Speech and Hearing Sciences
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7192
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Item RELIABILITY AND VALIDITY OF ACOUSTIC VOICE ANALYSIS USING SMARTPHONE RECORDINGS FOR CLINICAL AND REMOTE ASSESSMENT(Queen Margaret University, Edinburgh, 2025-05) Jannetts, StephenThis thesis addresses the critical need for reliable and accessible methods to assess and monitor vocal health, particularly among occupational voice users and patients accessing speech and language therapy remotely. Traditional clinical methods, including patient self-reports and acoustic analyses conducted during isolated visits, provide only limited snapshots of vocal health, often missing daily fluctuations essential for long-term well-being. Leveraging advancements in smartphone technology, which offers sophisticated audio processing and widespread accessibility, this research explores the feasibility and clinical utility of smartphone-based acoustic voice analysis. The research comprises four comprehensive studies. Studies 1, 1b and 1c evaluate the reliability of acoustic measurements obtained from four smartphone models compared to a professional studio microphone in a controlled environment. Results indicate that measures such as cepstral peak prominence (CPPS), harmonics-tonoise ratio (HNR), long-term average spectrum (LTAS) slope, and glottal noise excitation ratio (GNE) demonstrate acceptable random error, suggesting that smartphones can reliably capture these parameters under controlled conditions. Study 2 validates the use of loudspeakers to transmit pre-recorded voice signals for acoustic analysis. The study finds minimal systematic bias and acceptable random errors, particularly for reading passages, affirming the reliability of loudspeaker transmitted recordings for standardised voice assessments. Study 3 assesses the validity and reliability of smartphones in field environments, comparing their performance to a studio-grade reference microphone. Higher-end smartphones, such as the iPhone 6s, reliably capture fundamental frequency (F0), CPPS, LTAS slope, and GNE, although shimmer and jitter measures exhibit significant variability. Study 4 investigates the impact of ambient noise on smartphone recordings, revealing that spectral measures remain stable, while parameters like shimmer and jitter are adversely affected by background noise. This underscores the necessity for controlled recording environments or robust noise mitigation strategies in real-world applications. Overall, this thesis demonstrates that smartphones hold significant potential for remote and real-time vocal health monitoring, particularly when focused on specific acoustic measures and controlled recording conditions. The findings contribute to the development of standardised protocols, enhancing the integration of smartphone technology into clinical voice assessment and telehealth services.Item INVESTIGATING HEARING CARE IN CARE HOMES FOR OLDER PEOPLE IN SCOTLAND THROUGH THE TRANSFORMATIVE WORLDVIEW(Queen Margaret University, Edinburgh, 2023-12) White, AmyCommunication is a human right and a critical enabler of other human rights. The 2021 World Report on Hearing states that age-related hearing loss should be recognised as a public health priority, owing to its impact on brain health and communication. Prevalence of deafness in care homes for older people is around 90%, yet is largely undetected and untreated. Recommendations to address these issues include hearing screening and staff training. However, solutions are not presented in the context of any legislative health and social care improvement framework. The Public Services Reform (Scotland) Act 2010 transformed the care home sector to enhance safeguarding practices for older people. In addition, the Scottish Government’s See Hear Strategy pledges support for older people living with deafness to experience equality of access to health and social care services. This thesis investigated hearing care in care homes for older people through the lens of the Scottish Government’s framework for health and social care, using a two-stage mixed-methods design, underpinned by the Transformative worldview. Stage 1 explored the landscape of hearing care in care homes using documentary analysis. Sources of evidence centred on the regulatory organisations involved in the care sector. Online focus groups with the Care Inspectorate were also conducted. It was established hearing care training is not mandatory for care home staff and no regulatory framework for hearing care scrutiny exists in which to safeguard the sensory needs of older people in Scotland’s care homes. Stage 2 formed an instrumental case study of a single care home for older people in which the real-life context of hearing care was explored through documentary analysis, questionnaire, focus groups with staff and hearing assessments with residents. Results revealed there was no policy for identifying residents living with deafness nor any core workforce learning structure related to hearing care. Staff identified knowledge gaps and welcomed more opportunities for training. The prevalence of deafness across 21 residents was between 76-90%. Integrating the results of Stage 1 and 2 suggests Transformative reform is required at the level of both the care home workforce and the wider organisations involved in service improvement and regulation, to meet the recommendations of the See Hear Strategy and achieve equality for older people. The See Hear Strategy will be refreshed in 2025 and the Scottish Government is preparing major reforms through the launch of a National Care Service by 2026. This thesis is therefore timely, highlighting the need for hearing care to be recognised as a priority in care homes, and embedded in any new framework for social care to further social justice and reinforce the human right to communication.Item A Fragmented Profession within the System of Professions: The Experience of the Audiology Professional in the United Kingdom(Queen Margaret University, Edinburgh, 2023-06-28) Steenkamp, LizanneThe main purpose of this study was to explore the lived experience of audiology professionals in the United Kingdom. For the purposes of this study an audiology professional is defined as someone who completed a United Kingdom or International course/training pathway in audiology and who is working in the UK. The definition can include audiologists, hear(ing) care assistants, hearing aid dispensers, hearing therapists and clinical scientists. Audiology professionals working in Higher Education were also included. Working in two different contexts with similar and dissimilar aspects of role descriptions, as well as boundaries of practice led to the research question: What is the experience of audiology professionals