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、社交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 发声功能亢进：由于过度或不平衡的肌肉力量而导致的异常发声模式。初级阶段 声带小结的治疗是声音疗法；然而，治疗的成功率各不相同，这通常是 这归因于缺乏专门针对嗓音障碍儿童的具有凝聚力和理论基础的框架。 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 声带小结患儿的发育。尽管对成人发声功能亢进的初步研究 提示存在无序的听觉-运动整合，目前还没有研究确定发声运动的特征 发声功能亢进儿童的对照研究。因为发声机制和发声运动控制都是已知的 在整个生命周期中的变化，重要的是专门检查发声儿童的发声运动控制 为了开发一种儿科专用的有效发声治疗的框架，我们正在开发一种新的治疗方法。该项目将调查 通过两个特定的目标控制声带小结儿童的发声运动，这两个目标都基于理论 方向转化为关节速度(DIVA)模型是一种广泛使用的神经网络模型 语音马达控制。两组学龄儿童(7岁；0-12岁；11岁)将参加：一组 诊断为声带小结，第二例典型地发展为年龄和性别匹配的对照。这两个目标 将通过一次试验性会议来解决。基频(Fo)扰动的响应 将患有声带小结的儿童与对照组进行比较。目标1将决定参与者的能力 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调节。 对fo持续扰动的适应性反应的大小或方向的潜在差异将是 检查过了。此外，这些反应的大小将根据参与者的听觉进行评估 FO的敏锐度。目标2将通过对意想不到的反射反应的分析来表征反馈控制 Fo的扰动，以及fo变率的基线。这项研究的结果将有助于更好地理解 儿童发声运动发育和声带小结之间的相互作用，这对于进一步 儿科专用疗法的发展。

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.