Auditory-vocal integration impairment: New challenges and opportunities for voice assessment and therapy

Abstract

This reflection paper addresses the importance of the interaction between voice perception and voice production, emphasizing the processes of auditory-vocal integration that are not yet widely reported in the context of voice clinicians. Given the above, this article seeks to 1) highlight the important link between voice production and voice perception and 2) consider whether this relationship might be exploited clinically for diagnostic purposes and therapeutic benefit. Existing theories on speech production and its interaction with auditory perception provide context for discussing why the evaluation of auditory-vocal processes could help identify associated origins of dysphonia and inform the clinician around appropriate management strategies. Incorporating auditory-vocal integration assessment through sensorimotor adaptation paradigm testing could prove to be an important addition to voice assessment protocols at the clinical level. Further, if future studies can specify the means to manipulate and enhance a person’s auditory-vocal integration, the efficiency of voice therapy could be increased, leading to improved quality of life for people with voice disorders.

The Relationship Between Pitch Discrimination and Fundamental Frequency Variation: Effects of Singing Status and Vocal Hyperfunction

“…This includes a publication of recommendations for emphasizing the processes of auditory-vocal integration in assessment and treatment of voice disorders. 14 Therapy programs, such as Lee Silverman Voice Treatment (LSVT Loud), have been suggested to improve auditoryvocal integration of vocal pitch production in individuals with Parkinson's Disease, 16 and research on commercially available clinical devices that alter auditory feedback, such as Forbrain 15 with the intention of enhancing auditorymotor processing and integration. However, based on the preliminary finding from this study, there is a reason to consider future investigations of pitch perception/production relationships separately from interpretations surrounding the articulatory domain.…”