The perceptual effects of behavioral therapy for EVT have not yet been widely or systematically studied. Similarly, injection of botulinum toxin into the laryngeal musculature did not have a significant group-level effect on perceptual ratings, but had a significant effect on perceptual ratings that were compared using paired-sample statistical tests and individual participant analyses. Perceptual assessments revealed that the medication propranolol had no significant effect on voice ratings when data were analyzed on a group-level however, substantial perceptual changes were noted for individual participants. Perceptual ratings of pre-treatment and post-treatment audio recordings were compared to evaluate the efficacy of treatments including oral administration of medication, injection of botulinum toxin into affected musculature, and behavioral therapy provided by speech-language pathologists. The most commonly described perceptual assessment procedures involved systematic ratings of these voice features using 100 mm visual analog scales or Likert scales. Perceptual assessments rated the primary feature of vocal tremor, as well as voice quality features like roughness or breathiness and vocal effort. These assessments most commonly involved in-person collection of audio recordings that were later analyzed using auditory-perceptual and acoustical methods. Thus, the purpose of this study was to evaluate the accuracy of remote signal transmission and recording for acoustical and perceptual assessment of EVT in order to inform treatment research and telepractice.Ī variety of clinic-based and laboratory-based assessments have been used in previous studies to evaluate the efficacy of medical and behavioral treatments of EVT. Furthermore, remote acoustical and perceptual assessment might allow clinicians to monitor clients’ treatment responses and optimize treatment approaches during telepractice. Remote acoustical and perceptual assessments might facilitate studies with larger samples of participants and repeated measures that could clarify treatment effects and identify optimal treatment candidates. All of these studies involved in-person data collection in clinic and laboratory settings, and the majority of these studies had small sample sizes and few data points, which may have limited detection of change and characterization of individual participants’ responses. Although, previous studies have investigated the effects of medical and behavioral interventions on the acoustical and perceptual severity of EVT, outcomes were inconsistent across studies and across participants. When essential tremor affects the respiratory, laryngeal, pharyngeal-oral, or velopharyngeal-nasal subsystems, the speaker may develop essential vocal tremor (EVT) involving shakiness of the voice and modulation of the fundamental frequency ( f o) and intensity. Essential tremor is the most common of these movement disorders with a prevalence of approximately 5% in individuals over the age of 65 years. Vocal tremor is a neurological voice disorder caused by essential tremor, dystonia, Parkinson disease, and cerebellar dysfunction.
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