Australian Journal of Human Communication Disorders

ISSN: 0310-6853 (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/iasl18

Acoustic Investigations of Abnormal Voice Quality

— A Review

Jennifer M. Oates & Robert J. Kirkby

To cite this article: Jennifer M. Oates & Robert J. Kirkby (1979) Acoustic Investigations of
Abnormal Voice Quality — A Review, Australian Journal of Human Communication Disorders,
7:1, 4-15, DOI: 10.3109/asl2.1979.7.issue-1.03

To link to this article: http://dx.doi.org/10.3109/asl2.1979.7.issue-1.03

Published online: 01 Oct 2014.

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 4 Aust. J. of Human Comm. Dis. 7, 1.1979

ACOUSTIC INVESTIGATIONS OF ABNORMAL VOICE QUALlTY-

A REVIEW

Jennifer M. Oates
School of Communication Disorders
Lincoln Institute

Robert J. Kirkby
Department of Behavioural Sciences
Lincoln Institute
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The present paper was concerned with acoustic investigations of abnormal voice quality
in clinical patients and subjects trained to simulate abnormal voice qualities. A review
of studies relating to the acoustic components of hoarseness, harshness, the dysphonia
of subjects with various laryngeal pathologies, and simulated roughness indicated that
these conditions were characterised by very similar acoustic correlates. It appeared that
this lack of acoustic differentiation reflected a number of problems, including: the
semantic confusions of voice quality terminology; the failure of previous studies to
control for the type of laryngeal pathology underlying perceptual categories; and, a
lack of consistency in instrumentation, measurement techniques, and interpretation of
acoustic findings. The authors have suggested that these problems must be substantially
reduced in future studies in order that complete physiological and acoustic data for
voice quality abnormalities can be delineated, and an empirically-based terminology
~')r the perceptual description of these disorders developed.

The accurate identification, description, and subsequent treatment of patients with

voice quality disturbances has long been a problem facing speech pathologists. The
difficulty in this clinical process has stemmed from the lack of complete data on the
physiological, acoustic, and perceptual components of voice quality, and from a lack
of agreement on a universal terminology for the perceptual description of these
disorders.
Brodnitz (1967) has suggested that the confusion existing in the field of voice
quality might be substantially reduced if a terminology could be based on the findings
of scientific research and their relationship to auditory perception. Acoustic
analysis is one element that could provide an objective reference point for the speech
pathologist's task of identifying, describing and treating voice quality disorders.
 OATES. KIRKBY: Abnormal Voice Quality 5

Previous investigators have clearly indicated that the establishment of an empirical

system utilising acoustic analysis would be of value in the clinical setting for the
management of vocal disorders (Cooper, 1974; Hiki et al., 1975; Lieberman, 1963;
Perello and Tosi, 1974; von Leden and Koike, 1970). On the clinical aspect,
acoustic studies of vocal quality could provide a comprehensive data base, consisting
of the acoustic correlation of normal voice quality and of all laryngeal pathologies.
This data would allow the speech pathologist to use acoustic tests as a screening
medium for initial detection of voice quality disorders, to establish the physical basis
of each pathology, and to describe the nature and severity of the voice quality
disorder according to objectively derived baseline parameters. Treatment planning
could then be based on the physical data rather than solely on subjective, perceptual
assessments. If acoustic analysis could be carried out at regular intervals during
therapy, evaluation of a patient's progress could also be based on the physical data
as well as on listener judgements.
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In regard to the research aspect, acoustic studies could provide the speech
pathologist with further data concerning the acoustic and inferred physiological
components of normal voice, and the voices of patients with particular laryngeal
pathologies. A terminology could then be based on this objective data, which would
allow a more consistent description of the nature and severity of the quality disorder.
Until this physical data is delineated and an empirically-based terminology
developed, the possibility of inappropriate treatment planning and inaccurate evalua-
tion of a patient's progress remains asa potential problem for the speech pathologist.
In the present paper the authors have reviewed previous acoustic studies of abnormal
voice quality and presented suggestions which could substantially reduce problems of
these earlier investigations.

