Evaluating Voice Assessment as a Method in the Study of Male Adolescent Growth
Newly available data from a paediatric clinic study validate the use of voice as a safe and non-intrusive measurement of key progression points in male puberty, says Prof Martin Ashley, in collaboration with a paediatric consultant.
In 2013 the Royal College of Paediatrics and Child Health published the third edition of its UK growth chart for boys aged 2-18. Regarded as the definitive normative standards for adolescent growth and development, these charts have reflected a growing trend to include voice assessment as a method of assessing progression through male puberty. The advantage of voice-based methods is that they are non-intrusive and thus potentially suitable for use in larger scale studies where methods such as orchidometry would be problematic.
Questions naturally arise about how valid voice-based methods are and the extent to which they can be relied upon as a primary tool for study, and perhaps health screening in large populations. This lecture reports on how a study of adolescent male voices, undertaken initially in the context of singing, has been extended through work in a paediatric clinic to answer these questions.
The original study, undertaken at Edge Hill University with funding from the Arts and Humanities Research Council, created a digital audio archive of over one thousand recordings of the speaking voices of boys aged 11-14. The recordings were analysed and classified according to a system originated by John Cooksey that proposed a direct correspondence between categories of voice development and the five pubertal stages of JM Tanner. Through ongoing collaboration between the study’s principal and co-investigators, a smartphone app known as Speech Test was developed that purported to indicate pubertal stage on the basis of a simple voice sampling task.
Further collaboration was then sought to investigate the validity of this app through clinical trial by a paediatrician. After approval by the relevant ethics committees, use of the app was added to the protocol for examination of boys presenting for examination at a leading London paediatric clinic. Data are now available on 73 boys that include testicular volume (considered the clinical reference standard of male puberty) Tanner G and PH staging, testosterone levels through saliva assay and voice staging as indicated by Speech Test. Analysis of these data has identified key events of male puberty that are reliably and simply detected by the Speech Test app. A need for further voice sampling of younger boys (aged 8-10) has subsequently arisen in order to answer new questions about the secular trend to earlier puberty and the development of the voice during the peri-pubertal phase.
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