SLPCase-ControlJournal of voice : official journal of the Voice Foundation2021

Effects of Vocal Intensity and Fundamental Frequency on Cepstral Peak Prominence in Patients with Voice Disorders and Vocally Healthy Controls.

Meike Brockmann-Bauser, Jarrad H Van Stan, Marilia Carvalho Sampaio and 3 others

PMID 31859213

WHAT IT FOUND

Louder voice production significantly increases the acoustic measure of voice quality (CPPS), independent of pathology.

A quiet speaker may score lower than a loud one with the same vocal health. Clinicians must control for sound pressure level when interpreting these scores.

Key findings

01CPPS increased by an average of 2.2 dB for every 10 dB increase in voice sound pressure level.

02Fundamental frequency (pitch) had a much weaker relationship with CPPS than loudness did.

03In soft phonation, healthy controls had significantly higher CPPS scores than patients, but no group difference was found at comfortable or loud volumes.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study included only women, so results may not apply to men. 60% of participants were professional vocal performers (singers/actors), which may not represent the typical clinical caseload of untrained voices. The study only examined sustained vowels, not connected speech. The range of fundamental frequencies produced was limited, so the effect of pitch extremes is unknown.

Declared interests

The authors declare no conflicts of interest. The study was supported by grants from the National Institute on Deafness and Other Communication Disorders (NIDCD) and the National Institute of Biomedical Imaging and Bioengineering (NIBIB).

The easy way to misread this

Do not assume that a low CPPS score indicates vocal pathology. The study shows that quieter voices naturally produce lower scores. A patient with healthy vocal folds who speaks softly may have the same acoustic profile as a patient with dysphonia who speaks loudly.

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