ACOUSTIC STUDIES OF ABNORMAL VOICE QUALITY

The majority of research in this area has considered voice quality as a paralinguis-
tic phenomena resulting from vocal fold vibratory patterns. These studies will be
reviewed according to the two approaches prevalent in the investigation of abnormal
voice quality. The most common approach has been to measure acoustic correlates of
the voice quality of clinical subjects with abnormal voices. The alternative approach
has involved laboratory experiments where subjects with normal voices have been
trained to simulate abnormal qualities.

STUDIES OF PATHOLOGIC VOICE QUALITY

Hoarseness
A survey of the literature suggests that "hoarseness" has been the disorder most
often investigated. Extensive studies of hoarseness have been carried out by
Yanagihara (1967a, 1967b). In the first study, Yanagihara required 30 adult subjects
to phonate five cardinal vowels, sustaining each for several seconds with no restric-
tions on pitch or loudness. Tape recordings of these vowels were evaluated percep-
tually by three otolaryngologists, according to the degree of hoarseness (slight,
moderate, or severe). Ten patients were chosen with each degree of severity.
 6 Aust. J. of Human Comm. Dis. 7, 1. 1979

Sonagrams were made of the series of vowels using a narrow band filter. Sections
were taken at approximate mid-points of the vowels and four discriminable acoustic
patterns were delineated as follows:
Type I: Regular harmonic components were mixed with noise components, chiefly
in the formant regions.
Type II: Noise components in the second formants predominated over the
harmonics. Slight additional noise components were present in the high frequency
region above 3,000 Hz.
Type Ill: Second formants were completely replaced by noise components and the
additional noise above 3,000 Hz. was further intensified and increased in range.
Type IV: Second formants were completely replaced by noise, and the first
formants lost periodic components. More intense high frequency noise was seen.
Yanagihara (1967 a) concluded that the noise components and changes of
harmonic structure were positively correlated with the perceptual degree of hoarse-
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ness. It was suggested that the noise may have originated in turbulent airflow, due to
incomplete glottal closure, or to irregular vibratory patterns. The loss of high
frequency harmonics was attributed to an incomplete or shorter closing phase of the
glottis. Yanagihara (1967a) pointed out that these two acoustic features were
probably not the only components of hoarseness; he noted that aperiodicity of
fundamental frequency could also be a relevant factor.
In a second and more comprehensive study, Yanagihara (1967b) investigated
results from spectrographic analysis of the five cardinal vowels, high speed
cinematographic analysis of glottal area function during phonation of lei, and
measures of airflow rate during phonation of la/. Ten adult subjects, seven males
and three females, participated in all three examinations. Each subject had a degree
of hoarseness due to some laryngeal pathology. A comparison of the spectrographic
findings with the results of glottal area wave analyses indicated that the degree of
abnormality in the acoustic findings was closely related to the extent of cycle-to-cycle
changes in the shape, amplitude, and periodicity of the glottal area waves. That is,
the subjects with extreme irregularity in glottal area waves tended to show more
changes in harmonic structure and more noise components in their spectrograms.
Consistent with his earlier finding, the results of Yanagihara's (1967b) study
indicated that the noise components were stronger than the harmonic components
when the hoarseness became more severe. This phenomenon began at higher
frequencies and extended into lower frequencies.
From the results of this study, Yanagihara (1967b) concluded that while minor
aperiodicity in the glottal area wave would affect the higher frequency components,
lower frequencies would also alter when aperiodicity increased. Hoarseness was thus
seen as a multidimensional disorder with perturbation of fundamental frequency,
changes in harmonic structure, and additional noise components as the acoustic
correlates. These cycle-to-cycle and overall changes in the voice spectrum had a
direct effect on the perceptual judgement of the severity of hoarseness.
Yanagihara's (1967a, 1967b) findings were consistent with those of an earlier and
less extensive study by Moore and Thomson (1965). In the Moore and Thomson
study, glottal changes were recorded by ultra high-speed cinematography in two
adult males, one with severe and one with moderate hoarseness. From the analysis of
motion pictures of sections of 25 consecutive cycles of vibration, it was found that
random variability in the opening and closing phases of vocal fold vibration was
 OATES. KIRKBY: Abnormal Voice Quality 7

