The role of auditory and kinaesthetic feedback mechanisms on phonatory stability in children.

Auditory feedback plays an important role in phonatory control. When auditory feedback is disrupted, various changes are observed in vocal motor control. Vocal intensity and fundamental frequency (F0) levels tend to increase in response to auditory masking. Because of the close reflexive links between the auditory and phonatory systems, it is likely that phonatory stability may be disrupted when auditory feedback is disrupted or altered. However, studies on phonatory stability under auditory masking condition in adult subjects showed that most of the subjects maintained normal levels of phonatory stability. The authors in the earlier investigations suggested that auditory feedback is not the sole contributor to vocal motor control and phonatory stability, a complex neuromuscular reflex system known as kinaesthetic feedback may play a role in controlling phonatory stability when auditory feedback is disrupted or lacking. This proposes the need to further investigate this phenomenon as to whether children show similar patterns of phonatory stability under auditory masking since their neuromotor systems are still at developmental stage, less mature and are less resistant to altered auditory feedback than adults. A total of 40 normal hearing and speaking children (20 male and 20 female) between the age group of 6 and 8 years participated as subjects. The acoustic parameters such as shimmer, jitter and harmonic-to-noise ratio (HNR) were measures and compared between no masking condition (0 dB ML) and masking condition (90 dB ML). Despite the neuromotor systems being less mature in children and less resistant than adults to altered auditory feedback, most of the children in the study demonstrated increased phonatory stability which was reflected by reduced shimmer, jitter and increased HNR values. This study implicates that most of the children demonstrate well established patterns of kinaesthetic feedback, which might have allowed them to maintain normal levels of vocal motor control even in the presence of disturbed auditory feedback. Hence, it can be concluded that children also exhibit kinaesthetic feedback mechanism to control phonatory stability when auditory feedback is disrupted which in turn highlights the importance of kinaesthetic feedback to be included in the therapeutic/intervention approaches for children with hearing and neurogenic speech deficits.