Using VOCALAB For Voice and Speech Therapy

Transcription

1 Using VOCALAB For Voice and Speech Therapy Anne MENIN-SICARD, Speech Therapist in Toulouse, France Etienne SICARD Professeur at INSA, University of Toulouse, France June

2 About the authors Anne Menin-Sicard received her B.Sc in Speech- Language Pathology from the University of Toulouse, France, in 1993 and a Master in Speech Sciences from the University of Grenoble, France, She specializes in language and voice disorders. She developped the Vocalab and Diadolab tools and trained more than 300 speech therapists. She authored a book and several publications in relation with these tools. anne.sicard2@orange.fr Etienne SICARD received the M.Sc in 1985 and a PhD from the University of Toulouse, France in He is currently a professor at INSA engineering school. He is the author of tools such as Vocalab, Diadolab, as well as more than 200 publications. He is research director at LURCO laboratory, France, for developping voice quality indicators and building a data base of pathological voices. etienne.sicard@insa-toulouse.fr

3 Contents I- General presentation II. Using VOCALAB in Evaluation III- Using VOCALAB in Therapy IV- Sound, Videos, Web VI-Conclusion

4 I GENERAL PRESENTATION

5 1. Software Objectives VOCALAB: Born out of a need for a small accessible and user-friendly tool for visualization of all parameters of speech in real time, accessible to all speech therapists. Designed by Anne MENIN-SICARD, Speech Therapist Programmed by Etienne Sicard Professor at INSA, University of Toulouse, France Published starting 2001 GERIP ( Research conducted within LURCO lab lurco.unadreo.org

6 1. Software Objectives Having a tool for visual feedback, reliable, accessible and easy to understand, giving access to most important voice parameters and enhance speech therapy Target pathologies: voice, speech, deafness, dysarthria, stuttering, Access to increased objectivity = more credibility, assessment of good practices Standardize our practices with references and common benchmarks

7 2. Software Objectives Welcome screen

8 2. Software Objectives 4 Main Screens Patient Evaluate Theraphy Media Library

9 3. Theoretical background The sound recording should be of good quality Do you hear noise? Distorted sound? Computer noise 50 Hz The recorded «a» is mixed with computer noise Suggestion: Good microphone, external USB device for good quality sound recording

10 3. Theoretical background Sound acquisition chain : setup Good quality microphone Good quality sound acquisition card Good quality speakers No need for super quality but poor quality is dangerous for later voice quality evaluation The distance mouth/microphone should be fixed 6 to 12 cm (use a ruler) Doing this way: o Sound recordings may be compared o Breathing noise has limited impact o The speaker can still adapt his attitude o Oral hygiene is acceptable

11 3. Theoretical background Item Son [u] (as in «you») Characteristics Quasi sinusoidal wave Frequency aspect of the sound Time domain aspect of the sound Capture sound in real time

12 3. Theoretical background The spectrogram : time, frequency, amplitude High frequency Low energy High Energy Low frequency Time

13 3. Theoretical background Voice: F0 and harmonics Fundamental frequency: frequency at which the vocal folds vibrate (F0) Harmonics: components of sound, 2.F0 frequency 3.F0, etc... temps

14 3. Theoretical background Formants Modification of the vocal tract Mouth closed Tongue back - front Mouth opened

15 3. Theoretical background Formants : energy zones move with vowels Normal spectrogram «Filtered» spectrogram using «Formants»

16 4. Sound acquisition Sound acquisition chain : the good tuning (Real time spectrum + power) Speak «loudly» Speak «sofly» Speak «normally» «Power» tab

17 6. Evaluate the sound Hear the sound, see the spectrogram Hear the latest sound you recorded or loaded Zoom = one spectrogram in full screen Only one spectrum of the sound, full screen

18 6. Evaluate the sound Get the indicator values Click again to go back to the 2- screens mode Ask for indicators

19 7. Conson and high frequencies /s/f/j/ch/z/j/ - Configure VOCALAB in 0-10,000 Hz mode Very high frequency contents /ch/ /j/ /f/ /z/ /s/

20 II- USING VOCALAB FOR EVALUATION

21 1. Patient Acces to patient data

22 1. Patient Patient File - History Add patient name For information only Used to keep a record of patient data Identity Minimum medical information Context of the pathology Associated personal problems Voice characteristics Communication disorders Objective analysis will be added at end of file Fill information

23 1. Patient Patient File - Auto-evaluation Tune cursors with patient s answers Five questions to the patient Score 1 (poor) to 5 (very good) Helps the patient to describe his voice Helps to specify the therapeutic axis that will result from this selfassessment. Being quick and positive Total score used as a initial point Get the total score

