The most common types of voice disorders are associated with hyperfunctional voice use in daily life. Although current clinical practice uses measures from brief laboratory recordings to assess vocal function, it is unclear how these relate to an individual's habitual voice use. The purpose of this study was to quantify the correlation and offset between voice features computed from laboratory and ambulatory recordings in speakers with and without vocal hyperfunction. Features derived from a neck-surface accelerometer included estimates of sound pressure level, fundamental frequency, cepstral peak prominence, and spectral tilt. Whereas some measures from laboratory recordings correlated significantly with those captured during daily life, only approximately 6-52% of the actual variance was accounted for. Thus, brief voice assessments are quite limited in the extent to which they can accurately characterize the daily voice use of speakers with and without vocal hyperfunction.

We investigate the connection between the autonomic nervous system and the voice in patients with vocal hyperfunction and healthy-control groups. We present a methodology and preliminary results of two multi-modal measurement streams that capture this relationship. Subjects were instrumented for daily, ambulatory collection of their voice and wrist-based electrodermal activity. Measures of vocal function (e.g., fundamental frequency) were computed, as well as measures of autonomic function (e.g., skin conductance response). Spearman correlation coefficients were calculated to measure the relationship between vocal and autonomic function over sliding windows throughout each observation day. We found preliminary evidence that patients with a subtype of vocal hyperfunction (non-phonotraumatic vocal hyperfunction) exhibit a coupling between the autonomic nervous system and the vocal system. Understanding how the autonomic nervous system interacts with the voice may provide new insights into the etiology/pathophysiology of vocal hyperfunction and improve prevention, diagnosis and treatment of these disorders.

The goal of this study was to investigate the performance of different feature types for voice quality classification using multiple classifiers. The study compared the COVAREP feature set; which included glottal source features, frequency warped cepstrum and harmonic model features; against the mel-frequency cepstral coefficients (MFCCs) computed from the acoustic voice signal, acoustic-based glottal inverse filtered (GIF) waveform, and electroglottographic (EGG) waveform. Our hypothesis was that MFCCs can capture the perceived voice quality from either of these three voice signals. Experiments were carried out on recordings from 28 participants with normal vocal status who were prompted to sustain vowels with modal and non-modal voice qualities. Recordings were rated by an expert listener using the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), and the ratings were transformed into a dichotomous label (presence or absence) for the prompted voice qualities of modal voice, breathiness, strain, and roughness. The classification was done using support vector machines, random forests, deep neural networks and Gaussian mixture model classifiers, which were built as speaker independent using a leave-one-speaker-out strategy. The best classification accuracy of 79.97% was achieved for the full COVAREP set. The harmonic model features were the best performing subset, with 78.47% accuracy, and the static+dynamic MFCCs scored at 74.52%. A closer analysis showed that MFCC and dynamic MFCC features were able to classify modal, breathy, and strained voice quality dimensions from the acoustic and GIF waveforms. Reduced classification performance was exhibited by the EGG waveform.

Monitoring subglottal neck-surface acceleration has received renewed attention due to the ability of low-profile accelerometers to confidentially and noninvasively track properties related to normal and disordered voice characteristics and behavior. This study investigated the ability of subglottal neck-surface acceleration to yield vocal function measures traditionally derived from the acoustic voice signal and help guide the development of clinically functional accelerometer-based measures from a physiological perspective. Results are reported for 82 adult speakers with voice disorders and 52 adult speakers with normal voices who produced the sustained vowels /a/, /i/, and /u/ at a comfortable pitch and loudness during the simultaneous recording of radiated acoustic pressure and subglottal neck-surface acceleration. As expected, timing-related measures of jitter exhibited the strongest correlation between acoustic and neck-surface acceleration waveforms (r≤0.99), whereas amplitude-based measures of shimmer correlated less strongly (r≤0.74). Additionally, weaker correlations were exhibited by spectral measures of harmonics-to-noise ratio (r≤0.69) and tilt (r≤0.57), whereas the cepstral peak prominence correlated more strongly (r≤0.90). These empirical relationships provide evidence to support the use of accelerometers as effective complements to acoustic recordings in the assessment and monitoring of vocal function in the laboratory, clinic, and during an individual's daily activities.

Many common voice disorders are chronic or recurring conditions that are likely to result from inefficient and/or abusive patterns of vocal behavior, termed vocal hyperfunction. Thus an ongoing goal in clinical voice assessment is the long-term monitoring of noninvasively derived measures to track hyperfunction. This paper reports on a smartphone-based voice health monitor that records the high-bandwidth accelerometer signal from the neck skin above the collarbone. Data collection is under way from patients with vocal hyperfunction and matched-control subjects to create a dataset designed to identify the best set of diagnostic measures for hyperfunctional patterns of vocal behavior. Vocal status is tracked from neck acceleration using previously-developed vocal dose measures and novel model-based features of glottal airflow estimates. Clinically, the treatment of hyperfunctional disorders would be greatly enhanced by the ability to unobtrusively monitor and quantify detrimental behaviors and, ultimately, to provide real-time biofeedback that could facilitate healthier voice use.