistance to the electrical flow across the electrodes is quite low.
• The resistance varies as a function of the degree of contact of the vocal folds.
• When connected to an output device such as a computer with the appropriate
display software, the resulting waveform depicts the change in resistance across the
two electrodes, which corresponds to the relative contact of the vocal folds.
 00 Instrumentation

Opening phase is of greater duration than the closing phase, and the closed phase
occupies the shortest duration of the vibratory cycle within the range of typical
speaking ƒo for men and women.
05 Measurement Of Muscle Activity
 01 ELECTROMYOGRAPHY

• Electromyography (EMG) is the most direct way to assess muscle activation of

the larynx and articulators (Hillel, 2001).
• It is clinically feasible only with medical supervision and laryngological expertise.
• The most discriminate signals are obtained with thin bipolar hooked-wire
electrodes inserted into the muscles through the skin of the neck.
• But useful data can sometimes be obtained with surface electrodes or monopolar
needle electrodes.
• With hooked-wire electrodes, a pair of hair-thin wires is inserted into the belly of a
laryngeal muscle (eg, cricothyroid or thyroarytenoid) with a needle cannula. When
the needle cannula is retracted, the wires stay in place (with a small separation
between the tips) because they are hooked to the muscle fibers, like fishhooks.
 01 ELECTROMYOGRAPHY
• As invasive as this may seem, it is rare that a subject feels any discomfort after a
day or two, given that muscle tissue heals relatively fast.
• The needle tracks created by EMG are less severe, and the subjects would only get
a few insertions in a typical EMG session.
• More importantly, several months of rest time are generally recommended if
repeated sessions are necessary.
• The EMG signal recorded from the electrodes is amplified and processed to
obtain a graph of muscle activity over time.
• changes that occur with pitch, loudness, and voice quality are meaningful if the
hooked wires stay in place during a session. Re-insertion changes the magnitude
and nature of the EMG signal (Hillel, 2001)
06 Measures Of Resonance
 01 NASOMETRY

Nasometry is a computer-based procedure used to measure the acoustic correlates of

resonance and audible nasal emission. Nasometry provides indirect information
regarding the function of the velopharyngeal valve.

During production of the speech passage, the Nasometer II (Kay PENTAX, Montvale,
NJ) captures data regarding acoustic energy from both the nasal cavity and the oral
cavity during speech in real time. It then calculates the average ratio of nasal/total
(nasal plus oral) acoustic energy and converts this to a percentage value for the
nasalance score. This score gives the examiner information about the relative
percentage of nasality in speech.
 01 NASOMETRY

The aerodynamic procedure involves the use of oral and nasal catheters that are
connected to pressure transducers, and a flow tube that is connected to a heated
pneumotachograph. The transducers convert the detected air pressure or flow into
electrical signals. The pneumotachograph determines the rate of airflow.
 02 TONAR
TONAR as an instrumental approach to the measurement of nasality.
TONAR is a system that makes use of separated oral and nasal signals to quantitize
nasality" (Fletcher and Bishop, 1970).
The principal purpose of this system is to enable the calculation of ratios that reflect
the relative acoustic output emitted from the nose versus the mouth. Separation of
sound emitted from the nose and mouth during speech is accomplished by two lead
chambers designed to conform with general external facial contours. Individual
microphones suspended in fiberglass packing are contained in both the oral and the
nasal chambers of the sound separator.
 02 TONAR
Speech signals obtained in this microphone-sound separator system are used to derive
a numerical acoustic ratio score, expressed as "nasalance percentage." These resultant
measures are purported to reflect the relative ratio of acoustic energy within selected
frequency passbands emitted from the nose and mouth during speech.
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