Analyses of sustained vowels in Down Syndrome (DS): a case study using spectrograms and perturbation data to investigate voice quality in four adults with DS

OBJECTIVES: Automatic acoustic measures of voice quality in people with Down syndrome (DS) do not reliably reflect perceived voice qualities. This study used acoustic data and visual spectral data to investigate the relationship between perceived voice qualities and acoustic measures.

STUDY DESIGN: Participants were four young adults (two males, two females; mean age 23.8 years) with DS and severe learning disabilities, at least one of whom had a hearing impairment.

METHODS: Participants imitated sustained /i/, /u/, and /a/ vowels at predetermined target pitches within their vocal range. Medial portions of vowels were analyzed, using Praat, for fundamental frequency, harmonics-to-noise ratio, jitter, and shimmer. Spectrograms were used to identify the presence and the duration of subharmonics at onset and offset, and mid-vowel. The presence of diplophonia was assessed by auditory evaluation.

RESULTS: Perturbation data were highest for /a/ vowels and lowest for /u/ vowels. Intermittent productions of subharmonics were evident in spectrograms, some of which coincided with perceived diplophonia. The incidence, location, duration, and intensity of subharmonics differed between the four participants.

CONCLUSIONS: Although the acoustic data do not clearly indicate atypical phonation, diplophonia and subharmonics reflect nonmodal phonation. The findings suggest that these may contribute to different perceived voice qualities in the study group and that these qualities may result from intermittent involvement of supraglottal structures. Further research is required to confirm the findings in the wider DS population, and to assess the relationships between voice quality, vowel type, and physiological measures.