Purpose The purpose of this document is threefold: (a) review the uses of the terms \"vocal fatigue,\" \"vocal effort,\" \"vocal load,\" and \"vocal loading\" (as found in the literature) in order to track the occurrence and the related evolution of research; (b) present a \"linguistically modeled\" definition of the same from the review of literature on the terms; and (c) propose conceptualized definitions of the concepts. Method A comprehensive literature search was conducted using PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scientific Electronic Library Online. Four terms (\"vocal fatigue,\" \"vocal effort,\" \"vocal load,\" and \"vocal loading\"), as well as possible variants, were included in the search, and their usages were compiled into conceptual definitions. Finally, a focus group of eight experts in the field (current authors) worked together to make conceptual connections and proposed consensus definitions. Results The occurrence and frequency of \"vocal load,\" \"vocal loading,\" \"vocal effort,\" and \"vocal fatigue\" in the literature are presented, and summary definitions are developed. The results indicate that these terms appear to be often interchanged with blurred distinctions. Therefore, the focus group proposes the use of two new terms, \"vocal demand\" and \"vocal demand response,\" in place of the terms \"vocal load\" and \"vocal loading.\" We also propose standardized definitions for all four concepts. Conclusion Through a comprehensive literature search, the terms \"vocal fatigue,\" \"vocal effort,\" \"vocal load,\" and \"vocal loading\" were explored, new terms were proposed, and standardized definitions were presented. Future work should refine these proposed definitions as research continues to address vocal health concerns.

Purpose The purpose of this study was to evaluate the reliability and validity of the Kannada version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). Method The Kannada version of CAPE-V comprises six phrases that are phonetically designed as per the CAPE-V requirements. Sixty-five (21 individuals with dysphonia and 44 asymptomatic) participants were enrolled for the instrument psychometric validation. The interrater and intrarater reliability as well as validity were assessed. Results High level of agreement was noted between the three raters across all the CAPE-V parameters, highest for pitch (intraclass correlation coefficient value = .98) and lowest for loudness (intraclass correlation coefficient value = .96). High intrarater reliability agreement (intraclass correlation coefficient value > .97) was also noted for all the parameters. Among the correlation for parameters that are comparable between CAPE-V and the Grade, Roughness, Breathiness, Asthenia, and Strain scale, the highest correlation was noted for overall severity. There was a significant difference noted between the study and control groups for all parameters except loudness. The discriminant function analysis and classification revealed that 98% were correctly identified. Conclusion The Kannada version of CAPE-V has been proven to be a psychometrically reliable and valid tool to use for auditory-perceptual evaluation of voice.

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OBJECTIVE: This tutorial addresses fundamental characteristics of microphones (frequency response, frequency range, dynamic range, and directionality), which are important for accurate measurements of voice and speech.
METHODS: Technical and voice literature was reviewed and analyzed. The following recommendations on desirable microphone characteristics were formulated: The frequency response of microphones should be flat (i.e., variation of less than 2 dB) within the frequency range between the lowest expected fundamental frequency of voice and the highest spectral component of interest. The equivalent noise level of the microphones is recommended to be at least 15 dB lower than the sound level of the softest phonations. The upper limit of the dynamic range of the microphone should be above the sound level of the loudest phonations. Directional microphones should be placed at the distance that corresponds to their maximally flat frequency response, to avoid the proximity effect; otherwise, they will be unsuitable for spectral and level measurements. Numerical values for these recommendations were derived for the microphone distances of 30 cm and 5 cm.
CONCLUSIONS: The recommendations, while preliminary and in need of further numerical justification, should provide the basis for better accuracy and repeatability of studies on voice and speech production in the future.

OBJECTIVE: Supracricoid laryngectomy (SCL) permits local control and 5-year survival rates similar to total laryngectomy in selected cases of advanced-stage laryngeal carcinoma. Although most of the reports regarding the surgical technique and oncological results have been proposed by European groups, increased interest in SCL has also been shown in recent years by American surgeons. There is still a lack of comprehensive studies about functional outcomes (respiration, deglutition, phonation) after SCL. Materials and methods This report briefly evaluates the functional outcomes of SCL recorded by the Department of Otolaryngology Head and Neck Surgery of Padua University since 1998 and critically reviews recent English-language literature describing SCL functional results.
RESULTS: The present review confirms that the available data on functional results were collected using heterogeneous methods, parameters, and evaluation scales.
CONCLUSIONS: Every effort has to be made to uniform the format for presenting outcome data, particularly on swallowing and voice parameters. Defining guidelines to evaluate the functional results of SCL may facilitate interstudy comparability.

The proposal of this guideline or basic protocol is an attempt to reach better agreement and uniformity concerning the methodology for functional assessment of pathological voices. The purpose is to allow relevant comparisons with the literature when presenting/publishing the results of voice treatment, e.g. a phonosurgical technique, or a new/improved instrument or procedure for investigating the pathological voice. Meta-analyses of results of voice treatments are generally limited--and even impossible--due to the major diversity in assessing functional outcomes. A minimal, multidimensional set of basic measurements is proposed, suitable for all \"common\" dysphonias: it includes 5 different approaches: perception (grade, roughness, breathiness), videostroboscopy (closure, regularity, mucosal wave and symmetry), acoustics (jitter, shimmer, Fo-range and softest intensity), aerodynamics (phonation quotient), and self rating by the patient. The protocol is elaborated on the base of an exhaustive review of the literature, the experience of the Committee members, and of plenary discussions within the European Laryngological Society. Instrumentation is kept to a minimum, but considered essential for professionals performing phonosurgery.

Sixty subjects between the ages of 21 and 48 months were placed into groups based on mean length of utterance (MLU) and chronological age (CA) to test Stampe\'s hypothesis about the development of phonological processes. The subjects were given the Phonological Process Analysis (Weiner, 1979), and a proportion score for each of sixteen phonological processes was derived for each subject. The use of the various phonological processes across MLU groups and age groups was analyzed by multiple regression correlation, three-way ANOVA, and Tukey\'s HSD tests. MLU was found to be the best classification for the subjects for describing the phonological processes. The results and discussions present MLU-referenced guidelines regarding the emergence, duration, elimination, and universality of the sixteen phonological processes.