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https://codas.org.br/article/doi/10.1590/2317-1782/20242023047pt
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Cepstral Peak Prominence Smoothed - CPPS e Acoustic Voice Quality Index - AVQI em vozes infantis saudáveis e alteradas: comparação, relação com julgamento perceptivo-auditivo e pontos de corte

Cepstral Peak Prominence Smoothed - CPPS and Acoustic Voice Quality Index - AVQI in healthy and altered children’s voices: comparation, relationship with auditoryperceptual judgment and cut-off points

Evelyn Carla dos Santos Rabelo; Ana Paula Dassie-Leite; Vanessa Veis Ribeiro; Glaucya Madazio; Mara Suzana Behlau

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Resumo

RESUMO: Objetivo: Comparar as medidas acústicas de Cepstral Peak Prominence Smoothed (CPPS) e Acoustic Voice Quality Index (AVQI) de crianças com vozes normais e alteradas, relacionar com o julgamento perceptivo-auditivo (JPA) da voz e estabelecer pontos de corte.

Método: Gravações vocais das tarefas de vogal sustentada e contagem de números de 185 crianças foram selecionadas em um banco de dados e submetidas a análise acústica com extração das medidas de CPPS e AVQI, e ao JPA. O JPA foi realizado individualmente para cada tarefa e as amostras foram classificadas posteriormente como normal ou alterada, e para as tarefas em conjunto definindo-se se a criança passaria ou falharia em uma situação de triagem vocal.

Resultados: Crianças com JPA alterado e que falharam na triagem apresentaram valores menores de CPPS e maiores de AVQI, do que as com JPA normal e que passaram na triagem. O JPA da tarefa de vogal sustentada se relacionou ao CPPS e AVQI, e da tarefa de contagem de números relacionou-se apenas ao AVQI e CPPS números. Os pontos de corte que diferenciam crianças com e sem desvio vocal são 14,07 para o CPPS vogal, 7,62 para o CPPS números e 2,01 para o AVQI.

Conclusão: Crianças com JPA alterado apresentaram maiores valores de AVQI e menores valores de CPPs. O JPA da tarefa de vogal previu todas as medidas acústicas, porém, de contagem previu apenas as medidas extraídas dela. As três medidas foram semelhantes na identificação de vozes sem desvio e vozes disfônicas.

Palavras-chave

Voz, Crianças, Acústica, Pico Cepstral, Qualidade Vocal

Abstract

Purpose: To compare the acoustic measurements of Cepstral Peak Prominence Smoothed (CPPS) and Acoustic Voice Quality Index (AVQI) of children with normal and altered voices, to relationship with auditory-perceptual judgment (APJ) and to establish cut-off points.

Methods: Vocal recordings of the sustained vowel and number counting tasks of 185 children were selected from a database and submitted to acoustic analysis with extraction of CPPS and AVQI measurements, and to APJ. The APJ was performed individually for each task, classified as normal or altered, and for the tasks together defining whether the child would pass or fail in a situation of vocal screening.

Results: Children with altered APJ and who failed the screening had lower CPPS values and higher AVQI values, than those with normal APJ and who passed the screening. The APJ of the sustained vowel task was related to CPPS and AVQI, and APJ of the number counting task was related only to AVQI and CPPS numbers. The cut-off points that differentiate children with and without vocal deviation are 14.07 for the vowel CPPS, 7.62 for the CPPS numbers and 2.01 for the AVQI.

Conclusion: Children with altered voices, have higher AVQI values and lower CPPS values, when detected in children with voices within the normal range. The acoustic measurements were related to the auditory perceptual judgment of vocal quality in the sustained vowel task, however, the number counting task was related only to the AVQI and CPPS. The cut-off points that differentiate children with and without vocal deviation are 14.07 for the CPPS vowel, 7.62 for the CPPS numbers and 2.01 for the AVQI. The three measures were similar in identifying voices without deviation and dysphonic voices.

Keywords

Voice; Children; Acoustics; Cepstral Peak; Vocal Quality

Referências

1 Carding PN, Roulstone S, Northstone K. The prevalence of childhood dysphonia: a cross-sectional study. J Voice. 2006;20(4):623-30. http://doi.org/10.1016/j.jvoice.2005.07.004. PMid:16360302.

