Ambulatory Voice Biofeedback: Relative Frequency and Summary Feedback Effects on Performance and Retention of Reduced Vocal Intensity in the Daily Lives of Participants With Normal Voices Purpose Ambulatory voice biofeedback has the potential to significantly improve voice therapy effectiveness by targeting carryover of desired behaviors outside the therapy session (i.e., retention). This study applies motor learning concepts (reduced frequency and delayed, summary feedback) that demonstrate increased retention to ambulatory voice monitoring for training nurses to talk ... Research Article
Research Article  |   April 14, 2017
Ambulatory Voice Biofeedback: Relative Frequency and Summary Feedback Effects on Performance and Retention of Reduced Vocal Intensity in the Daily Lives of Participants With Normal Voices
 
Author Affiliations & Notes
  • Jarrad H. Van Stan
    Massachusetts General Hospital, Boston
    MGH Institute of Health Professions, Boston, MA
    Harvard Medical School, Boston, MA
  • Daryush D. Mehta
    Massachusetts General Hospital, Boston
    MGH Institute of Health Professions, Boston, MA
    Harvard Medical School, Boston, MA
  • Dagmar Sternad
    Northeastern University, Boston, MA
  • Robert Petit
    Independent Scholar, Boston, MA
  • Robert E. Hillman
    Massachusetts General Hospital, Boston
    MGH Institute of Health Professions, Boston, MA
    Harvard Medical School, Boston, MA
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Jarrad H. Van Stan: jvanstan@mghihp.edu
  • Editor: Julie Liss
    Editor: Julie Liss×
  • Associate Editor: Tanya Eadie
    Associate Editor: Tanya Eadie×
Article Information
Speech, Voice & Prosody / Speech / Research Articles
Research Article   |   April 14, 2017
Ambulatory Voice Biofeedback: Relative Frequency and Summary Feedback Effects on Performance and Retention of Reduced Vocal Intensity in the Daily Lives of Participants With Normal Voices
Journal of Speech, Language, and Hearing Research, April 2017, Vol. 60, 853-864. doi:10.1044/2016_JSLHR-S-16-0164
History: Received April 22, 2016 , Revised July 14, 2016 , Accepted October 8, 2016
 
Journal of Speech, Language, and Hearing Research, April 2017, Vol. 60, 853-864. doi:10.1044/2016_JSLHR-S-16-0164
History: Received April 22, 2016; Revised July 14, 2016; Accepted October 8, 2016

Purpose Ambulatory voice biofeedback has the potential to significantly improve voice therapy effectiveness by targeting carryover of desired behaviors outside the therapy session (i.e., retention). This study applies motor learning concepts (reduced frequency and delayed, summary feedback) that demonstrate increased retention to ambulatory voice monitoring for training nurses to talk softer during work hours.

Method Forty-eight nurses with normal voices wore the Voice Health Monitor (Mehta, Zañartu, Feng, Cheyne, & Hillman, 2012) for 6 days: 3 baseline days, 1 biofeedback day, 1 short-term retention day, and 1 long-term retention day. Participants were block-randomized into 3 different biofeedback groups: 100%, 25%, and Summary. Performance was measured in terms of compliance time below a participant-specific vocal intensity threshold.

Results All participants exhibited a significant increase in compliance time (Cohen's d = 4.5) during biofeedback days compared with baseline days. The Summary feedback group exhibited statistically smaller performance reduction during both short-term (d = 1.14) and long-term (d = 1.04) retention days compared with the 100% feedback group.

Conclusions These findings suggest that modifications in feedback frequency and timing affect retention of a modified vocal behavior in daily life. Future work calls for studying the potential beneficial impact of ambulatory voice biofeedback in participants with behaviorally based voice disorders.

Acknowledgments
This study was supported by the Voice Health Institute, Boston, Massachusetts, the National Institute on Deafness and Other Communication Disorders Grants R33 DC011588 (awarded to Dr. Hillman) and F31 DC014412 (awarded to Dr. Van Stan), and the National Institute of Child Health and Human Development R01 HD087089 (awarded to Dr. Sternad). The article's contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
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