more extreme for the severely hoarse subject. Oscillographic analysis of 5 to 15 sec.
segments of the vocalisations of the subject with severe hoarseness revealed that no
more than two consecutive waves were the same length.
In addition to aperiodicity of the fundamental frequency, Yanagihara (1967b)
found that cycle-to-cycle changes in the amplitude of the glottal area wave were
related to the degree of hoarseness. This supported Wendahl's (1966) observation
that the sensation of hoarseness may be caused by cycle-to-cycle amplitude variations
of the impulse. Wendahl (1966) labelled the hoarseness caused by this amplitude
change as "shimmer". Laryngeal analog synthesis has established a linear relation-
ship between shimmer and listener judgements of hoarseness, with as little as 1 db. of
shimmer between adjacent cycles being sufficient for subjective detection of rough-
ness in the signal (Wendahl, 1966). Wendahl (1963) had also suggested that hoarse-
ness could be due to aperiodic changes in the fundamental frequency from cycle-to-
cycle, in which case it was experienced as "jitter". In an earlier study, Wendahl
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(1961) used an analog of the larynx to study the effect of these aperiodic wave
periods on judgement of hoarseness. He found that small amounts of aperiodicity, as
little as 1 Hz. around a median frequency of 100 Hz. were detectable and that
deviations of ± 10Hz. were judged as extremely rough. As Wendahl (1961) pointed
out, it was almost impossible to differentiate perceptually between hoarseness due to
jitter and hoarseness due to shimmer.
Other studies of the acoustic correlates of hoarseness were carried out by Iwata
and von Leden (1970) who used the Voice Print, a modification of the Sonograph,
which provided a contour display spectrogram. Five adult subjects with various
laryngeal pathologies, but all with hoarse voices, were required to sustain the vowel
/a:/ for several seconds at comfortable pitch and loudness levels. Voice prints with
a normal scale up to 8,000 Hz, and a print with an expanded scale up to 2,000 Hz.
to show details of energy in the first formant region were obtained. The voice prints
allowed a detailed spectral view of the amplitude characteristics in terms of frequency
and time. Iwata and von Leden (1970) found that the acoustic energy distribution in
the first formant was important in detecting laryngeal pathology. As the degree of
hoarseness increased, the formant bars widened and became irregular in frequency
and time. These changes were related to the increase of noise components and to the
fluctuation of fundamental frequency.
Two of the subjects in the Iwata and von Leden study had laryngeal neoplasms and
severe hoarseness. The voice prints for these subjects showed irregularity in the
acoustic energy for the entire frequency range, particularly in the lower frequencies.
Extensions of high energy distribution from the first formant coalesced with the
adjacent fundamental and second formant bars, with disintegration of the formant
pattern. However, the subjects with laryngeal paralysis presented different acoustic
results even though their voices were rated as hoarse. The first formant bar indicated
a much lower energy distribution with less overlap between adjacent formants.
According to Iwata and von Leden (1970) these results suggested that hoarseness
was not a single quality disorder, but a pathology comprised of discrete subgroups.
Lowered fundamental frequency has been cited often as an acoustic correlate of
hoarseness. In an investigation of fundamental frequency and hoarseness, Cooper
(1974) measured fundamental frequency from narrow band spectrograms of the
voices of adult patients with a variety of laryngeal pathologies. The severity of
hoarseness was judged using Yanagihara's (1967a) classification of noise in relation
to the harmonic structure of the voice wave. Cooper found that a lower fundamental
 8 Aust. J. of Human Comm. Dis. 7, 1.1979

frequency was present with more severe hoarseness and a higher fundamental
frequency was associated with less hoarseness.
Shipp and Huntington (1965) investigated the voices of 26 adults with acute
laryngitic hoarseness. The results, obtained from oscillographic analysis of readings
of a sentence from a standard passage, indicated no significant differences between
the mean fundamental frequencies of normal and hoarse voices. This inconsistency
between the findings of Shipp and Huntington and those of Cooper may have arisen
through differences in the laryngeal pathologies underlying the voice quality disorders
investigated. Shipp and Huntington studied a specific pathology (acute laryngeal
hoarseness), whereas Cooper (1974) studied a variety of laryngeal pathologies; thus
the acoustic components of the voices corresponding to the different pathologies
would be expected to differ.

