Review: Applied Linguistics; Phonetics: Edwin Yiu (ed., 2013)

EDITOR: Edwin M-Y. Yiu
TITLE: International Perspectives on Voice Disorders
SERIES TITLE: Communication Disorders Across Languages
PUBLISHER: Multilingual Matters
YEAR: 2013

REVIEWER: Claudia Enbe, Kaye College Israel


This book fills a current gap in the field of Voice Research. This books is
intended for researchers in Speech Language Pathology and Otolaryngology in
order to understand the anatomical and voice therapy research developments in
different countries of the world such as: Australia, Belgium, Brazil, China,
Hong Kong, Israel, Japan, the UK and the USA.

Voice research has a long history, but in the last thirty years, there has
been an increase of studies in anatomical and clinical voice assessment.
However, different points of view, various methodological approaches and
diverse techniques of analysis have caused controversial discussions in the

The book starts with a table of contents, followed by a list of contributors,
and a brief editor’s note. The book has two parts: the first part is about
”Current Issues in Voice Assessment and Intervention: a World Perspective”,
and the second part about ”Contemporary Voice Research: A World
Perspective.” Part I has nine chapters and part II has eight chapters.

Each chapter begins with an introduction of voice research development in each
country. There is also a description of materials and methods used in each
country in order to evaluate and treat speech disorders. Many countries also
have specific techniques used to solve anatomical disorders in the vocal
folds. Each chapter ends with a bibliography.

Chapter 1, “Current issues in voice assessment and intervention in Australia,”
consists of an overview of the Clinical Voice practice in Australia, by
Jennifer Oates, Janet Baker and Anne Vertigan. The authors walk the reader
through voice practice in Australia and discuss the current practices in the
education of speech pathologists, the professional development, different
types of voice services and cultural influences. They describe the
contributions in the areas of neurophysiology, respiratory, phonatory,
auditory and perceptual evaluation, instrumental assessment and diagnostic
classification, acoustic features in singing and acting voice, in which
Australian speech pathologists have a strong participation.

Chapter 2, “Current issues in voice assessment and intervention in Belgium” is
by Marc S. De Bodt, Bernadette Timmermans and Kristiane M. Van Lierde. This
chapter summarizes voice research in Belgium. The chapter reviews a number of
projects that have been done in order to focus voice training, preventive
strategies by using warming-up and voice therapy like laryngeal biofeedback in
order to change laryngeal postures and a manual circumlaryngeal treatment for
improving the range of movements of the laryngeal joints.

Chapter 3, “Speech language pathology and the voice specialist in Brazil: an
overview,” is by Mara Behlau, Gisele Oliveira, Glaucya Madazio and Rosiane
Yamasaki. This chapter summarizes the development of the profession of speech
pathologists in Brazil. The chapter introduces the perceptual and acoustic
analysis of voice, self-assessment protocols and therapeutic practice in order
to evaluate a voice quality and adequate treatment.

Chapter 4, deals with “ Current issues in voice assessment and intervention in
China,” by Wen Xu and Demin Han. The authors introduce the chapter with an
overview of clinical examination of voice disorders in China. In this country,
voice assessment is carried out by a physician as the speech pathology/therapy
profession does not exist. The clinical practice is based in two clinical
voice assessments:  the first one is voice related to the quality of life, and
the other one, the laryngeal function. There is a focus on the patient’s own
perspective of how voice problems affect his or her quality of life.

Chapter 5 deals with “Current issues in voice assessment and intervention in
Hong Kong,” by Estella P-M. Ma and Triska K-Y.Lee. This chapter consists of an
overview of the voice assessment and treatment in Hong Kong. The major spoken
language in Hong Kong is a Cantonese, a Chinese dialect which is a tone
language. This type of language influences in the voice features and the
measures cannot be compared with a range of voice found in American English
speakers. The author introduces a number of assessment tools created for the

Chapter 6 is about “Current issues in voice assessment and intervention in
Israel.” In this chapter, Ofer Amir summarizes the historical development of
voice disorder treatments in Israel. Similar to other countries, voice
evaluation includes a medical and laryngeal examination performed by the
otolaryngologist and a functional voice evaluation given by a speech
pathologist. Even though there are many instrumental techniques for voice
evaluation (like fibro-laringoscopy, stroboscopy and acoustic analysis), the
use of indirect laryngology in the clinical practice is still found. The
author concludes that in recent years, the clinical practice incorporates
standardized guidelines for voice evaluation translated into Hebrew.

