Vocal motor control in children with vocal nodules

项目摘要 学龄儿童的声音障碍可能会对身体、社会和情感造成毁灭性的后果。 声带小结是儿童最常见的嗓音障碍，通常伴有 发声机能亢进：由于过度或不平衡的肌肉力量而导致的异常发声模式。主 声带小结的治疗是声音治疗;然而，治疗的成功率各不相同，这通常是 这归因于缺乏一个专门针对语音障碍儿童的有凝聚力的、基于理论的框架。 缺乏这一框架的一个潜在原因是缺乏关于发声运动的知识 儿童声带小结的治疗虽然在成人声带功能亢进的初步工作， 提示存在发音-运动整合障碍，但尚未有研究表明发音运动的特征 控制发声功能亢进的儿童。由于发声机制和发声运动控制都是已知的， 在整个生命周期的变化，重要的是要专门检查声乐运动控制的儿童与声乐 结节，以制定一个儿科特定的框架，有效的语音治疗。本项目将调查 声带小结患儿的声带运动控制通过两个特定的目标，都是基于理论 关节速度方向（DIVA）模型的框架，一种广泛使用的神经网络模型， 言语运动控制两组学龄儿童（7岁;0 - 12岁;11岁）将参加： 第一组被诊断为声带小结，第二组是年龄和性别相匹配的对照组。两个目标 将通过一次实验性会议来解决。对基频（fo）扰动的响应 将与对照组进行比较。目标1将确定参与者的能力， 更新他们的前馈发声运动控制系统，以及这种能力是否由听觉敏锐度介导。 对fo持续扰动的适应性反应的幅度或方向的潜在差异将是 考察此外，这些反应的幅度将根据参与者的听觉 视力目标2将通过分析对意外事件的自反反应来表征FO的反馈控制 FO的扰动以及基线FO变异性。这项研究的结果将导致更好的理解 儿童声带运动发育和声带小结之间的相互作用，这是必要的， 开发儿科特异性疗法。

Project Summary Voice disorders in school-age children can have devastating physical, social, and emotional consequences. Vocal nodules are the most commonly diagnosed voice disorder in children and are typically accompanied by vocal hyperfunction: aberrant phonation patterns due to excessive or unbalanced muscular forces. The primary treatment for vocal nodules is voice therapy; however therapy has variable success rates, which is often attributed to a lack of a cohesive, theoretically-based framework specifically for children with voice disorders. One potential reason for the absence of this framework is the lack of knowledge regarding vocal motor development in children with vocal nodules. Although preliminary work in adults with vocal hyperfunction suggests the presence of disordered auditory-motor integration, no studies have yet characterized vocal motor control in children with vocal hyperfunction. As both the vocal mechanism and vocal motor control are known to change across the lifespan, it is important to specifically examine vocal motor control in children with vocal nodules in order to develop a pediatric-specific framework for effective voice therapy. This project will investigate vocal motor control in children with vocal nodules through two specific aims, both based on the theoretical framework of the Directions Into Velocities of Articulators (DIVA) model, a widely used neural network model of speech motor control. Two groups of school-age children (7;0 – 12;11 years) will participate: one group diagnosed with vocal nodules and the second typically developing age- and sex- matched controls. Both aims will be addressed using one experimental session. The response to perturbation of fundamental frequency (fo) in children with vocal nodules will be compared to controls. Aim 1 will determine the ability of participants to update their feedforward vocal motor control system and whether this ability is mediated by auditory acuity. Potential differences in the magnitude or direction of adaptive responses to sustained perturbation of fo will be examined. In addition, the magnitude of those responses will be evaluated in relation to participants’ auditory acuity of fo. Aim 2 will characterize feedback control of fo via analysis of reflexive responses to unexpected perturbations of fo, as well as baseline fo variability. Results from this study will lead to improved understanding of the interaction between vocal motor development and vocal nodules in children, which is essential for further development of pediatric-specific therapies.