24 2. Real Time Spectrum

25 2. Real Time Spectrum Two screens for spectrogram Therapist on top, patient below. You give a sound (on top «Therapist») The patient tries to copy (using bottom spectrum «Patient») The therapist /s/z/s/z/ /s/ /z/ /s/ /z/ The patient

26 2. Real Time Spectrum Proof of progress Before/After therapy You load the sound before therapy on top You load the sound after therapy in the bottom > Voice Data Base AS009-before AS009-after

27 3. Voice Quality Five indicators: alteration of the attack pitch instability associated with phase plot amplitude instability noise relative to the signal harmonic poverty Threshold normal voice / pathological voice around 1.0 for all indicators Value <0.8: Green <value <1.5: Orange - Value> 1.5: Red AS004

28 3. Voice Quality Alteration of the attack. Evaluates the characteristics within 300 ms after the detected attack. Start: black vertical line End: green vertical line. The indicator evaluates: Pitch Instability Instability in amplitude relative to an ideal ramp The noise from the harmonics of the voice 300 ms zone detected as the attack (you may select an other one) Attack alteration indicator AS004

29 3. Voice Quality Pitch Instability Based on the evaluation of F0, which appears as a black horizontal line superposition to the lowest harmonic. Evaluates the variation of the fundamental frequency over time. Strongly correlated to the Jitter. AS005 Pitch variation indicator (Jitter) Zoom at 500 Hz to visualize F0 variations Unstable part Phase drawing showing some instability

30 3. Voice Quality Phase portrait Other graphic representation of pitch instability. VOCALAB defines three areas: In the center, the stable pitch (green) A little distant, a less stable pitch (yellow) More distant, chaotic pitch (red)

31 3. Voice Quality Amplitude Instability The color palette gives the amplitude information in the spectrogram The indicator evaluates the color changes over time (Shimmer) Pitch is very stable but High Amplitude Instability indication Unstable amplitude AS014

32 3. Voice Quality Power tab The instability amplitude is also illustrated through the "power" tab. Short-term shimmer leads to sharp peaks Mid-term shimmer lead to waves VOCALAB computes both Instable Select power screen» Rather stable AS014

33 3. Voice Quality Noise / Signal indicator The spectrogram shows the presence of noise between the harmonics, especially visible in the band Hz. In this case, the noise indicator is above the threshold of pathology (>1.0) Noise between harmonics SP029 Noise/Signal Indicator

34 3. Voice Quality AS006 -Child, 8, vocal cord nodule Evaluation: Important noise Pitch Instability Therapeutic axis: Relaxation perilaryngeal Decrease the hyperadduction Work on vowel attack Work on low intensity sounds Work on voice comfort AS006 - Before

35 3. Voice Quality AS006 -Child, 8 y.old, vocal cord nodule After therapy Less noise Better control of pitch The patient icon gives access to a menu displaying the indicator evolution

36 4. Phonetogram

37 4. Phonetogram Analyze the vocal dynamics vs. frequency Amplitude in Y Axis Up to 4 different files may be displayed using different colors Frequency in X Axis Play each note as references for the patient AS010 Sirens Before and After

38 4. Phonetogram Vocal dynamics improvement after therapy Before: Poor dynamic capabilities After: Large frequency range and dynamics AS033 Sirens Before and After

39 5. Phonation Time

40 5. Phonation Time A metrics for breath management & laryngeal performance Target: s/z and a/z ratio Selection Male/Female s/z a/z Phonation time VOCALAB will compute the average of upto 3 /a/, 3/s/ and 3 /z/, from which ratios will be derived Sound production Instructions

41 6. F0 and Vocal Range

42 6. F0 and Vocal Range Pitch and range of the voice Standards Selection Measurements Piano keyboard Settings Statistics Instructions

43 6. F0 and Vocal Range Extract Average F0 Click here to start computing F0 Click «Average F0» Ask the patient to speak naturally (using a given text) during 10 seconds minimum When the average fundamental frequency do not move anymore, click again «Average F0» to stop computing

44 6. F0 and Vocal Range Extract Vocal Range Click «F0 Range» Ask the patient to pronounce a /u/ from lowest to highest possible pitch Propose up/down and up/down range When a significant cumulation of point appears, click again «F0 Range» to stop computing Click here to start computing the vocal range

45 6. F0 and Vocal Range Example of Vocal Range Before/after therapy Before : High F0 Limited range AS009 - before Before : Lower F0 Extended range AS009 - after