2 Oliveira RC, Teixeira LC, Gama ACC, Medeiros AM. Análise perceptivo-auditiva, acústica e autopercepção vocal em crianças. J Soc Bras Fonoaudiol. 2011;23(2):158-63. http://doi.org/10.1590/S2179-64912011000200013. PMid:21829932.

3 Connor NP, Cohen SB, Theis SM, Thibeault SL, Heatley DG, Bless DM. Attitudes of children with dysphonia. J Voice. 2008;22(2):197-209. http://doi.org/10.1016/j.jvoice.2006.09.005. PMid:17512168.

4 Dejonckere PH. Voice problems in children: pathogenesis and diagnosis. Int J Pediatr Otorhinolaryngol. 1999;49(Suppl 1):S311-4. http://doi.org/10.1016/S0165-5876(99)00230-X. PMid:10577828.

5 Lopes L, Dajer M, Camargo Z. Análise acústica na clínica vocal. In: Lopes L, Moreti F, Ribeiro LL, Pereira EC, editores. Fundamentos e atualidades em voz clínica. Rio de Janeiro: Thieme; 2019. p. 31-47.

6 Behlau M, Azevedo R, Pontes P. Conceito de voz normal e classificação das disfonias. In: Behlau M, editor. Voz: o livro do especialista. Rio de Janeiro: Revinter; 2001. p. 53-84.

7 Costa C, Dassie-Leite AP, Madazio G, Behlau M. Avaliação perceptivo-auditiva da voz: comparação de diferentes tarefas de fala na identificação de crianças com e sem lesões laríngeas. CoDAS. 2023;35(2):e20210198. http://doi.org/10.1590/2317-1782/20212021198en. PMid:36888744.

8 McAllister A, Sjölander P. Children’s voice and voice disorderes. Semin Speech Lang. 2013;34(2):71-9. http://doi.org/10.1055/s-0033-1342978. PMid:23633171.

9 Esen Aydinli F, Özcebe E, İncebay Ö. Use of cepstral analysis for differentiating dysphonic from normal voices in children. Int J Pediatr Otorhinolaryngol. 2019;116:107-13. http://doi.org/10.1016/j.ijporl.2018.10.029. PMid:30554679.

10 Lopes LW, Sousa ESS, Silva ACF, Silva IM, Paiva MAA, Vieira VJD, et al. Cepstral measures in the assessment of severity of voice disorders. CoDAS. 2019;31(4):e20180175. http://doi.org/10.1590/2317-1782/20182018175. PMid:31433040.

11 Awan SN, Roy N, Zhang D, Cohen SM. Validation of the Cepstral Spectral Index of Dysphonia (CSID) as a screening tool for voice disorders: development of clinical cutoff scores. J Voice. 2016;30(2):130-44. http://doi.org/10.1016/j.jvoice.2015.04.009. PMid:26361215.

12 Englert M, Latoszek BB, Maryn Y, Behlau M. Validation of the Acoustic Voice Quality Index, Version 03.01, to the Brazilian Portuguese Language. J Voice. 2021;35(1):160.e15-21. http://doi.org/10.1016/j.jvoice.2019.07.024. PMid:31474432.

13 Hillenbrand J, Houde RA. Acoustic correlates of breathy vocal quality: dysphonic voices and continuous speech. J Speech Hear Res. 1996;39(2):311-21. http://doi.org/10.1044/jshr.3902.311. PMid:8729919.

14 Demirci AN, Köse A, Aydinli FE, İncebay Ö, Yilmaz T. Investigating the cepstral acoustic characteristics of voice in healthy children. Int J Pediatr Otorhinolaryngol. 2021;148:110815. http://doi.org/10.1016/j.ijporl.2021.110815. PMid:34217000.

15 Reynolds V, Buckland A, Bailey J, Lipscombe J, Nathan E, Vijayasekaran S, et al. Objective assessment of pediatric voice disorders with the acoustic voice quality index. J Voice. 2012;26(5):672.e1-7. http://doi.org/10.1016/j.jvoice.2012.02.002. PMid:22632794.