Summary
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The studies of hoarseness have isolated a number of acoustic correlates consist-

ently associated with the perceptual classification. These correlates are the presence
of noise in the formant regions and high frequencies, a weakness of the high frequency
harmonics, aperiodicity of the fundamental frequency, and cycle-to-cycle intensity
variations of the voice wave. The interaction between fundamental frequency and
hoarseness has not been resolved. The few studies in this area have indicated that
fundamental frequency in hoarseness may be either lowered or essentially the same
as in the normal voice.

Harshness
"Harshness" is a perceptual classification of voice quality often regarded as
typically lower in pitch than the normal voice (Moore, 1971b; van Riper and Irwin,
1958). Michel and Hollien (1968) investigated differences in mean fundamental
frequency between the normal voice, vocal fry, and harshness. In their study, 10
adult males with normal voices read a phonetically balanced passage, once in their
normal voice, and then once using vocal fry. Ten adult males with voices judged
perceptually as harsh also recorded the passage. The fundamental frequencies of the
subjects' voices were acoustically determined by a fundamental frequency indicator
and a phonellogram. No significant difference in mean fundamental frequency was
found between the samples and Michel and Hollien (1968) suggested that fundamen-
tal frequency was not an appropriate parameter to differentiate normal and harsh
voices. However, these investigators noted that there was more variability among the
individual harsh fundamental ranges than among the vocal fry or normal voice
ranges. This suggested that the range of fundamental frequency variation was a
possible parameter to discriminate harsh from normal voices.
Bowler (1964) also investigated the fundamental frequency of perceptually
delineated harsh voices. Oscillograms were made of readings of a phonetically
balanced passage by 44 adult subjects. The recordings of all subjects were judged to
contain examples of harshness. It was found that the distribution of fundamental
frequency for the harsh portions was markedly skewed towards the lower end of the
distribution, whereas the distributions for the normal samples were relatively
symmetrical. These findings did not agree with Michel and Hollien's (1968) results,
possibly because of a difference in the method of voice sampling in the two studies.
 OATES. KIRKBY: Abnormal Voice Quality 9

Michel and Hollien's samples of harshness were obtained from subjects who had
habitual harsh voices, whereas Bowler's samples were isolated examples of harshness
from subjects whose voices were normal.
Bowler (1964) also found that the range of fundamental frequency means for the
harsh sections of the samples was twice that for the non-harsh sections. Abrupt
changes of the fundamental frequency, typically one octave in upward or downward
directions, occurred from wave to wave in the harsh samples. A downward break,
followed almost immediately by an upward break returning approximately to the
point at wbich the downward break began, was the most common pattern for the
harsh samples. Michel and Hollien's (1968) finding of more variability among the
fundamental frequency ranges of harsh voices was in accord with Bowler's (1964)
results. Zemlin (1968) also reported that harshness seemed to be related to
fundamental frequency differences between cycles of vocal fold vibration, in addition
to noise factors.
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Summary
Harshness has been associated with abrupt cycle-to-cycle changes in fundamental
frequency and with noise factors. As with hoarseness, there have been conflicting
findings concerning fundamental frequency: for harsh voices, this variable has been
reported to be no different from the normal voice or to be lowered.

Pathologic ~oice quality - various laryngeal pathologies

The remainder of the studies of pathologic voice quality have investigated the
acoustic features of the voices of patients with various laryngeal pathologies, but with
no specific perceptual classification assigned to their voices. Potter et al. (1947)
stated that dysphonia was related to a weakness in upper harmonics, harmonic and
resonance discontinuity, and to partial or complete absence of the higher resonance
bars. Although these results were obtained from some of the earliest work with the
Sonagraph, they closely parallel the findings of the more recent acoustic studies of
hoarseness, reviewed above.
Iwata and von Leden (1970) investigated fundamental frequency perturbations in
normal and pathologic voices. Adults with various types of pathology and those with
normal voices were required to produce the vowel /a:/ at comfortable pitch and
loudness levels. The acoustic signals were picked up by a contact microphone from
the pretracheal area during phonation. Curves were drawn for pitch perturbations
and it was found that very small changes in wave lengths between adjacent vibratory
cycles occurred in the normal voices. However, variation was significantly greater for
the subjects with laryngeal pathologies. These perturbations were found to be far
more irregular and frequent in patients with laryngeal disease than in subjects with
normal voices.
Koike (1969), investigating a procedure for the evaluation of laryngeal function,
carried out a study of the vowel amplitude modulations in patients with laryngeal
paralysis or neoplasms. The subjects were required to sustain the vowel /a:/ at
comfortable pitch and loudness levels, while the signals were recorded from the
larynx by a contact microphone. The envelope amplitude of the registered signal at
each main fundamental amplitude peak was measured for 30 consecutive periods.
 10 Aust. J. of Human Comm. Dis. 7. 1. 1979

On the basis of the recorded amplitudes Koike suggested that, although his technique
might distinguish between laryngeal paralysis and neoplasms, considerably more
work needed to be carried out before a valid and reliable tool for general clinical use
could be developed.

