Relationship Between Laryngeal Signs and Symptoms, Acoustic Measures, and Quality of Life in Finnish Primary and Kindergarten School Teachers

Abstract

Objective This study investigated the relationship between the acoustic measure smoothed cepstral peak prominence (CPPS), teacher's quality of life as measured by the voice activity and participation profile (VAPP), laryngeal signs and symptoms, voice related health problems and laryngoscopic findings in Finnish teachers. The relationship between CPPS and sound pressure level (SPL) was also assessed. Methods Vowel and text samples from 183 healthy Finnish teachers (99 kindergarten teachers [KT] and 84 primary school teachers [PST]) were analyzed for CPPS. Text reading was recorded in conversational loudness by PST, and KT were recorded wearing headphones, while listening to a masking noise of children talking to simulate their classroom voice and environment. CPPS values were correlated with the VAPP, self-reported laryngeal signs and symptoms, voice related health variables, and laryngoscopic findings. Results There was a significant difference between the two groups for CPPS text, PST showed significantly lower CPPS values (10.44) than KT (11.52). There was no difference between the two groups for CPPS vowel phonation. There was a significant correlation between SPL text and CPPS text for KT (P < 0.001, r = 0.43) but not for PST (P < 0.10, r = 0.16). There was a significant correlation between SPL vowel and CPPS vowel for both PST (P < 0.001, r = 0.47) and KT (P < 0.001, r = 0.45). CPPS did not correlate with the VAPP, laryngeal signs and symptoms, health variables or laryngeal findings. Factorial analysis of variance resulted in a significant relationship between the VAPP, laryngeal signs and symptoms, and teacher type. Teacher type and symptoms had a significant effect on VAPP scores. Conclusions In the present work CPPS does not correlate with vocal health indicators of functionally healthy teachers. CPPS was significantly influenced by differences in speaking voice SPL, emphasizing the impact of recording conditions and technique. There was a significant relationship between laryngeal signs and symptoms, teacher type and the VAPP. Laryngeal signs and symptoms and teacher type are important variables and should be included in the clinical evaluation of occupational voice users, and voice problems.

CPPS and Voice-Source Parameters: Objective Analysis of the Singing Voice

“…1,3,16,69 CPPS was determined for each tone using the 'To PowerCepstrogram' function, following the method reported in Watts et al, 3 and used by others. 1,16,19 It is important to note that the 'Peak search pitch range (Hz)' was increased from 60 to 330 Hz (standard) to 60 to 1000 Hz to accommodate the f o of all generated tones in Conditions 1.1 and 1.2. PRAAT has two available methods for determining CPPS, however the newer method used here has proven to be robust and is simpler in implementation.…”

“…Several studies have found that CPPS improved with increased SPL values. 15,17,19,20 In these studies, voice samples were taken from spoken passages and elicited and sustained vowel conditions, all within habitual speech range and at various levels of intensity.…”

A Practical Guide to Calculating Cepstral Peak Prominence in Praat

“…Although numerous studies have shown the strong relationship between dysphonia and CPP 3,[7][8][9][10][11][12][13][14][15][16] , significant external factors unrelated to dysphonia may also influence CPP. These factors include patient-controlled factors (such as prosodic changes in loudness or fundamental frequency [17][18][19][20][21][22][23][24] ), recording environment or microphone used 25,26 , stimuli type (sustained vowel, continuous speech), and phonemes present in stimuli 17,[27][28][29][30][31][32][33] , as well as the program used to calculate CPP values 9,10,15,24,26,27,[34][35][36] . Therefore, it is essential that clinicians using CPP reduce as many of these external factors as possible when comparing across patients or within the same patient across time points (i.e., before and after therapy).…”

Systems Approaches to Occupational Vocal Health: Considerations for Community Faith Leaders

“…Systemically addressing occupational vocal health is advocated for the 25–33% of global labour forces who are vocally reliant to undertake work-related activity and participation (Buckley et al in press; Palheta Neto et al, 2009 ; Titze et al, 1997 ; Vilkman, 2001 , 2004 ). Reliance on voice for workability increases workers’ risks of poor vocal health (Buckley et al, 2015 ; Fuentes-López et al, 2019 ; Morawska & Niebudek-Bogusz, 2017 ; Munier et al, 2019 ; Rezende et al, 2020 ; Titze et al, 1997 ; Verdolini & Ramig, 2001 ). In overall terms, poor vocal health also negatively affects vocally reliant workers’ health and well-being.…”