16 Heman-Ackah YD, Michael DD, Baroody MM, Ostrowski R, Hillenbrand J, Heuer RJ, et al. Cepstral peak prominence: a more reliable measure of dysphonia. Ann Otol Rhinol Laryngol. 2003;112(4):324-33. http://doi.org/10.1177/000348940311200406. PMid:12731627.

17 Behlau M, Madazio G, Feijó D, Pontes P. Avaliação de voz. In: Behlau M, editor. Voz o livro do especialista. Rio de Janeiro: Revinter; 2004. p. 96-104.

18 Guimarães MF, Behlau M, Panhoca I. Análise perceptivo-auditiva da estabilidade vocal de adolescentes em diferentes tarefas fonatórias. Pro Fono. 2010;22(4):455-8. http://doi.org/10.1590/S0104-56872010000400016.

19 Maryn Y, Roy N. Sustained vowels and continuous speech in the auditory-perceptual evaluation of dysphonia severity. J Soc Bras Fonoaudiol. 2012;24(2):107-12. http://doi.org/10.1590/S2179-64912012000200003. PMid:22832675.

20 Tavares EL, Brasolotto A, Santana MF, Padovan CA, Martins RH. Estudo epidemiológico de disfonias em crianças de 4 a 12 anos. Rev Bras Otorrinolaringol. 2011;77(6):736-46. http://doi.org/10.1590/S1808-86942011000600010.

21 Englert MV, Latoszek BB, Behlau M. The impact of languages and cultural backgrounds on voice quality analyses. Folia Phoniatr Logop. 2022;74(2):141-52. http://doi.org/10.1159/000518206. PMid:34348304.

22 Maryn Y, De Bodt M, Barsties B, Roy N. The value of the Acoustic Voice Quality Index as a measure of dysphonia severity in subjects speaking different languages. Eur Arch Otorhinolaryngol. 2014;271(6):1609-19. PMid:24162765.

23 Maia AA, Gama AC, Kümmer AM. Características comportamentais de crianças disfônicas: revisão integrativa da literatura. CoDAS. 2014;26(2):159-63. http://doi.org/10.1590/2317-1782/2014408IN. PMid:24918510.

24 Jayakumar T, Benoy JJ, Yasin HM. Effect of age and gender on acoustic voice quality index across lifespan: a cross-sectional study in Indian population. J Voice. 2022;36(3):436.e1-8. http://doi.org/10.1016/j.jvoice.2020.05.025. PMid:32600874.

25 Watts CR, Awan SN. Use of Spectral/Cepstral analyses for differentiating normal from hypofunctional voices in sustained vowel and continuous speech contexts. J Speech Lang Hear Res. 2011;54(6):1525-37. http://doi.org/10.1044/1092-4388(2011/10-0209). PMid:22180020.

26 Brinca LF, Batista APF, Tavares AI, Gonçalves IC, Moreno ML. Use of cepstral analyses for differentiating normal from dysphonic voices: A comparative study of connected speech versus sustained vowel in european portuguese female speakers. J Voice. 2014;28(3):282-6. http://doi.org/10.1016/j.jvoice.2013.10.001. PMid:24491499.

27 Spazzapan EA, Marino VCDC, Fabbron EMG. Smoothed cepstral peak analysis of Brazilian children and adolescents speakers. J Voice. 2022. No prelo. http://doi.org/10.1016/j.jvoice.2022.02.002. PMid:35260286.

28 Mahalingam S, Boominathan P, Arunachalam R, Venkatesh L, Srinivas S. Cepstral measures to analyze vocal fatigue in individuals with hyperfunctional voice disorder. J Voice. 2021;35(6):815-21. http://doi.org/10.1016/j.jvoice.2020.02.007. PMid:32184054.

29 Tavares ELM, de Labio RB, Martins RHG. Estudo normativo dos parâmetros acústicos vocais de crianças de 4 a 12 anos de idade sem sintomas vocais: estudo piloto. Rev Bras Otorrinolaringol. 2010;76(4):485-90.

30 Abo-Ras YA, El-Maghraby R, Abdou RM. The normative study of acoustic parameters in normal Egyptian children aged 4-12 years. Alex J Med. 2013;49(3):211-4. http://doi.org/10.1016/j.ajme.2013.02.001.
 


Submetido em:
14/03/2023

Aceito em:
27/12/2023

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