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Purpose: The goal of this review article is to provide a summary of the progression of altered auditory feedback (AAF) as a method to understand the pathophysiology of voice disorders. This review article focuses on populations with voice disorders that have thus far been studied using AAF, including individuals with Parkinson's disease, cerebellar degeneration, hyperfunctional voice disorders, vocal fold paralysis, and laryngeal dystonia. Studies using AAF have found that individuals with Parkinson's disease, cerebellar degeneration, and laryngeal dystonia have hyperactive auditory feedback responses due to differing underlying causes. In persons with PD, the hyperactivity may be a compensatory mechanism for atypically weak feedforward motor control. In individuals with cerebellar degeneration and laryngeal dystonia, the reasons for hyperactivity remain unknown. Individuals with hyperfunctional voice disorders may have auditory–motor integration deficits, suggesting atypical updating of feedforward motor control. Conclusions: These findings have the potential to provide critical insights to clinicians in selecting the most effective therapy techniques for individuals with voice disorders. Future collaboration between clinicians and researchers with the shared objective of improving AAF as an ecologically feasible and valid tool for clinical assessment may provide more personalized therapy targets for individuals with voice disorders.

Purpose: Auditory feedback is thought to contribute to the online control of speech production. Yet, the standard method of estimating auditory feedback control (i.e., reflexive responses to auditory–motor perturbations), although sound, requires specialized instrumentation, meticulous calibration, unnatural tasks, and specific acoustic environments. The purpose of this study was to explore more ecologically valid features of speech production to determine their relationships with auditory feedback mechanisms. Method: Two previously proposed measures of within-utterance variability (centering and baseline variability) were compared with reflexive response magnitudes in 30 adults with typical speech. These three measures were estimated for both the laryngeal and articulatory subsystems of speech. Results: Regardless of the speech subsystem, neither centering nor baseline variability was shown to be related to reflexive response magnitudes. Likewise, no relationships were found between centering and baseline variability. Conclusions: Despite previous suggestions that centering and baseline variability may be related to auditory feedback mechanisms, this study did not support these assertions. However, the detection of such relationships may have required a larger degree of variability in responses, relative to that found in those with typical speech. Future research on these relationships is warranted in populations with more heterogeneous responses, such as children or clinical populations. Supplemental Material https://doi.org/10.23641/asha.17330546