in becoming and being an audiology professional in the United Kingdom? The following strands narrowed the focus of the study and helped to identify the appropriate methodological approach: 1. The experience of becoming an audiology professional 2. The experience of being an audiology professional 3. The impact of change in education pathways and service delivery on the audiology professional The research question was explored through an Exploratory Sequential Mixed Methods approach starting with interviews of eight participants followed by a survey circulated to the wider profession with 329 respondents. Data analysis consists of interpretive phenomenological analysis of the interviews and descriptive statistics for the surveys. The results from both stages will be discussed in relation to the sociology of professions, specifically Abbott’s (1988) system of professions with elements of Bourdieu’s social world theory (1985). The results sketch a fragmented profession divided by titles, professional organisations, and regulatory bodies as well as many education pathways across the private sector and the NHS.Item ACOUSTIC SPEECH MARKERS FOR TRACKING CHANGES IN HYPOKINETIC DYSARTHRIA ASSOCIATED WITH PARKINSON’S DISEASE(Queen Margaret University, Edinburgh, 2023-06-28) Murali, MridhulaPrevious research has identified certain overarching features of hypokinetic dysarthria associated with Parkinson’s Disease and found it manifests differently between individuals. Acoustic analysis has often been used to find correlates of perceptual features for differential diagnosis. However, acoustic parameters that are robust for differential diagnosis may not be sensitive to tracking speech changes. Previous longitudinal studies have had limited sample sizes or variable lengths between data collection. This study focused on using acoustic correlates of perceptual features to identify acoustic markers able to track speech changes in people with Parkinson’s Disease (PwPD) over six months. The thesis presents how this study has addressed limitations of previous studies to make a novel contribution to current knowledge. Speech data was collected from 63 PwPD and 47 control speakers using an online podcast software at two time points, six months apart (T1 and T2). Recordings of a standard reading passage, minimal pairs, sustained phonation, and spontaneous speech were collected. Perceptual severity ratings were given by two speech and language therapists for T1 and T2, and acoustic parameters of voice, articulation and prosody were investigated. Two analyses were conducted: a) to identify which acoustic parameters can track perceptual speech changes over time and b) to identify which acoustic parameters can track changes in speech intelligibility over time. An additional attempt was made to identify if these parameters showed group differences for differential diagnosis between PwPD and control speakers at T1 and T2. Results showed that specific acoustic parameters in voice quality, articulation and prosody could differentiate between PwPD and controls, or detect speech changes between T1 and T2, but not both factors. However, specific acoustic parameters within articulation could detect significant group and speech change differences across T1 and T2. The thesis discusses these results, their implications, and the potential for future studies.Item VOCAL BIOMARKERS OF CLINICAL DEPRESSION: WORKING TOWARDS AN INTEGRATED MODEL OF DEPRESSION AND SPEECH(Queen Margaret University, Edinburgh, 2021) Miley Wilson, Erin VictoriaSpeech output has long been considered a sensitive marker of a person’s mental state. It has been previously examined as a possible biomarker for diagnosis and treatment response for certain mental health conditions, including clinical depression. To date, it has been difficult to draw robust conclusions from past results due to diversity in samples, speech material, investigated parameters, and analytical methods. Within this exploratory study of speech in clinically depressed individuals, articulatory and phonatory behaviours are examined in relation to psychomotor symptom profiles and overall symptom severity. A systematic review provided context from the existing body of knowledge on the effects of depression on speech, and provided context for experimental setup within this body of work. Examinations of vowel space, monophthong, and diphthong productions as well as a multivariate acoustic analysis of other speech parameters (e.g., F0 range, perturbation measures, composite measures, etc.) are undertaken with the goal of creating a working model of the effects of depression on speech. Initial results demonstrate that overall vowel space area was not different between depressed and healthy speakers, but on closer inspection, this was due to more specific deficits seen in depressed patients along the first formant (F1) axis. Speakers with depression were more likely to produce centralised vowels along F1, as compared to F2—and this was more pronounced for low-front vowels, which are more complex given the degree of tongue-jaw coupling required for production. This pattern was seen in both monophthong and diphthong productions. Other articulatory and phonatory measures were inspected in a factor analysis as well, suggesting additional vocal biomarkers for consideration in diagnosis and treatment assessment of depression—including aperiodicity measures (e.g., higher shimmer and jitter), changes in spectral slope and tilt, and additive noise measures such as increased harmonics-to-noise ratio. Intonation was also affected by diagnostic status, but only for specific speech tasks. These results suggest that laryngeal and articulatory control is reduced by depression. Findings support the clinical utility of combining Ellgring and Scherer’s (1996) psychomotor retardation and social-emotional hypotheses to explain the effects of depression on speech, which suggest observed changes are due to a combination of cognitive, psycho-physiological and motoric mechanisms. Ultimately, depressive speech is able to be modelled along a continuum of hypo- to hyper-speech, where depressed individuals are able to assess communicative situations, assess speech requirements, and then engage in the minimum amount of motoric output necessary to convey their message. As speakers fluctuate with depressive symptoms throughout the course of their disorder, they move along the hypo-hyper-speech continuum and their speech is impacted accordingly. Recommendations for future clinical investigations of the effects of depression on speech are also presented, including suggestions for recording and reporting standards. Results contribute towards cross-disciplinary research into speech analysis between the fields of psychiatry, computer science, and speech science.