Chapter 7 deals with “Contemporary phonosurgery in Japan.” The author, Koichi
Tsunoda, reports that Japanese laryngologists have a strong interest in
laryngeal research in order to develop phonosurgical procedures. Different
methods in laryngeal surgery are described in this chapter, such as the
treatment of sulcus vocalis and vocal fold paralysis.

Chapter 8 is about “Current issues in voice assessment and intervention in the
United Kingdom.” In the first part of the chapter, Paul Carding offers a
description about the National Health Service in the UK. He claims that speech
and voice pathologists perform laryngeal endoscopies for both assessments and
treatment. At the end of the chapter, he describes different studies in order
to investigate treatment efficacy/effectiveness in voice disorder.

Chapter 9 turns to the United States. In “Current issues in voice assessment
and intervention in the USA,”  Tanya L. Eadie and Edie R. Hapner state that
diagnoses of laryngeal pathology that affect voice are provided only by
physicians. Speech/language pathologists perform the assessment and effective
behavioral treatment of dysphonia. Even though in the USA the clinical
practice of the speech/language pathologists is governed by the American
Speech- Language-Hearing Association (ASHA), there is not yet one standardized
protocol for assessing voice pathology. In consequence, variations in voice
measurements provide difficulties to establish the diagnosis of voice
disorders across different centers.  The gold standard is the use of
laryngo-videostroboscopy using endoscopy for clinical practice, but still
there is a use of the indirect lanyngoscopy to evaluate voice disorders. At
the end of the chapter, the authors summarize different tools for voice
assessment currently used in the clinical practice.

Chapter 10 returns to Japan. In “Contemporary voice research in Japan,
“Shigeru Hirano gives a historical perspective on voice research in Japan. The
author claims that especially between 1975 and 1985 there were a great number
of studies in histological research that contributed to the research in voice
field.  The author also describes a variety of studies in histology,
physiology, neurolaryngology, imagining, regenerative medicine and
phonosurgery that have been carried out in Japan and have contributed to the
understanding of voice functioning.

In chapter 11, “A USA perspective: vocal fold injuries and their management,”
by Nicole Yee-Key Li and Katherine Verdolini Abbott, the authors explain the
general principle of wound healing, current investigations of phonotrauma and
surgical trauma  and techniques used in the USA. The studies show that
phonotrauma may result from a single traumatic force with a great magnitude or
from repeated forces of relative small magnitude. Different investigations for
therapeutics techniques are summarized.

Chapter 12 deals with “Cognitive behavioural therapy in the treatment of
functional dysphonia in the United Kingdom. “ Paul Carding, Vicent Deary and
Tracy Miller explain the use of cognitive behavioural therapy (CBT) techniques
with which individuals with functional dysphonia (FD) are treated.  The use of
CBT techniques helps improve significantly the anxiety and depression of the
individual with FD. These two categories have not been used in conventional
voice therapy. However, in terms of quality of voice, the traditional voice
techniques and the CBT techniques have similar results. At the end of the
chapter the authors provide an appendix with an  explanation of the CBT

Chapter 13 is about “Acupuncture and voice treatment.” In this chapter, Edwin
M-L.Yiu explains studies that used acupuncture to improve the vocal functions
in phonotraumatic voice problems. Another technique is the use of laser
stimulation of acupoints for individuals that cannot tolerate a traditional

Chapter 14 deals with the “Application of Motor Learning Principles in Voice
Motor Learning.” In this chapter, Estella P-M. Ma and Edwin M-L. Yiu describe
some studies applying the theories of motor learning to individuals with
hyperfuntional or phonotraumatic voice disorders. The authors conclude that
general motor learning principles cannot be always applicable to the learning
of vocal skills and it requires further investigations in the field.