46 III USING VOCALAB FOR THERAPY

47 1. Breathing Improve /s/z/ch/ Using an animation Give a Target Click the microphone

48 2. Richness Frequency selection Improve the stability of the voice Improve stability in intensity View the harmonics of voice View the singing formant (around 3500 Hz) Compare patient/therapist Therapist on the left, patient on the right

49 3. Articulation View the sound waveform View periodic / aperiodic character, voiced / unvoiced, occlusive / constrictive of all phonems. Motivate the patient to repeat the exercise with animations Select an animation Click here when you consider the patient made the appropriate sound

50 4. Pitch Focus on the pitch variations by tracking and displaying F0 Viewing the pitch stability The therapist proposes a profile, the patient tries to follow Improves the stability of the voice Improves the pitch control Give a Target profile adapted to the patient Select patient or therapist The patient tries to reproduce the profile

51 5. Synthesis The objective measurements of the voice are summarized in the patient file The evolution of indicators before and after therapy can be displayed

52 6. Auto-Evaluation after Therapy Initial auto-evaluation After therapy Important handicap Moderate handicap The relationship between acoustic analysis and patient perception was established Therapeutic axis were defined based on the auto-evaluation The self-assessment provides an accurate metric of the therapy, seen from the patient

53 IV SOUNDS, VIDEOS, WEB

54 1. Sounds from the Media Library Sounds of the Media Library More than 100 sound files Education and reference purpose Access to files of the on-line data base

55 55 2. Sounds from the Data Base Sounds of > Voice Data Base Comments More details Pathology Before/After Classification Speech Therapist

56 2. Sounds from the Data Base Classification Coding giving the most patient information. Classification according to ASHA (USA), from Classification Manual For Voice Disorders, 2006, by K. Verdolini STRUCTURAL DISEASES OF LARYNX INFLAMMATORY CONDITIONS OF THE LARYNX TRAUMA, INJURY OR OPERATION OF LARYNX SYSTEMIC CONDITIONS AFFECTING VOICE AERODIGESTIVE DISORDERS AFFECTING THE VOICE PSYCHIATRIC AND PSYCHOLOGICAL DISORDERS NEUROLOGICAL DISORDERS AFFECTING THE VOICE OTHER DISORDERS AFFECTING THE VOICE OTHER VOICE DISORDERS AS001-a-7120F44.WAV AS001 : Speech Therapist Anne Sicard, patient 001, -a- : sound /a/ 7120 : pathology F = femme 44 = 44 ans

57 2. Sounds from the Data Base Classification Full list of pathologies Search by first letters of some keywords

58 58 3. Videos from the Media Library Educational support for patient which eases the understanding of his pathology Refreshes the speech therapist own knowledge Allows to understand the relationship between pathology and therapy Requires a mp4 Xvid driver - installation from the Gerip setup

59 59 3. Videos from the Media Library Edema which interferes with the joining of vocal folds Disruption of vibration Rubbish laryngeal performance glottal leak Webbing that reduces the length of the vocal folds Increase of the fundamental frequency Breathing troubles

60 4. Vocalab Web Site Trainings: dates and places, programs and registration form Publications Application notes On-line documentation FAQ Educational slides How to purchase the software 60

61 4. Vocalab Web Site More than 15 YouTube illustrations on-line covering each tool Richness Breathness Patient File 61

62 4. Vocalab Web Site On-line Support: Adjust the sound card Procedure to record sounds Compare 2 spectrum On-line Education: Correspondence time/frequency Pure sound db Noise Chirp Vowels

63 V CONCLUSION

64 Conclusion VOCALAB increases the skills and credibility of speech therapy. The spectrogram provides an objective, precise and very rich illustration of the voice Real time is one of the key added value compared to other software The real-time visualization has a disinhibiting effect and empowering Tools play a mediating role in the therapeutic relationship Tools does not replace the expertise of the therapist

65 Conclusion Indicators provide objective measurements of the voice quality VOCALAB is continuously improved thanks to user s feedback VOCALAB has been designed mainly for clinical use VOCALAB is used daily by more than 2500 speech therapists in France, Belgium, Switzerland, Morocco and Canada VOCALAB is used by numerous Speech Therapy Universities for introducing acoustics, phonetics, and voice disorders The English version of VOCALAB 4 is targeted to international use by speech therapists VOCALAB 4 to be presented in Israel, Switzerland and Ireland

66 Publications Coming soon On-line PDF from HAL CNRS server

67 Thank you for your attention