Laryngeal diadochokinesis (LDDK) is a quick and simple test thought to provide insight related to neuromotor function of the larynx. It involves the rapid production of: (1) /hʌ/ to assess vocal fold abduction (posterior cricoarytenoid function); and (2) /ʌ/ to assess vocal fold adduction (thyroarytenoid function).
First, instruct patients to “take a deep breath and repeat (/hʌ/ or /ʌ/) as fast as you can, keeping the sound precise for 7 seconds. Don’t stop until I tell you.” Record or upload audio files directly into Praat (Praat is software free for download great for voice analysis)
Second, open the LDDK recording in Praat. Then select the beginning 3-5 seconds of the task, making sure to avoid the first and last 0.5 seconds of the task. To improve ease of interpretation, select "Intensity" > "Show Intensity"
Lastly, count the number of syllables, and divide by the total duration of the highlighted segment, then compare to age and sex norms. In this example, 32 syllables produced over the course of 5.69 seconds. 32/5.69 = 5.62 syllables per second. This LDDK within normal limits for this person's age and sex!
References
Lombard, L., & Solomon, N. P. (2019). Laryngeal diadochokinesis across the adult lifespan. Journal of Voice.
Disher, M. K. (2019). Reliability of Laryngeal Diadochokinesis Measures (Doctoral dissertation, Indiana University of Pennsylvania).
Neel, A. T., Palmer, P. M., Sprouls, G., & Morrison, L. (2015). Muscle weakness and speech in oculopharyngeal muscular dystrophy. Journal of Speech, Language, and Hearing Research, 58(1), 1-12.
Bassich-Zeren, C. J. (2004). Vocal dysfunction in young-onset Parkinson's disease (Doctoral dissertation).
Verdolini, K., & Palmer, P. M. (1997). Assessment of a" profiles" approach to voice screening. Journal of Medical Speech Language Pathology, 5, 217-232.
Leeper, H. A., Millard, K. M., Bandur, D. L., & Hudson, A. J. (1996). An Investigation of Vocal Function in Subgroups of Individuals with ALS. Journal of Medical Speech Language Pathology, 4, 163-182.
Renout, K. A., Leeper, H. A., Bandur, D. L., & Hudson, A. J. (1995). Vocal fold diadochokinetic function of individuals with amyotrophic lateral sclerosis. American Journal of Speech-Language Pathology, 4(1), 73-80.
Kreul, E. J. (1972). Neuromuscular control examination (NMC) for Parkinsonism: Vowel prolongations and diadochokinetic and reading rates. Journal of Speech and Hearing Research, 15(1), 72-83