Chapter 15 presents “Contemporary voice research: a China perspective.”
Jiangping Kong and Gaowu Wang summarize some studies base on a linguistic
perspective. There are more than 80 languages used in China. Differences in
voice characteristics are found for each lexical tone according to each
language (e.g tense/lax phonation, voiced aspiration). The authors say that
the fields of phonetics and linguistics integrate a physiological model of
voice production with phonetic and linguistic theories.

Chapter 16 is an “Analysis of professional voice users in the clinical
setting.” Cate Madill and Patricia Mc Cabe introduce the use of the acoustic
analysis and the visual assessment of the vocal tract for the description of
voice features of professional voice users. Some studies of singing voice and
professional spoken voice are summarized.

Chapter 17 turns to Belgium. In “Contemporary voice research: a Belgian
perspective” Marc De Bodt and Youri Maryn refer to the contribution of
objective voice measurements in clinical practice. However, the results need
to be taken into account carefully by comparing perceptual and acoustic
metrics in order to describe voice quality. The authors suggest the use of
multivariate approaches and also describe different protocols used in Belgium
in order to assessment voice disorders.


This book, part of the prestigious ”Communication Disorders Across Language”
series (edited by Nicole Muller and Martin Ball), is a pioneering work that
brings together the state-of-the-art in voice research and the therapeutic
treatment of voice in the world. The studies on voice started more than a
century ago, but today the use of instrumental techniques and computerized
systems predominate the research in the field. However, the analysis of the
voice and voice disorders are still the subjects of discussions in academic
research. The main problem is a variety of features in the voice characterized
by a particular language, but also the voice is specific to each human
associated with his/ her history and cultural differences. These aspects may
have comparable conclusions within countries and in communities in the field.

The book offers a broad historical research development in different countries
such as Australia, Belgium, Brazil, China, Hong Kong, Israel, Japan, the UK
and the USA. The majority of chapters have a review of the research and the
state of the clinic voice treatment in each country and a bibliography. Though
each chapter is written by a different author(s) , the writing style is
uniform, and each chapter provides details by introducing the local historical
development of voice research in each state. The book contains 17 chapters
from different areas of anatomy and therapeutic voice research in the world.
They were written by some of the finest researchers our each area has to
offer. This book is appropriate for researchers in the field for physician’s
otolaryngologist, speech language pathologist and other areas like psychology,
linguistics, alternative medicine and voice teachers in order to understand
more the research on voice disorders. Though it is technical, it offers
extensive and actualized details to ensure clarity in the writing, while also
educating to the reader on the particular topic.

Another merit of the book is the breadth of areas included. This book exposes
the past, present and further investigations in the clinical voice assessment
and therapy. It is very interesting to note that in the majority of health
services in the world, if an individual has a voice disorder, the first
assessment is done by the physician’s otolaryngologist, who is making a
medical diagnosis of the anatomical structure of vocal folds and upper vocal
structures. Then, the patients are referred to a speech pathologist. In some
cases, there is a relationship between the otolaryngological clinician and the
speech pathologist, but sometimes there is a limited understanding of the role
and skill base of the speech pathologist in a multidisciplinary collaboration.
Many authors describe that some countries have speech pathology services
either in the public or private system, but sometimes, the scope and time
access is limited by insurance plans to a number of sessions for the
treatment. Some countries assign voice disorders low priority according to
referred criteria or to a medical condition. In some countries, voice problems
may receive low priority in comparison to areas of speech or dysphagia in a
community health centre.

It is very interesting to note that while the interest in voice research is
growing around the world, near to 5-10% of the population is interested in
consulting about voice disorders. Even though the voice is a tool of work for
many professions like singers, actors, teachers and solders, low interest is
still found in these individuals to care about the quality of voice.

To conclude, I note that this book is an important bridge between voice
research and clinical voice treatment that will promote the use standardized
methods of analysis and an increase in the awareness of voice disorders.


Claudia Enbe (PhD) is a Speech Language Pathologist. She earned her PhD in the
Department of Foreign Languages and Linguistics  from Ben Gurion University of
the Negev, Israel in 2009. She has worked in clinical therapy in Voice and
Language at Healthcare Services and in private care for over twenty years in
Argentina and Israel. She is teaching at the Kaye Academic College of
Education, Israel. Her subjects of interest include speech, voice, prosody and
language acquisition in typically and atypically Spanish and Hebrew speaking
children and adults.

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