Summary
The presence of various laryngeal pathologies, then, has been associated with the
acoustic parameters of cycle-to-cycle irregularity in the fundamental freq uency,
weakness of high frequency harmonics, changes in amplitude modulation. and
harmonic and resonance discontinuity.
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STUDIES OF SIMULATED VOICE QUALITY DISTURBANCES

Several studies have investigated the acoustic components of simulated roughness
(Emanuel and Sansone, 1969; Lively and Emanuel, 1970). In these studies, subjects
were instructed to produce rough vowels by simulating a "tense" phonation and
avoiding vocal fry. Emanuel and Sansone (1969) instructed seven normal speaking
adult males to sustain four cardinal vowels for 7 secs.; first in a normal voice, and
then with a rough voice. A 2 sec. tape loop from each voice recording was analysed
with a constant bandwidth wave analyser in a narrow 3 Hz. bandwidth mode. The
output display provided a frequency-by-amplitude spectrum of both harmonic and
noise components. When the total spectral range from 100 to 8,000 Hz. was
considered, the mean noise levels for the rough productions were twice those for the
normal productions. Although the harmonics were not measured, visual examination
of the spectra indicated that harmonics tended to decrease in amplitude with an
increase in spectral noise.
Previous investigations had suggested that perceived hoarseness was related to
aperiodicity of the fundamental frequency as well as to spectral noise (Moore and
Thomson, 1965; Moore and von Leden, 1958). On this basis, Emanuel and Sansone
( 1969) also investigated the hypothesis that the presence of spectral noise was related
to aperiodicity. An acoustic pulse train of almost perfect periodicity and a similar
train of jittered signal, were produced by a pulse generator assembly. Spectra were
derived, and it was seen that noise components did not appear in the spectra of the
periodic signal. However, when the signal was jittered by a random and rapid
variation of the pulse repetition rates, noise components appeared and harmonic
amplitudes were diminished. On this basis aperiodicity of the fundamental frequency
was proposed as a possible cause of the increased spectral noise levels and decreased
harmonic amplitudes in rough vowels.
Two similar studies were carried out by Emanuel and Lively (1970) and Emanuel
and Sansone (1970). In both of these studies, 20 normally speaking adults sustained
7 sec. productions of four cardinal vowels in a normal voice and then in a simulated
rough voice. The recordings were rated for roughness by trained judges, and the
vowels were analysed using a constant bandwidth wave analyser in its 3 Hz. mode.
Noise levels of the vowels correlated highly with the median roughness ratings for
both males and females. It was found that roughness tended to be higher as the level
of spectral noise increased.
 OATES, KIRKBY: Abnormal Voice Quality 11

Lively and Emanuel (1970) have attempted a comprehensive explanation of vowel

roughness on the basis of physiological and acoustic studies of roughness and hoarse-
ness, compared with the commonly accepted physiology of normal voice production.
It should be noted that they treated roughness and hoarseness as very similar voice
qualities. Lively and Emanuel (1970) hypothesised that aperiodic variations in vocal
fold movements caused turbulence in the glottally-emitted air puffs, and thus caused
aperiodic variations in the period and amplitude of the glottal volume-velocity wave
and the corresponding acoustic voice wave. They further hypothesised that spectral
noise components were derived from aperiodic variations of the acoustic wave and
the underlying variations in glottal airflow and vocal fold movements. Harmonic
components, however, resulted from periodic features. Finally, Lively and Emanuel
(1970) suggested that the spectral information critical to the perception of vowel
roughness was a ratio of harmonic to inharmonic energy. The ratio of harmonic to
inharrnonic energy decreased from low to high frequencies and was inversely related
to the degree of perceived roughness. The majority of research findings cited in the
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literature are consistent with Lively and Emanuel's (1970) explanation (see, for
example, Iwata and von Leden, 1970; More and Thomson, 1965; Wendahl, 1963,
1966). However, Yanagihara (1967a) has outlined two additions to this explanation.
Yanagihara hypothesised that noise components were due to turbulent airflow caused
by incomplete glottal closure and that loss of high frequency harmonics was the result
of incomplete or shorter closing phases of the glottis.

THE SUPRAGLOnAL TRACT AND VOICE QUALITY DISORDERS

It appears that the relationships between paralinguistic factors and the resonance
function of the supraglottal tract have been rarely cited in the literature. Linklater
(1968) reported that both frequency of the first formant as well as formant band-
widths affected judgements of roughness. Linklater found that trained judges' ratings
of roughness were a function of the frequency of the first formant: the lower the first
formant, the less rough the vowels were rated. Kvols (1969), in a study of the second
formant and its relationship to vowel perceptions, found that average human formant
bandwidths were judged as rougher than those either narrower or wider than
listeners were accustomed to hearing. Apart from the reports of Linklater (1968) and
Kvols (1969), there has been little objective evidence for glottal-supraglottal tract
interactions underlying voice quality disturbances.
Moncur and Brackett (1974) proposed some relationships between voice quality and
the dimensions, openings, and textures of the resonators. They hypothesised that
changes in the surface tension of the pharynx and oral cavities occurred with
contraction and relaxation of antagonistic muscle groups in the wall structure. They
suggested that these surface tension changes contributed to the quality of the voice.
Moncur and Brackett (1974) described, as an example, the condition where the
vocal folds were pressed tightly together. They indicated that this hypervalving
extended into the laryngopharynx so that the surface tension was increased and the
cavity size reduced. This effect in turn altered the strength of the resonances and
theoretically caused a change in the formant amplitudes. A change in formant
amplitude has been cited as contributing to a change in paralinguistic voice quality
 12 Aust. J. of Human Comm. Dis. 7, 1. 1979

(Fant, 1960; Peterson, 1961). Additionally, an increase in formant frequencies with

the smaller cavity size may also have occurred, but no conclusive experimental
studies have tested this or any other of Moncur and Brackett's (1974) proposals.
Michel and Wendahl (1971), expressing their view that the glottis and vocal tract had
direct influences on each other, also concluded that in the abnormal voice specifica-
tion of the conditions of the supraglottal structures was important.
A specific relationship between the different configurations of the supraglottal
tract for vowel sounds, and acoustic and perceptual correlates, has been established
(Rees, 1958; Sherman and Linke, 1952; Yanagihara, 1967a). This relationship has
been considered in some studies of voice quality disorders. For example, Sherman
and Linke (1952) found that vowels produced with a high tongue position were less
harsh than vowels produced with a low tongue position, and that lax vowels were less
harsh than tense vowels. Rees (1958) also showed that harshness was perceived as
more severe in low vowels than in high vowels.
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The above findings led several researchers to investigate a possible relationship

between acoustic correlates of voice quality disorders and supraglottal tract con-
figurations of the vowels. Yanagihara (1967a) found that the range and energy of
noise eomponents in perceived hoarseness were more evident on la:/, lei and li:1
than on lu:1 and 10:1 productions. Emanuel and Sansone (1969) concluded that
spectral noise levels in both normal and rough vowels varied with the tongue height
in each vowel's articulation. The high vowel li:1 was characterised by the least
spectral noise, and the low vowel lrel by the most noise. Emanuel and Sansone
tentatively suggested that, at least for normal vowels, those produced with high
tongue positions tended to be produced with greater periodicity of vocal fold
vibration than those with low positions. Although the precise association between
the configurations of the supraglottal tract for vowel sounds and the components of
abnormal voice quality has not yet been established, it is quite clear that the
relationship does exist.

DISCUSSION
Although investigations of perceptual classifications of quality disorders have'
involved studies of hoarseness, roughness, and harshness, as well as studies of the
general dysphonia of patients with different laryngeal pathologies, very similar
acoustic results have been found for all conditions. These common findings and their
physiological interpretations have been summarised in Table 1.
It appears that the small number of differences in acoustic findings that have been
reported probably reflect differences in the severity of a "general" quality disorder
rather than differences between various perceptual classifications. The differentiation
was established in studies of both hoarseness and roughness, where it was found that
the severity of perceived disturbance varied with changes in the intensity and range of
spectral noise. The lack of any further reports of differences across perceptual
categories could reflect a number of problems.
Firstly, the problem of nomenclature: the voice qualities which were classified
under different perceptual terms, such as hoarse and harsh, may in fact represent a
very similar vocal disorder (Lively and Emanuel, 1970). This again points to the
semantic confusions prevalent in this area and to the dangers of using perceptual
terms which are often ambiguous and inconsistent in meaning.
 OATES. KIRKBY: Abnormal Voice Quality 13

TABLE 1. Acoustic and Physiological Findings of Studies of Abnormal Voice Quality.

Acoustic Finding Suggested Physiological Published Findings

Correlates

1. Fundamental frequency Frequency of vocal fold Cooper (1974)

may be lower than the vibration may be lower than, Bowler (1964)
normal voice or the same or the same as the normal Shipp and Huntington (1965)
as the normal voice. No voice. Michel and Hollien (1968)
conclusive results.
2. Weakness of high Incomplete or shorter closing Potter 1:( al. ( 1947)
frequency harmonics. phase of the glottis. Yanagihara (l967a. 1967b)
Aperiodic vibration of the Emanuel and Sansone (1969. 1970)
vocal folds.
3. Noise in the formant Aperiodicity of vocal fold Zemlin (1968)
regions and high vibration. Amplitude Iwata and von Leden (1970)
frequencies. variation in vocal fold Emanuel and Sansone (1969. 1970)
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vibration. Turbulent airflow Lively and Emanuel (1970)

due to incomplete glottal
closure.
4. Aperiodicity of the Aperiodic vocal fold
fundamental frequency. vibration.
5. Intensity variation of the Cycle-to-cycle amplitude
glottal waveform. variation of vocal fold
vibration.
6. Change in formant Change in surface tension
amplitudes. * of the oral and pharyngeal
cavity walls. Cavity size
change.
7. Change in formant Change in the size of the
frequencies. * oral and pharyngeal cavities.
Wendahl (1963)
Bowler (\964)
Moore and Thomson (\965)
Iwata and von Leden (1970)
Wendahl (1966)
Yanagihara (1967b)
Koike (1969)
Moncur and Brackett (1974)
Moncur and Brackett (1974)

• Points 6 and 7 list as yet unverified proposals concerning the supragloual tract resonance function and its
relation to voice quality abnormality.

Secondly, the problem related to a failure to control for the type of laryngeal
pathology underlying the perceptual category: the studies of Cooper (1974), Iwata
and von Leden (1970) and Yanagihara (1967a, 1967b) investigated subjects whose
voices were classified within a specific perceptual category, or merely as dysphonic,
but each sample comprised subjects with several different laryngeal conditions.
Differences which may have been detected if the sample involved a single patho-
logical condition may have been obscured through findings based on a blurred
collection of pathologies. Evidence has been provided by Koike (1969) and Iwata
and von Leden (1970), that differences can exist between different pathologies which
are assigned the same perceptual classification. These investigators found that
differentiation between laryngeal paralysis and neoplasms could be made on the basis
of intensity variations and the range of spectral noise, when both pathologies gave
rise to a voice quality labelled as "hoarseness".
Thus, it seems that acoustic studies of voice quality could be more sensitive if a
specific laryngeal pathology, rather than a perceptually classified group with several
underlying pathological conditions, was studied in detail.
 14 Aust. J. of Human Comm. Dis. 7,1. 1979

Thirdly, there has been a lack of consistency in the type and use of instrumenta-
tion, and the measurement and interpretation of acoustic findings, across and within
studies. Because of these differences, and the possible error associated with some of
the measurement techniques used (see for example, Blake, 1970; F ant, 1956;
Lindblom, 1962; Peterson and Barney, 1952) the accuracy of the earlier studies of
abnormal voice quality is questionable.
Clearly, this review indicates a need for speech pathologists to undertake studies
where these problems of nomenclature, mixing of laryngeal pathologies, instrumenta-
tion, and measurement are substantially reduced (see for example, Oates 1978).

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